Resectable Pancreatic Cancer: Who Really Benefits From Resection?

Barugola, Giuliano; Partelli, Stefano; Marcucci, Stefano; Sartori, Nora; Capelli, Paola; Bassi, Claudio; Pederzoli, Paolo; Falconi, Massimo

doi:10.1245/s10434-009-0670-7

Cited by 147 publications

(120 citation statements)

References 27 publications

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“…At the time of diagnosis only 14% of patients could be surgically treated and up to 30% of them die within 12 months [1]. Therefore, further clinical investigations on preoperative patient qualification are needed.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Rudnicki

Agrawal²,

Grzebieniak³

et al. 2010

Folia Histochem Cytobiol.

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Abstract:The prognosis in patients with pancreatic cancer is poor and some authors describe it as a lethal disease. At the time of diagnosis only 14% of patients could be surgically treated and up to 30% of them die within 12 months. Therefore, further clinical investigations on preoperative patient qualification are needed. A total of 81 patients were included into the study. The CA 19-9 concentration was measured before surgery by an automated, commercially available enzyme immunoassay in Axsym analyzer (Abott Diagnostics Laboratory). A value of 37 U/ml was used as the upper limit of normal levels. Tumors were staged according to the Union Against Cancer (UICC) of 2004 and graded during the histological evaluation according to the G0-G4 scale. All patients were monitored every three month via outpatient clinic visits. In the case of missing visit we contacted the families to establish the cause. We assessed perioperative, 12 month, 2 year and 5 year survival. Twelve moth, 2 year and 5 year survival were assessed in the whole studied population and in the group of patients with the exception of these who died during the perioperative period. The total five year survival was 6%. The median time of survival was 467 days (range: 163 -586 days). The perioperative period was survived by 91.4% patients, 12 months were survived by 71.6% patients, 2 years were survived by 35.8% patients, 5 years were survived by 6.2% patients. The serum Ca 19-9 level was above the normal limit in 80.5% patients. ROC curve analysis revealed that CA 19-9 level of more than 106 U/ml was linked to 2 year survival with 79.3% sensitivity and 74.5% specificity. Preoperative level of CA 19-9 below 106U/ml represents a predictive factor of 2-and 5-year survival, independent of other factors, such as lower size of the tumor, absence of metastases to lymph nodes, female gender of patients.After exclusion of the patients who died in the perioperative period, no relationship could have been disclosed between preoperative CA 19-9 levels and one year survival. The observation points to the chance that patients with higher levels of CA 19-9 harbour micrometastases, the development of which is sufficiently slow to allow for a one-year survival of the patients but which increase the risk of death after two and five years

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Section: Introductionmentioning

confidence: 99%

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Rudnicki

Agrawal²,

Grzebieniak³

et al. 2010

Folia Histochem Cytobiol.

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“…In view of the high mortality rate, it is necessary to offer curative resection, as this is the only chance for long-term survival. On the other hand, this chance is rather small, with only about 20% 5-year survival rate in case of curative resection, and the procedure is not free of risk for mortality, which depends on the medical centers' experience and ranges from 3.8% to 16.3% [6,7] . Furthermore, morbidity after resection can limit the use of adjuvant chemotherapy.…”

Section: Role Of Radiologymentioning

confidence: 99%

“…The achievement of an R0-resection is one of the most significant parameters for survival [6] . Therefore, the first goal of radiological assessment is to confirm the probability of R0-resection without the necessity of arterial reconstruction [8] .…”

Section: Role Of Radiologymentioning

confidence: 99%

Perioperative treatment options in resectable pancreatic cancer - how to improve long-term survival

Sinn

Bahra

Denecke

et al. 2016

WJGO

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“…The most significant factor predicting long-term survival in PC is a radical resection (R0), which is unfortunately feasible in only about 20% of cases at diagnosis [2]. Patients with locally advanced pancreatic cancer (LAPC) and borderline resectable PC have about a 50% chance for curative resection, as compared with stage I and II PC [3,4], mainly because of the high frequency of invasion of the retroperitoneal margin and/or the nervous plexus of the superior mesenteric artery.…”

Section: Introductionmentioning

confidence: 99%

A Case of Locally Advanced Pancreatic Cancer Successfully Resected after 14 Months Therapy with Gemcitabine and Meriva<sup>®</sup>

Soldà

Bardini

Zingales

et al. 2016

IJPPE

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Abstract. Pancreatic cancer (PC) is one of the leading cause of cancer death. Neoadjuvant therapy has been progressively used in the context of locally advanced/unresectable disease improve patients' outcome. New drugs combination are associated with increased response rate but at the expense of higher toxicities. We presented a case of a patient with locally advanced disease treated who could undergo surgery after 14 cycles of therapy with gemcitabine and curcumin conjugated with phospholipids (Meriva ® ). Treatment was well tolerated without severe toxicities or impairment of quality of life. The patient is disease free at 9 month from surgery and 28 months from initial diagnosis and he still is in good clinical conditions. The combination of gemcitabine and Meriva® was effective in allowing radical surgery in a patient with locally advanced PC. Moreover, this results was obtained with minimally toxic regimen.Introduction.

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Resectable Pancreatic Cancer: Who Really Benefits From Resection?

Abstract: Duration of symptoms, CA 19-9 serum level, and pathological grading possibly retrieved by endoscopic ultrasound-guided biopsy can be preoperatively used to identify patients with disease that is not suitable for up-front surgery, even if deemed resectable by high-quality imaging.

Cited by 147 publications

References 27 publications

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Prognostic value of CA 19-9 level in resectable pancreatic adenocarcinoma.

Perioperative treatment options in resectable pancreatic cancer - how to improve long-term survival

A Case of Locally Advanced Pancreatic Cancer Successfully Resected after 14 Months Therapy with Gemcitabine and Meriva<sup>®</sup>

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