#15#
Revisiones (todas) *** Reviews (all)
Pancreatic cancer.
February - March 2013
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[1]
TÍTULO / TITLE: - Anti-diabetic medications and risk of pancreatic cancer in patients with diabetes mellitus: a systematic review and meta-analysis.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Am J Gastroenterol. 2013 Apr;108(4):510-9. doi: 10.1038/ajg.2013.7. Epub 2013 Feb 12.
●● Enlace al texto completo (gratuito o de pago) 1038/ajg.2013.7
AUTORES / AUTHORS: - Singh S; Singh PP; Singh AG; Murad MH; McWilliams RR; Chari ST
INSTITUCIÓN / INSTITUTION: - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
RESUMEN / SUMMARY: - OBJECTIVES: Several preclinical and observational studies have shown that anti-diabetic medications (ADMs) may modify the risk of pancreatic cancer (PaC). We performed a systematic review and meta-analysis evaluating the effect of metformin, sulfonylureas (SUs), thiazolidinediones (TZDs), and insulin on the risk of PaC in patients with diabetes mellitus (DM). METHODS: We conducted a systematic search of Medline, EMBASE, and Web of Science, up to June 2012, and published abstracts from major gastroenterology and oncology meetings from 2003 to 2012. Studies were included if they (1) evaluated and clearly defined exposure to metformin, SU, TZDs, and/or insulin, (2) reported PaC outcomes in patients with DM and (3) reported relative risks or odds ratio (OR) or provided data for their estimation. Summary OR estimates with 95% confidence intervals (CIs) were estimated using the random-effects model. RESULTS: Eleven studies (6 cohort, 3 case-control, and 2 randomized controlled trials (RCTs)) reported 1770 cases of PaC in 730,664 patients with DM. Meta-analysis of observational studies showed no significant association between metformin (n=9 studies; adjusted OR 0.76, 95% CI 0.57-1.03, P=0.073), insulin (n=7 studies; adjusted OR 1.59, 95% CI 0.85-2.96, P=0.144), or TZD (n=4 studies; adjusted OR 1.02, 95% CI 0.81-1.30, P=0.844) use and risk of developing PaC. Use of SU was associated with a 70% increase in the odds of PaC (n=8 studies; adjusted OR 1.70, 95% CI 1.27-2.28, P<0.001). There was considerable inherent heterogeneity between studies not explained by study design, setting, or comparator drug and is likely related to confounding by indication and reverse causality. The pooled analyses of the two RCTs were underpowered and provided non-significant results with wide, non-informative 95% CIs. CONCLUSIONS: Although SU seems to be associated with increased risk of PaC, meta-analysis of existing studies does not support a protective or harmful association between ADM use and risk of PaC in patients with DM. There was considerable heterogeneity across studies, and future, well-designed, prospective studies would be required to understand this association better.
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[2]
TÍTULO / TITLE: - Pancreatic well-differentiated neuroendocrine neoplasms (pWDNENs): what place for everolimus and sunitinib derived from ESMO clinical practice guidelines in the therapeutic algorithm?
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Ann Oncol. 2013 Mar 13.
●● Enlace al texto completo (gratuito o de pago) 1093/annonc/mdt102
AUTORES / AUTHORS: - Pusceddu S; Buzzoni R; De Braud F
INSTITUCIÓN / INSTITUTION: - Medical Oncology Unit;
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[3]
TÍTULO / TITLE: - Pancreatic cancer and diabetes.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Adv Exp Med Biol. 2012;771:229-39.
AUTORES / AUTHORS: - Morrison M
INSTITUCIÓN / INSTITUTION: - Swedish Organ Transplant Division, Swedish Medical Center, Seattle, Washington, USA. maureen.morrison@swedish.org
RESUMEN / SUMMARY: - Diabetes studies have increasingly been associated with several types of cancer. Diabetes and pancreatic cancer have a unique relationship. Genetic mutations, such as activation of the KRAS2 oncogene, inactivation of the tumor-suppressor gene CDKN2A, inactivation of the tumor-suppressor gene TP53 and deleted in pancreatic cancer 4 (DPC4) gene defects are seen in those with pancreatic cancer. Approximately 80% of those patients, diagnosed with pancreatic cancer, are identified as having concomitant diabetes with a poor prognostic factor. Damaged pancreatic tissue, secondary to pancreatic cancer, leads to diabetes as islet cells and beta cells are taken over by malignancy. Additionally, those on certain anti-diabetic regimens are shown to be at a higher risk of developing pancreatic cancer due to the effect of stimulation on the pancreatic beta and islet cells. Therefore, diabetes is thought to be both a potential cause and effect of pancreatic cancer. Diabetes has become a pandemic, and pancreatic cancer is one of the most lethal forms of malignancy known. In order to better understand these diseases and how they are associated, more research needs to be done. Particularly, research focusing on different types of diabetes in the setting of pancreatic cancer will be an important issue for further understanding of the link between diabetes and pancreatic cancer.
