Oligometastatic Disease in Pancreatic Cancer - How to Proceed

Renz, Bernhard W.; Boeck, Stefan; Roeder, Falk; Trumm, C.; Heinemann, Volker; Werner, Jens

doi:10.1159/000455027

Cited by 37 publications

(31 citation statements)

References 74 publications

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“…Surgical resection remains the only potentially curative therapy, but most PDAC patients are diagnosed at advanced stages and miss their chance for operation [3,4]. This disappointing outcome is partly due to the uncontrolled rapid tumor growth and invasion of PDAC.…”

Section: Introductionmentioning

confidence: 99%

Tumor-Secreted Exosomal miR-222 Promotes Tumor Progression via Regulating P27 Expression and Re-Localization in Pancreatic Cancer

Yang

Wang

et al. 2018

Cell Physiol Biochem

102

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Background/Aims: MicroRNAs (miRNAs) or exosomes have recently been shown to play vital regulatory or communication roles in cancer biology. However, the roles and mechanisms of exosomal miRNAs in pancreatic ductal adenocarcinoma (PDAC) remain unknown. We aimed to investigate the detailed roles and mechanisms of tumor-generated exosomal miRNAs in progression of PDAC. Methods: miR-222 was identified by miRNA microarray studies in exosomes of PDAC cells, and further analyzed in plasma exosomes of PDAC patients. The regulatory mechanisms of miR-222 were explored by qRT-PCR, WB, dual-luciferase assays and immunofluorescence or confocal analysis. Other biological assays include transwell, xenograft models and so on. Results: miR-222 is significantly high in tumor exosomes or highly invasive PDAC cells. miR-222 could directly regulate p27 to promote cell invasion and proliferation. miR-222 could also activate AKT by inhibiting PPP2R2A expression, thus inducing p27 phosphorylation and cytoplasmic p27 expression to promote cell survival, invasion and metastasis. Expressions of miR-222 and p27 were significantly inversely correlated, and cytoplasmic p27, instead of nuclear p27, was associated with tumor malignancy. miR-222 could be transmitted between PDAC cells via exosome communication, and the exosomal miR-222 communication is functional. Plasma exosomal miR-222 in PDAC patients was high and significantly correlated to tumor size and TNM stage, and was an independent risk factor for PDAC patient survival. Conclusion: Tumor-generated exosomes could promote invasion and proliferation of neighboring tumor cells via miR-222 transmission, the plasma exosomal miR-222 plays important roles and may be a useful prognostic maker in PDAC.

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Section: Introductionmentioning

confidence: 99%

Tumor-Secreted Exosomal miR-222 Promotes Tumor Progression via Regulating P27 Expression and Re-Localization in Pancreatic Cancer

Yang

Wang

et al. 2018

Cell Physiol Biochem

102

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“…New chemotherapeutic regimens also significantly prolong the survival of PDAC patients with metastatic tumors 7,8 . Thus, especially in the context of multimodal therapies, surgery for PDAC patients with metastasis, especially those with oligometastatic and metachronous disease, has gained interest 9,10 . Several studies have reported that for selected cases with distant metastasis, resection might relevantly prolong survival, compared to palliative treatment 9-11 . In this study, we utilized the surveillance, epidemiology, and end results (SEER) program database and relevant reported clinical studies and case series to comprehensively generate evidence of the impact of surgery for PDAC patients with distant metastasis.…”

mentioning

confidence: 99%

Surgery for synchronous and metachronous single-organ metastasis of pancreatic cancer: a SEER database analysis and systematic literature review

Liu

Michalski

Liu

et al. 2020

Sci Rep

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Surgery for metastatic pancreatic cancer remains controversial as the survival benefit is questionable. the aim of the present study was to analyze the survival of these patients using data extracted from the surveillance, epidemiology, and end results (SeeR) program database. further, studies on resection for metastatic disease to the lung were systematically reviewed. A total of 11,541 cases with synchronous distant metastasis were analyzed. the median survival of single-organ metastasis was better than of multi-organ metastasis (single-organ 4.0 ± 0.07 months, two-organs 3.0 ± 0.13 months, three/fourorgans 2.0 ± 0.19 months; p < 0.0001). Single organ lung metastasis had longer median survival times compared to the other sites (lung 6.0 ± 0.32 months, HR 0.87, 95% CI 0.78-0.97; p = 0.013). Resection of the primary tumor was associated with longer survival in synchronous single-organ metastasis to the lung compared to no resection (14.0 ± 1.93 months vs 6.0 ± 0.31 months, p < 0.0001). A systematic literature review identified 79 cases of metachronous lung metastasis with a survival of 120.0 ± 6.32 months and 83.0 ± 24.84 months following resection of the primary tumor and metastasis, respectively. Lower tnM staging, longer interval to metastasis, and single metastatic lesion correlated with better survival. Resection in highly selected pancreatic cancer patients with synchronous and metachronous lung only metastasis might confer a survival benefit and should be considered on an individual basis.

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“…The feasibility and safety of combined pancreatectomies and liver resections has been already demonstrated (95). Actually most patients resected for M1 liver PDAC reported in the literature underwent wedge/atypical only liver resections (96)(97)(98).…”

Section: Resection For M1 Pdacmentioning

confidence: 98%

“…Interestingly, a recent multicentric study has shown that the overall survival is significantly higher in patients with oligometastatic M1 PDAC of the head who underwent resection, compared with bypass, while for M1 PDAC of the body and tail no differences were observed (102). Recent reviews of the literature have shown that resection for M1 liver PDAC might have a survival benefit in carefully selected patients, particularly with metachronous metastases (96,98).…”

Section: Resection For M1 Pdacmentioning

confidence: 99%

Onco-surgical Strategies in Pancreatic Ductal Adenocarcinoma

Popescu¹,

Dumitraşcu²

2017

SGO

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Pancreatic ductal adenocarcinoma (PDAC) is an important healthcare problem because is a leading cause of death by cancer. PDAC is a highly lethal disease with a very dismal prognosis. Most patients present advanced disease at diagnosis. The management of a patient diagnosed with PDAC should be discussed in a multidisciplinary team in high-volume centers. Pancreatectomy represents the single hope of long-term survival for a patient with PDAC but the resectability rate is less than 20% of the cases. Several progresses were observed in the last years regarding the surgical and oncological approach for PDAC. The aim of the paper is to make a brief review of the current onco-surgical strategies available for patients with PDAC.

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Oligometastatic Disease in Pancreatic Cancer - How to Proceed

Cited by 37 publications

References 74 publications

Tumor-Secreted Exosomal miR-222 Promotes Tumor Progression via Regulating P27 Expression and Re-Localization in Pancreatic Cancer

Tumor-Secreted Exosomal miR-222 Promotes Tumor Progression via Regulating P27 Expression and Re-Localization in Pancreatic Cancer

Surgery for synchronous and metachronous single-organ metastasis of pancreatic cancer: a SEER database analysis and systematic literature review

Onco-surgical Strategies in Pancreatic Ductal Adenocarcinoma

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