Journal of Pancreatic Cancer最新文献_第7页

Incremental Role of Fluorine 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Assessment of Computed Tomography-Inconspicuous Pancreatic Lesions. 氟- 18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在计算机断层扫描-不明显胰腺病变评估中的作用

Journal of Pancreatic Cancer Pub Date : 2017-09-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0014

Fathinul Fikri Ahmad Saad, Anna Misyail Abdul Rashid, Mohamad Syafeeq Faeez Md Noh

{"title":"Incremental Role of Fluorine 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Assessment of Computed Tomography-Inconspicuous Pancreatic Lesions.","authors":"Fathinul Fikri Ahmad Saad, Anna Misyail Abdul Rashid, Mohamad Syafeeq Faeez Md Noh","doi":"10.1089/pancan.2017.0014","DOIUrl":"https://doi.org/10.1089/pancan.2017.0014","url":null,"abstract":"Background: Pancreatic malignancies encompass a heterogenous group of disorders, with poor prognosis at diagnosis. Traditionally, conventional computed tomography (CT) has been used for diagnosis, staging, and follow up. However, this technique lacks functional information; and is limited in diagnosis of occult pancreatic disease. Hybrid imaging in the form of positron emission tomography (PET)/CT provides a potential avenue for early detection and subsequent appropriate therapy. Case Presentation: A 60-year-old male, with a history of abdominal aortic aneurysm which was repaired, came with a complaint of 2 months history of back pain, radiating to the front. The pain was relieved on leaning forward, and aggravated by lying on his back. CT angiography of the abdomen was done, which revealed a concealed aortic aneurysm and a significant atrophy of the pancreatic tail. The serum cancer antigen (CA) 19-9 was elevated (50.0 U/mL, reference range 0.0-37.0 U/mL). At this juncture, the PET scan done revealed no discernible abnormalities. Patient was put on close follow-up in view of the rising trend of CA 19-9 levels. Three months following the initial scans, a repeat 18F-FDG (fluorine 18 fluorodeoxyglucose) PET/CT revealed an FDG-avid lesion at the neck of the pancreas on PET without perceptible changes on the correlated CT. A Whipple's procedure ensued, with histopathological examination findings of pancreatic adenocarcinoma. Conclusion: This article discusses the role of PET/CT in the early diagnosis of inconspicuous pancreatic lesions; which could have averted immediate medical therapy.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36897796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Digital Ischemia and Necrosis: A Rarely Described Complication of Gemcitabine in Pancreatic Adenocarcinoma. 手指缺血和坏死:吉西他滨治疗胰腺腺癌的罕见并发症。

Journal of Pancreatic Cancer Pub Date : 2017-08-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0012

Eiichiro So, Zachary D Crees, Danielle Crites, Andrea Wang-Gillam

{"title":"Digital Ischemia and Necrosis: A Rarely Described Complication of Gemcitabine in Pancreatic Adenocarcinoma.","authors":"Eiichiro So, Zachary D Crees, Danielle Crites, Andrea Wang-Gillam","doi":"10.1089/pancan.2017.0012","DOIUrl":"https://doi.org/10.1089/pancan.2017.0012","url":null,"abstract":"Background: Gemcitabine, alone or in combination with other agents, has become an important part of the standard of care for treatment of both resectable and unresectable/advanced pancreatic adenocarcinoma. Gemcitabine is generally considered to have a favorable toxicity profile, with myelosuppression and hepatotoxicity as the most common adverse effects. There are just two prior published case reports of gemcitabine-associated digital toxicity in the treatment of pancreatic adenocarcinoma, and few case reports when considering all solid tumors. Presentation: A 70-year-old female developed hand numbness and tingling while receiving nab-paclitaxel plus gemcitabine for metastatic pancreatic adenocarcinoma. There was initial concern for Raynaud's or nab-paclitaxel-associated neuropathy, thus nab-paclitaxel was discontinued. However, her symptoms progressed to severe pain and her digits became dusky. An extensive evaluation revealed no alternative etiology except gemcitabine-associated digital ischemia (DI). The patient was treated with discontinuation of gemcitabine, and starting nitrates, opiates, calcium-channel blockers, and enoxaparin but eventually progressed to dry gangrene. Conclusion: Here we report a case of gemcitabine-associated DI, along with a review of the literature. Although a rare complication, DI must be recognized and treated promptly to reduce the likelihood of serious and permanent morbidity.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36842971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Enhanced Vascular Collateralization Through the Pancreaticoduodenal Arcade Secondary to Median Arcuate Ligament Compression of the Celiac Axis in the Setting of Pancreatic Body Adenocarcinoma: The Ideal Scenario for the Modified Appleby Procedure. 胰腺体腺癌继发于腹腔轴中弓韧带压迫的胰十二指肠拱桥血管侧支增强：改良 Appleby 手术的理想方案。

