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Cirugia Y Cirujanos 2023Pancreatic cancer is the seventh leading cause of death worldwide, with ductal adenocarcinoma as the most frequent neoplasm. Half of the patients who are diagnosed have... (Review)
Review
BACKGROUND
Pancreatic cancer is the seventh leading cause of death worldwide, with ductal adenocarcinoma as the most frequent neoplasm. Half of the patients who are diagnosed have metastases at the time of diagnosis.
OBJECTIVE
A review of the treatment of resectable pancreatic adenocarcinoma with oligometastatic disease was carried out in order to present an overview of the existing evidence.
METHOD
A bibliographic search was carried in PubMed/Medline, Clinical Key and Index Medicus vhith MESH terms, from the year 1993 to 2022.
RESULTS
Patients with liver or lung metastases due to pancreatic ductal adenocarcinoma who undergo surgery and chemotherapy have a longer survival in carefully selected patients.
CONCLUSIONS
The evidence regarding surgery in patients with pancreatic ductal adenocarcinoma and oligometastasis is limited and further randomized controlled trials are needed for both scenarios. As well as established criteria that help the selection of patients who can receive this type of treatment.
Topics: Humans; Pancreatic Neoplasms; Adenocarcinoma; Carcinoma, Pancreatic Ductal; Lung Neoplasms
PubMed: 37084317
DOI: 10.24875/CIRU.22000364 -
Aging Mar 2015
Topics: Humans; MicroRNAs; Neoplasm Metastasis; Neoplasms
PubMed: 25868522
DOI: 10.18632/aging.100731 -
Annals of Gastroenterological Surgery May 2023Oligometastatic disease has been proposed as an intermediate state between localized and polymetastatic disease that can benefit from multimodal treatment, including... (Review)
Review
Oligometastatic disease has been proposed as an intermediate state between localized and polymetastatic disease that can benefit from multimodal treatment, including surgery. There is a growing concern about performing surgery for oligometastatic pancreatic ductal adenocarcinoma, although there is still little evidence. We reviewed articles published between 2021 and 2022, focusing mainly on surgical outcomes. Furthermore, we summarized the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discuss future perspectives. In liver oligometastasis, multimodal treatment including surgery achieved favorable long-term survival, especially in patients with good responses to preoperative chemotherapy, with a median survival time from 25.5 to 54.6 months. In addition, the data from the National Cancer Database in the United States showed that patients who underwent surgery for oligometastatic liver metastases had a significantly longer overall survival than those who received chemotherapy alone. Prognostic biomarkers were identified, including carbohydrate antigen 19-9 (CA19-9) levels at diagnosis and preoperative chemotherapy with normalization of CA19-9 levels or favorable radiological response. Patients with lung oligometastasis had a more favorable long-term prognosis than those with other recurrence sites, and the updated literature further confirmed the previous studies. Overall survival was favorable, with 84 months after initial surgery and 29.2 months after metastasectomy, and a 5-year survival rate of 60.6% was also reported. In peritoneal oligometastasis, the results of conversion surgery after good responses to preoperative treatment with intraperitoneal therapy or systematic chemotherapy were reported, and the conversion rate and long-term prognosis were favorable. There is a growing concern about performing surgery for oligometastatic pancreatic ductal adenocarcinoma. We reviewed articles published between 2021 and 2022, focusing mainly on surgical outcomes. Furthermore, we summarize the current status of surgery in multidisciplinary treatment of oligometastatic pancreatic cancer and discuss future perspectives.
PubMed: 37152775
DOI: 10.1002/ags3.12655 -
Cancer Journal (Sudbury, Mass.) 2020Oligometastasis represents an intermediate disease stage between localized and widely metastatic cancer. Efficient identification of patients with oligometastasis... (Review)
Review
Oligometastasis represents an intermediate disease stage between localized and widely metastatic cancer. Efficient identification of patients with oligometastasis remains a barrier for accrual on clinical trials of oligometastasis-directed therapy. Here we review the prospect of circulating tumor DNA-based monitoring to promote sensitive, specific, and cost-efficient detection of cancer recurrence during posttreatment surveillance. Thus, an impetus for the development and implementation of clinical-grade circulating tumor DNA assays should be for the positive impact they will have on clinical investigations of oligometastasis-directed therapy.
