Pancreatic disorders & therapy最新文献_第8页

Early vs. Late Chemoradiation Therapy and the Postoperative Interval to Adjuvant Therapy Do Not Correspond to Local Recurrence in Resected Pancreatic Cancer 早期与晚期放化疗及术后辅助治疗间隔与切除胰腺癌局部复发无关

Pancreatic disorders & therapy Pub Date : 2015-04-02 DOI: 10.4172/2165-7092.1000151

A. Patel, S. Nagarajan, E. Scher, C. Schonewolf, S. Balasubramanian, E. Poplin, R. Moss, D. August, D. Carpizo, L. Melstrom, S. Jabbour

{"title":"Early vs. Late Chemoradiation Therapy and the Postoperative Interval to Adjuvant Therapy Do Not Correspond to Local Recurrence in Resected Pancreatic Cancer","authors":"A. Patel, S. Nagarajan, E. Scher, C. Schonewolf, S. Balasubramanian, E. Poplin, R. Moss, D. August, D. Carpizo, L. Melstrom, S. Jabbour","doi":"10.4172/2165-7092.1000151","DOIUrl":"https://doi.org/10.4172/2165-7092.1000151","url":null,"abstract":"Objective Standard postoperative therapy for pancreatic cancer consists of both chemotherapy alone and chemoradiation. We sought to investigate whether the sequence of chemotherapy and chemoradiation and overall time to initiation of adjuvant therapy would impact local vs. distant recurrence. Methods After Institutional Review Board approval, resected pancreas cancer patient charts were evaluated for medical background, surgical, pathological, chemoradiation (CRT), and follow-up. Local recurrence (LR) was defined as failures occurring in the postoperative bed and regional lymph nodes. Early vs. late CRT was defined by whether CRT was given early (within 1–2 cycles of adjuvant chemotherapy) or late in the course of adjuvant chemotherapy (after the 3rd cycle of chemotherapy). The postoperative interval variance was compared to LR factors such as progression-free survival (PFS) and overall survival (OS). Results Of the 34 eligible patients, 47% (n=16) underwent early CRT and 41% (n=14) underwent late CRT. 12% (n=14) did not undergo any induction chemotherapy. At median follow-up of 22 months, 53% (n=18) had metastases, 24% (n=8) had LR, and 24% (n=8) were disease free. Kaplan-Meier curves revealed that early vs. late CRT did not appear to significantly impact OS (p=0.63), PFS (p=0.085) or LR (p=0.19). Postoperative interval did not affect PFS (p=0.42) or OS (p=0.93). Conclusions Early vs. late CRT and the time to initiation of adjuvant therapy were not significantly associated with LR in patients with resected pancreatic cancer. Future prospective studies are required to determine if sequencing of chemotherapy, CRT, or the postoperative interval impact survival and patterns of recurrence.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90493993","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}

引用次数: 8

Thromboprophylaxis in Pancreatic Cancer: Why isn’t Prime Time Here Compared to Multiple Myeloma? 胰腺癌的血栓预防:为什么与多发性骨髓瘤相比没有黄金时间?

Pancreatic disorders & therapy Pub Date : 2015-03-27 DOI: 10.4172/2165-7092.1000E137

A. Maraveyas, I. Muazzam

{"title":"Thromboprophylaxis in Pancreatic Cancer: Why isn’t Prime Time Here Compared to Multiple Myeloma?","authors":"A. Maraveyas, I. Muazzam","doi":"10.4172/2165-7092.1000E137","DOIUrl":"https://doi.org/10.4172/2165-7092.1000E137","url":null,"abstract":"Hypercoagulability and the clinical manifestation of VTE are shared by most cancers and the use of chemotherapy canfurther increase this risk. VTE in cancer patients results in increased morbidity and mortality [1]. Patients with advanced pancreatic cancer (APC) have one of the worst prognoses of all malignancies and the highest incidence of disease provoked venous thromboembolism (VTE) [2]. Given the prominence of VTE in APC, it is not surprising that data on VTE prevention for APC have been generated from subgroup analysis of non-APC targeted placebo-controlled randomized trials of cancer patients treated with chemotherapy. Further data is derived from trials dedicated to evaluate VTE prophylaxis in APC patients. These studies have been rather homogeneous in that only low molecular weight heparins (LMWH) have been investigated for anticoagulation. The choice of LMWH was partly industry driven (e.g. study of new agent such as the semi-synthetic LMWH semuloparin) and partly due to the established superiority of LMWH over vitamin K analogues in terms of safety and efficacy both in VTE prophylaxis when given in nononcologic settings and in the therapeutic (treatment) settings of malignancy associated established VTE [3].","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"52 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2015-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88805770","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}

