Studying the Post-Operatory and Molecular Modifications in the Chronic Pancreatitis and Pancreatic Cancer - The Importance of the Micronutrients and Pancreatic Enzyme Supplementation

Timofte, Daniel; Bințințan, Vasile; Munteanu, I.; Blaj, Mihaela; Anton, Emil; Ciobîcă, Alin; Şurlin, Valeriu

doi:10.18052/www.scipress.com/ilns.47.89

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Moreover, in the recent decades the development of surgical techniques have only improved postoperative mortality, without having any significant impact on the survival, with specialized pancreatic surgery centres reporting a mortality below 5% [10,11].…”

Section: Introductionmentioning

confidence: 99%

Survival Prediction for Romanian Patients with Pancreatic Cancer

Timofte¹,

Blaj²,

Petrariu³

et al. 2017

Surgery

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Journal of Surgery IntroductionPancreatic cancer is one of the most lethal malignancies worldwide, and ranks fourth in the total number of deaths related to cancer in patients of both genders. Moreover, in 2013 the United States registered about 45,000 new cases, and reported that the number of expected deaths was very similar to the number of new cases. Also, the median overall survival at 5 years is between 2 and 6% [1].Also, adenocarcinoma of the pancreas is the most common type of pancreatic neoplasm, with all of its subtypes accounting for 85% of cases [1,2].Currently, curative treatment is only possible in cases of resectable disease and during the initial stages [3]. Still, although complete surgical resection is the only potential curative approach of this disease, it can only be performed in 10 to 20% of patients, since most individuals present with advanced disease upon diagnosis [3,4]. Moreover, after surgical resection, 7 to 25% of patients have a 5-year survival rate [5], with better results in individuals which undergo curative resection (R0) [6].The prognosis for the patients with pancreatic cancer and which have indication for the resection with curative intent is determined by the lymphatic metastasis, the invasion of vascular walls and the peripancreatic nerve plexus or also by the degree of the micrometastases in nearby tissues and organs.As we mentioned before, unfortunately 95% of patients come to the doctor when the cancer is advanced and unresectable [7][8][9]. Moreover, in the recent decades the development of surgical techniques have only improved postoperative mortality, without having any significant impact on the survival, with specialized pancreatic surgery centres reporting a mortality below 5% [10,11].Approximately 60% of pancreatic cancers have cephalic location. With the reduction of operative mortality after duodenopancreatectomies, improved survival rates of 30% were reported [12], which is three times higher than previously published results [13,14]. AbstractPancreatic cancer is one of the most lethal malignancies worldwide and in some of the latest statistics ranks fourth in the total number of deaths related to cancer in patients of both genders. Currently, curative treatment is only possible in cases of resectable disease and during the initial stages. Still, although complete surgical resection is the only potential curative approach of this disease, it can only be performed in 10 to 20% of patients, since most individuals present with advanced disease upon diagnosis. Moreover, in the recent decades the development and improvement of surgical techniques have only improved postoperative mortality, without having any significant impact on the survival, with specialized pancreatic surgery centres reporting mortality below 5%. In this way, in the present study conducted on 188 patients from the "St. Spiridon" Clinical Emergency Hospital Iasi, we were interested in determining the survival rates in pancreatic cancer, as well as looking at the staging criteria for adenocarcinom...

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Section: Introductionmentioning

confidence: 99%

Survival Prediction for Romanian Patients with Pancreatic Cancer

Timofte¹,

Blaj²,

Petrariu³

et al. 2017

Surgery

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“…In this way, it is know that the main symptoms (e.g. pain and jaundice) appear later in the evolution, when the tumor is already locally advanced and unresectable, which makes the prognosis of the disorder quite grim [8]. It is also estimated that almost 95% of the patients are presenting to the doctor in the advanced and unresectable stages of the disease [9,10].…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of the Relative Distribution of Romanian Patients with Pancreatic Neoplasm

Timofte

Ionescu

Ochiuz

2016

IJPPE

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Abstract. This study describes the specific features of the distribution of Romanian patients with pancreatic neoplasm. The analysis was made on 188 patients from Clinical Emergency Hospital "Sf. Spiridon, Iasi", Romania, all with solid form of pancreatic cancer. Moreover, the distribution by age, gender, tumor location in the pancreas or by the stages from the TNM system was analyzed and compared with other studies from other countries. Thus, in our sample the median age was 65 years old. In addition, 53% of the patients had rural origin and 47% urban origin. Also, regarding the pancreatic tumor location, by far the most frequent was the cephalic location (75%). Moreover, when we study the distribution by presence of metastases at the time of diagnosis, we observed that 62.1% are located in the liver and 21.2% into the peritoneum. In addition, when we staged the ductal adenocarcinoma of the pancreas according to the TNM (tumour grade, nodal status and metastases) system, where T1-T3 constitutes a resectable tumour and T4 indicates an unresectable tumour, we found that group T4 stage tumor predominated (63.8%), while in regards to the regional lymph nodes (e.g. N in TNM classification) we observed that in an overwhelming proportion Nx stage predominates (88.6%). Moreover, no distant metastasis was found in 63% of patients, by using M in TNM classification. In this way, a better understanding of the specific characteristics for the affected population could prove to be extremely important, especially considering the fact during the last decades the development of the surgical methods and techniques for this disorder had no significant impact on the survival rate.

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Micronutritional status after pylorus preserving duodenopancreatectomy: analysis of data from a randomized controlled trial

Tabriz

Uslar

Obonyo

et al. 2021

Sci Rep

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Physical frailty and nutritional malassimilation are often observed after pancreaticoduodenectomy for pancreatic cancer. But long-term data concerning the course of micronutrient status is still missing. Micronutrient status after pylorus preserving pancreaticoduodenectomy with a follow-up of 12 months was evaluated using data of a randomized controlled trial. 47 patients were randomized with respect to the physiotherapy regimen they received (intensified physiotherapy: n = 22; standard physiotherapy: n = 25). Nutritional status was recorded preoperatively and postoperatively after one week, 3, 6 and 12 months. BMI, body fat measurement and albumin, lipid, iron and bone metabolism parameters, vitamins A, B1 B6 and B12, homocysteine, folic acid, and trace elements were measured. Laboratory values were analyzed descriptively. Differences between the groups were analyzed using the t-test in SPSS. For vitamin D, B1, B6 and iron a deficiency over time could be demonstrated with 50% of all patients or more being below normal range. The other laboratory values were in low normal range after 3 months and later. Significant differences between groups were found in cholesterol, HDL and selenium levels (corrected p-values < 0.033 in all cases). Vitamin D and iron should be supplemented postoperatively in the long term, and vitamin B1 and B6 substitution should be considered in symptomatic patients. Levels of malnutrition induced fatigue should be comparable between both groups. However, the role of nutritional status on other health-related aspects such as quality of life should be the focus of further studies.Trial Registration Number in the German Registry for Clinical Studies: DRKS00006786; Date of Registration: 01.10.2014.

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Studying the Post-Operatory and Molecular Modifications in the Chronic Pancreatitis and Pancreatic Cancer - The Importance of the Micronutrients and Pancreatic Enzyme Supplementation

Cited by 3 publications

References 17 publications

Survival Prediction for Romanian Patients with Pancreatic Cancer

Survival Prediction for Romanian Patients with Pancreatic Cancer

An Evaluation of the Relative Distribution of Romanian Patients with Pancreatic Neoplasm

Micronutritional status after pylorus preserving duodenopancreatectomy: analysis of data from a randomized controlled trial

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