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The New England Journal of Medicine Feb 1992
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Annals of Oncology : Official Journal... Jan 1995The management of patients with pancreatic carcinoma poses many problems. The diagnosis is usually made late, generally because the patients present late, but it is not... (Review)
Review
The management of patients with pancreatic carcinoma poses many problems. The diagnosis is usually made late, generally because the patients present late, but it is not unusual to find patients who have had many negative investigations for vague upper abdominal symptoms only to be diagnosed as having pancreatic carcinoma many months later. Staging the disease is equally difficult and often inaccurate. The results of treatment are to date discouraging even in those patients diagnosed early. But the outlook is not totally dismal; in recent years the results for surgical resection of pancreatic lesions have improved; adjuvant treatment may finally be having an effect, although small, on this relentless disease. The most notable inroad made in the management of pancreatic cancer in the last 10 years is the improvement in palliation due to the use of the endoprosthesis. In spite of the poor results we must continue to search actively for more accurate methods of diagnosis and better methods of treatment.
Topics: Antigens, Neoplasm; Biliary Tract Surgical Procedures; Biomarkers, Tumor; Carcinoma; Combined Modality Therapy; Diagnostic Imaging; Humans; Palliative Care; Pancreatic Neoplasms; Prostheses and Implants
PubMed: 7536026
DOI: 10.1093/oxfordjournals.annonc.a059031 -
Radiologia 2018Pancreatic carcinoma is becoming more common in our environment; the mortality rate for this tumor has barely changed over the last 20 years. Early diagnosis and... (Review)
Review
Pancreatic carcinoma is becoming more common in our environment; the mortality rate for this tumor has barely changed over the last 20 years. Early diagnosis and accurate staging are crucial to ensure an appropriate therapeutic approach, which should aim to improve survival in patients in whom complete resection is possible and to minimize surgical morbidity and mortality in those with a high risk of residual disease after the intervention. Various imaging techniques are used for tumor staging: multidetector computed tomography (CT), magnetic resonance imaging, positron emission tomography (PET)-CT, endoscopic ultrasound, and diagnostic laparoscopy. Currently, multidetector CT is the technique of choice for the study of pancreatic tumors; thus, this article aims to review the state of the art in staging adenocarcinoma of the pancreas, focusing mainly on the applications and limitations of this technique.
Topics: Humans; Neoplasm Metastasis; Neoplasm Staging; Pancreatic Neoplasms; Tomography, X-Ray Computed
PubMed: 29078990
DOI: 10.1016/j.rx.2017.08.004 -
Lancet (London, England) Feb 1997
Review
Topics: Carcinoma; Combined Modality Therapy; Humans; Neoplasm Staging; Palliative Care; Pancreatectomy; Pancreatic Neoplasms
PubMed: 9040589
DOI: 10.1016/s0140-6736(96)05523-7 -
Digestive Endoscopy : Official Journal... Jan 2020Despite recent advances in diagnostic imaging modalities, most cases of pancreatic carcinoma are discovered at an unresectable stage, resulting in poor prognosis. Early... (Review)
Review
Despite recent advances in diagnostic imaging modalities, most cases of pancreatic carcinoma are discovered at an unresectable stage, resulting in poor prognosis. Early diagnosis is essential to ensure curative treatment and improve the prognosis of pancreatic carcinoma. Imaging modalities with high diagnostic ability are necessary for the early diagnosis of pancreatic carcinoma. Endoscopic ultrasonography is a reliable and efficient diagnostic modality because it provides superior spatial resolution and should be incorporated into screening programs in patients at high risk of pancreatic carcinoma. Endoscopy facilitates cytopathological diagnosis based on samples collected via endoscopic ultrasonography-guided fine-needle aspiration and endoscopic retrograde cholangiopancreatography. Cytodiagnosis with endoscopic naso-pancreatic drainage is useful in patients with carcinoma in situ. In this review, we highlight the potential role of endoscopy in the early diagnosis of pancreatic carcinoma. We provide an overview of the endoscopy tools used for the diagnosis of pancreatic carcinoma, discuss the diagnostic ability of these tools for small carcinomas and carcinomas in situ, and propose a strategy for endoscopy-based screening of early pancreatic carcinoma.