引用次数: 6

Surveillance of Pancreatic Ductal Adenocarcinoma in Chronic Pancreatitis: An Ongoing Challenge 慢性胰腺炎胰腺导管腺癌的监测:一个持续的挑战

Pancreatic disorders & therapy Pub Date : 2015-02-27 DOI: 10.4172/2165-7092.1000149

S. Pongprasobchai, P. Kongkam, R. Rerknimitr

引用次数: 9

Complete Agenesis of Dorsal Pancreas -A Rare Congenital Anomaly: Case Presentation with Imaging Findings and Review of Literature 胰腺背侧完全发育不全——罕见的先天性异常:病例表现、影像学表现及文献回顾

Pancreatic disorders & therapy Pub Date : 2015-02-24 DOI: 10.4172/2165-7092.1000150

Ravinder Kumar, K. Vyas, N. Agrahari, J. Kundu

引用次数: 6

Acute Pancreatitis is a Predictive Factor for Malignancy in Mixed or Main Duct Intraductal Papillary Mucinous Neoplasms 急性胰腺炎是混合性或主要导管内乳头状黏液性肿瘤恶性肿瘤的预测因素

Pancreatic disorders & therapy Pub Date : 2015-02-18 DOI: 10.4172/2165-7092.1000148

W. Kimura, Koji Tezuka

{"title":"Acute Pancreatitis is a Predictive Factor for Malignancy in Mixed or Main Duct Intraductal Papillary Mucinous Neoplasms","authors":"W. Kimura, Koji Tezuka","doi":"10.4172/2165-7092.1000148","DOIUrl":"https://doi.org/10.4172/2165-7092.1000148","url":null,"abstract":"Objectives: It is still unclear whether acute pancreatitis (AP) is a predictor of malignancy. Using patients enrolled \u0000from a single institution, the objective of this study was to determine whether AP as a complication of intraductal \u0000papillary mucinous neoplasm (IPMN) predicts malignancy, and to clarify the clinicopathological characteristics of \u0000IPMN with AP. \u0000Methods: The clinicopathological features of 87 patients who underwent surgical resection for IPMN between \u0000October 1998 and May 2010 were investigated. In this study, malignancy was defined as high-grade dysplasia (noninvasive \u0000carcinoma) and invasive carcinoma. Macroscopic classification was based on the 2012 international \u0000consensus guidelines and IPMN with a main pancreatic duct size of >5 mm was classified as either mixed or main \u0000duct IPMN. \u0000Results: Among the patients, who underwent surgical resection for IPMN, AP was present in 18% (16/87) and \u0000malignancy was present in 43% (37/87). The median period from the first AP episode until surgery was 5.5 months \u0000(range: 1.0-116.3 months). There was no significant difference in the frequency of malignancy between IPMN \u0000patients with and without AP [63% (10/16) vs. 38% (27/71); p=0.096]. In mixed or main duct IPMN, malignancy was \u0000more frequent in patients with AP than in those without AP [91% (10/11) vs. 48% (22/46); P=0.016]. Comparison of \u0000the clinicopathological features between malignant IPMN with and without AP showed that the frequency of highgrade \u0000dysplasia (non-invasive carcinoma) was significantly higher in the former [80% (8/10) vs. 37% (10/27); \u0000P=0.029]. \u0000Conclusions: AP itself may not be a predictive factor for malignancy in IPMN, but may be such a predictor in \u0000mixed or main duct IPMN. AP is also an important clinical sign that must not be overlooked, as it may indicate the \u0000presence of malignant lesions at an earlier stage.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"79 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2015-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84120660","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}

引用次数: 3

Studies of the Mechanisms Causing Pancreatitis in Severe Hypertriglyceridemia 重度高甘油三酯血症引起胰腺炎的机制研究

Pancreatic disorders & therapy Pub Date : 2014-12-21 DOI: 10.4172/2165-7092.1000147

