Annals of Pancreatic Cancer最新文献

{"title":"Volatile organic compound analysis for the diagnosis of pancreatic cancer","authors":"B. Crosby, A. Ridzuan-Allen, J. P. O'Neill","doi":"10.21037/APC-20-39","DOIUrl":"https://doi.org/10.21037/APC-20-39","url":null,"abstract":": As pancreatic cancer lacks any characteristic clinical symptoms within its early stages, the development of new diagnostic tools is essential in improving outcomes. The analysis of volatile organic compounds (VOCs) produced by pancreatic cancer cells and/or the tumour microenvironment is one such tool. Cancer-related alterations in cell metabolism result in marked shifts in the spectra and concentrations of the VOCs produced. These changes are specific to each cancer and, as such, the last few decades have seen extensive efforts to develop VOC biomarkers, by identifying key differences between healthy controls and individuals with cancer. Being non-invasive in nature and cheaper than other investigation techniques, VOC analysis is certainly an attractive method. A pooled analysis of all the current literature related to pancreatic cancer, highlights the significant potential of the technique: sensitivities of 87.67%, 85.00% and 83.30% as well as specificities of 87.00%, 81.00% and 81.90% have all been shown for breath, urine and bile respectively. However, before being utilised clinically, certain challenges, such as standardisation of methodology, must be addressed. This review, critically examines the progress made in the development of VOC analysis, as a diagnostic tool in early pancreatic cancer, and will also highlight the current challenges and limitations that exist.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74359851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of germline ATM mutations and survival in pancreatic cancer","authors":"A. Gower, G. Gresham, Kellie Spector, N. Haladjian, John Lee, Sejal Mehta, A. Osipov, A. Hendifar","doi":"10.21037/APC-20-38","DOIUrl":"https://doi.org/10.21037/APC-20-38","url":null,"abstract":"Background: Germline mutations in ataxia telangiectasia mutated (ATM) predispose patients to an increased risk of developing pancreatic cancer. There is mounting evidence that germline mutations in DNA damage response genes confer survival benefit in pancreatic cancer, however, the influence of ATM mutations in pancreatic cancer has not been established. Better understanding into the role of ATM mutations may have implications for prognosis and treatment modalities. Methods: Two hundred and thirty-nine patients who were seen at a single institution between 2007 and 2019 with biopsy confirmed pancreatic cancer were retrospectively identified; 219 patients with adenocarcinoma or adenosquamous carcinoma next-generation sequencing (NGS) testing of their tumors by March 20th, 2020. Sixty-seven of the 219 patients also had germline testing. Results: Germline ATM mutated pancreatic adenocarcinoma are associated with improved overall survival (OS) versus those with wildtype ATM or somatically mutated ATM. Furthermore, we show that somatic ATM mutations are associated with worse survival. Conclusions: We hypothesize that the function of germline ATM mutations in DNA double strand break repair likely renders tumor cells more responsive to overall treatment regimen, thus leading to clinical benefit. As pancreatic cancer has fully entered the era of precision medicine, this study further highlights the importance of routinely testing for germline mutations and suggests that germline ATM is a possible prognostic biomarker that may potentially be exploited therapeutically with targeted therapies such as PARP inhibitors. This study warrants more exploration of ATM with regard to clinical significance and actionability.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74289248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drain and nasogastric tube use following pancreatoduodenectomy: a narrative review","authors":"T. Russell, P. Labib, S. Aroori","doi":"10.21037/apc-21-18","DOIUrl":"https://doi.org/10.21037/apc-21-18","url":null,"abstract":"","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83589410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selected intra-operative factors which affect pancreaticoduodenectomy outcomes: a narrative review","authors":"T. Russell, P. Labib, S. Aroori","doi":"10.21037/apc-21-16","DOIUrl":"https://doi.org/10.21037/apc-21-16","url":null,"abstract":"","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76339753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series: FDG-avid lymphadenopathy during oncologic staging of pancreatic adenocarcinoma after COVID-19 vaccination","authors":"J. Nathan, P. Navin, M. Truty, Benzon M. Dy","doi":"10.21037/apc-21-8","DOIUrl":"https://doi.org/10.21037/apc-21-8","url":null,"abstract":": COVID-19 vaccination is becoming widely available to millions of patients across the world. Lymphadenopathy after recent COVID-19 vaccination is a common side effect that can cause upstaging in oncology patients as it can be misdiagnosed as metastatic disease. This can potentially change treatment and have devastating consequences. We present three cases of FDG-avid lymphadenopathy after recent COVID-19 vaccination in patients undergoing oncologic staging for pancreatic