Journal of Pancreatic Cancer Pub Date : 2017-08-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0008

Kathleen A Holoyda, Warren R Maley, Charles J Yeo

{"title":"Enhanced Vascular Collateralization Through the Pancreaticoduodenal Arcade Secondary to Median Arcuate Ligament Compression of the Celiac Axis in the Setting of Pancreatic Body Adenocarcinoma: The Ideal Scenario for the Modified Appleby Procedure.","authors":"Kathleen A Holoyda, Warren R Maley, Charles J Yeo","doi":"10.1089/pancan.2017.0008","DOIUrl":"10.1089/pancan.2017.0008","url":null,"abstract":"Background: A modified Appleby procedure for pancreatic body tumors relies upon collateral vessels maintaining blood flow to the proper hepatic artery (PHA) through the pancreaticoduodenal arcade (PDA) off of the superior mesenteric artery (SMA). Compression of the celiac axis by the median arcuate ligament (MAL) promotes the expansion of collateral vessels without preoperative intervention. Case Presentation: A 51-year-old male with asymptomatic compression of the celiac artery presented with new onset insulin-dependent diabetes mellitus. He underwent imaging that demonstrated a locally advanced pancreatic body tumor that encased the superior mesenteric vein and portal vein confluence and involved the common hepatic artery. He had an adequate response to neoadjuvant FOLFIRINOX chemotherapy and underwent an uncomplicated modified Appleby procedure with a margin negative resection. Hepatic blood flow was adequate through the PHA as a result of collateralization of blood flow through the PDA off the SMA. The enhanced collateralization appeared to have occurred secondary to compression of the celiac axis by the MAL. Conclusions: Herein we present a unique case in which improved collateral blood flow through the PDA and the gastroduodenal artery to the PHA occurred due to celiac artery compression by the MAL. This vascular anomaly fortuitously improved the ability to achieve an R0 resection of a locally advanced pancreatic adenocarcinoma of the body of the pancreas by a modified Appleby procedure.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36842970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety Study of Targeted and Localized Intra-Arterial Delivery of Gemcitabine in Patients with Locally Advanced Pancreatic Adenocarcinoma. 靶向和局部动脉内给药吉西他滨治疗局部晚期胰腺腺癌的安全性研究。

Journal of Pancreatic Cancer Pub Date : 2017-08-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0011

Alexander S Rosemurgy, Sharona B Ross, Paul L Vitulli, Reza Malek, Jaili Li, Ramtin Agah

