Survival in 1001 Patients with Carcinoma of the Pancreas

Connolly, Mark W.; Dawson, Peter J.; Michelassi, Fabrizio; Moossa, A. R.; Lowenstein, Florence E.

doi:10.1097/00000658-198709000-00015

Cited by 256 publications

(93 citation statements)

References 27 publications

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“…At that point, the opportunity for curative therapy, which is surgery at an early stage, has already passed. Even though complete resection may still be achieved, the rate of relapses is high (Connolly et al, 1987;Trede et al, 1990;Cameron et al, 1991). Adjuvant combination therapy may offer a small survival advantage but is associated with treatment related morbidity.…”

mentioning

confidence: 99%

Heparanase expression is a prognostic indicator for postoperative survival in pancreatic adenocarcinoma

et al. 2002

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Pancreatic ductal adenocarcinoma has a median survival of less than 6 months from diagnosis. This is due to the difficulty in early diagnosis, the aggressive biological behaviour of the tumour and a lack of effective therapies for advanced disease. Mammalian heparanase is a heparan-sulphate proteoglycan cleaving enzyme. It helps to degrade the extracellular matrix and basement membranes and is involved in angiogenesis. Degradation of extracellular matrix and basement membranes as well as angiogenesis are key conditions for tumour cell spreading. Therefore, we have analysed the expression of heparanase in human pancreatic cancer tissue and cell lines. Heparanase is expressed in cell lines derived from primary tumours as well as from metastatic sites. By immunohistochemical analysis, it is preferentially expressed at the invading edge of a tumour at both metastatic and primary tumour sites. There is a trend towards heparanase expression in metastasising tumours as compared to locally growing tumours. Postoperative survival correlates inversely with heparanase expression of the tumour reflected by a median survival of 34 and 17 month for heparanase negative and positive tumours, respectively. Our results suggest, that heparanase promotes cancer cell invasion in pancreatic carcinoma and could be used as a prognostic indicator for postoperative survival of patients.

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confidence: 99%

Heparanase expression is a prognostic indicator for postoperative survival in pancreatic adenocarcinoma

et al. 2002

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“…Thus the number of Whipple operations performed for true PDAC may be lower and consequently the rate of five year survivors somewhat higher. The five year survival rate after a Whipple procedure has been reported to be approximately 5% in other studies [24][25][26][27] although there are also several reports with better long term results, especially those performed in single institutions. 7-16 28-30 Adjuvant chemotherapy may also have a significant survival benefit in patients with resected pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish Cancer Registry

Carpelan-Holmström

Nordling²,

Pukkala³

et al. 2005

Gut

283

176

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“…1 Despite advances in surgical techniques for performing pancreaticoduodenectomy and perioperative management, the overall 5-year survival rate is only 2% to 3%. 2,3 The overall prognosis remains poor, because 90% of all periampullary cancers are unresectable by the time they are identified, having distant metastasis or tumor involvement of the portal vein (PV), superior mesenteric vessels, and celiac trunk, the major determinants against surgical resection. 4,5 Consequently, the ability to stage the cancer in patients preoperatively as accurately as possible is essential to avoid exploration of patients with unresectable cancer.…”

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confidence: 99%

State‐of‐the‐art ultrasonography is as accurate as helical computed tomography and computed tomographic angiography for detecting unresectable periampullary cancer.

Morrin

Kruskal²,

Raptopoulos³

et al. 2001

J of Ultrasound Medicine

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AbbreviationsCT, computed tomography; CTA, computed tomographic angiography; PV, portal vein; SMA, superior mesenteric artery; SMV, superior mesenteric vein; SV, splenic vein Article Objective. To compare the ability of state-of-the-art ultrasonography with that of helical computed tomography and computed tomographic angiography in detecting unresectable periampullary cancer. In most patients periampullary cancer is unresectable because of either distant metastasis or local vascular involvement. The advent of gray scale and color Doppler ultrasonography has improved the ability of ultrasonography to detect vascular involvement. Methods. Twenty-three consecutive patients with periampullary cancer were enrolled for prospective staging of their disease by comparing helical computed tomography and computed tomographic angiography with gray scale and color Doppler ultrasonography of the abdomen. Portal vein, superior mesenteric vein, splenic vein, and superior mesenteric artery involvement was graded 0 to 4, grade 0 being no vascular involvement and grade 4 being total occlusion of the vessel. Agreement between ultrasonography and computed tomographic angiography for determining vascular involvement was measured by χ 2 analysis. Results. Two patients (9%) were excluded because excessive overlying bowel gas hampered the ability of ultrasonography to visualize the pancreas. For the remaining 21 patients, there was significant agreement between ultrasonography and computed tomographic angiography for detecting vascular involvement in all vessels (P < .001; portal vein, κ = 0.67; superior mesenteric vein, κ = 0.67; splenic vein, κ = 0.85; and superior mesenteric artery, κ = 0.59). Ultrasonography was in agreement with computed tomographic angiography in all cases of unresectability. Both modalities were equally poor in preoperatively showing lymphadenopathy and metastases. Conclusions. Provided that there is adequate visualization on ultrasonography of the head of the pancreas in the periampullary region, then state-of-the-art gray scale and color Doppler ultrasonography are as accurate as helical computed tomography and computed tomographic angiography for detecting the unresectability of periampullary cancer. If performed as the initial investigation and the region of the pancreatic head is clearly shown, and if vascular encasement or occlusion or distant metastasis is identified, further investigations are unnecessary.

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Survival in 1001 Patients with Carcinoma of the Pancreas

Cited by 256 publications

References 27 publications

Heparanase expression is a prognostic indicator for postoperative survival in pancreatic adenocarcinoma

Heparanase expression is a prognostic indicator for postoperative survival in pancreatic adenocarcinoma

Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study re-evaluating the data of the Finnish Cancer Registry

State‐of‐the‐art ultrasonography is as accurate as helical computed tomography and computed tomographic angiography for detecting unresectable periampullary cancer.

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