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[4]
TÍTULO / TITLE: - Pancreatic resection for metastatic melanoma originating from the nasal cavity: a case report and literature review.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Anticancer Res. 2013 Feb;33(2):567-73.
AUTORES / AUTHORS: - Sugimoto M; Gotohda N; Kato Y; Takahashi S; Kinoshita T; Shibasaki H; Kojima M; Ochiai A; Zenda S; Akimoto T; Konishi M
INSTITUCIÓN / INSTITUTION: - National Cancer Center East, 6-5-1 Kashiwa-no-ha, Kashiwa, Chiba 277-8577, Japan. ngotohda@east.ncc.go.jp
RESUMEN / SUMMARY: - Metastatic pancreatic malignant melanoma is considered to be a highly aggressive neoplasm, and only few metastasectomies for lesions originating from the skin or the ocular region have been reported. We report a case of resection of pancreatic metastasis of malignant melanoma originating from the nasal cavity. An isolated pancreatic tumor was detected in a 46-year-old man who had undergone proton-beam therapy for nasal melanoma 12 months earlier. He underwent distal pancreatectomy with splenectomy and the pathological diagnosis was metastatic malignant melanoma. We review cases of malignant melanoma metastatic to the pancreas and further discuss their incidence, therapeutic strategy, and outcome of mucosal melanoma of the head and neck.
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[5]
TÍTULO / TITLE: - Aggressive Surgery for Borderline Resectable Pancreatic Cancer: Evaluation of National Comprehensive Cancer Network Guidelines.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Pancreas. 2013 Mar 25.
●● Enlace al texto completo (gratuito o de pago) 1097/MPA.0b013e31827b2d7c
AUTORES / AUTHORS: - Yamada S; Fujii T; Sugimoto H; Nomoto S; Takeda S; Kodera Y; Nakao A
INSTITUCIÓN / INSTITUTION: - From the *Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine; and daggerDepartment of Surgery, Nagoya Central Hospital, Nagoya, Japan.
RESUMEN / SUMMARY: - OBJECTIVES: The objective of this study was to evaluate the relevance of defining borderline resectable (BR) pancreatic cancer as a distinct entity in the treatment scheme of pancreatic cancer as proposed by the National Comprehensive Cancer Network. METHODS: Among 375 patients with pancreatic cancer, 137 patients were deemed to have resectable disease ® by preoperative imaging studies, whereas 96 were found to have an unresectable disease during surgery. The remaining 142 patients fulfilled the definition of BR and were further classified into 3 subgroups based on the National Comprehensive Cancer Network guidelines: portal vein invasion (PV[+]), common hepatic artery invasion (CHA[+]), and superior mesenteric artery invasion (SMA[+]). PV(+) was subdivided into types B, C, and D according to the degree of portal vein invasion. RESULTS: Patients in the R group had significantly better survival than those in the PV(+) group (P = 0.0038), who in turn survived significantly longer than those classified as SMA(+) (P = 0.041). Type B patients survived significantly longer than did types C and D patients (P = 0.013 and P = 0.030, respectively). In PV(+) patients, compliance with postoperative chemotherapy at 3 and 6 months was 56.9% and 44.6%, respectively, substantially inferior to patients with resectable disease (72.6% and 54.7%, respectively). CONCLUSIONS: The optimal treatment strategy may differ among various subgroups within the BR category.
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[6]
TÍTULO / TITLE: - Current status on the diagnosis and evaluation of pancreatic tumour in Asia with particular emphasis on the role of endoscopic ultrasound.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - J Gastroenterol Hepatol. 2013 Mar 11. doi: 10.1111/jgh.12198.
●● Enlace al texto completo (gratuito o de pago) 1111/jgh.12198
AUTORES / AUTHORS: - Kongkam P; Ang TL; Vu CK; Dy FT; Yasuda K; Rerknimitr R; Varadarajulu S; Dhir V; Chong VH; Jin ZD; Wong JY; Ho KY
INSTITUCIÓN / INSTITUTION: - Endoscopic Ultrasound Research Unit, Chulalongkorn University, Bangkok, Thailand.