{"title":"Safety Study of Targeted and Localized Intra-Arterial Delivery of Gemcitabine in Patients with Locally Advanced Pancreatic Adenocarcinoma.","authors":"Alexander S Rosemurgy, Sharona B Ross, Paul L Vitulli, Reza Malek, Jaili Li, Ramtin Agah","doi":"10.1089/pancan.2017.0011","DOIUrl":"https://doi.org/10.1089/pancan.2017.0011","url":null,"abstract":"Purpose: This is a first-in-man safety study in locally advanced pancreatic cancer (LAPC) using a targeted intra-arterial delivery catheter (RenovoCath™). Methods: Twenty patients were enrolled in a four-stage dose escalation of intra-arterial, locally delivered gemcitabine, at doses up to 1000 mg/m2. Patients' symptoms and laboratory values were monitored for safety and tolerability. Secondary endpoints included the effect on tumor size, tumor markers, and survival. Results: One hundred one treatments were administered to 20 patients. Five patients dropped out early due to adverse events or withdrawing consent. Serious adverse events and complications were as follows: sepsis (n = 3), grade 3 neutropenia (n = 3), guide-mediated vascular dissection (n = 3), and pulmonary toxicity (n = 1). There were no cases of elevated liver or pancreatic enzymes. All sepsis cases occurred in patients with biliary stent/drains, prompting the addition of periprocedural treatment with antibiotics, which effectively prevented further sepsis in the study. Efficacy analysis was limited to 15 patients who received more than two treatments. Fifty-eight percent of these patients had a reduction in CA 19-9 tumor markers, 3 patients had tumor progression, 1 had partial response, and 11 showed disease stability. The survival rate at 12 months was 60%. Conclusions: The results demonstrate feasibility of localized and selective intra-arterial chemotherapy delivery to the pancreas utilizing the RenovoCath. With gemcitabine, this approach is safe, with the sole prerequisite of perioperative antibiotics for patients with prior biliary drainage/stent. Efficacy results suggest a survival benefit when compared to historical control, especially in patients with prior radiation therapy.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36842973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Perioperative Management of Factor V Leiden and Pancreatic Adenocarcinoma. 因子V莱顿与胰腺腺癌的围手术期处理。

Journal of Pancreatic Cancer Pub Date : 2017-08-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0010

Thomas J O'Malley, Renganaden Sooppan, Charles J Yeo

引用次数: 0

One Distinctive Presentation in Radiology of Pancreatic Cancer: A Rare Case Report. 胰腺癌放射学的一种独特表现:一例罕见病例报告。

Journal of Pancreatic Cancer Pub Date : 2017-07-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0009

He Xu, Qingkai Zhang, Xue Gao, Dong Shang

引用次数: 1

Anaplastic Pancreatic Carcinoma Arising Within a Mucinous Cystic Neoplasm of the Pancreas: A Case Report and a Brief Review of the Literature. 胰腺粘液囊性肿瘤内发生间变性胰腺癌:1例报告及文献回顾。

Journal of Pancreatic Cancer Pub Date : 2017-07-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0004

Alessandro Paniccia, Robert Torphy, Kalpana Devaraj, Richard D Schulick

{"title":"Anaplastic Pancreatic Carcinoma Arising Within a Mucinous Cystic Neoplasm of the Pancreas: A Case Report and a Brief Review of the Literature.","authors":"Alessandro Paniccia, Robert Torphy, Kalpana Devaraj, Richard D Schulick","doi":"10.1089/pancan.2017.0004","DOIUrl":"https://doi.org/10.1089/pancan.2017.0004","url":null,"abstract":"Background: Anaplastic pancreatic carcinomas (APCs) are among the least frequently encountered pancreatic malignancies, ranging from 0.5% to 7% of all nonendocrine pancreatic malignancies. Furthermore, few cases of APCs have been described arising within a pancreatic mucinous cystic neoplasm (MCN). Case Presentation: A 36-year-old female presented with left upper quadrant pain and a 10 × 8 cm complex cystic mass in the pancreatic tail. Fine needle aspiration of the cyst showed papillary clusters of cells with mild cytological atypia, cyst fluid carcinoembryonic antigen >4000 ng/mL, and amylase of 25 U/L. After an open distal pancreatectomy and splenectomy, the specimen revealed an MCN with multifocal microscopic foci of invasive well-differentiated adenocarcinoma. After additional sampling, foci of undifferentiated malignancy-morphologically resembling sarcomas but with immunohistochemical staining consistent with anaplastic carcinoma-were identified. The patient had an uneventful recovery and is currently undergoing a regimen of gemcitabine-based adjuvant chemotherapy; she remains disease-free at 5 months after initial diagnosis. Conclusions: In this study, we describe a rare case of APC originating from a large pancreatic MCN lesion. This case underlines the importance of scrupulous pathological evaluation of the entire MCN epithelium and adds to the limited world literature of APC originating from pancreatic MCN lesions.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pancan.2017.0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36842969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