adenocarcinoma. Patient 1 is a 57-year-old female that developed FDG-avid supraclavicular lymphadenopathy after recent COVID-19 vaccination while undergoing pancreatic adenocarcinoma restaging. Excisional biopsy ruled out metastatic disease, and the patient subsequently underwent radiotherapy and surgery. Patients 2 and 3 are a 49-year-old female and 62-year-old male with pancreatic adenocarcinoma undergoing restaging that developed axillary FDG-avid lymphadenopathy after recent vaccination, respectively. The decision was made to observe the lymphadenopathy in both cases as they continued neoadjuvant chemotherapy since they were not metabolically optimized for surgery. Lymphadenopathy in oncology patients after recent COVID-19 vaccination should be managed with a multi-disciplinary team that includes the surgeon, oncologist, primary care provider, and radiologist. Factors such as surgical candidacy, likelihood of reactive lymphadenopathy, probability of metastatic disease, and risk of delaying surgery or treatment should be taken into consideration. Diagnostic imaging and procedures should be avoided if the outcome will not change treatment.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88500110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The robotic central pancreatectomy: surgical technique, and literature review","authors":"Krishna Kotecha, Advait Pandya, R. Prabha, R. Maitra, A. Mittal, J. Samra","doi":"10.21037/apc-21-7","DOIUrl":"https://doi.org/10.21037/apc-21-7","url":null,"abstract":"","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85967590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling human pancreatic ductal adenocarcinoma for translational research: current options, challenges, and prospective directions.","authors":"Reecha Suri, Jacquelyn W Zimmerman, Richard A Burkhart","doi":"10.21037/apc-20-29","DOIUrl":"10.21037/apc-20-29","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) is a devastating malignancy with one of the lowest survival rates. Early detection, an improved understanding of tumor biology, and novel therapeutic discoveries are needed in order to improve overall patient survival. Scientific progress towards meeting these goals relies upon accurate modeling of the human disease. From two-dimensional (2D) cell lines to the advanced modeling available today, we aim to characterize the critical tools in efforts to further understand PDAC biology. The National Center for Biotechnology Information's PubMed and the Elsevier's SCOPUS were used to perform a comprehensive literature review evaluating preclinical human-derived PDAC models. Keywords included pancreatic cancer, PDAC, preclinical models, <i>KRAS</i> mutations, xenograft, co-culturing fibroblasts, co-culturing lymphocytes and PDAC immunotherapy Initial search was limited to articles about PDAC and was then expanded to include other gastrointestinal malignancies where information may complement our effort. A supervised review of the key literature's references was utilized to augment the capture of relevant data. The discovery and refinement of techniques enabling immortalized 2D cell culture provided the cornerstone for modern cancer biology research. Cell lines have been widely used to represent PDAC <i>in vitro</i> but are limited in capacity to model three-dimensional (3D) tumor attributes and interactions within the tumor microenvironment. Xenografts are an alternative method to model PDAC with improved capacity to understand certain aspects of 3D tumor biology <i>in vivo</i> while limited by the use of immunodeficient mice. Advances of <i>in vitro</i> modeling techniques have led to 3D organoid models for PDAC biology. Co-culturing models in the 3D environment have been proposed as an efficient modeling system for improving upon the limitations encountered in the standard 2D and xenograft tumor models. The integrated network of cells and stroma that comprise PDAC <i>in vivo</i> need to be accurately depicted <i>ex vivo</i> to continue to make progress in this disease. Recapitulating the complex tumor microenvironment in a preclinical model of human disease is an outstanding and urgent need in PDAC. Definitive characterization of available human models for PDAC serves to further the core mission of pancreatic cancer translational research.</p>","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/5b/nihms-1689290.PMC8059695.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38907958","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}

{"title":"Quantitative metric for assessment of pancreatic ductal adenocarcinoma treatment response in T1-weighted gadolinium-enhanced magnetic resonance imaging.","authors":"Joy Liau,&nbsp;Srinivasan Vedantham,&nbsp;Hani M Babiker,&nbsp;Travis McGlothin,&nbsp;Diego R Martin","doi":"10.21037/apc-20-25","DOIUrl":"https://doi.org/10.21037/apc-20-25","url":null,"abstract":"<p><strong>Background: </strong>We theoretically derived a new quantitative metric reflecting the product of T1 signal intensity and contrast media concentration (<i>T1C</i>) using first principles for the signal provided by the gradient echo sequence. This metric can be used with conventional gadolinium contrast-enhanced magnetic resonance imaging (CE-MRI) exams. We used this metric to test our hypothesis that gadolinium enhancement changes with pancreatic ductal adenocarcinoma (PDA) treatment response, and that this metric may differentiate responders from non-responders.