RESUMEN / SUMMARY: - In Asia, the incidence of pancreatic cancer in some countries has been increasing. Owing to most cases being diagnosed late, prognosis for pancreatic cancer remains dismal. It is clear the future for pancreatic cancer is early detection. While the possible presence of pancreatic masses is often first raised by non-invasive abdominal imaging such as computerized tomography (CT) and magnetic resonance imaging (MRI), smaller lesions and locoregional lymph node metastases are often not detectable by these means. Endoscopic ultrasonography (EUS) offers a higher sensitivity (93-100%) for the detection of small potentially curable pancreatic masses than other existing imaging modalities. It is also recommended to evaluate portal vein confluence, portal vein, celiac axis and SMA origin, and exclude respectability. Due to the closer proximity of EUS to the target structure, and lower rate of needle tract seeding, EUS-guided fine needle aspiration (FNA) of pancreatic mass is considered the most suitable tissue acquisition technique. Lastly, EUS also enables the performance of endoscopic interventions. Its performance can be further enhanced with newer techniques, including contrast enhanced ultrasound and elastrography. It is anticipated that in the near future, molecular technologies may make it possible to detect microscopic amounts of cancer in tissue or blood, predict relapse and survival after therapy, as well as determine optimal therapy.
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[7]
TÍTULO / TITLE: - Staging of gastroenteropancreatic neuroendocrine tumors: how we do it based on an evidence-based approach.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Clin Imaging. 2013 Mar;37(2):194-200. doi: 10.1016/j.clinimag.2012.05.006. Epub 2012 Jun 15.
●● Enlace al texto completo (gratuito o de pago) 1016/j.clinimag.2012.05.006
AUTORES / AUTHORS: - McDermott S; O’Neill AC; Skehan SJ
INSTITUCIÓN / INSTITUTION: - St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: mcdermottshaunagh@gmail.com.
RESUMEN / SUMMARY: - In contrast to other common types of malignant tumors, the vast majority of gastroenteropancreatic neuroendocrine tumors are well differentiated and slowly growing with only a minority showing aggressive behavior. It is important to accurately stage patients radiologically so the correct treatment can be implemented and to improve prognosis. In this article, we critically appraise the current literature in an effort to establish the current role of radiologic imaging in the staging of neuroendocrine tumors. We also discuss our protocol for staging neuroendocrine tumors.
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[8]
TÍTULO / TITLE: - Multiple metastatic leiomyosarcoma of the pancreas: a first case report and review of the literature.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Intern Med. 2013;52(5):561-6. Epub 2013 Mar 1.
AUTORES / AUTHORS: - Ogura T; Masuda D; Kurisu Y; Miyamoto Y; Hayashi M; Imoto A; Takii M; Takeuchi T; Inoue T; Tokioka S; Uchiyama K; Umegaki E; Higuchi K
INSTITUCIÓN / INSTITUTION: - The 2nd Department of Internal Medicine, Osaka Medical College, Japan.
RESUMEN / SUMMARY: - A 60-year-old woman was referred to our hospital with swelling of the right leg. After surgery, leiomyosarcoma of the right leg was diagnosed. Computed tomography showed two hypovascular masses in the pancreatic body and tail that were heterogeneously enhanced compared with the pancreatic parenchyma. On endoscopic ultrasonography, the tumors in the pancreatic body and tail both exhibited regular margins and were visualized as well-circumscribed masses with uneven interiors. Distal pancreatectomy was performed under a presumptive diagnosis of metastatic pancreatic leiomyosarcoma diagnosed based on the findings of EUS-FNA. On laparotomy, peritoneal washing cytology yielded negative results, and no dissemination was observed. Ultimately, metastatic pancreatic leiomyosarcoma was histologically diagnosed.
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[9]
TÍTULO / TITLE: - Current evidence for histone deacetylase inhibitors in pancreatic cancer.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - World J Gastroenterol. 2013 Feb 14;19(6):813-28. doi: 10.3748/wjg.v19.i6.813.
●● Enlace al texto completo (gratuito o de pago) 3748/wjg.v19.i6.813
AUTORES / AUTHORS: - Koutsounas I; Giaginis C; Patsouris E; Theocharis S
INSTITUCIÓN / INSTITUTION: - First Department of Pathology, Medical School, National and Kapodistrian University of Athens, GR-11527 Athens, Greece.
