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Pancreatic Neoplasms: HELP
Articles from Switzerland
Based on 342 articles published since 2008
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These are the 342 published articles about Pancreatic Neoplasms that originated from Switzerland during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14
1 Guideline Consensus statement on mandatory measurements in pancreatic cancer trials (COMM-PACT) for systemic treatment of unresectable disease. 2018

Ter Veer, Emil / van Rijssen, L Bengt / Besselink, Marc G / Mali, Rosa M A / Berlin, Jordan D / Boeck, Stefan / Bonnetain, Franck / Chau, Ian / Conroy, Thierry / Van Cutsem, Eric / Deplanque, Gael / Friess, Helmut / Glimelius, Bengt / Goldstein, David / Herrmann, Richard / Labianca, Roberto / Van Laethem, Jean-Luc / Macarulla, Teresa / van der Meer, Jonathan H M / Neoptolemos, John P / Okusaka, Takuji / O'Reilly, Eileen M / Pelzer, Uwe / Philip, Philip A / van der Poel, Marcel J / Reni, Michele / Scheithauer, Werner / Siveke, Jens T / Verslype, Chris / Busch, Olivier R / Wilmink, Johanna W / van Oijen, Martijn G H / van Laarhoven, Hanneke W M. ·Department of Medical Oncology, Cancer Center Amsterdam, Academic Medical Center, Amsterdam, Netherlands. · Department of Surgery, Cancer Center Amsterdam, Academic Medical Center, Amsterdam, Netherlands. · Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA. · Department of Internal Medicine III, Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany. · Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France. · Royal Marsden NHS Foundation Trust, London and Surrey, UK. · Department of Medical Oncology, Institut de Cancérologie de Lorraine and Lorraine University, Vandoeuvre-lès-Nancy, France. · Department of Gastroenterology and Digestive Oncology, University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium. · Department of Oncology, Hôpital Riviera-Chablais, Vevey, Switzerland. · Department of Surgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany. · Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. · Nelune Cancer Centre, Prince of Wales Hospital, Prince of Wales Clinical School University of New South Wales, Randwick, NSW, Australia. · Department of Medical Oncology, University Hospital Basel, Basel, Switzerland. · Cancer Center, ASST Papa Giovanni XXIII, Bergamo, Italy. · Department of Gastroenterology, Gastrointestinal Cancer Unit, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium. · Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain. · Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK. · Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan. · Gastrointestinal Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA. · Department of Hematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany. · Department of Oncology, Karmanos Cancer Center, Wayne State University, Detroit, MI, USA. · Department of Medical Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Department of Internal Medicine I, Medical University Vienna, Vienna, Austria. · Division of Solid Tumor Translational Oncology, West German Cancer Cancer, University Hospital Essen, Essen, Germany; German Cancer Consortium (DKTK, partner site Essen) and German Cancer Research Center, DKFZ, Heidelberg, Germany. · Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium. · Department of Medical Oncology, Cancer Center Amsterdam, Academic Medical Center, Amsterdam, Netherlands. Electronic address: h.vanlaarhoven@amc.uva.nl. ·Lancet Oncol · Pubmed #29508762.

ABSTRACT: Variations in the reporting of potentially confounding variables in studies investigating systemic treatments for unresectable pancreatic cancer pose challenges in drawing accurate comparisons between findings. In this Review, we establish the first international consensus on mandatory baseline and prognostic characteristics in future trials for the treatment of unresectable pancreatic cancer. We did a systematic literature search to find phase 3 trials investigating first-line systemic treatment for locally advanced or metastatic pancreatic cancer to identify baseline characteristics and prognostic variables. We created a structured overview showing the reporting frequencies of baseline characteristics and the prognostic relevance of identified variables. We used a modified Delphi panel of two rounds involving an international panel of 23 leading medical oncologists in the field of pancreatic cancer to develop a consensus on the various variables identified. In total, 39 randomised controlled trials that had data on 15 863 patients were included, of which 32 baseline characteristics and 26 prognostic characteristics were identified. After two consensus rounds, 23 baseline characteristics and 12 prognostic characteristics were designated as mandatory for future pancreatic cancer trials. The COnsensus statement on Mandatory Measurements in unresectable PAncreatic Cancer Trials (COMM-PACT) identifies a mandatory set of baseline and prognostic characteristics to allow adequate comparison of outcomes between pancreatic cancer studies.

2 Guideline Pancreatic cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. 2008

Herrmann, R / Jelic, S / Anonymous3450598. ·Division of Oncology, Department of Internal Medicine, University Hospital of Basel, Basel, Switzerland. ·Ann Oncol · Pubmed #18456756.

