Survival benefits of portal vein resection for pancreatic cancer

Nakagohri, Toshio; Kinoshita, Taira; Konishi, Masaru; Inoue, Kazuto; Takahashi, Shinichiro

doi:10.1016/s0002-9610(03)00173-9

Cited by 126 publications

(88 citation statements)

References 19 publications

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“…13,29 Accurate information concerning the relation of the tumor with the superior mesenteric artery and superior mesenteric-portal vein are particularly critical as more and more centers no longer consider venous involvement a contraindication to surgical resection. 16,30,31 In the current study, three patients with adenocarcinoma of the pancreas were initially deemed to be unresectable at the other institution solely due to tumor abutment/ involvement with the portal vein. Pancreaticoduodenectomy with vascular resection in properly selected patients, however, can be associated with a median survival of approximately 2 years, which is not different from those who undergo standard pancreaticoduodenectomy.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

et al. 2008

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Purpose-To evaluate the impact of a multidisciplinary clinic on the clinical care recommendations of patients with pancreatic cancer compared with the recommendations the patients received prior to review by the multidisciplinary tumor board.Methods-The records of 203 consecutive patients referred to the Johns Hopkins pancreatic multidisciplinary clinic were prospectively collected from November 2006 to October 2007. Crosssectional imaging, pathology, and medical history were evaluated by a panel of medical/radiation oncologists, surgical oncologists, pathologists, diagnostic radiologists, and geneticists. Alterations in treatment recommendations between the outside institution and the multidisciplinary clinic were recorded and compared.Results-On presentation, the outside computed tomography (CT) report described locally advanced/unresectable disease (34.9%), metastatic disease (17.7%), and locally advanced disease with metastasis (1.1%). On review of submitted imaging and imaging performed at Hopkins, 38 out of 203 (18.7%) NIH Public Access Author ManuscriptAnn Surg Oncol. Author manuscript; available in PMC 2010 July 20. Conclusion-The single-day pancreatic multidisciplinary clinic provided a comprehensive and coordinated evaluation of patients that led to changes in therapeutic recommendations in close to one-quarter of patients. KeywordsMultidisciplinary; Pancreas; Cancer; OutcomeAs the care of patients with cancer has become more complex, fewer patients are being treated with single-modality therapy. Rather, most patients with cancer are now cared for using a combination of surgery, chemotherapy, and/or radiation therapy. As such, multidisciplinary cancer clinics have become increasingly prevalent in the management of patients with malignancies. Multidisciplinary clinics allow specialists to work together to develop consensus recommendations in accordance with guidelines and protocols endorsed by the clinical team. 1 Over time, multidisciplinary care has become accepted as the optimal mechanism for delivering care in oncology. [1][2][3] In the USA, both the Commission on Cancer and the American College of Surgeons require multidisciplinary cancer conferences for the accreditation of health centers delivering multidisciplinary care. [3][4][5] Although multidisciplinary care has widely been endorsed and accepted, the impact of formal multidisciplinary clinics has yet to be established. In fact, little qualitative and quantitative research exists to determine the impact of multidisciplinary clinics on patient outcomes.6 Data on the effect of multidisciplinary clinics on patient outcomes are clearly important, as these clinics require a substantial amount of clinical and institutional resources. While improved outcomes in breast cancer patients treated at multidisciplinary clinics have been documented, 7 , 8 no such data exist for patients with gastrointestinal malignancies. Specifically, the impact of multidisciplinary clinics to treat patients with pancreatic cancer has not been previously documen...

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Section: Discussionmentioning

confidence: 99%

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

et al. 2008

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“…[13][14][15][16] However, it is still unclear whether curative pancreatic resection with PV resection will offer a better chance of longterm survival for patients with PV wall invasion. In fact, reports included some bias because they considered together various types of primary tumor and/or included curative and noncurative resections.…”

Section: Commentmentioning

confidence: 99%

Significance of the Depth of Portal Vein Wall Invasion After Curative Resection for Pancreatic Adenocarcinoma

Fukuda

Oussoultzoglou²,

Bachellier³

et al. 2007

Arch Surg

109

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“…Clinical studies have confirmed that patients with vessel invasion by tumors had an increased risk of recurrence and a poorer prognosis compared with those who had tumor-free vessels in a range of cancers, including breast cancer, hepatocellular carcinoma and papillary thyroid carcinoma (23)(24)(25). In addition, in patients without pre-operative metastasis, resection of the tumor-invaded vessels conferred a survival benefit, with a similar long-term prognosis compared with patients without vessel invasion by tumors (26,27). Thus, removal of tumor emboli and tumor-invaded vessels can eliminate a critical origin of CTCs and minimize the possibility and extent of tumor metastasis, as well as tumor-associated mortality.…”

Section: Hypothesismentioning

confidence: 94%

A circulating tumor cell cluster-based model for tumor metastasis (Hypothesis)

Hong

Li²,

Zhang

2016

Oncology Letters

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Abstract. Metastasis is the major cause of mortality in patients with malignancies; however, the mechanisms of tumor cell dissemination and metastasis formation are obscure. Circulating tumor cells (CTCs) are believed to be a critical step for distant metastasis and are associated with a poor patient prognosis. The precise processes of metastasis formation from CTCs are vague. In the present study, we hypothesize that two CTC cluster-based mechanisms of tumor cell inoculation in ectopic organs may be viable: i) Formation of a micro-cancer embolus due to interception of CTC clusters by small vessels; and ii) formation of micrometastasis in an extravasation-dependent or -independent manner. Pathological evidence of micro-cancer emboli is critical for the verifications of this hypothesis. If proved true, this hypothesis will provide a novel perspective for cancer metastasis and has valuable clinical implications.

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Survival benefits of portal vein resection for pancreatic cancer

Cited by 126 publications

References 19 publications

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

Evaluating the Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer

Significance of the Depth of Portal Vein Wall Invasion After Curative Resection for Pancreatic Adenocarcinoma

A circulating tumor cell cluster-based model for tumor metastasis (Hypothesis)

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