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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 -
Diagnostic and Interventional Imaging Dec 2016Pancreatic ductal carcinoma is one of the deadliest cancers in the world. The only hope for prolonged survival still remains surgery with complete R0 resection even if... (Review)
Review
Pancreatic ductal carcinoma is one of the deadliest cancers in the world. The only hope for prolonged survival still remains surgery with complete R0 resection even if most patients will promptly develop metastases and/or local relapses. Due to the silent nature of the disease, fewer than 20% of patients are eligible for a curative-intent resection. As no gain in survival is expected in case of residual tumor, imaging plays a major role for diagnosis and staging to select patients who will undergo surgery. Multidetector-row computed tomography and magnetic resonance imaging are the key stones and radiologists must be aware of imaging protocols, standardized terms and critical points for structured reporting to assess the tumor staging, minimize potential the morbidity associated with surgery and offer patients the best therapeutic strategy.
Topics: Carcinoma, Pancreatic Ductal; Humans; Magnetic Resonance Imaging; Multidetector Computed Tomography; Neoplasm Staging; Pancreatectomy; Pancreatic Neoplasms; Prognosis; Risk Factors; Sensitivity and Specificity; Ultrasonography
PubMed: 27567314
DOI: 10.1016/j.diii.2016.07.008 -
Frontiers in Immunology 2022Acinar-to-ductal metaplasia (ADM) is a recently recognized, yet less well-studied, precursor lesion of pancreatic ductal adenocarcinoma (PDAC) developed in the setting...
An integrated model of acinar to ductal metaplasia-related N7-methyladenosine regulators predicts prognosis and immunotherapy in pancreatic carcinoma based on digital spatial profiling.
Acinar-to-ductal metaplasia (ADM) is a recently recognized, yet less well-studied, precursor lesion of pancreatic ductal adenocarcinoma (PDAC) developed in the setting of chronic pancreatitis. Through digital spatial mRNA profiling, we compared ADM and adjacent PDAC tissues from patient samples to unveil the bridging genes during the malignant transformation of pancreatitis. By comparing the bridging genes with the 7-methylguanosine (m7G)-seq dataset, we screened 19 m7G methylation genes for a subsequent large sample analysis. We constructed the "m7G score" model based on the RNA-seq data for pancreatic cancer in The Cancer Genome Atlas (TCGA) database and The Gene Expression Omnibus (GEO) database. Tumors with a high m7G score were characterized by increased immune cell infiltration, increased genomic instability, higher response rate to combined immune checkpoint inhibitors (ICIs), and overall poor survival. These findings indicate that the m7G score is associated with tumor invasiveness, immune cell infiltration, ICI treatment response, and overall patients' survival. We also identified FN1 and ITGB1 as core genes in the m7Gscore model, which affect immune cell infiltration and genomic instability not only in pancreatic cancer but also in pan-cancer. FN1 and ITGB1 can inhibit immune T cell activition by upregulation of macrophages and neutrophils, thereby leading to immune escape of pancreatic cancer cells and reducing the response rate of ICI treatment.
Topics: Carcinoma, Pancreatic Ductal; Genomic Instability; Humans; Immunotherapy; Metaplasia; Pancreatic Neoplasms; Prognosis
PubMed: 35979350
DOI: 10.3389/fimmu.2022.961457 -
Journal of Cancer Research and... Dec 2021Extrapancreatic manifestations can complicate pancreatic disorders. Pancreatic panniculitis, characterized by subcutaneous fat necrosis, develops in 0.3%-3% of patients...
Extrapancreatic manifestations can complicate pancreatic disorders. Pancreatic panniculitis, characterized by subcutaneous fat necrosis, develops in 0.3%-3% of patients with pancreatic disorders. Occasionally, pancreatic panniculitis and polyarthritis occur in the same patient with pancreatic diseases, a rare symptomatic triad known as pancreatitis, panniculitis, and polyarthritis (PPP) syndrome. PPP syndrome is primarily caused by acute or chronic pancreatitis and pancreatic carcinoma. Almost half of the patients with PPP syndrome do not present with gastrointestinal signs, which may lead to a delayed diagnosis of underlying pancreatic disease. The skin and arthritic symptoms may be mistaken for rheumatic diseases. The histological finding of skin lesions is a valuable clue for diagnosing pancreatic diseases. Due to the high mortality rate when PPP syndrome is associated with pancreatic carcinoma, we highlight that the pancreas should be thoroughly examined if a skin biopsy indicates pancreatic panniculitis.