RESUMEN / SUMMARY: - Pancreatic cancer is one of the most aggressive human cancers, with more than 200 000 deaths worldwide every year. Despite recent efforts, conventional treatment approaches, such as surgery and classic chemotherapy, have only slightly improved patient outcomes. More effective and well-tolerated therapies are required to reverse the current poor prognosis of this type of neoplasm. Among new agents, histone deacetylase inhibitors (HDACIs) are now being tested. HDACIs have multiple biological effects related to acetylation of histones and many non-histone proteins that are involved in regulation of gene expression, apoptosis, cell cycle progression and angiogenesis. HDACIs induce cell cycle arrest and can activate the extrinsic and intrinsic pathways of apoptosis in different cancer cell lines. In the present review, the main mechanisms by which HDACIs act in pancreatic cancer cells in vitro, as well as their antiproliferative effects in animal models are presented. HDACIs constitute a promising treatment for pancreatic cancer with encouraging anti-tumor effects, at well-tolerated doses.
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[10]
TÍTULO / TITLE: - Minimally invasive necrosectomy versus conventional surgery in the treatment of infected pancreatic necrosis: a systematic review and a meta-analysis of comparative studies.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Surg Laparosc Endosc Percutan Tech. 2013 Feb;23(1):8-20. doi: 10.1097/SLE.0b013e3182754bca.
●● Enlace al texto completo (gratuito o de pago) 1097/SLE.0b013e3182754bca
AUTORES / AUTHORS: - Cirocchi R; Trastulli S; Desiderio J; Boselli C; Parisi A; Noya G; Falconi M
INSTITUCIÓN / INSTITUTION: - Department of General Surgery, University of Perugia, St Maria Hospital, Terni, Italy.
RESUMEN / SUMMARY: - AIM: The purpose of this meta-analysis and systematic review is to compare minimally invasive necrosectomy (MIN) versus open necrosectomy (ON) surgery for infected necrosis of acute pancreatitis. METHODS: One randomized controlled trial and 3 clinical controlled trials were selected, with a total of 336 patients (215 patients who underwent MIN and 121 patients underwent ON) included after searching in the following databases: Medline, Embase, Cochrane Central Register of Controlled Trials, BioMed Central, Science Citation Index (from inception to August 2011), Greynet, SIGLE (System for Information on Grey Literature in Europe), National Technological Information Service, British Library Integrated catalogue, and the Current Controlled Trials. Statistical analysis is performed using the odds ratio (OR) and weighted mean difference with 95% confidence interval (CI). RESULTS: After the analysis of the data amenable to polling, significant advantages were found in favor of the MIN in terms of: incidence of multiple organ failure (OR, 0.16; 95% CI, 0.06-0.39) (P < 0.0001), incisional hernias (OR, 0.23; 95% CI, 0.06-0.90) (P = 0.03), new-onset diabetes (OR, 0.32; 95% CI, 0.12-0.88) (P = 0.03), and for the use of pancreatic enzymes (OR, 0.005; 95% CI, 0.04-0.57) (P = 0.005). No differences were found in terms of mortality rate (OR, 0.43; 95% CI, 0.18-1.05) (P = 0.06), multiple systemic complications (OR, 0.34; 95% CI, 0.01-8.60) (P = 0.51), surgical reintervention for further necrosectomy (OR, 0.16; 95% CI, 0.00-3.07) (P = 0.19), intra-abdominal bleeding (OR, 0.79; 95% CI, 0.41-1.50) (P = 0.46), enterocutaneous fistula or perforation of visceral organs (OR, 0.52; 95% CI, 0.27-1.00) (P = 0.05), pancreatic fistula (OR, 0.66; 95% CI, 0.30-1.46) (P = 0.30), and surgical reintervention for postoperative complications (OR, 0.50; 95% CI, 0.23-1.08) (P = 0.08). CONCLUSIONS: The lack of comparative studies and high heterogeneity of the data present in the literature did not permit to draw a definitive conclusion on this topic. The results of the present meta-analysis might be helpful to design future high-powered randomized studies that compare MIN with ON for acute necrotizing pancreatitis.
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[11]
TÍTULO / TITLE: - CA19-9 and CA242 as tumor markers for the diagnosis of pancreatic cancer: a meta-analysis.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Clin Exp Med. 2013 Mar 3.