ABSTRACT: -- No abstract --

3 Review Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas: A surgeon's plea to centering attention on the liver. 2018

Keutgen, Xavier M / Schadde, Erik / Pommier, Rodney F / Halfdanarson, Thorvardur R / Howe, James R / Kebebew, Electron. ·Rush University Medical Center, Department of Surgery, Division of Surgical Oncology, Chicago, IL, USA. Electronic address: Xavier_keutgen@rush.edu. · Rush University Medical Center, Department of Surgery, Division of Surgical Oncology, Chicago, IL, USA; Cantonal Hospital Winterthur, Department of Surgery, Winterthur, Zurich, Switzerland; University of Zurich, Institute of Physiology, Zurich, Switzerland. · Oregon Health & Science University, Department of Surgery, Division of Surgical Oncology, Portland, OR, USA. · Mayo Clinic, Department of Oncology, Division of Medical Oncology, Rochester, MN, USA. · University of Iowa, Department of Surgery, Division of Surgical Oncology, Iowa City, IA, USA. · Stanford University, Department of Surgery, Division of Surgical Oncology, Stanford, CA, USA. ·Semin Oncol · Pubmed #30318110.

ABSTRACT: Over 50% of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have stage IV disease at presentation and the most likely organ to be affected by metastases is the liver. Hepatic involvement and hepatic tumor burden is a key prognostic factor affecting survival of these patients and 80% eventually die of liver failure due to tumor dissemination within the liver. This commentary explores the efficacy and limitations of systemic treatments in patients with GEP-NETs and liver metastases. Landmark randomized trials using systemic therapies including sandostatin (PROMID), lanreotide (CLARINET), everolimus (RADIANT 3 and 4), sunitinib and Peptide Receptor Radionuclide Therapy (NETTER-1) have not shown efficacy in reducing liver tumor burden in patients with stage IV GEP-NETs with liver metastases as outlined in this review. Although often overlooked, surgical debulking has been associated with a significant survival advantage in large retrospective studies and in our opinion should remain an important therapeutic option for patients with stage IV GEP-NETs and liver metastases.

4 Review Translational molecular imaging in exocrine pancreatic cancer. 2018

Cornelissen, Bart / Knight, James C / Mukherjee, Somnath / Evangelista, Laura / Xavier, Catarina / Caobelli, Federico / Del Vecchio, Silvana / Rbah-Vidal, Latifa / Barbet, Jacques / de Jong, Marion / van Leeuwen, Fijs W B. ·CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, Oxford University, Oxford, UK. bart.cornelissen@oncology.ox.ac.uk. · CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, Oxford University, Oxford, UK. · Istituto Oncologico Veneto I.R.C.C.S., Padova, Italy. · Vrije Universiteit Brussel, Brussels, Belgium. · Department of Radiology, Universitätsspital Basel, Basel, Switzerland. · Universita' degli Studi di Napoli "Federico II", Naples, Italy. · CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France. · Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands. · Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. ·Eur J Nucl Med Mol Imaging · Pubmed #30225616.

ABSTRACT: Effective treatment for pancreatic cancer remains challenging, particularly the treatment of pancreatic ductal adenocarcinoma (PDAC), which makes up more than 95% of all pancreatic cancers. Late diagnosis and failure of chemotherapy and radiotherapy are all too common, and many patients die soon after diagnosis. Here, we make the case for the increased use of molecular imaging in PDAC preclinical research and in patient management.