Topics: Biopsy, Fine-Needle; Carcinoma in Situ; Cytodiagnosis; Early Detection of Cancer; Endoscopy, Digestive System; Endosonography; Humans; Pancreatic Neoplasms; Prognosis
PubMed: 31219200
DOI: 10.1111/den.13467 -
Seminars in Cancer Biology Nov 2022Pancreatic carcinoma is associated with one of the worst clinical outcomes throughout the globe because of its aggressive, metastatic, and drug-resistant nature. During... (Review)
Review
Pancreatic carcinoma is associated with one of the worst clinical outcomes throughout the globe because of its aggressive, metastatic, and drug-resistant nature. During the past decade, several studies have shown that oral, gut, and tumor microbiota play a critical role in the modulation of metabolism and immune responses. Growing pieces of evidence have proved beyond a doubt that the microbiota has a unique ability to influence the tumor microenvironment as well as the metabolism of chemotherapeutic agents or drugs. Given this, microbiota, known as the ecological community of microorganisms, stands to be an avenue of quality research. In this review, we provide detailed and critical information on the role of oral, gut, and pancreatic microbiota disruptions in the development of pancreatic carcinoma. Moreover, we comprehensively discuss the different types of microbiota, their potential role, and mechanism associated with pancreatic carcinoma. The microbiome provides the unique opportunity to enhance the effectiveness of chemotherapeutic agents and immunotherapies for pancreatic cancer by maintaining the right type of microbiota and holds a promising future to enhance the clinical outcomes of patients with pancreatic carcinoma.
Topics: Humans; Gastrointestinal Microbiome; Pancreatic Neoplasms; Microbiota; Immunotherapy; Antineoplastic Agents; Tumor Microenvironment
PubMed: 34051351
DOI: 10.1016/j.semcancer.2021.05.027 -
Der Chirurg; Zeitschrift Fur Alle... Aug 2011Less than 10% of pancreatic ductal adenocarcinomas are based on a hereditary syndrome. In contrast a positive family history for pancreatic cancer raises the individual... (Review)
Review
Less than 10% of pancreatic ductal adenocarcinomas are based on a hereditary syndrome. In contrast a positive family history for pancreatic cancer raises the individual risk for the development of pancreatic and extrapancreatic malignancies.While 70% of hereditary pancreatic carcinomas can be attributed to the familiar pancreatic cancer syndrome 30% are caused by other hereditary syndromes, e.g., Peutz-Jeghers syndrome or familial adenomatous polyposis. Furthermore, genetically determined pancreatitis (e.g., hereditary pancreatitis or cystic fibrosis) can lead to pancreatic cancer.Up to now conclusive data for routine screening of high risk patients are not available which is due in part to the difficult identification of high risk patients and the problematic classification of detected pancreatic lesions. Therefore, high risk patients should be included in controlled clinical trials for screening. Small pancreatic lesions are not clear indications for surgical resection as false positive results can hamper a clear diagnosis and prophylactic pancreatectomy is not recommended. In the case of a histologically proven carcinoma a prophylactic extension of resection might be reasonable. Prevention of familial pancreatic cancer can be achieved through nicotine abstinence.
Topics: Algorithms; Carcinoma; Carcinoma, Pancreatic Ductal; DNA Mutational Analysis; Early Diagnosis; Humans; Mass Screening; Neoplasms, Multiple Primary; Pancreas; Pancreatectomy; Pancreatic Neoplasms; Pedigree; Risk Factors; Smoking Cessation; Syndrome
PubMed: 21487813
DOI: 10.1007/s00104-011-2084-x -
The New England Journal of Medicine Jun 1992
Topics: Adenocarcinoma; Humans; Palliative Care; Pancreatic Neoplasms
PubMed: 1375706
DOI: 10.1056/NEJM199206253262615 -
Southern Medical Journal Jul 1982This retrospective review of 33 consecutive patients with cancer of the pancreas was undertaken to investigate epidemiologic factors, presenting symptoms, diagnostic...
This retrospective review of 33 consecutive patients with cancer of the pancreas was undertaken to investigate epidemiologic factors, presenting symptoms, diagnostic methods, site and extent of cancer, treatment approaches, and survival data. The most frequent presenting complaint, reported by 23 patients (70%), was abdominal pain. Diagnosis was established by radiography or radionuclide scanning in 11 patients (33%). Nine patients (27%) were inoperable. One patient (3%) received resection in attempt for cure, 15 (46%) had palliative bypass procedures, and eight (25%) had laparotomy only. Eighteen patients (55%) received chemotherapy, with or without operation, and two (6%) had irradiation. The mean survival was 5.1 months. One third of the patients were dead a month after diagnosis. All patients died within 16 months of diagnosis, regardless of treatment method or extent of disease.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Pancreatic Neoplasms; Tomography, X-Ray Computed; United States
PubMed: 7089642
DOI: 10.1097/00007611-198207000-00003 -
Der Internist Sep 2000
Review
Topics: Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Carcinoma; Diagnosis, Differential; Genetic Predisposition to Disease; Humans; Incidence; Neoplasm Staging; Palliative Care; Pancreatic Neoplasms; Risk Factors
PubMed: 11006872
DOI: 10.1007/s001080050637