Journal of pancreatology最新文献

{"title":"Advantage of oncological outcome of robotic-assisted pancreatoduodenectomy (RPD) in stage I pancreatic ductal adenocarcinomas (PDAC)","authors":"Jingfeng Li, Shulin Zhao, Jiabin Jin, Yusheng Shi, Yuanchi Weng, Mengmin Chen, Haoda Chen, Zhiwei Xu, Xiaxing Deng, Baiyong Shen, C. Peng","doi":"10.1097/JP9.0000000000000102","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000102","url":null,"abstract":"Background: Robotic-assisted pancreatoduodenectomy (RPD) has been widely performed in the treatment of pancreatic tumors. The oncologic outcome in the early stage of pancreatic ductal adenocarcinomas (PDAC) operated by RPD has not been evaluated. Methods: Clinical data of pathology confirmed stage I PDAC from January 2015 to December 2020 in Ruijin hospital, Shanghai Jiao Tong University School of Medicine was collected and retrospectively analyzed. Patients were divided into the open pancreaticoduodenectomy (OPD) group and the RPD group. Clinicopathological data and prognosis data were compared and analyzed. Results: A total of 426 patients were enrolled in this study, including 342 patients in the OPD group and 84 patients in the RPD group. The baseline characteristics of both groups were equivalent. Incidence of R1 resection was significantly lower in RPD group (3 [3.6%] vs 40 [11.7%], P = .044). RPD group was associated with better disease-free survival (DFS) and overall survival (OS) (DFS: Haszard Ratio [HR]: 0.681, 95% confidence interval [CI]: 0.491–0.945, P = .022; OS: HR: 0.667, 95% CI: 0.478–0.932, P = .017). T2 stage was associated with poor DFS and OS (DFS: HR: 1.471, 95% CI: 1.092–1.981, P = .011; OS: HR: 1.616, 95% CI: 1.209–2.160, P = .035). R1 resection was associated with poor OS (HR: 1.483, 95% CI: 1.028–2.140, P = .035) while adjuvant therapy was associated with better OS (HR: 0.589, 95% CI: 0.452–0.766, P < .001). Kaplan–Meier estimate showed significantly longer DFS and OS in RPD group (DFS: P = .004; OS: P = .009). Conclusion: For stage I PDAC patients, RPD surgery achieved higher R0 resection rates and better DFS and OS. T1 stage was associated with better DFS. R0 resection and adjuvant therapy were the accesses to better OS.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"125 - 131"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42253694","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":"Advances in the treatment of gastroenteropancreatic neuroendocrine neoplasms with somatostatin analogs","authors":"Ming Lu, Panpan Zhang, Jianwei Zhang, Jie Li","doi":"10.1097/JP9.0000000000000078","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000078","url":null,"abstract":"Neuroendocrine neoplasms (NENs) include well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Somatostatin receptors (SSTRs) are highly expressed on NETs cells, and somatostatin analogs (SSAs) could bind to SSTRs with high affinities, regulating cell proliferation and hormone secretion. As many clinical trials have demonstrated the antiproliferative efficacy and safety of SSAs in metastatic gastroenteropancreatic NETs (GEP-NETs), SSAs have been recommended by multiple NEN guidelines as the first-line therapy of GEP-NETs. In recent years, more and more researches have been exploring new therapeutic possibilities of SSA in GEP-NETs, such as high-dose SSA as second-line therapy, SSA in metastatic GEP-NETs with Ki-67 > 10%, SSA as adjuvant therapy for postoperative pancreatic NETs patients, and combinations of SSA with chemotherapy or targeted therapy. In this review, we summarized the latest published or released researches and discussed new application attempts of SSA in GEP-NETs.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"6 1","pages":"23 - 27"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41394501","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":"Registry study outcomes from surgical management of pancreatic ductal adenocarcinoma in China","authors":"P. Szatmary, J. Kleeff","doi":"10.1097/jp9.0000000000000089","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000089","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47763423","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 application of FAPI-targeted theranostics in pancreatic cancer: a narrative review","authors":"Meixi Liu, M. Hacker, L. Huo, Xiang Li","doi":"10.1097/JP9.0000000000000090","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000090","url":null,"abstract":"Pancreatic cancer is one of the most lethal malignancies in the world. Cancer-associated fibroblasts are one of the main components of tumor microenvironment in pancreatic cancer and play an essential role in tumor progression. Fibroblast activation protein that is expressed in specific subtypes of cancer-associated fibroblasts promotes tumor growth and is related to poor survival. Recent researches have preliminarily demonstrated a promising potential of radiopharmaceuticals targeting fibroblast activation protein in diagnosis and therapy of pancreatic cancer. This article comprehensively reviews the current development and clinical translation of fibroblast activation protein inhibitor-targeting radiopharmaceuticals in pancreatic cancer and provides significant perspectives for future investigations.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"78 - 86"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47516455","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":"Insight of pancreatic cancer: recommendations for improving its therapeutic efficacy in the next decade","authors":"Zhihang Xu, Wenquan Wang, W. Lou, Liang Liu","doi":"10.1097/JP9.0000000000000093","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000093","url":null,"abstract":"Pancreatic cancer is one of the most malignant digestive system tumors. The effectiveness of pancreatic cancer treatment is still dismal, and the 5-year survival rate is only about 10%. Further improving the diagnosis and treatment of pancreatic cancer is the top priority of oncology research and clinical practice. Based on the existing clinical and scientific research experience, the review provides insight into the hotspots and future directions for pancreatic cancer, which focuses on early detection, early diagnosis, molecular typing and precise treatment, new drug development and regimen combination, immunotherapy, database development, model establishment, surgical technology and strategy change, as well as innovation of traditional Chinese medicine and breakthrough of treatment concept.