Topics: Arthritis; Humans; Pancreatic Neoplasms; Pancreatitis; Panniculitis
PubMed: 35381750
DOI: 10.4103/jcrt.jcrt_2386_21 -
The International Journal of Biological... May 2018Pancreatic carcinoma is a highly malignant disease associated with an extremely poor prognosis, which is caused by late presentation, aggressive invasion and metastases,... (Review)
Review
Pancreatic carcinoma is a highly malignant disease associated with an extremely poor prognosis, which is caused by late presentation, aggressive invasion and metastases, as well as the detection of pancreatic carcinoma in its advanced stages. Thus, better understanding of the tumour biology of this malignancy is sorely needed to improve the clinical outcome. A great challenge for the medical practice is finding a new biomarker of pancreatic carcinoma that will be helpful in diagnosis, in prognosis and in making clinical decisions, including the assessment of patients' response to therapy. It is suggested that selected chemokines and their specific receptors play an important role in tumour progression, such as tumour growth, angiogenesis, proliferation and development of metastasis. In the present review, general characteristics of chemokines and their specific receptors as well as the significance of these molecules in tumour development are described. The crucial issue of this review is to summarise the importance of various chemokines and their specific receptors in pancreatic carcinoma. Understanding the role of chemokines in the pathogenesis of pancreatic carcinoma is extremely important since these proteins may be used as a potential tool in the diagnosis and prognosis of pancreatic carcinoma patients.
Topics: Biomarkers, Tumor; Carcinoma; Cell Proliferation; Chemokines; Disease Progression; Humans; Neoplasm Metastasis; Pancreatic Neoplasms; Prognosis
PubMed: 29799354
DOI: 10.1177/1724600817753094 -
Journal of Cancer Research and... 2020The safety and efficacy of irreversible electroporation (IRE) for locally advanced pancreatic carcinoma (LAPC) are well established. However, whether adjuvant...
CONTEXT
The safety and efficacy of irreversible electroporation (IRE) for locally advanced pancreatic carcinoma (LAPC) are well established. However, whether adjuvant chemoradiotherapy after IRE increases, the survival rate remains unknown. Therefore, this study evaluated the effect of chemoradiotherapy combined with IRE in patients with LAPC.
SUBJECTS AND METHODS
We retrospectively analyzed 42 patients with LAPC between July 2015 and December 2016 at PLA General Hospital treated with IRE or IRE combined with radiation and/or chemotherapy. These patients were divided into the IRE group and the combined-therapy group. All patients underwent computed tomography (CT), magnetic resonance imaging, and positron-emission tomography-CT and no signs of metastases were found. The prognosis of these patients was observed.
RESULTS
The times after operation and after diagnosis in the combined-therapy group (304.20 ± 118.54) and (334.40 ± 114.07) days, respectively, were better those than in the IRE group (214.36 ± 95.68) and (244.68 ± 110.61) days, respectively. Moreover, patients in the combined-therapy group had a significantly better survival rate than the IRE group (80 vs. 45.45%, P < 0.05).
CONCLUSIONS
IRE combined with radiotherapy or chemotherapy was superior to IRE alone for the treatment of LAPC, as it prolonged the survival time and improved the survival rate, making it worthy of wide dissemination and clinical application.
Topics: Chemoradiotherapy, Adjuvant; Electroporation; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pancreatic Neoplasms; Positron-Emission Tomography; Prognosis; Retrospective Studies; Survival Rate; Tomography, X-Ray Computed
PubMed: 32474514
DOI: 10.4103/jcrt.JCRT_773_18 -
World Journal of Gastroenterology Jan 2016Pancreatic carcinoma is a common cancer of the digestive system with a poor prognosis. It is characterized by insidious onset, rapid progression, a high degree of... (Review)
Review
Pancreatic carcinoma is a common cancer of the digestive system with a poor prognosis. It is characterized by insidious onset, rapid progression, a high degree of malignancy and early metastasis. At present, radical surgery is considered the only curative option for treatment, however, the majority of patients with pancreatic cancer are diagnosed too late to undergo surgery. The sensitivity of pancreatic cancer to chemotherapy or radiotherapy is also poor. As a result, there is no standard treatment for patients with advanced pancreatic cancer. Cryoablation is generally considered to be an effective palliative treatment for pancreatic cancer. It has the advantages of minimal invasion and improved targeting, and is potentially safe with less pain to the patients. It is especially suitable in patients with unresectable pancreatic cancer. However, our initial findings suggest that cryotherapy combined with 125-iodine seed implantation, immunotherapy or various other treatments for advanced pancreatic cancer can improve survival in patients with unresectable or metastatic pancreatic cancer. Although these findings require further in-depth study, the initial results are encouraging. This paper reviews the safety and efficacy of cryoablation, including combined approaches, in the treatment of pancreatic cancer.
