Long-term survivors after resection of carcinoma of the head of the pancreas: significance of histologically curative resection

Nagakawa, Takukazu; Sanada, Hirofumi; Ichii, Michiko; Sugama, Junko; Ueno, Koichi; Konishi, Ichiro; Ohta, Tetsuo; Kayahara, Masato; Kitagawa, Hirohisa

doi:10.1007/s00534-004-0917-4

Cited by 42 publications

(39 citation statements)

References 11 publications

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“…Just the same, not only does radical removal of pancreatic body carcinoma with the use of Appleby's technique improve patient life quality, it also significantly prolongs survival, which was attested to, not only in cases of arterial resection necessitating no reconstruction [5,11,[13][14][15][16][17][18][19][20][21] , but in those resorting to repair as well [16,[23][24][25] . Completeness (radicality) of resection is one of the dominant independent prognostic factors for pancreatic cancer [46][47][48][49][50][51][52][53] . A curative resection of tumor is the only means of treatment that will hold out a hope of longterm survival for pancreatic cancer patients, although only 10%-15% of them would be eligible for a radical procedure [54] .…”

Section: Discussionmentioning

confidence: 99%

Liver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy

Егоров

Petrov²,

Lozhkin³

et al. 2013

WJGS

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Reported here are two cases of a modified Appleby operation for borderline resectable ductal adenocarcinoma of the pancreatic body, in one of which a R0 distal resection was attended to by excision, not only of the celiac axis, but also of the common and left hepatic arteries in the presence of arterial anatomic variation Michels, type Ⅷb. The possibility and avenues of the maintenance of the blood supply to the left hepatic lobe after surgical aggression of this kind are demonstrated employing computed tomography (CT) and 3-D CT angiography. Furthermore, both cases highlight all important worrisome aspects of pancreatic cancer resectability prediction.

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Section: Discussionmentioning

confidence: 99%

Liver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy

Егоров

Petrov²,

Lozhkin³

et al. 2013

WJGS

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“…[2] Perineural invasion, lymphatic and venous infiltration, poor differentiation, peritoneal metastases and tumor size ≥2 cm in diameter are poor prognostic factors. [3] Although poor prognostic factors are well established, limited information is available about the good prognostic factors. Furthermore, we did not know the potential predictor markers that may have a role to identify patients who benefit most from the chemotherapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

Long term survival of a metastatic patient with pancreatic adenocarcinoma: a rare case report and review of the literature

Degirmenci¹

2014

TJ Oncol

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Tedavi alanındaki önemli gelişmelere rağmen ileri evre pankreas kanseri olan hastaların prognuzu oldukça kötüdür. Hastaların ortalama yaşam süresi üç-altı aydır ve beş yıl süre-li yaşam oranı ise %5'ten azdır. Bu yazıda, karın ağrısı ve kilo kaybı şikayetleri ile başvuran 55 yaşında bir erkek hasta sunuldu. Hastanın çoklu karaciğer metastazı olan pankreas kanseri olduğu saptandı. Takiben hastaya, 21 günde bir gemitabin 1250 mg/m 2 birinci ve sekizinci gün; sisplatin 80 mg/ m 2 birinci gün olan kemoterapi protokolü uygulandı. Altıncı kür sonunda parsiyel yanıt alındığı, fakat buna üçüncü derece nötropeninin eşlik ettiği saptandı. Bu yüzden sisplatin kesildi ve tedaviye tek başına gemsitabin ile devam edildi. 18 siklus sonunda manyetik rezonans görüntüleme ile karaciğer metastazlarının tamamen kaybolduğu görüldü. Hematolojik ve böbrek toksisitesi nedeniyle tedaviye gemsitabin ile devam edilebildi ve beşinci yılın sonunda tam yanıt halen sürmek-teydi. Literatürü taradığımızda tam yanıt alınıp uzun süreli sağkalımı olan çok az sayıda olguya rastlanmaktadır. Despite recent advances in therapeutics, the prognosis of patients with advanced pancreatic cancer has remained poor. Median survival of patient is 3-6 months and five year survival rate is less than 5%. We report a case of fifty-five-yearold male with complaints of abdominal pain and weight loss. Patient was diagnosed as pancreas adenocarcinoma with multiple hepatic metastases. Then, the patient received gemcitabine 1250 mg/m 2 at day 1 and 8; cisplatin 80 mg/m 2 at day 1 and a cycle of therapy was defined as 21 days. After six cycles, partial response was achieved, but associated with grade 3 neutropenia. So, cisplatin was stopped and patient was treated with gemcitabine monotherapy. After 18 cycles, complete response in hepatic metastases was observed with magnetic resonance imaging. Due to hematologic and renal toxicity, only gemcitabine monotherapy was continued in our patient, but still indicating complete remission in his fifth year.

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“…Though the postoperative mortality had decreased from 20 % to 5 % in most of the centers, the 5 year survival varied from 5 to 20 % [22,27]. R0 resection varied from 20 % to 90 % depending on the method of histopathological examination [28][29][30][31][32]. The most commonly involved margins were the medial margins (60-80 %) and the posterior margins [22].…”

Section: Review Of Literaturementioning

confidence: 99%

Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

Ramachandra

Challa

2014

Indian J Surg Oncol

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Pancreatic cancer is associated with poor prognosis and surgery remains the main modality of treatment. Negative resection margin is an important prognostic factor for survival. Retropancreatic margin or the medial margin is the most common site of positive resection margin. Mesopancreas was proposed in analogy with mesorectum, which is considered as a fusion fascia formed embryologically during the development of pancreas. This mesopancreas lies posterior to the pancreas and contains pancreaticoduodenal vessels, lymphatics, nerve plexus and loose areolar tissue. Various technical modifications were proposed for better dissection of mesopancreas like posterior approach and artery first approach. There is an increased rate of R0 resection by these technical modifications but whether this will turn to increase in survival rates is yet to be established.

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Long-term survivors after resection of carcinoma of the head of the pancreas: significance of histologically curative resection

Cited by 42 publications

References 11 publications

Liver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy

Liver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy

Long term survival of a metastatic patient with pancreatic adenocarcinoma: a rare case report and review of the literature

Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

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