B. Christophersen, R. Sørby, K. Nordstoga

{"title":"Studies of the Mechanisms Causing Pancreatitis in Severe Hypertriglyceridemia","authors":"B. Christophersen, R. Sørby, K. Nordstoga","doi":"10.4172/2165-7092.1000147","DOIUrl":"https://doi.org/10.4172/2165-7092.1000147","url":null,"abstract":"Hypertriglyceridemia has been estimated to cause around 7% to 10% of the total number of cases of acute pancreatitis in man. The mechanisms involved in the progression of hypertriglyceridemia to pancreatitis are not well understood. \u0000In this paper, we refer to different mechanisms proposed by previous authors to explain the pathogenesis. We discuss these theories in relation to our own experimental results. It has been difficult to verify previous theories because pancreas biopsies cannot easily be obtained in humans in the early, mild stages of acute pancreatitis. In patients with severe pancreatitis, the pancreas is typically grossly pathological. We have used an animal model with lipoproteinlipase deficiency. In these animals, severe hypertriglyceridemia can be induced by feeding a high-fat diet, which in turn induces the development of severe pancreatitis. By sacrificing animals at different times, it was possible with the use of light- and electron microscopy to monitor the development of acute pancreatitis from the earliest detectable changes to the most advanced, full-blown stages. \u0000We found that the earliest detactable changes consisted of a selective degeneration of the mitochondria in the exocrine cells. At the same early stage the other intracellular structures, including the endoplasmatic reticulum, were well preserved. Mitochondria are known to be the major source of cellular free radicals liberated by the electron transport chain which may lead to oxidative stress. In normal cells antioxidant mechanisms such as vitamin E, glutathion peroxidase and others will neutralize free radicals and thus prevent oxidative stress. Our finding of an initial mitochondrial degeneration, probably caused by free fatty acids deranging the mitochondial function, support the view that antioxidants may have a role in the prevention of recurrent hypertriglyceridemia-induced pancreatitis.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"68 1 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2014-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83624489","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}

引用次数: 2

Simultaneous Courvoisier?s and Double Duct Signs 同时拿破仑吗?s和双管道标志

Pancreatic disorders & therapy Pub Date : 2014-12-14 DOI: 10.4172/2165-7092.1000146

S. Agrawal

引用次数: 2

Ã¢Â€ÂœStep UpÃ¢Â€Â Approach in the Management of Pancreatic Necrosis. Is it A Step in the Right Direction? Ã¢Â€ÂœStep UpÃ¢Â€Â胰腺坏死的治疗方法。这是朝着正确方向迈出的一步吗?

Pancreatic disorders & therapy Pub Date : 2014-11-28 DOI: 10.4172/2165-7092.1000E136

N. Machado, N. Machado

引用次数: 2

Solid Pseudopapillary Tumor of the Pancreas with Massive Cystic Degeneration; Source of Diagnostic Confusion 胰腺实性假乳头状瘤合并大量囊性变性诊断混淆的来源

Pancreatic disorders & therapy Pub Date : 2014-11-16 DOI: 10.4172/2165-7092.1000145

Austin Ostermeier, M. Nicholl

{"title":"Solid Pseudopapillary Tumor of the Pancreas with Massive Cystic Degeneration; Source of Diagnostic Confusion","authors":"Austin Ostermeier, M. Nicholl","doi":"10.4172/2165-7092.1000145","DOIUrl":"https://doi.org/10.4172/2165-7092.1000145","url":null,"abstract":"Introduction: Typically found in young women, solid pseudopapillary tumors of the pancreas (SPTP) are part of the differential diagnosis for solid and cystic neoplasms of the pancreas. SPTP may cause diagnostic confusion when presenting with massive cystic degeneration. \u0000Case Report: A 59 year-old woman undergoing surveillance PET-CT was found to have a 9 cm, calcified, complex cyst arising in the pancreatic tail. Endoscopic ultrasound, as well as cytology and fluid analysis from fine needle aspiration findings were thought to be consistent with pancreatic pseudocyst; however, after referral to a specialty surgical clinic, resection was offered because the unusual appearance and presentation of the pseudocyst triggered concern for an underlying neoplasm. After distal pancreatectomy with splenectomy, histologic examination of the cyst revealed SPTP with necrosis and no evidence of pancreatic pseudocyst. \u0000Discussion: SPTP may be confused for pancreatic pseudocyst when significant tumor necrosis and cystic degeneration has occurred. Clinicians evaluating pancreas cysts must keep a high index of suspicion for cystic neoplasm particularly when the history lacks the common causes of pancreatic pseudocyst.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"64 2","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2014-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7092.1000145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72464388","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}

引用次数: 0

Solid Pseudopapillary Neoplasms of the Pancreas: A Review 胰腺实性假乳头状瘤:综述

Pancreatic disorders & therapy Pub Date : 2014-11-02 DOI: 10.4172/2165-7092.1000143

K. Poruk, elliot k fishman, M. Weiss

引用次数: 4