Annals of Pancreatic Cancer最新文献

{"title":"EUS- versus ERCP-guided biliary drainage for malignant biliary obstruction: evidence from randomized controlled studies","authors":"Ke Chen, Zheling Chen, W. Jin, Qicong Zhu, Chao Lu, Yuanyu Wang, Yu-cheng Zhou, Y. Mou","doi":"10.21037/apc.2019.08.01","DOIUrl":"https://doi.org/10.21037/apc.2019.08.01","url":null,"abstract":"Background: Endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD) is the first-line technique for the management of malignant biliary obstruction. Previous evidence demonstrated that endoscopic ultrasound-guided biliary drainage (EUS-BD) is technically safe and feasible, and EUS-BD has been used as the alternative palliative treatment when ERCP fails. We aimed to compare the therapeutic efficacies and procedure-associated complications of EUS-BD and ERCP as the first treatment option. \u0000 Methods: Studies comparing efficacies and complications of EUS-BD and ERCP-BD for the management of malignant biliary obstruction published before January 25, 2019 were searched. The patient characteristics, variables regarding to the therapeutic efficacies and procedure-associated complications of EUS-BD were compared to that of ERCP-BD by meta-analyses. \u0000 Results: After screening 821 studies, three randomized clinical trials (RCTs) comparing the therapeutic efficacies and complications of EUS-BD and ERCP-BD for the palliative treatment of malignant obstructive jaundice were included. No significant difference was found between EUS-BD and ERCP-BD regarding to the technical success rate, clinical success rate, procedure time, and stent patency at 3 months and 6 months. The incidence of overall adverse events was also similar between the two groups. EUS-BD showed higher frequency of stent patency at 12 months. In addition, EUS-BD showed significant decreased incidence of procedure-associated pancreatitis [odds ratio (OR) =0.08, 95% confidence intervals (CI): 0.01 to 0.62, P=0.02) and reintervention rate (OR =0.25, 95% CI: 0.12 to 0.54, P=0.0004). \u0000 Conclusions: Compared to ERCP-BD, EUS-BD showed equivalent therapeutic efficacy with decreased incidence of pancreatitis and reintervention rate. EUS-BD, like ERCP-BD, could be the first-line technique for the management of malignant biliary obstruction.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90447518","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":"Genetics and biology of pancreatic cancer and its precursor lesions: lessons learned from human pathology and mouse models","authors":"Motoyuki Tsuda, A. Fukuda, K. Takaori, H. Seno","doi":"10.21037/APC.2019.07.02","DOIUrl":"https://doi.org/10.21037/APC.2019.07.02","url":null,"abstract":"Pancreatic ductal adenocarcinoma (PDA) is one of the most fatal malignancies; it has an extremely poor prognosis due to its late diagnosis and limited response to conventional treatments. To improve PDA prognosis, new diagnostic and treatment strategies are urgently required. Recent genomic sequencing analyses revealed several mutated core signaling pathways and transcriptomic subtypes in PDA. A better understanding of PDA biology based on these genetic insights would promote the future development of novel diagnostic methods and treatments. In this review, we summarize our current understanding of PDA genetics and biology, predominantly via insights from mouse model studies.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80252430","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":"Superior mesenteric artery-first approach with laparoscopic pancreaticoduodenectomy","authors":"Xu Sun, J. Mao, Xiaofeng Ni, Qiang Yan","doi":"10.21037/APC.2019.07.01","DOIUrl":"https://doi.org/10.21037/APC.2019.07.01","url":null,"abstract":"Laparoscopic technique has conquered almost all the abdominal operations, and laparoscopic pancreaticoduodenectomy (LPD) has become a routine procedure due to its advantages in intraoperative blood loss, postoperative recovery and shorter hospital stay. With the improved surgical techniques and accumulated laparoscopic experience in recent years, the resectability of pancreatic cancer is determined by the involvement of superior mesenteric artery (SMA) instead of the portal vein (PV)/superior mesenteric vein (SMV) invasion, leading to the birth of “artery-first approach”. In our experience, SMA-first approach has its advantage in patients with local advanced pancreatic cancer requiring combination with SMV resection. Right posterior SMA approach and inferior infracolic SMA approach are the two easy and practical techniques among the popular SAM-first approaches demonstrated for LPD. However, it is necessary for pancreatic surgeons to be skilled with the different techniques in case of some challenging occasions.