●● Enlace al texto completo (gratuito o de pago) 1007/s10238-013-0234-9
AUTORES / AUTHORS: - Gui JC; Yan WL; Liu XD
INSTITUCIÓN / INSTITUTION: - Department of Nuclear Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd., Shanghai, 200040, People’s Republic of China.
RESUMEN / SUMMARY: - Pancreatic cancer has the worst prognosis of any gastrointestinal cancer, with the mortality approaching the incidence. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the sensitivity and specificity of CA19-9 and CA242 in pancreatic cancer. We searched PubMed, EMBASE, and the Cochrane Library for studies that evaluated the diagnostic validity of CA19-9 and CA242 between January 1966 and March 2011. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve. A total of 11 studies that included 2,316 patients who fulfilled all of the inclusion criteria were considered for analysis. The pooled sensitivities for CA242 and CA19-9 were 0.719 (95 % confidence interval [CI] 0.690-0.746) and 0.803 (95 % CI 0.777-0.826), respectively. The pooled specificities of CA242 and CA19-9 were 0.868 (95 % CI 0.849-0.885) and 0.802 (95 % CI 0.780-0.823), respectively. The diagnostic odds ratio (DOR) estimate was significantly higher for CA242 (16.261) than for CA19-9 (15.637). Our meta-analysis showed that CA242 and CA19-9 could play different roles in the diagnosis of pancreatic cancer. Although the sensitivity of CA242 is lower than that of CA19-9, its specificity is greater.
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[12]
TÍTULO / TITLE: - Endoscopic ultrasound guided fine needle aspiration for the diagnosis of pancreatic cystic neoplasms: a meta-analysis.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Pancreatology. 2013 Jan-Feb;13(1):48-57. doi: 10.1016/j.pan.2012.11.313. Epub 2012 Dec 4.
●● Enlace al texto completo (gratuito o de pago) 1016/j.pan.2012.11.313
AUTORES / AUTHORS: - Thornton GD; McPhail MJ; Nayagam S; Hewitt MJ; Vlavianos P; Monahan KJ
INSTITUCIÓN / INSTITUTION: - Imperial College London, South Kensington Campus, Exhibition Road, London, United Kingdom. george.thornton07@imperial.ac.uk
RESUMEN / SUMMARY: - BACKGROUND AND OBJECTIVES: Mucinous cystic neoplasms and intraductal papillary mucinous tumours have greater malignant potential than serous cystic neoplasms. EUS alone is inadequate for characterising these lesions but the addition of FNA may significantly improve diagnostic accuracy. The performance of EUS-FNA is highly variable in published studies. AIM: To determine the diagnostic accuracy of EUS-FNA to differentiate mucinous versus non-mucinous cystic lesions with cyst fluid analysis for cytology and carcinoembryonic antigen (CEA) by performing a meta-analysis of published studies. METHODS: Relevant studies were identified via structured database search and included if they used a reference standard of definitive surgical histology or clinical follow-up of at least 6 months. Data from selected studies were pooled to give summary sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio and Receiver Operating Characteristic (ROC) curve. Pre-defined subgroup analysis was performed. RESULTS: Eighteen studies (published 2002-2011) were included, with a total of 1438 patients. For cytology, pooled sensitivity was 54(95%CI 49-59)% and specificity 93(90-95)%. The diagnostic odds ratio (DOR) was 13.3 (4.37-49.43), with I(2) of 77.1%. For CEA sensitivity was 63(59-67)% and specificity 88(83-91)%. The DOR was 10.76(6.29-18.41) with an I(2) of 25.4%. The diagnostic accuracy of EUS-FNA was enhanced in prospective studies and studies of <36 months duration. No impact of publication bias on our results was demonstrated. CONCLUSIONS: Fine-needle aspiration has moderate sensitivity but high specificity for mucinous lesions. EUS-FNA, when used in conjunction with cross sectional imaging, is a useful diagnostic tool for the correct identification of mucinous cysts.
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[13]
TÍTULO / TITLE: - European experts consensus statement on cystic tumours of the pancreas.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Dig Liver Dis. 2013 Feb 13. pii: S1590-8658(13)00012-1. doi: 10.1016/j.dld.2013.01.010.
●● Enlace al texto completo (gratuito o de pago) 1016/j.dld.2013.01.010
AUTORES / AUTHORS: - Del Chiaro M; Verbeke C; Salvia R; Kloppel G; Werner J; McKay C; Friess H; Manfredi R; Van Cutsem E; Lohr M; Segersvard R
INSTITUCIÓN / INSTITUTION: - Division of Surgery, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. Electronic address: marco.del-chiaro@karolinska.se.