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"58 - 68"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49460524","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":"Neoadjuvant therapy for resectable pancreatic cancer: a narrative review","authors":"Chengfang Wang, Yingsheng Wu, Weilin Wang","doi":"10.1097/JP9.0000000000000091","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000091","url":null,"abstract":"The use of neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma remains controversial and limited. Therefore, this literature review aimed to assess the feasibility, safety, and efficacy of this treatment. A database search of peer-reviewed articles published in English between January 1990 and June 2021 in PubMed, MEDLINE, and the Web of Science was performed. Original articles, review articles, and meta-analyses relevant to the topic were selected. We found 2 to 4 cycles with FOLFIRINOX, gemcitabine plus nab-paclitaxel, gemcitabine plus S-1, or gemcitabine alone were the most acceptable treatments. Considering the risk of adverse events and cancer progression, NAT is considered safe and tolerable, with a comparable resection rate. Although NAT can result in moderate tumor responses and some extent of local control (improvement of complete resection rate and negative lymph node metastases), no obvious survival benefit is observed. To date, the survival benefits of NAT for resectable pancreatic ductal adenocarcinoma have been very limited. It is too early to say that NAT is the best treatment option for resectable pancreatic cancer.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"69 - 77"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46358036","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":"Comparison of regional arterial chemotherapy and systemic intravenous chemotherapy for advanced pancreatic cancer: a systematic review and meta-analysis","authors":"Cheng Li, Wenyi Guo, Shihong Chen, Jianwei Xu, Feng Li, Lei Wang","doi":"10.1097/JP9.0000000000000092","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000092","url":null,"abstract":"Chemotherapy is the mainstay of treatment for advanced pancreatic cancer (stage III/IV). However, conventional systemic intravenous chemotherapy (SIC) has been unsatisfactory for pancreatic cancer. In recent years, regional arterial infusion chemotherapy (RAIC) has been clinically used as a new chemotherapy regimen for the treatment of advanced pancreatic cancer, but its efficacy is controversial. The purpose of this study was to evaluate the clinical efficacy and safety of RAIC. We searched literatures in databases such as PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI. After screening, this meta-analysis finally included 9 randomized controlled trials (RCTs) with 444 patients (230 RAIC and 214 SIC). We used the Cochrane Risk of Bias 2.0 tool to assess risk of bias for included RCTs. Outcomes were overall survival (OS), overall response rate (ORR), adverse events rate (AER), and pain remission rate. Outcome indicators used relative risk (RR) and its 95% confidence interval (CI) as effect analysis statistics. The results showed that RAIC had some advantages over SIC in terms of ORR, OS, incidence of leukopenia, and pain remission. In conclusion, compared with SIC, RAIC has better clinical efficacy and lower toxicity in the treatment of advanced pancreatic cancer.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"49 - 57"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42014405","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":"Pancreatic lymphangioma: two case reports from an institutional experience with a rare entity and review of literature","authors":"A. Tan-Garcia, S. Lee, Jen-San Wong, T. Ho, K. Ng, K. H. Tony Lim","doi":"10.1097/JP9.0000000000000095","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000095","url":null,"abstract":"Pancreatic lymphangiomas are very rare benign cystic lesions that pose a diagnostic dilemma due to their resemblance to other non-neoplastic and neoplastic pancreatic cystic lesions. As such, pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised lesion. We present 2 cases of pancreatic lymphangioma, determine its prevalence at our institution and perform a detailed review of published literature since 2010. Case 1 is a 36-year-old male and case 2 is a 35-year-old female, both of which presented with abdominal pain. These were the only cases of pancreatic lymphangiomas reported at our institution since 2010. We reviewed 69 cases of pancreatic lymphangiomas from 52 publications. It affects predominantly females with a median age of 43 and such patients typically present with abdominal pain (58.8%) or are asymptomatic (27.9%). The median size is 8.6 cm, the most common location is the head of pancreas and the most common imaging finding is that of a multilocular cyst. Majority of patients underwent surgical resection (69.6%). Endoscopic ultrasound-guided fine-needle aspiration features of pancreatic lymphangiomas include chylous cyst fluid, elevated fluid triglyceride levels (15/16 cases) and numerous lymphocytes on cytology. The majority of patients with elevated fluid triglyceride levels (13/15 cases) were managed conservatively. Pancreatic lymphangiomas are rare pancreatic cystic lesions that may be diagnosed preoperatively using a multidisciplinary and multimodal approach involving clinical, radiological, biochemical and cytological features, allowing greater confidence in the selection of patients who can be managed conservatively.