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89114554","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":"Cellular crosstalk mediating immune evasion in pancreatic cancer microenvironment","authors":"Chenggang Gao, Q. Shen, T. Yin","doi":"10.21037/APC.2019.06.04","DOIUrl":"https://doi.org/10.21037/APC.2019.06.04","url":null,"abstract":"Pancreatic ductal adenocarcinoma (PDAC) is the fourth most common cause of death from cancer worldwide, with a poor 5-year survival rate of 6%. Immunity in PDAC patients is diminished and the associated immune evasion is an underinvestigated field. The microenvironment of pancreatic cancer is an intricate mesh-like network in which various resident cell populations are closely interacting. To understand the roles played by these cell types, we attempt to delineate the diversified components in pancreatic cancer microenvironment and their contributions in hampering immune escape. In sum, there are two tiers of force influencing the clinical outcome of patients with pancreatic cancer. The anti-tumor force includes CD8+ T cells, NK cells, M1-type macrophages, Th1 cells, and dendritic cells (DCs). The other force facilitates tumor cells to become free of attacks from immune system, including cancer cells, PSCs, M2-type tumor-associate macrophages (TAMs), myeloid-derived suppressor cells (MDSCs), Tregs, and Th2 cells. Combined therapy to break the balance between the two forces maybe a promising strategy to benefit patients with pancreatic cancer.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"171 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73123435","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":"Insights into the biology and treatment strategies of pancreatic neuroendocrine tumors.","authors":"J. Buicko, B. Finnerty, Tiantian Zhang, B. Kim, T. Fahey, Yi-Chieh Nancy Du","doi":"10.21037/APC.2019.06.02","DOIUrl":"https://doi.org/10.21037/APC.2019.06.02","url":null,"abstract":"Pancreatic neuroendocrine tumors (PNETs) are the second most common primary pancreatic neoplasms after pancreatic ductal adenocarcinoma. PNETs present with widely various clinical manifestation and unfavorable survival rate. The recent advances in next generation sequencing have significantly increased our understanding of the molecular landscape of PNETs and help guide the development of targeted therapies. This review intends to outline a holistic picture of the tumors by discussing current understanding of clinical presentations, up-to-date treatment strategies, novel mouse models, and molecular biology of PNETs. Furthermore, we will provide insight into the future development of more effective targeted therapies that are necessary to manage PNETs.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85432189","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":"Ductal vs. acinar? Recent insights into identifying cell lineage of pancreatic ductal adenocarcinoma.","authors":"Yi Xu, Jun Liu, Michael Nipper, Pei Wang","doi":"10.21037/APC.2019.06.03","DOIUrl":"https://doi.org/10.21037/APC.2019.06.03","url":null,"abstract":"Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease with a 5-year survival rate of less than 8%. To date, there are no early detection methods or effective treatments available. Many questions remain to be answered in regards to the pathogenesis of PDAC, among which, the controversy over the cell lineage of PDAC demands more attention. Ductal cells were originally thought to be the cell of origin for PDAC due to the ductal morphology of most cases of PDAC. However, recent studies have demonstrated that acinar cells are more sensitive to KRAS mutation and tend to develop to PanIN and PDAC effectively, very likely by undergoing acinar to ductal metaplasia into a transient state that contributes to PDAC initiation. There is also evidence that both ductal and acinar cells can potentially develop to PDAC when exposed to certain genetic settings and stimuli, suggesting that more scrutiny is required for the identification of the true cell lineage of individual cases of PDAC. In this work, we summarize recent findings in the identification of the cellular origin of PDAC, with the goal of advancing our knowledge on the initiation and progression of the disease. We also discuss various models and techniques for investigating early events of PDAC. Better understanding of these cellular events is crucial to identify new methods for the early diagnosis and treatment of PDAC.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82919409","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":"Endoscopic therapy: a promising treatment for pancreatic cancer","authors":"Xiaotian Sun, Yan Liu","doi":"10.21037/APC.2019.05.03","DOIUrl":"https://doi.org/10.21037/APC.2019.05.03","url":null,"abstract":"Pancreatic cancer remains one of the most malignant tumors all over the world (1,2). Most of the patients were diagnosed as advanced pancreatic cancer, which was unresectable. Although great progress has been made to elucidate the molecular pathogenesis and explore novel treatments for pancreatic cancer, the 5-year mortality and morbidity of pancreatic cancer is still high, and the survival is poor (3).","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91549883","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":"How