Predictive risk factors for peritoneal recurrence after pancreatic cancer resection and strategies for its prevention

Ariake, Kyohei; Motoi, Fuyuhiko; Ohtsuka, Hideo; Fukase, Koji; Masuda, Koichi; Mizuma, Masamichi; Hayashi, Hiroki; Nakagawa, Kazuhiko; Morikawa, Takanori; Maeda, Shin; Takadate, Tatsuyuki; Naitoh, Takeshi; Egawa, Shinichi; Unno, Michiaki

doi:10.1007/s00595-017-1531-9

Cited by 20 publications

(14 citation statements)

References 28 publications

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“…The weighted median OS in 13 studies was 19·8 (range 14·0–30·0) months for LR recurrence, 15·0 (10·0–17·7) months for liver recurrence, 30·4 (24·1–40·3) months for lung recurrence and 14·1 (5·5–17·0) months for PeD ( Fig . ).…”

Section: Resultsmentioning

confidence: 98%

“…After removal of 690 duplicates, a further 2588 articles were excluded after title and abstract screening because they did not meet the prespecified inclusion criteria. The full texts of the remaining 468 studies were evaluated in more detail, and 89 studies were found to meet the eligibility criteria for this systematic review. Among them, 22 studies containing information on clinical factors relevant to recurrence sites were selected for the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The Cochrane Collaboration tool for assessing risk of bias showed that one study had no domain with a high risk of bias and three studies had one of seven domains with a high risk of bias ( Table S3 , supporting information). The overall risk of bias in non‐randomized studies, according to ROBINS‐I, was moderate in 48 studies and serious in 37 studies ( Table S4 , supporting information).…”

Section: Resultsmentioning

confidence: 99%

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Meta-analysis of recurrence pattern after resection for pancreatic cancer

Tanaka

Mihaljevic

Probst

et al. 2019

British Journal of Surgery

139

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Background: Initial recurrence mapping of resected pancreatic ductal adenocarcinoma (PDAC) could help in stratifying patient subpopulations for optimal postoperative follow-up. The aim of this systematic review and meta-analysis was to investigate the initial recurrence patterns of PDAC and to correlate them with clinicopathological factors.Methods: MEDLINE and Web of Science databases were searched systematically for studies reporting first recurrence patterns after PDAC resection. Data were extracted from the studies selected for inclusion. Pooled odds ratios (ORs) and 95 per cent confidence intervals were calculated to determine the clinicopathological factors related to the recurrence sites. The weighted average of median overall survival was calculated.Results: Eighty-nine studies with 17 313 patients undergoing PDAC resection were included. The weighted median rates of initial recurrence were 20⋅8 per cent for locoregional sites, 26⋅5 per cent for liver, 11⋅4 per cent for lung and 13⋅5 per cent for peritoneal dissemination. The weighted median overall survival times were 19⋅8 months for locoregional recurrence, 15⋅0 months for liver recurrence, 30⋅4 months for lung recurrence and 14⋅1 months for peritoneal dissemination. Meta-analysis revealed that R1 (direct) resection (OR 2⋅21, 95 per cent c.i. 1⋅12 to 4⋅35), perineural invasion (OR 5⋅19, 2⋅79 to 9⋅64) and positive peritoneal lavage cytology (OR 5⋅29, 3⋅03 to 9⋅25) were significantly associated with peritoneal dissemination as initial recurrence site. Low grade of tumour differentiation was significantly associated with liver recurrence (OR 4⋅15, 1⋅71 to 10⋅07).

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Meta-analysis of recurrence pattern after resection for pancreatic cancer

Tanaka

Mihaljevic

Probst

et al. 2019

British Journal of Surgery

139

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“…The life expectancy of patients with pleural mesothelioma is often less than 15 months. 41,42 Peritoneal dissemination is frequently caused by recurrent abdominal malignancy in patients with gastrointestinal cancer, 21,22 ovarian cancer, [43][44][45] or pancreatic cancer, [46][47][48] resulting in a poor prognosis for patients. With a great deal of continuous effort to improve the chemotherapeutic regimens, the prognosis of these advanced cancers has currently improved.…”

Section: Discussionmentioning

confidence: 99%

A novel intraperitoneal therapy for gastric cancer with DFP‐10825, a unique RNAi therapeutic targeting thymidylate synthase, in a peritoneally disseminated xenograft model

Ando

Fukushima

Eshima³

et al. 2019

Cancer Medicine

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Purpose In advanced gastric cancer, peritoneal dissemination is a life‐threatening mode of metastasis. Since the treatment options with conventional chemotherapy remain limited, any novel therapeutic strategy that could control such metastasis would improve the outcome of treatment. We recently developed a unique RNA interference therapeutic regimen (DFP‐10825) consisting of short hairpin RNA against thymidylate synthase (TS shRNA) and cationic liposomes. The treatment with DFP‐10825 has shown remarkable antitumor activity in peritoneally disseminated human ovarian cancer–bearing mice via intraperitoneal administration. In this study, we expanded DFP‐10825 to the treatment of peritoneally disseminated gastric cancer. Methods DFP‐10825 was administered intraperitoneally into mice with intraperitoneally implanted human gastric cancer cells (MKN45 or NCI‐N87). Antitumor activity and host survival benefits were monitored. Intraperitoneal distribution of fluorescence‐labeled DFP‐10825 was monitored in this MKN45 peritoneally disseminated mouse model. Results Intraperitoneal injection of DFP‐10825 suppressed tumor growth in two peritoneally disseminated cancer models (MKN45 and NCI‐N87) and increased the survival time of the MKN45 model without severe side effects. Throughout the treatment regimen, no significant body weight loss was associated with the administration of DFP‐10825. Interestingly, after intraperitoneal injection, fluorescence‐labeled DFP‐10825 retained for more than 72 hours in the peritoneal cavity and selectively accumulated in disseminated tumors. Conclusions Intraperitoneal injection of DFP‐10825 demonstrated effective antitumor activity without systemic severe adverse effects via the selective delivery of RNAi molecules into disseminated tumors in the peritoneal cavity. Our current study indicates that DFP‐10825 could become an alternative option to improve the outcomes of patients with peritoneally disseminated gastric cancer.

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“…However, complete remission does not mean that the cancer cells are absent, but that there is no apparent evidence of cancer. Therefore, since the reemergence of cancer is always possible, a cancer patient after having completed the treatment is required to participate in regular diagnostic procedures The risk of recurrence depends on the cancer type [6][7][8][9].…”

Section: Is It Permanent?mentioning

confidence: 99%