5 Review Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC). 2018

Neuzillet, Cindy / Gaujoux, Sébastien / Williet, Nicolas / Bachet, Jean-Baptiste / Bauguion, Lucile / Colson Durand, Laurianne / Conroy, Thierry / Dahan, Laetitia / Gilabert, Marine / Huguet, Florence / Marthey, Lysiane / Meilleroux, Julie / de Mestier, Louis / Napoléon, Bertrand / Portales, Fabienne / Sa Cunha, Antonio / Schwarz, Lilian / Taieb, Julien / Chibaudel, Benoist / Bouché, Olivier / Hammel, Pascal / Anonymous680992 / Anonymous690992 / Anonymous700992 / Anonymous710992 / Anonymous720992 / Anonymous730992 / Anonymous740992 / Anonymous750992 / Anonymous760992 / Anonymous770992. ·Department of Medical Oncology, Curie Institute, Versailles Saint-Quentin University (UVSQ), Saint-Cloud, France. Electronic address: cindy.neuzillet@gmail.com. · Department of Digestive, Hepato-Biliary and Pancreatic Surgery, Cochin Hospital, AP-HP, Paris Descartes Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France. · Hepato-Gastroenterology Department, University Hospital of Saint-Etienne, Saint Priest en Jarez, France. · Hepato-Gastroenterology Department, Pitié Salpétrière University Hospital, AP-HP, Paris Cedex 13, France. · Hepato-Gastroenterology Department, Departmental Hospital Center, La Roche sur Yon, France. · Department of Radiotherapy, Henri Mondor Hospital, AP-HP, Université Paris Est Creteil, Créteil, France. · Department of Medical Oncology, Lorraine Institute of Oncology and Lorraine University, Vandoeuvre-lès-Nancy Cedex, France. · Digestive Oncology Department, "DACCORD" (Digestif, Anatomie pathologique, Chirurgie, CISIH, Oncologie, Radiothérapie, Dermatologie) pole, CHU Timone, Marseille Cedex 05, France. · Paoli Calmettes Institute, Department of Medical Oncology and Cancer Research Center of Marseille (CRCM), INSERM U1068 Stress Cell, Aix-Marseille University, Marseille, France. · Department of Oncology and Radiotherapy, Tenon Hospital, East Paris University Hospitals, AP-HP, Paris Sorbonne University, Paris, France. · Gastroenterology Department, Béclère Hospital, AP-HP, Clamart, France. · Pathology Department, Toulouse University Hospital, Toulouse, France. · Department of Gastroenterology-Pancreatology, Beaujon Hospital, APHP, Paris 7 University, Clichy, France. · Jean Mermoz Private Hospital, Ramsay Générale de Santé, Lyon, France. · Digestive Oncology Department, Regional Institute of Cancer, Montpellier, France. · INSERM UMR 935, Paul Brousse Hospital, Hepatobiliary Center, AP-HP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. · Department of Digestive Surgery, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France and Genomic and Personalized Medicine in Cancer and Neurological Disorders, UMR 1245 INSERM, Rouen University, France. · Hepato-Gastroenterology and Digestive Oncology Department, Georges Pompidou European Hospital, AP-HP, Paris, France. · Department of Medical Oncology, Franco-British Institute, Levallois-Perret, France. · Hepato-Gastroenterology and Digestive Oncology Department, Robert Debré University Hospital, Avenue Général Koenig, 51092 Reims Cedex, France. · Department of Digestive Oncology, Beaujon University Hospital (AP-HP), Paris VII Diderot University, Clichy-la-Garenne, France. Electronic address: pascal.hammel@aphp.fr. ·Dig Liver Dis · Pubmed #30219670.

ABSTRACT: BACKGROUND: This document is a summary of the French intergroup guidelines regarding the management of pancreatic adenocarcinoma (PA), updated in July 2018. DESIGN: This collaborative work was produced under the auspices of all French medical and surgical societies involved in the management of PA. It is based on the previous guidelines, recent literature review and expert opinions. Recommendations were graded in three categories, according to the level of evidence. RESULTS: Over the last seven years, significant changes in PA management have been implemented in clinical practice. Imaging/staging: diffusion magnetic resonance imaging is useful before surgery to rule out small liver metastases. SURGERY: centralization of pancreatic surgery in expert centers is associated with a decreased postoperative mortality. Adjuvant chemotherapy: modified FOLFIRINOX in fit patients, or gemcitabine, or 5-FU, or gemcitabine plus capecitabine, to be discussed on a case-by-case basis. Locally advanced PA: no survival benefit of chemoradiotherapy. Metastatic PA: FOLFIRINOX and gemcitabine plus nab-paclitaxel combination are first-line standards in fit patients; second-line with 5FU/nal-IRI or 5FU/oxaliplatin combination after first-line gemcitabine. CONCLUSION: Guidelines for management of PA are continuously evolving and need to be regularly updated. This constant progress is made possible through clinical and translational research. However, as each individual case is particular, they cannot substitute to multidisciplinary tumor board discussion.

6 Review The Problem of High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms: Well-Differentiated Neuroendocrine Tumors, Neuroendocrine Carcinomas, and Beyond. 2018

Sorbye, Halfdan / Baudin, Eric / Perren, Aurel. ·Department of Oncology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Science, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway. Electronic address: halfdan.sorbye@helse-bergen.no. · Endocrine Oncology, Gustave Roussy, rue Édouard-Vaillant 114, Villejuif 94800, France. · Department of Pathology, University of Bern, Murtenstrasse 31, Bern 3008, Switzerland. ·Endocrinol Metab Clin North Am · Pubmed #30098724.