to teach and train laparoscopic pancreatoduodenectomy","authors":"M. Zwart, M. Foppen, J. Hilst, T. Rooij, O. Busch, M. Besselink","doi":"10.21037/APC.2019.04.01","DOIUrl":"https://doi.org/10.21037/APC.2019.04.01","url":null,"abstract":"Laparoscopic surgery was developed to minimize the impact of surgery and enhance patient recovery, as compared with open surgery. Although laparoscopy has become the standard for most common gastrointestinal procedures, laparoscopic pancreatoduodenectomy has not yet been implemented and has not been standardized. This complex procedure is associated with a long learning curve with potentially a negative impact on patient outcomes during introduction. In this narrative review we discuss the methods and materials required for teaching and practicing laparoscopic pancreatoduodenectomy, which include a minimum volume of 22–30 laparoscopic pancreatoduodenectomies per year.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81172042","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":"Position emission tomography imaging in pancreatic cancer: recent progress and future directions","authors":"Xiaoli Zhang, Xue Meng, Hui Zhu, Qiuan Yang, K. Morris, Terence Herman, Jinming Yu, Min Li","doi":"10.21037/APC.2019.03.02","DOIUrl":"https://doi.org/10.21037/APC.2019.03.02","url":null,"abstract":"Pancreatic cancer (PC) is one of the leading causes of cancer death worldwide. Limited therapeutic options are available. Therefore, how to detect early-stage tumors and how to monitor treatment efficacy and outcomes to allow timely salvage therapies are of crucial importance. Position emission tomography (PET) imaging provides more tumor-associated functional, biochemical and molecular information, without some of the intrinsic limitations of traditional imaging modalities. PET is highlighted as a potential tool to help better understand the mechanism of PC and personalize individual therapeutic regimens. In this review, we outline the available PET imaging modalities and their prospective applications in PC.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75527886","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":"Impact of prior cholecystectomy on perioperative outcomes after resection for pancreatic cancer: a single-center, retrospective cohort study in a Chinese population","authors":"L. Yin, Xinchun Liu, Tongtai Liu, Yue Fu, Yunpeng Peng, D. Ding, Zipeng Lu, Wen-tao Gao, Junli Wu, K. Jiang, Jishu Wei, Y. Miao","doi":"10.21037/APC.2019.03.01","DOIUrl":"https://doi.org/10.21037/APC.2019.03.01","url":null,"abstract":"Background: Cholecystectomy is carried out as one of the most extensive abdominal surgery. Patients with a long-term history of cholecystectomy may have an increased risk of pancreatic cancer. However, it’s uncertain whether prior cholecystectomy is associated with the outcome of patients with pancreatic cancer. This study was to demonstrate that prior cholecystectomy may lead to adverse perioperative outcomes in patients with pancreatic adenocarcinoma. Methods: Retrospective study comprising 755 consecutive patients with pathological diagnosis of pancreatic adenocarcinoma in Pancreas Center of the First Affiliated Hospital of Nanjing Medical University (January 2010 to December 2015) was conducted. Demographic details, surgery, tumor stage, pathology and complications were assessed. Patients were divided into NPC (no prior cholecystectomy) group and PC (prior cholecystectomy) group. PC group consist of three subgroups: RC (recent cholecystectomy), LTC (long term cholecystectomy), MTC (medium term cholecystectomy) group. Results: A total of 9.3% (70/755) of the patients underwent prior cholecystectomy, which was significantly more frequent than other operations. The rate is also abnormally higher than Chinese population (1.2%, 31/2,579). Five hundred and fifty-three patients with radical resection were selected. Compared to NPC group, PC group has more progressive tumor with relatively higher level of serum CA19-9 and possibly higher rate of lymph node metastasis. Further analysis showed that RC group had remarkably longer surgery time and more blood loss than NPC group. There was no significant difference of operative time and blood loss between LTC/MTC group and NPC group. Postoperatively, there was no statistical difference between LTC/MTC group and NPC group in complications as POPF (postoperative pancreatic fistula), DGE (delayed gastric emptying), hemorrhage and infection. There was also no notably difference in length of hospital stay these two groups. Conclusions: There is an abnormally high proportion of patients with cholecystectomy history in Chinese patients with pancreatic cancer. Patients with recent cholecystectomy history may have adverse perioperative outcome.","PeriodicalId":8372,"journal":{"name":"Annals of Pancreatic Cancer","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90387294","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}