Pancreaticoduodenectomy for Cancer of the Head of the Pancreas 201 Patients

Yeo, Charles J.; Cameron, John L.; Lillemoe, Keith D.; Sitzmann, James V.; Hruban, Ralph H.; Goodman, Steven N.; Dooley, William C.; Coleman, Jo Ann; Pitt, Henry A.

doi:10.1097/00000658-199506000-00011

Cited by 905 publications

(581 citation statements)

References 31 publications

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“…Pathologic predictors of survival after surgery include vascular invasion (Griffanti-Bartoli et al, 1994), perineural invasion (Hermanek, 1998;Ozaki et al, 1999), histological tumour grade (Greer and Brennan, 1993), not achieving a clear margin (Yeo et al, 1995) and tumour size (Fortner et al, 1996). Taking all these factors into account, Fortner and co-workers (1996) reported that, in 52 patients undergoing potentially curative regional pancreatectomy, tumour size was the strongest predictor of survival independent of lymph node metastases.…”

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confidence: 99%

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

et al. 2004

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The aim of the present study was to examine the relationship between the clinicopathological status, the pre-and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for ductal adenocarcinoma of the head of the pancreas. Patients (n ¼ 65) who underwent resection of ductal adenocarcinoma of the head of pancreas between 1993 and 2001, and had pre-and postoperative measurements of C-reactive protein, were included in the study. The majority of patients had stage III disease (International Union Against Cancer Criteria, IUCC), positive circumferential margin involvement (R 1 ), tumour size greater than 25 mm with perineural and lymph node invasion and died within the follow-up period. On multivariate analysis, tumour size (hazard ratio (HR) 2.10, 95% confidence interval (CI) 1.20 -3.68, P ¼ 0.009), vascular invasion (HR 2.58, 95% CI 1.48 -4.50, Po0.001) and postoperative C-reactive protein (HR 2.00, 95% CI 1.14 -3.52, P ¼ 0.015) retained independent significance. Those patients with a postoperative C-reactive protein p10 mg l À1 had a median survival of 21.5 months compared with 8.4 months in those patients with a C-reactive protein 410 mg l À1 (Po0.001). The results of the present study indicate that, in patients who have undergone potentially curative resection for ductal adenocarcinoma of the head of pancreas, the presence of a systemic inflammatory response predicts poor outcome.

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confidence: 99%

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

et al. 2004

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“…There have also been advances in surgery, as the mortality is now less than 5% in these centers [1,2,4,5,7,8].…”

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Are There Indications for Palliative Resection in Pancreatic Cancer?

et al. 1999

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“…In fact, pancreatic carcinoma is refractory to chemotherapy and radiotherapy. [1][2][3] Inactivation of p53, a constant feature of pancreatic carcino- Gene therapy of pancreatic cancer blocking HMGA1 F Trapasso et al ma, 27,28 could account for resistance to therapy. In fact, p53 function is required for growth arrest or apoptosis after administration of DNA-damaging agents.…”

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confidence: 99%

“…In addition, for all stages of surgically resectable disease combined, the overall 5-year survival is less than 15% of cases. [1][2][3] Therefore, alternative therapeutic strategies are urgently required for pancreatic cancer. The aim of our study was to evaluate whether suppression of HMGA1 protein synthesis with an adenoviral vector could benefit patients with pancreatic cancer.…”

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Therapy of human pancreatic carcinoma based on suppression of HMGA1 protein synthesis in preclinical models

et al. 2004

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Pancreatic carcinoma is one of the most aggressive tumors, and, being refractory to conventional therapies, is an excellent target for new therapeutic approaches. Based on our previous finding of high HMGA1 expression in pancreatic cancer cells compared to normal pancreatic tissue, we evaluated whether suppression of HMGA1 protein expression could be a treatment option for patients affected by pancreatic cancer. Here we report that HMGA1 proteins are overexpressed in pancreatic carcinoma cell lines, and their downregulation through an adenovirus carrying the HMGA1 gene in an antisense orientation (Ad Yas-GFP) results in the death of three human pancreatic carcinoma cell lines (PANC1, Hs766T and PSN1). Pretreatment of PANC1 and PSN1 cells with Ad Yas-GFP suppressed and reduced, respectively, their ability to form xenograft tumors in nude mice. To further verify the role of HMGA1 in pancreatic tumorigenesis, we used a HMGA1 antisense phosphorothioate oligodeoxynucleotide (ODN); its addition induced a decrease in HMGA1 protein levels and a significant reduction of the proliferation rate of PANC1-, Hs766T-and PSN1-treated cells. Therefore, suppression of HMGA1 protein synthesis by an HMGA1 antisense approach seems to be a feasible treatment strategy in pancreatic carcinomas.

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Pancreaticoduodenectomy for Cancer of the Head of the Pancreas 201 Patients

Abstract: The survival of patients with pancreatic adenocarcinoma treated by pancreaticoduodenectomy is improving. Aspects of tumor biology, such as DNA content, tumor diameter, nodal status and margin status, are the strongest predictors of outcome.

Cited by 905 publications

References 31 publications

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

Are There Indications for Palliative Resection in Pancreatic Cancer?

Therapy of human pancreatic carcinoma based on suppression of HMGA1 protein synthesis in preclinical models

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