RESUMEN / SUMMARY: - Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm, branch- and main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm). European expert pancreatologists provide updated recommendations: diagnostic computerized tomography and/or magnetic resonance imaging are indicated in all patients with cystic lesion of the pancreas. Endoscopic ultrasound with cyst fluid analysis may be used but there is no evidence to suggest this as a routine diagnostic method. The role of pancreatoscopy remains to be established. Resection should be considered in all symptomatic lesions, in mucinous cystic neoplasm, main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm as well as in branch duct intraductal papillary mucinous neoplasm with mural nodules, dilated main pancreatic duct >6mm and possibly if rapidly increasing in size. An oncological partial resection should be performed in main duct intraductal papillary mucinous neoplasm and in lesions with a suspicion of malignancy, otherwise organ preserving procedures may be considered. Frozen section of the transection margin in intraductal papillary mucinous neoplasm is suggested. Follow up after resection is recommended for intraductal papillary mucinous neoplasm, solid pseudo-papillary neoplasm and invasive cancer.
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[14]
TÍTULO / TITLE: - Chronic Hepatitis B Virus Infection and Risk of Pancreatic Cancer: A Meta-analysis.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Asian Pac J Cancer Prev. 2013;14(1):275-9.
AUTORES / AUTHORS: - Li L; Wu B; Yang LB; Yin GC; Liu JY
INSTITUCIÓN / INSTITUTION: - Department of Gastroenterology, Shandong Provincial Hospital, Shandong University, Jinan, China E-mail : lilktaian@126.com.
RESUMEN / SUMMARY: - Objectives: A number of studies have shown that chronic hepatitis B virus infection is implicated in susceptibility to pancreatic cancer. However, the results are still controversial. This meta-analysis aimed to quantitatively assess the relationship between chronic hepatitis B virus infection and incidence of pancreatic cancer of cohort and case-control studies. Methods: A literature search was performed for entries from 1990 to 2012 using PUBMED and EMBASE. Studies were included if they reported odds ratios (ORs) and corresponding 95% CIs of pancreatic cancer with respect to the infection of hepatitis B virus. Results: Eight studies met the inclusion criteria, which included five case-control studies and three cohort studies. Compared with individuals who have not infection of hepatitis B virus, the pooled OR of pancreatic cancer was 1.403 (95%CI: 1.139-1.729, P=0.001) for patients with hepatitis B virus infection. Sub-group analysis by study design showed that the summary OR was 1.43 (95%CI: 1.06-1.94, P=0.021) when pooling case-control studies and 1.31 (95%CI: 1.00- 1.72, P=0.05) when pooling cohort studies. Conclusion: Findings from this meta-analysis suggest that chronic hepatitis B virus infection may increase the risk of pancreatic cancer. This relationship needs to be confirmed by further follow-up studies.
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[15]
TÍTULO / TITLE: - Gemcitabine plus erlotinib for advanced pancreatic cancer: a systematic review with meta-analysis.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - PLoS One. 2013;8(3):e57528. doi: 10.1371/journal.pone.0057528. Epub 2013 Mar 5.
●● Enlace al texto completo (gratuito o de pago) 1371/journal.pone.0057528
AUTORES / AUTHORS: - Yang ZY; Yuan JQ; Di MY; Zheng DY; Chen JZ; Ding H; Wu XY; Huang YF; Mao C; Tang JL
INSTITUCIÓN / INSTITUTION: - Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China ; The Hong Kong Branch of The Chinese Cochrane Centre, The Chinese University of Hong Kong, Hong Kong, China.
