Article
Oncology
Ho-Kyoung Lee, Yoo-Seok Yoon, Ho-Seong Han, Jun Suh Lee, Hee Young Na, Soomin Ahn, Jaewoo Park, Kwangrok Jung, Jae Hyup Jung, Jaihwan Kim, Jin-Hyeonk Hwang, Jong-chan Lee
Summary: Unexpected para-aortic lymph node metastasis in pancreatic cancer surgery has a negative prognostic impact comparable to radiological PALN metastasis. Prompt pathologic evaluation and modification of surgical strategy is crucial for patients with unexpected PALN metastasis. Multivariable analysis showed positive PALN as a negative prognostic factor, emphasizing the importance of detecting and managing unexpected PALN enlargement during surgery.
Article
Oncology
Hao Cheng, Jin-Hong Xu, Xiao-Hong Kang, Xiao-Mei Liu, Hai-Feng Wang, Zhi-Xia Wang, Hao-Qi Pan, Qing-Qin Zhang, Xue-Lian Xu
Summary: The study aimed to develop a clinical model to accurately predict the risk of lymph node metastasis (LNM) in resectable pancreatic cancer (PC) patients. Six independent risk factors were identified and included in the nomogram, which showed good predictive performance in the internal and external validation groups.
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
(2023)
Review
Oncology
Ali Fawaz, Omar Abdel-Rahman
Summary: This article reviews the literature on the definitions and management of borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) and finds that there is heterogeneity in the definitions of BR-PDAC and a high risk of positive margins after surgery. Currently, a neoadjuvant treatment approach involving chemotherapy is preferred to improve the margin negative resection rate. However, the older gemcitabine-based regimens are commonly used in neoadjuvant therapy, while modern multi-agent regimens such as FOLFIRINOX are considered more effective. Accurately selecting patients for resection based on restaging CT scans after neoadjuvant therapy is challenging. Furthermore, the role of adjuvant therapy in BR-PDAC patients receiving neoadjuvant therapy needs further investigation.
CANCER MANAGEMENT AND RESEARCH
(2022)
Article
Oncology
Masafumi Imamura, Minoru Nagayama, Daisuke Kyuno, Shigenori Ota, Takeshi Murakami, Akina Kimura, Hiroshi Yamaguchi, Toru Kato, Yasutoshi Kimura, Ichiro Takemasa
Summary: Most patients with pancreatic ductal adenocarcinoma experience a recurrence after surgery, with preoperative and postoperative elevated CA19-9 levels, as well as a tumor size >3.0 cm, independently predicting early recurrence. Early recurrence is associated with more frequent liver metastasis, suggesting the presence of undetected micrometastases. New biomarkers are needed to accurately identify patients at risk for early recurrence.
Review
Surgery
Michail N. Mavros, Dimitrios Moris, Paul J. Karanicolas, Matthew H. G. Katz, Eileen M. O'Reilly, Timothy M. Pawlik
Summary: Neoadjuvant treatment may be preferable for upfront resectable PDAC. Patient selection and precision oncology can improve the management and outcomes of PDAC.
Review
Oncology
Aurelien Lambert, Lilian Schwarz, Michel Ducreux, Thierry Conroy
Summary: Only 10-20% of patients with resectable pancreatic adenocarcinoma have potentially resectable disease. After surgical extirpation of tumors, up to 80% of patients will develop cancer recurrence, and adjuvant chemotherapy is the best strategy to improve overall survival. Neoadjuvant treatment shows some promising results but still requires further investigation to be validated.
Review
Oncology
Eva Versteijne, Ignace H. J. T. de Hingh, Marjolein Y. V. Homs, Martijn P. W. Intven, Joost M. Klaase, Hjalmar C. van Santvoort, Judith de Vos-Geelen, Johanna W. Wilmink, Geertjan van Tienhoven
Summary: There is a global shift towards a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer. Randomized studies show that neoadjuvant chemotherapy or chemoradiotherapy improves overall survival. However, more effective chemotherapy regimens, such as FOLFIRINOX and Gemcitabine/Nab-paclitaxel, should be investigated in combination with radiotherapy to further improve outcomes.