Topics: Chemotherapy, Adjuvant; Cryosurgery; Diffusion of Innovation; Humans; Immunotherapy; Palliative Care; Pancreatic Neoplasms; Postoperative Complications; Radiotherapy, Adjuvant; Risk Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 26811625
DOI: 10.3748/wjg.v22.i2.790 -
International Journal of Molecular... Jan 2022Hereditary pancreatic cancers are caused by several inherited genes. Familial pancreatic cancer is defined as pancreatic cancer arising in a patient with at least two... (Review)
Review
Hereditary pancreatic cancers are caused by several inherited genes. Familial pancreatic cancer is defined as pancreatic cancer arising in a patient with at least two first-degree relatives with pancreatic cancer in the absence of an identified genetic cause. Hereditary pancreatic cancer syndromes and familial pancreatic cancers account for about 10% of pancreatic cancer cases. Germline mutations in and and mismatch repair genes ( and ) are among the well-known inherited susceptibility genes. Currently available targeted medications include poly (ADP-ribose) polymerase inhibitors (PARP) for cases with mutant and immune checkpoint inhibitors for cases with mismatch repair deficiency. Loss of heterozygosity of hereditary pancreatic cancer susceptibility genes such as plays a key role in carcinogenesis and sensitivity to PARP inhibitors. Signature 3 identified by whole genome sequencing is also associated with homologous recombination deficiency and sensitivity to targeted therapies. In this review, we summarize molecular features and treatments of hereditary pancreatic cancer syndromes and surveillance procedures for unaffected high-risk cases. We also review transgenic murine models to gain a better understanding of carcinogenesis in hereditary pancreatic cancer.
Topics: Biomarkers, Tumor; Carcinoma; Disease Management; Genetic Predisposition to Disease; Germ-Line Mutation; Humans; Neoplastic Syndromes, Hereditary; Pancreatic Neoplasms
PubMed: 35163129
DOI: 10.3390/ijms23031205 -
International Journal of Molecular... Apr 2023The first discovery of cancer stem cells (CSCs) in leukaemia triggered active research on stemness in neoplastic tissues. CSCs represent a subpopulation of malignant... (Review)
Review
The first discovery of cancer stem cells (CSCs) in leukaemia triggered active research on stemness in neoplastic tissues. CSCs represent a subpopulation of malignant cells, defined by unique properties: a dedifferentiated state, self-renewal, pluripotency, an inherent resistance to chemo- and radiotherapy, the presence of certain epigenetic alterations, as well as a higher tumorigenicity in comparison with the general population of cancer cells. A combination of these features highlights CSCs as a high-priority target during cancer treatment. The presence of CSCs has been confirmed in multiple malignancies, including pancreatic ductal adenocarcinoma, an entity that is well known for its dismal prognosis. As the aggressive course of pancreatic carcinoma is partly attributable to treatment resistance, CSCs could contribute to adverse outcomes. The aim of this review is to summarize the current information regarding the markers and molecular features of CSCs in pancreatic ductal adenocarcinoma and the therapeutic options to remove them.
Topics: Humans; Pancreatic Neoplasms; Carcinoma, Pancreatic Ductal; Neoplastic Stem Cells
PubMed: 37108193
DOI: 10.3390/ijms24087030 -
Modern Pathology : An Official Journal... Jan 2018Neoadjuvant therapy is increasingly used to treat patients with a wide variety of malignancies. Histologic evaluation of treated specimens provides important prognostic... (Review)
Review
Neoadjuvant therapy is increasingly used to treat patients with a wide variety of malignancies. Histologic evaluation of treated specimens provides important prognostic information and may guide subsequent chemotherapy. Neoadjuvant therapy is commonly employed in the treatment of locally advanced rectal adenocarcinoma, hepatic colorectal metastases, esophageal/esophagogastric junction carcinoma, and pancreatic ductal adenocarcinoma. Numerous tumor regression schemes have been used in these tumors and standardized approaches to evaluate these specimens are needed. In this review, the various tumor regression scoring systems that have been used in these organs are described and their associations with clinical outcomes are discussed. Recommendations regarding how to handle and report the histologic findings in these resections specimens are provided.
Topics: Adenocarcinoma; Aged; Carcinoma, Pancreatic Ductal; Chemotherapy, Adjuvant; Female; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Neoadjuvant Therapy; Pancreatic Neoplasms; Radiotherapy, Adjuvant; Treatment Outcome
PubMed: 28776577
DOI: 10.1038/modpathol.2017.87