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"98 - 109"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41516108","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":"Survey on the current status of the diagnosis and treatment of pancreatic cancer in public tertiary hospitals in China: a cross-sectional questionnaire-based, observational study","authors":"Wenming Wu, Qiaofei Liu, Jingcheng Zhang, Yupei Zhao","doi":"10.1097/JP9.0000000000000079","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000079","url":null,"abstract":"Abstract Objective: Pancreatic cancer is one of the most aggressive digestive system malignant tumors, and its clinical diagnosis and treatment are still challenging. To further understand the current status and improve the multidisciplinary collaboration for diagnosis and treatment of pancreatic cancer in China, we conducted an online questionnaire survey on the diagnosis and treatment status of pancreatic cancer in public tertiary hospitals of China in 2021. Methods: In this cross-sectional questionnaire-based, observational study, online questionnaires with real-name authentication were used to gather data from 500 clinicians, 50 pharmacists, and 1000 pancreatic cancer patients in tertiary general hospitals or cancer hospitals nationwide. Results: A total of 485 valid questionnaires were obtained from the clinicians, majority of whom were from economically better developed regions or cities of China. There were multi-disciplinary team treatment (MDT) clinics for pancreatic cancer patients in 60% of the hospitals. Minimally invasive surgeries could be performed in all the surveyed hospitals. However, open surgery was still the mainstream choice in most cases. Gemcitabine-based chemotherapy was the most popular first-line adjuvant regimen for pancreatic cancer. A total of 50 valid questionnaires were collected from pharmacists, 48% of them are not satisfactory with the efficacy of the chemotherapeutic drugs, and myelosuppression, liver, and renal damage were the most concerning side effects. In total, 1011 valid questionnaires were collected from the patients. Approximately, 48.4% of the patients did not know about pancreatic cancer before becoming ill. Over 80% of pancreatic cancer patients reported poor to very poor health-related quality of life, and the estimated overall medical expenses were within ¥400,000 ($58823.53) in 80% of the patients. Clinicians, pharmacists, and patients believe that popularizing scientific knowledge of pancreatic cancer, constructing MDT clinics and fast-lane system, and conducting clinical research will help further improve the diagnosis and treatment of pancreatic cancer. Conclusions: The MDT clinics for pancreatic cancer have been well developed in most of the public tertiary hospitals. Minimally invasive pancreatic surgery has developed rapidly in China; however, open surgery is still the mainstream choice for pancreatic cancer. The proportion of adjuvant treatment has been significantly improved, and the gemcitabine-based regimen is the most commonly used first-line regimen. Most of the public still lacks the general knowledge of pancreatic cancer, needing further popularization. The construction of a fast-lane treatment system and conducting of high-level clinical studies are the warm expectations of the clinicians and patients. The real-world situation of the diagnosis and treatment of pancreatic cancer in the other types of hospitals of China needs further exploration.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"4 1","pages":"164 - 169"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48342185","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":"Auto-intestine transplantation for pancreatic tumors with mesenteric root involvement: a systematic review and survival-based analysis","authors":"Dipesh Kumar Yadav, Xing Huang, Qi Zhang, Gang Zhang, X. Bai, T. Liang","doi":"10.1097/JP9.0000000000000081","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000081","url":null,"abstract":"Supplemental Digital Content is available in the text Abstract To analyze a long-term survival outcome of an auto-intestine transplantation (aINTx) for the patients with locally advanced pancreatic tumor and identify the potential prognostic factors, databases were carefully searched for the studies reporting the patients with a locally advanced pancreatic tumor which typically underwent aINTx. We performed a database search using PubMed, the Cochrane Library, EMBASE, and MEDLINE to identify multiple case series of the patients who had pancreatic tumors with mesenteric root involvement and underwent aINTx, to evaluate the treatment outcomes, and calculated the patient survival using the Kaplan–Meier method and Cox proportional hazard regression analysis to properly identify an independent predictor of the survival. A total of 9 retrospective studies with a total of 29 patients were included in our study. The calculated 1-, 2-, and 3-year survival rates for the patients with pancreatic cancer and benign or low grade pancreatic tumors were 49.64%, 22.06%, and 0% versus 100%, 100%, and 80%, respectively. The corresponding median survival time was 13.4 months and 84 months, respectively. Moreover, when stratifying the pancreatic cancer patients undergoing aINTx on the basis of neoadjuvant chemotherapy (aINTx + neoadjuvant vs aINTx - neoadjuvant) there was a significant difference in the survival (P = .01). The 1- and 2-year survival rates were 75% and 75% versus 34.1% and 0%, respectively. Corresponding median survival times were 24 months and 10 months, respectively. Our analysis shows the long-term survival benefit with acceptable morbidity and mortality of pancreatoduodenectomy and aINTx for the pancreatic tumors with the mesenteric root involvement that are otherwise unresectable by the conventional surgical techniques. However, from an oncological point of view, a larger study with the control group is required to determine its safety compared to less aggressive surgical treatment.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"4 1","pages":"153 - 163"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46070402","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}