C-Reactive Protein/Albumin Ratio and Prognostic Nutritional Index Are Strong Prognostic Indicators of Survival in Resected Pancreatic Ductal Adenocarcinoma. C-反应蛋白/白蛋白比值和预后营养指数是切除的胰腺导管腺癌存活率的有力预后指标。

Journal of Pancreatic Cancer Pub Date : 2017-07-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0006

Masahide Ikeguchi, Takehiko Hanaki, Kanenori Endo, Kazunori Suzuki, Seiichi Nakamura, Takashi Sawata, Tetsu Shimizu

{"title":"C-Reactive Protein/Albumin Ratio and Prognostic Nutritional Index Are Strong Prognostic Indicators of Survival in Resected Pancreatic Ductal Adenocarcinoma.","authors":"Masahide Ikeguchi, Takehiko Hanaki, Kanenori Endo, Kazunori Suzuki, Seiichi Nakamura, Takashi Sawata, Tetsu Shimizu","doi":"10.1089/pancan.2017.0006","DOIUrl":"10.1089/pancan.2017.0006","url":null,"abstract":"Purpose: We evaluated the clinical importance, such as the occurrence of postoperative pancreatic fistula (POPF) or prognosis, of preoperative serum markers of chronic inflammation, nutrition, and immunity, as well as that of serum tumor markers after curative resection of pancreatic ductal adenocarcinomas (PDACs). Methods: Between 2006 and 2015, 43 patients with PDACs underwent curative resection at Tottori Prefectural Central Hospital. We analyzed which preoperative indicators (i.e., C-reactive protein/albumin ratio [CAR], neutrophil/lymphocyte ratio [NLR], prognostic nutritional index [PNI], carcinoembryonic antigen [CEA], and carbohydrate antigen 19-9 [CA 19-9]) were the most relevant risk factors for occurrence of POPF and poor patient survival. Results: POPF was detected in 8/43 (18.6%) patients. One patient died of pancreatic fistula at 2 months postoperatively. Among nine candidate factors (operative procedure, operation time, tumor stage, preoperative serum amylase, preoperative CAR, NLR, PNI, CEA, and CA 19-9), we did not identify any significant risk factor for the occurrence of POPF. The 5-year overall survival (OS) rate of the 43 patients was 22.4%, and the overall median survival time was 21 months. The multivariate OS analysis demonstrated that high CAR and low PNI were strong preoperative markers of poor prognosis independently of tumor stage. Conclusions: Preoperative CAR and PNI are useful prognostic markers for patients with operable PDACs.","PeriodicalId":16655,"journal":{"name":"Journal of Pancreatic Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36842967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Central Pancreatectomy with Pancreaticojejunostomy for an Insulinoma: A Case Report with Literature Review. 中央胰切除术联合胰空肠吻合术治疗胰岛素瘤1例并文献复习。

Journal of Pancreatic Cancer Pub Date : 2017-06-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0003

Ramzy T Nagle, Valerie E Takyi, Charles J Yeo

引用次数: 0

Incidental Angiosarcoma of the Pancreas: A Case Report of a Rare, Asymptomatic Tumor. 胰腺偶发血管肉瘤1例:罕见无症状肿瘤。

Journal of Pancreatic Cancer Pub Date : 2017-05-01 eCollection Date: 2017-01-01 DOI: 10.1089/pancan.2017.0007

Patrick J Worth, Michael Turner, Chet W Hammill

引用次数: 5