The Lymph Node Ratio is the Strongest Prognostic Factor after Resection of Pancreatic Cancer

Riediger, Hartwig; Keck, Tobias; Wellner, Ulrich; Hausen, Axel zur; Adam, Ulrich; Hopt, Ulrich T.; Makowiec, Frank

doi:10.1007/s11605-009-0919-2

Cited by 316 publications

(220 citation statements)

References 26 publications

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“…A progressively worse lymph node positivity ratio was also associated with increased likelihood of receiving adjuvant treatment 32 . Those findings might relate to the hypothesis that patients with nodal disease derive the greatest benefit from adjuvant treatment 9,33,34 .…”

Section: Discussionmentioning

confidence: 93%

Predictors of Adjuvant Treatment for Pancreatic Adenocarcinoma at the Population Level

et al. 2016

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Section: Discussionmentioning

confidence: 93%

Predictors of Adjuvant Treatment for Pancreatic Adenocarcinoma at the Population Level

et al. 2016

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“…Az LNR (lymph node ratio) arány megkapható, ha az érintett nyirokcsomók számát elosztjuk az eltávolított nyirokcsomók számával, a 20% feletti arány rossz prognosztikai jelként értékelhető [18].…”

Section: 2unclassified

Pancreatic cancer.Evidence based management guidelines of the Hungarian Pancreatic Study Group

et al. 2015

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A pancreasrák gyakran későn diagnosztizált kórkép, amely a legrosszabb kórlefolyású betegségek csoportjába sorolható, ezért a szűrése, diagnosztikája, kezelése és palliációja korszerű és bizonyítékokon alapuló útmutatót igényel. A Magyar Hasnyálmirigy Munkacsoport célul tűzte ki, hogy a jelenleg elérhető nemzetközi irányvonalakat, illetve evidenciákat alapul véve a pancreasrák kezelésének kulcskérdései vonatkozásában bizonyíték alapú irányelveket fogalmazzon meg. A Magyar Hasnyálmirigy Munkacsoport által kijelölt előkészítő és konzulens munkacsoport lefordí-totta, és ahol szükségesnek találta, kiegészítette és/vagy módosította a nemzetközi irányelveket. Összesen 10 téma-körben (Rizikófaktorok és genetika, Szűrés, Diagnózis, Staging, Sebészi kezelés, Patológiai feldolgozás, Szisztémás kezelés, Sugárterápia, Palliáció és szupportív kezelés, Utánkövetés és rekurrencia) 37 releváns irányelv került össze-állításra. Az evidencia osztályozása a National Comprehensive Cancer Network (NCCN) rendszere alapján került meghatározásra. Az összeállított irányelvek a 2014. szeptember 12-ei konszenzustalálkozón kerültek bemutatásra és megvita tásra. A résztvevők 15 irányelvet teljes (95% feletti) egyetértéssel, míg 22 irányelvet erős (70% feletti) egyetértéssel fogadtak el. A Magyar Hasnyálmirigy Munkacsoport kezelési irányelvei az első, bizonyíték alapján készült pancreasrák-kezelési útmutató hazánkban. Az irányelv komoly segítséget nyújthat a pancreasrák oktatásához, a mindennapi betegellátáshoz és a megfelelő fi nanszírozás kialakításához. Ezért a szerzők bíznak abban, hogy ezen irányelvek minél szélesebb körben alapreferenciaként fognak szolgálni Magyarországon.

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“…Several poor predictors for successful resection have been identified, including lymph node involvement, 30 high tumor grade, 31 large tumor size, 32 elevated CA 19-9 levels, 32 and positive margins of tumors following resection. 33 These same factors are also indicative of recurrence of pancreatic tumors.…”

Section: Conventional Therapiesmentioning

confidence: 99%

Pancreatic cancer vaccine: a unique potential therapy

Cappello¹,

Principe²,

Novelli³

2015

GICTT

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Pancreatic ductal adenocarcinoma (PDA) is a lethal disease and is one of the cancers that is most resistant to traditional therapies. Historically, neither chemotherapy nor radiotherapy has provided any significant increase in the survival of patients with PDA. Despite intensive efforts, any attempts to improve the survival in the past 15 years have failed. This holds true even after the introduction of molecularly targeted agents, chosen on the basis of their involvement in pathways that are considered to be important in PDA development and progression. Recently, however, FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) treatment has provided a limited survival advantage in patients with advanced PDA. Therefore, effective therapeutic strategies are urgently needed to improve the survival rate of patients with PDA. Results from the last 10 years of research in the field of PDA have helped to identify new immunological targets and develop new vaccines that are capable of stimulating an immune response. In addition, the information obtained about the role of the tumor microenvironment in suppressing the immune response and the possibility of targeting PDA microenvironment to limit immune suppression and enhance the response of effector T-cells has opened new avenues for treating this incurable disease. The time is ripe for developing new therapeutic approaches that are able to effectively counteract the progression and spreading of PDA. This review discusses the potential prospects in the care of patients with pancreatic cancer through vaccination and its combination therapy with surgery, chemotherapy, targeting of the tumor microenvironment, and inhibition of immunological checkpoints. Keywords: pancreatic cancer, vaccines, T-cells, antibody, immunotherapy Pancreatic cancerAlthough lung, breast, prostate, and colorectal cancers are considered to be the "big four" cancer types in the USA, pancreas and liver cancers are expected to surpass breast, prostate, and colorectal cancers to become the second and third leading causes of cancer-related deaths by 2030, respectively.1 Pancreatic ductal adenocarcinomas (PDAs) arise from the exocrine pancreas and account for 95% of pancreatic cancers. In the USA, there were an estimated 48,960 cases of new-onset pancreatic cancer in 2015, which led to 40,560 deaths, with a 5-year survival rate of ∼7%.3 PDA is nearly universally lethal; ,20% of patients are suitable candidates for surgery at the time of diagnosis, and the median survival rate is 3.5 months and 12.6 months for nonresected patients and resected patients, respectively.2,4 PDA evolves from noninvasive precursor lesions that do not invade the basement membrane. [5][6][7] Three precursors have been characterized, namely, pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms, and mucinous cystic neoplasms.

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The Lymph Node Ratio is the Strongest Prognostic Factor after Resection of Pancreatic Cancer

Cited by 316 publications

References 26 publications

Predictors of Adjuvant Treatment for Pancreatic Adenocarcinoma at the Population Level

Predictors of Adjuvant Treatment for Pancreatic Adenocarcinoma at the Population Level

Pancreatic cancer.Evidence based management guidelines of the Hungarian Pancreatic Study Group

Pancreatic cancer vaccine: a unique potential therapy

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