The diagnosis and staging of pancreatic cancer: A comparison of endoscopic ultrasound and computed tomography with pancreas protocol

Du, Tianli; Bill, Katherine A.; Ford, Jennifer; Barawi, Mohammed; Hayward, R. David; Alame, Amer; Berri, Richard N.

doi:10.1016/j.amjsurg.2017.11.021

Cited by 20 publications

(19 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As a surrogate of this enhancement, the sizes of the extra-pancreatic disease which contraindicate the resection signi cantly decreased in the second period. Moreover, vascular contact is certainly better assessed nowadays via imaging eventually associated to EUS [12], but these improvements were not correlated with a reduction in NRR, which was surprising. It is now well-known that a short (< 30 days) delay between CT scan and surgery is crucial in order not to increase the NNR [13].…”

Section: Discussionmentioning

confidence: 99%

Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?

Mattevi

Garnier

Marchese

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose: To determine if improvement in imaging reduces the non-resection rate (NRR) among patients with pancreatic ductal adenocarcinoma (PDAC).Methods: From 2000 to 2019, 751 consecutive patients with PDAC were considered eligible for a intention-to-treat pancreatectomy and entered the operating room. In April 2011, our institution acquired a dual energy spectral computed tomography (CT) scanner and liver diffusion weighted magnetic resonance imaging (DW-MRI) was included in the imaging workup. We consequently considered 2 periods of inclusion: period #1 (February 2000–March 2011) and period #2 (April 2011–August 2019). Results: All patients underwent a preoperative CT scan with a median delay to surgery of 18 days. Liver DW-MRI was performed among 407 patients (54%). Median delay between CT and surgery decreased (21 days to 16 days, P<.01), and liver DW-MRI was significantly most prescribed during period #2 (14% vs 75%, P<.01). According to the intraoperative findings, the overall NRR was 24.5%, and remained stable over the two periods (24% vs 25%, respectively). While vascular invasion, liver metastasis, and carcinomatosis rates remained stable, PALNs invasion rate (0.4% vs 4.6%; P<0.001) significantly increased over the 2 periods. The mean size of the bigger extra pancreatic tumor significantly decrease (7.9mm vs 6.4mm (P<.01), respectively) when the resection was not done. In multivariate analysis, CA 19-9<500U/mL (P<.01), and liver DW-MRI prescription (P<.01) favoured the resection. Conclusions: Due to changes in our therapeutic strategies, the NRR did not decrease during two decades despite imaging improvement.

show abstract

Section: Discussionmentioning

confidence: 99%

Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?

Mattevi

Garnier

Marchese

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…As a surrogate of this enhancement, the sizes of the extra-pancreatic disease which contraindicate the resection signi cantly decreased in the second period. Moreover, vascular contact is certainly better assessed nowadays via imaging eventually associated to EUS [13], but these improvements were not correlated with a reduction in NRR, which was surprising. It is now well-known that a short (<30 days) delay between CT scan and surgery is crucial in order not to increase the NNR [14].…”

Section: Discussionmentioning

confidence: 99%

Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?

Mattevi

Garnier

Marchese

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose To determine if improvement in imaging reduces the non-resection rate (NRR) among patients with pancreatic ductal adenocarcinoma (PDAC). Methods From 2000 to 2019, 751 consecutive patients with PDAC were considered eligible for a intention-to-treat pancreatectomy and entered the operating room. In April 2011, our institution acquired a dual energy spectral computed tomography (CT) scanner and liver diffusion weighted magnetic resonance imaging (DW-MRI) was included in the imaging workup. We consequently considered 2 periods of inclusion: period #1 (February 2000–March 2011) and period #2 (April 2011–August 2019). Results All patients underwent a preoperative CT scan with a median delay to surgery of 18 days. Liver DW-MRI was performed among 407 patients (54%). Median delay between CT and surgery decreased (21 days to 16 days, P <.01), and liver DW-MRI was significantly most prescribed during period #2 (14% vs 75%, P <.01). According to the intraoperative findings, the overall NRR was 24.5%, and remained stable over the two periods (24% vs 25%, respectively). While vascular invasion, liver metastasis, and carcinomatosis rates remained stable, para-aortic lymph nodes invasion rate (0.4% vs 4.6%; P <0.001) significantly increased over the 2 periods. The mean size of the bigger extra pancreatic tumor significantly decrease (7.9mm vs 6.4mm ( P <.01), respectively) when the resection was not done. In multivariate analysis, CA 19-9<500U/mL ( P <.01), and liver DW-MRI prescription ( P <.01) favoured the resection. Conclusions Due to changes in our therapeutic strategies, the NRR did not decrease during two decades despite imaging improvement.

show abstract

“…At present, physicians are still unable to prevent it or even to propose an efficient treatment at the moment of its diagnosis. Indeed, alongside the absence of symptoms [ 1 ], chemo-resistance is another issue we have to face [ 2 ]. Moreover, with the rise of immunotherapies, new hopes are coming out and scientists attempt to detail the immune response against cancers in order to adapt and refine therapeutically strategies [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Expression of POU2F3 Transcription Factor Control Inflammation, Immunological Recruitment and Metastasis of Pancreatic Cancer in Mice

Bintz

Abuelafia

Gerbe

et al. 2020

Biology

View full text Add to dashboard Cite

TUFT cells have been described as strong modulators of inflammatory cells in several tissues including pancreas. TUFT cells, also known as DCLK1+ cells, are dependent of the transcriptional factor POU2F3. Several works report DCLK1+ cells in early stages of PDAC development suggesting an important role of TUFT cells in PDAC development. Therefore, we developed a mice model (PDX1-Cre;KrasG12D;Ink4afl/fl), known as PKI model, deficient or not of POU2F3. In this animal model, deficiency of POU2F3 results in the absence of TUFT cells in PDAC as expected. Although, tumor development and growth are not significantly influenced, the development of liver metastasis was almost completely inhibited in POU2F3-deficient mice. Surprisingly, the absence of metastasis was associated with a higher expression of epithelial-to-mesenchymal transition markers, but to a lower inflammatory microenvironment suggesting that inflammation influences metastasis production more than epithelial-to-mesenchymal transition in this animal model. We can conclude that POU2F3 could be a new therapeutic target for control PDAC progression.

show abstract

The diagnosis and staging of pancreatic cancer: A comparison of endoscopic ultrasound and computed tomography with pancreas protocol

Cited by 20 publications

References 7 publications

Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?

Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?

Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?

Expression of POU2F3 Transcription Factor Control Inflammation, Immunological Recruitment and Metastasis of Pancreatic Cancer in Mice

Contact Info

Product

Resources

About