FRONTIERS IN ONCOLOGY
(2022)
Article
Oncology
Jingkai Liu, Qiaofei Liu, Xiang Zhang, Ming Cui, Tong Li, Yalu Zhang, Quan Liao
Summary: The study identified three immune subtypes in pancreatic cancer patients and investigated their implications for immunotherapy response and prognosis prediction. It also highlighted the potential synergistic role of TGM2 with ICB therapy, suggesting personalized treatment strategies based on immune features.
CANCER CELL INTERNATIONAL
(2021)
Article
Oncology
Jin He, Richard D. Schulick, Marco Del Chiaro
Summary: The definition of BRPC should consider biological and conditional dimensions in addition to the anatomic relationship between the tumor and vessels. Neoadjuvant chemotherapy and surgery are associated with improved outcomes of BRPC.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Oncology
Nana Kimura, Suguru Yamada, Hideki Takami, Kenta Murotani, Isaku Yoshioka, Kazuto Shibuya, Fuminori Sonohara, Yui Hoshino, Katsuhisa Hirano, Toru Watanabe, Hayato Baba, Kosuke Mori, Takeshi Miwa, Mitsuro Kanda, Masamichi Hayashi, Koshi Matsui, Tomoyuki Okumura, Yasuhiro Kodera, Tsutomu Fujii
Summary: The study aimed to investigate the optimal neoadjuvant therapy for borderline resectable pancreatic cancer, specifically in cases where the cancer invades the portal vein or abuts major arteries. It was found that using newer chemotherapy regimens is crucial for improving the prognosis of such pancreatic cancers.
Article
Medicine, General & Internal
Takehiro Okabayashi, Kenta Sui, Motoyasu Tabuchi, Takahiro Murokawa, Shinichi Sakamoto, Jun Iwata, Sojiro Morita, Nobuto Okamoto, Tatsuo Iiyama, Yasuhiro Shimada, Toshiyoshi Fujiwara
Summary: This study evaluated the efficacy of neoadjuvant therapy for resectable pancreatic cancer and found that it can reduce the recurrence rate and improve the consistency of clinical and pathological staging.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Surgery
Kevin M. Turner, Aaron M. Delman, Jordan R. Kharofa, Milton T. Smith, Kyuran A. Choe, Olugbenga Olowokure, Gregory C. Wilson, Sameer H. Patel, Davendra Sohal, Syed A. Ahmad
Summary: The role of radiation therapy in borderline resectable pancreatic cancer is still controversial. Although it may improve local control, the benefits in a disease marked by systemic failure are questioned. There is no clear survival benefit of radiation therapy in borderline resectable pancreatic cancer.
Article
Oncology
Roberto Alva-Ruiz, Lavanya Yohanathan, Jennifer A. Yonkus, Amro M. Abdelrahman, Lindsey A. Gregory, Thorvadur R. Halfdanarson, Amit Mahipal, Robert R. McWilliams, Wen Wee Ma, Christopher L. Hallemeier, Rondell P. Graham, Travis E. Grotz, Rory L. Smoot, Sean P. Cleary, David M. Nagorney, Michael L. Kendrick, Mark J. Truty
Summary: This study reviewed patients with borderline resectable/locally advanced pancreatic ductal adenocarcinoma who underwent neoadjuvant chemotherapy followed by either continued first-line chemotherapy or chemotherapy switch. The results showed that patients undergoing chemotherapy switch with subsequent curative-intent surgical resection did not have significantly different recurrence-free survival and overall survival compared to those receiving first-line chemotherapy. However, patients undergoing chemotherapy switch without subsequent resection had significantly worse overall survival.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Review
Oncology
Susanna W. L. de Geus, Teviah E. Sachs
Summary: Over the past decade, neoadjuvant therapy has become the standard of care for borderline resectable and locally advanced pancreatic cancer. However, there is still debate regarding its value for clearly resectable disease. Meta-analyses suggest that neoadjuvant therapy can be offered as an acceptable standard of care, with recent studies showing superior survival for patients who tolerate neoadjuvant FOLFIRINOX. Ongoing randomized controlled trials are expected to provide more conclusive recommendations.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Jakob Kirkegard, Morten Ladekarl, Ida Ravnsbaek Johannsen, Frank Mortensen
Summary: This study aimed to evaluate the effect of adjuvant chemotherapy on survival in patients with node-negative pancreatic cancer after surgery using target trial emulation. The findings suggest that adjuvant chemotherapy does not improve survival in patients with node-negative pancreatic cancer.
BRITISH JOURNAL OF SURGERY
(2023)