</p><p><strong>Methods: </strong>Out of 264 initially identified patients, a final total of 35 patients with PDA were included in a retrospective study of responders (n=24) and non-responders (n=11), which used changes in cancer antigen 19-9 (CA 19-9) and tumor size as reference standards. <i>T1C</i> was computed for the pancreatic mass in the arterial, portal venous, and delayed phases in pre-treatment and post-treatment MRIs. Changes in measurements and correlations with treatment response were assessed by repeated measures analysis of variance and paired <i>t</i>-tests.</p><p><strong>Results: </strong>In the treatment responder group, <i>T1C</i> significantly increased in the arterial, portal venous, and delayed phases (P=7.57e-5, P=3.25e-4, P=1.75e-4). In the non-responder group, <i>T1C</i> did not significantly change in any phase (P>0.58). Post-treatment <i>T1C</i> significantly differed between responders and non-responders (P=0.044) by repeated measures analysis of variance.</p><p><strong>Conclusions: </strong><i>T1C</i> significantly increases in all phases of CE-MRI in responders to treatment, but does not change in non-responders. <i>T1C</i> correlates with treatment response, can be computed from clinical MRI exams, and may be useful as an additional metric to stratify patients undergoing treatment.</p>","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/c7/nihms-1650141.PMC7755136.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38755306","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}

{"title":"Predictive factors of improved postoperative outcomes in pancreatic resection include patient insurance status and facility surgical volume","authors":"D. Sykora, N. Landman, R. Butterfield, T. Bekaii-Saab, Yu-Hui Chang, D. Cortese","doi":"10.21037/apc-20-3","DOIUrl":"https://doi.org/10.21037/apc-20-3","url":null,"abstract":"Background: Resection is the only potentially curative treatment for pancreatic cancer. While previous studies have demonstrated outcome disparities at low volume facilities and in underinsured patients, few have evaluated institutional variables in a large sample using recent data reflective of our rapidly changing healthcare system. We investigated the impact of facility academic status, case volume, and insurance status on length of stay, and 30- and 90-day mortality. Methods: Data were retrieved from the National Cancer Database for 34,718 pancreatic cancer patients who underwent pancreatectomy between 01/01/2010–12/31/2015. Facilities were classified as “Very Low Volume” ( ≤ 5 surgical cases/year), “Low Volume” (6–16 cases/year), or “High Volume” (>16 cases/year). Multivariable logistic regression was used to investigate associations between facility or insurance factors and 30- and 90-day mortality. Results: Insurance status was the strongest predictor of positive outcomes, with privately insured patients demonstrating the shortest length of stay (9.6 days) and lower 30-day mortality [OR (95% CI) 0.61 (0.50, 0.74)] and 90-day mortality [OR (95% CI) 0.68 (0.60, 0.78)] than publicly insured patients (P<0.001). High-volume facilities displayed lower 30-day mortality [OR (95% CI) 0.60 (0.49, 0.72)] and 90-day mortality [OR (95% CI) 0.68 (0.60, 0.78)] than very low volume facilities (P<0.001). Compared to non-academic programs, academic programs displayed lower 90-day mortality [OR (95% CI) 0.84 (0.75, 0.94), P=0.002], but equivalent 30-day mortality. Conclusions: These data illustrate the persistent outcome gap affecting underserved or underinsured patients with pancreatic cancer despite efforts in quality improvement and healthcare reform.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79402249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resected metachronous renal metastasis of pancreatic cancer after pancreaticoduodenectomy—a case report","authors":"Y. Igata, Yuta Kobayashi, S. Okubo, J. Shindoh, M. Hashimoto","doi":"10.21037/apc-20-1","DOIUrl":"https://doi.org/10.21037/apc-20-1","url":null,"abstract":": Majority of patients experience recurrence of pancreatic cancer after pancreatectomy which results in poor prognosis. This is an initial report on a patient with resected solitary renal metastasis from pancreatic cancer. The case was a 58-year-old man who underwent pancreaticoduodenectomy for pancreatic cancer. He was on S1 treatment as adjuvant chemotherapy, where 10 mm left renal nodule was detected 9 months after primary resection. The renal nodule increased to 15 mm in 2 months, although there were no increase in tumor markers. Nephrectomy revealed that the pathological diagnosis was adenocarcinoma of pancreatic origin. No definite evidence of recurrence was observed with gemcitabine treatment for 10 months after nephrectomy. When a renal mass is newly detected in the post-operative course of pancreatic cancer, renal metastasis should be considered as a differential diagnosis. Among the multidisciplinary treatments, aggressive surgery for solitary renal metastasis may contribute to better survival in selected patients.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84094582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}