RESUMEN / SUMMARY: - BACKGROUND: This study aims to comprehensively summarize the currently available evidences on the efficacy and safety of gemcitabine plus erlotinib for treating advanced pancreatic cancer. METHODOLOGYPRINCIPAL FINDINGS: PubMed, EMBASE, The Cochrane Library and abstracts of recent major conferences were systematically searched to identify relevant publications. Studies that were conducted in advanced pancreatic cancer patients treated with gemcitabine plus erlotinib (with or without comparison with gemcitabine alone) and reporting objective response rate, disease control rate, progression-free survival, time-to-progression, overall survival, 1-year survival rate and/or adverse events were included. Data on objective response rate, disease control rate, 1-year survival rate and adverse events rate, respectively, were combined mainly by using Meta-Analyst software with a random-effects model. Data on progression-free survival, time-to-progression and overall survival were summarized descriptively. Sixteen studies containing 1,308 advanced pancreatic cancer patients treated with gemcitabine plus erlotinib were included. The reported median progression-free survival (or time-to-progression), median overall survival, 1-year survival rates, objective response rates and disease control rates were 2-9.6 months, 5-12.5 months, 20%-51%, 0%-28.6% and 25.0%-83.3%, respectively. The weighted 1-year survival rate, objective response rate and disease control rate based on studies reporting robust results were 27.9%, 9.1% and 57.0%, respectively. According to the studies with relevant data, the incidences of total and severe adverse events were 96.3% and 62.9%, respectively. The most frequently reported adverse events were leucopenia, rash, diarrhea, vomitting, neutropenia, thrombocytopenia, anaemia, stomatitis, drug-induced liver injury, fatigue and fever. Compared with gemcitabine alone, the progression-free survival and overall survival with gemcitabine plus erlotinib were significantly longer, but there were also more deaths and interstitial lung disease-like syndrome related to this treatment. CONCLUSIONSSIGNIFICANCE: Gemcitabine plus erlotinib represent a new option for the treatment of advanced pancreatic cancer, with mild but clinically meaningful additive efficacy compared with gemcitabine alone. Its safety profile is generally acceptable, although careful management is needed for some specific adverse events.
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[16]
TÍTULO / TITLE: - Surgery for pancreatic carcinoma: state of the art.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Indian J Surg. 2012 Feb;74(1):79-86. doi: 10.1007/s12262-011-0373-8. Epub 2011 Nov 24.
●● Enlace al texto completo (gratuito o de pago) 1007/s12262-011-0373-8
AUTORES / AUTHORS: - Shrikhande SV; Barreto SG
INSTITUCIÓN / INSTITUTION: - Department of GI and HPB Surgical Oncology, Tata Memorial Centre, Ernest Borges Marg, Parel, Mumbai, 400012 India.
RESUMEN / SUMMARY: - Carcinoma of the pancreas remains a malignancy with a generally dismal outcome owing to the delayed presentation of the disease. To date, surgery affords the best outcomes when a complete resection can be achieved. Improvements in imaging, surgical techniques and adjuvant therapies are perceived advancements in the management of this cancer. This article reviews the latest evidence in terms of the diagnosis and management of pancreatic cancer.
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[17]
TÍTULO / TITLE: - Concomitant pancreatic endocrine neoplasm and intraductal papillary mucinous neoplasm: a case report and literature review.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - World J Surg Oncol. 2013 Mar 21;11:75. doi: 10.1186/1477-7819-11-75.
●● Enlace al texto completo (gratuito o de pago) 1186/1477-7819-11-75
AUTORES / AUTHORS: - Kadota Y; Shinoda M; Tanabe M; Tsujikawa H; Ueno A; Masugi Y; Oshima G; Nishiyama R; Tanaka M; Mihara K; Abe Y; Yagi H; Kitago M; Itano O; Kawachi S; Aiura K; Tanimoto A; Sakamaoto M; Kitagawa Y
INSTITUCIÓN / INSTITUTION: - Department of Surgery, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan. masa02114@yahoo.co.jp.
RESUMEN / SUMMARY: - We report a case of concomitant pancreatic endocrine neoplasm (PEN) and intraductal papillary mucinous neoplasm (IPMN). A 74-year-old man had been followed-up for mixed-type IPMN for 10 years. Recent magnetic resonance images revealed an increase in size of the branch duct IPMN in the pancreas head, while the dilation of the main pancreatic duct showed minimal change. Although contrast-enhanced computed tomography and magnetic resonance imaging did not reveal any nodules in the branch duct IPMN, endoscopic ultrasound indicated a suspected nodule in the IPMN. A malignancy in the branch duct IPMN was suspected and we performed pylorus-preserving pancreatoduodenectomy with lymphadenectomy. The resected specimen contained a cystic lesion, 10 x 10 mm in diameter, in the head of the pancreas. Histological examination revealed that the dilated main pancreatic duct and the branch ducts were composed of intraductal papillary mucinous adenoma with mild atypia. No evidence of carcinoma was detected in the specimen. Incidentally, a 3-mm nodule consisting of small neuroendocrine cells was found in the main pancreatic duct. The cells demonstrated positive staining for chromogranin A, synaptophysin, and glucagon but negative staining for insulin and somatostatin. Therefore, the 3-mm nodule was diagnosed as a PEN. Since the mitotic count per 10 high-power fields was less than 2 and the Ki-67 index was less than 2%, the PEN was pathologically classified as low-grade (G1) according to the 2010 World Health Organization (WHO) criteria. Herein, we review the case and relevant studies in the literature and discuss issues related to the synchronous occurrence of the relatively rare tumors, PEN and IPMN.