Topics: Biomarkers, Tumor; Circulating Tumor DNA; Early Detection of Cancer; Humans; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms
PubMed: 32205535
DOI: 10.1097/PPO.0000000000000437 -
Cancer Research and Treatment Oct 2023
Topics: Humans; Radiation Oncologists; Medical Oncology; Terminal Care; Republic of Korea; Oncologists; Neoplasms; Attitude of Health Personnel
PubMed: 37402410
DOI: 10.4143/crt.2023.780 -
Chinese Journal of Cancer Research =... Aug 2015The incidence of pancreatic adenocarcinoma (PDAC) has steadily increased over the past several decades. The majority of PDAC patients will present with distant... (Review)
Review
The incidence of pancreatic adenocarcinoma (PDAC) has steadily increased over the past several decades. The majority of PDAC patients will present with distant metastases, limiting surgical management in this population. Hepatectomy and pulmonary metastasectomy (PM) has been well established for colorectal cancer patients with isolated, resectable hepatic or pulmonary metastatic disease. Recent advancements in effective systemic therapy for PDAC have led to the selection of certain patients where metastectomy may be potentially indicated. However, the indication for resection of oligometastases in PDAC is not well defined. This review will discuss the current literature on the surgical management of metastatic disease for PDAC with a specific focus on surgical resection for isolated hepatic and pulmonary metastases.
PubMed: 26361405
DOI: 10.3978/j.issn.1000-9604.2015.05.02 -
European Journal of Cardio-thoracic... Jul 2022
Topics: Head and Neck Neoplasms; Humans; Metastasectomy; Pneumonectomy
PubMed: 35312774
DOI: 10.1093/ejcts/ezac189 -
Seminars in Cancer Biology Feb 2020More than 70% of gastrointestinal (GI) cancers are diagnosed with metastases, leading to poor prognosis. For some cancer patients with limited sites of metastatic... (Review)
Review
More than 70% of gastrointestinal (GI) cancers are diagnosed with metastases, leading to poor prognosis. For some cancer patients with limited sites of metastatic tumors, the term oligometastatic disease (OMD) has been coined as opposed to systemic polymetastasis (PMD) disease. Stephan Paget first described an organ-specific pattern of metastasis in 1889, now known as the "seed and soil" theory where distinct cancer types are found to metastasize to different tumor-specific sites. Our understanding of the biology of tumor metastasis and specifically the molecular mechanisms driving their formation are still limited, in particular, as it relates to the genesis of oligometastasis. In the following review, we discuss recent advances in general understanding of this metastatic behavior including the role of specific signaling pathways, various molecular features and biomarkers, as well as the interaction of carcinoma cells with their tissue microenvironments (both primary and metastatic niches). The unique features that underlie OMD provide potential targets for localized therapy. As it relates to clinical practice, OMD is emerging as treatable with surgical resection and/or other local therapy options. Strategies currently being applied in the clinical management of OMD will be discussed including surgical, radiation-based therapy, ablation procedures, and the results of emerging clinical trials involving immunotherapy.
Topics: Biomarkers; Combined Modality Therapy; Disease Management; Disease Progression; Disease Susceptibility; Gastrointestinal Neoplasms; Humans; Karyotype; Neoplasm Metastasis; Phenotype; Treatment Outcome
PubMed: 31445220
DOI: 10.1016/j.semcancer.2019.08.026 -
International Journal of Radiation... Nov 2022
Topics: Humans; Radiosurgery
PubMed: 36244387
DOI: 10.1016/j.ijrobp.2022.07.026 -
BMJ Case Reports Mar 2022Upper gastrointestinal tumours can metastasise to many viscera including the female reproductive system (Krukenberg tumour). However, spread to the male genitalia is...
Upper gastrointestinal tumours can metastasise to many viscera including the female reproductive system (Krukenberg tumour). However, spread to the male genitalia is extremely rare. We report the case of a man in his 70s who underwent oesophagogastrectomy for oesophagogastric junctional (OGJ) cancer with a complete response to neoadjuvant treatment who presented 4 months after completing treatment with a solitary testicular metastases.
Topics: Adenocarcinoma; Esophageal Neoplasms; Esophagectomy; Esophagogastric Junction; Female; Humans; Male; Neoadjuvant Therapy; Testis
PubMed: 35232740
DOI: 10.1136/bcr-2021-247684