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[18]
TÍTULO / TITLE: - Dermoid cyst of the pancreas: a case report with literature review.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - J Radiol Case Rep. 2012 Dec;6(12):17-25. doi: 10.3941/jrcr.v6i12.1152. Epub 2012 Dec 1.
●● Enlace al texto completo (gratuito o de pago) 3941/jrcr.v6i12.1152
AUTORES / AUTHORS: - Lane J; Vance A; Finelli D; Williams G; Ravichandran P
INSTITUCIÓN / INSTITUTION: - Department of Pathology, Summa Health System, Akron, USA. laneja@summahealth.org
RESUMEN / SUMMARY: - Pancreatic dermoid cysts represent a rare entity with 35 cases described in the world literature, including the present one. Pre-operative diagnosis is difficult, with definitive diagnosis usually taking place intra-operatively. We report the case of a 63 year old male with a symptomatic, 6 cm cystic mass in the body of the pancreas. The pre-operative evaluation suggested a cystic neoplasm, but was indeterminate as to whether the lesion was benign or malignant. The diagnosis of dermoid cyst was made intra-operatively with frozen section. Although the diagnosis could not be made pre-operatively this retrospective report highlights the difficulty in evaluating cystic pancreatic lesions by imaging and summarizes the current body of knowledge on this rare entity.
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[19]
TÍTULO / TITLE: - Epidermoid cyst arising from an intrapancreatic accessory spleen: A case report and review of the literature.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - Oncol Lett. 2013 Feb;5(2):469-472. Epub 2012 Dec 4.
●● Enlace al texto completo (gratuito o de pago) 3892/ol.2012.1061
AUTORES / AUTHORS: - Hong R; Choi N; Sun K; Lim S; Han Y
INSTITUCIÓN / INSTITUTION: - Departments of Pathology, College of Medicine, Chosun University, Gwangju 501-759, Republic of Korea.
RESUMEN / SUMMARY: - We describe an epidermoid cyst arising from an accessory spleen of the pancreas. A 56-year-old female with iron deficiency anemia presented with dizziness. During the clinical workup, a 2x4 cm-sized mass was incidentally detected in the tail of the pancreas in a computed tomography (CT) scan. Under a clinical diagnosis of pancreatic cystic malignant tumor, a distal pancreatectomy was carried out. Grossly, the lesion was composed of a solid and cystic portion. Microscopic analysis revealed that the solid portion was an intrapancreatic accessory spleen and the cystic portion was an epidermoid cyst. An epidermoid cyst in an intrapancreatic accessory spleen is extremely rare and hence difficult to diagnose pre-operatively. Taking into account the possibility of such a cyst in the differential diagnosis of intrapancreatic cystic lesion is recommended.
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[20]
TÍTULO / TITLE: - Pancreatic cystic neoplasms: a review of preoperative diagnosis and management.
RESUMEN / SUMMARY: - Enlace al Resumen / Link to its Summary
REVISTA / JOURNAL: - J Zhejiang Univ Sci B. 2013 Mar;14(3):185-94. doi: 10.1631/jzus.B1200283.
●● Enlace al texto completo (gratuito o de pago) 1631/jzus.B1200283
AUTORES / AUTHORS: - Bai XL; Zhang Q; Masood N; Masood W; Zhang Y; Liang TB
INSTITUCIÓN / INSTITUTION: - Department of Hepatobiliary-Pancreatic Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
RESUMEN / SUMMARY: - Pancreatic cystic neoplasms (PCNs) are a diverse group of neoplasms in the pancreas, and are more increasingly encountered with widespread abdominal screening and improved imaging techniques. The most common types of PCNs are serous cystic neoplasms (SCNs), mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Clinicians frequently feel bewildered in the differential diagnosis and subsequent management among the various types of lesions in the pancreas, which may lead to overtreatment or delayed treatment. The current review provides recent developments in the understanding of the three most common types of PCNs, the latest modalities used in preoperative diagnosis and differential diagnosis, as well as the most up to date management. Suggestions for diagnosis and differential diagnosis of SCNs, MCNs, and IPMNs are also provided for young surgeons. Better understanding of these neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.
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