ABSTRACT: High-grade gastroenteropancreatic neuroendocrine neoplasms are well-differentiated neuroendocrine tumors or poorly differentiated small/large cell neuroendocrine carcinoma. Distinguishing these entities relies on different genetic backgrounds and resulting different biology. The new classification creates several problems. Almost all clinical treatment data on neuroendocrine neoplasms do not stratify between well and poorly differentiated, providing insufficient help in treatment selection. Treatment of gastroenteropancreatic neuroendocrine neoplasms should separate between well-differentiated neuroendocrine tumors and neuroendocrine carcinoma, and depends on primary tumor site, stage, proliferation rate, and clinical course. This article addresses how to diagnose and treat gastroenteropancreatic neuroendocrine neoplasms, focusing on well-differentiated neuroendocrine tumors versus neuroendocrine carcinomas.

7 Review Immunohistochemical Biomarkers of Gastrointestinal, Pancreatic, Pulmonary, and Thymic Neuroendocrine Neoplasms. 2018

Uccella, Silvia / La Rosa, Stefano / Volante, Marco / Papotti, Mauro. ·Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy. · Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland. stefano.larosa@chuv.ch. · Institut Universitaire de Pathologie, CHUV, 25 rue du Bugnon, 1011, Lausanne, Switzerland. stefano.larosa@chuv.ch. · Department of Oncology, San Luigi Hospital, University of Turin, Orbassano, Italy. · Department of Oncology, City of Health and Science, University of Turin, Turin, Italy. ·Endocr Pathol · Pubmed #29520563.

ABSTRACT: Neuroendocrine neoplasms (NENs) are a heterogeneous group of epithelial neoplastic proliferations that irrespective of their primary site share features of neural and endocrine differentiation including the presence of secretory granules, synaptic-like vesicles, and the ability to produce amine and/or peptide hormones. NENs encompass a wide spectrum of neoplasms ranging from well-differentiated indolent tumors to highly aggressive poorly differentiated neuroendocrine carcinomas. Most cases arise in the digestive system and in thoracic organs, i.e., the lung and thymus. A correct diagnostic approach is crucial for the management of patients with both digestive and thoracic NENs, because their high clinical and biological heterogeneity is related to their prognosis and response to therapy. In this context, immunohistochemistry represents an indispensable diagnostic tool that pathologists need to use for the correct diagnosis and classification of such neoplasms. In addition, immunohistochemistry is also useful in identifying prognostic and theranostic markers. In the present article, the authors will review the role of immunohistochemistry in the routine workup of digestive and thoracic NENs.

8 Review Ki67 labeling index: assessment and prognostic role in gastroenteropancreatic neuroendocrine neoplasms. 2018

Klöppel, Günter / La Rosa, Stefano. ·Institute of Pathology, Consultation Center for Pancreatic and Endocrine Tumors, Technical University of Munich, Trogerstr. 18, 81675, Munich, Germany. guenter.kloeppel@tum.de. · Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland. ·Virchows Arch · Pubmed #29134440.

ABSTRACT: In 1983, a monoclonal antibody, Ki67, was generated, that labeled the nuclei of proliferating non-neoplastic and neoplastic cells. The name Ki67 derived from the city of Kiel (Ki) where the antibody was produced in the university department of pathology and refers to the number of the original clone (67). Systematic assessment of the proliferative activity of tumors using Ki67 started in the 1990s, when Ki67, which only worked on frozen tissue, was complemented by the antibody MIB-1 that also worked in formalin-fixed tissues. Pancreatic neuroendocrine neoplasms (PanNENs) were the first endocrine tumors whose proliferative activity was assessed with Ki67. This approach was so successful that Ki67 was included as prognostic marker in the 2000 and 2004 WHO classifications of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). In 2010, the WHO classification of GEP-NENs introduced a three-tiered grading, originally proposed by ENETS in 2006 that was mainly based on the Ki67 index. As it has subsequently been shown that the Ki67 index is the most reliable factor in the prognostic evaluation of GEP-NENs, especially of PanNENs, the 2017 WHO classification of PanNENs requires its use and strongly recommends exact assessment of the proportion Ki67-labeled cells as basis for the calculation of the Ki67 index. Problems in assessing the Ki67 index include intertumoral and intratumoral staining heterogeneity and counting methods. Despite such problems, the Ki67 index has emerged as indispensable for the prognostic and therapeutic stratification of the majority of GEP-NENs and can barely be replaced by counting mitoses. In future, however, it can be anticipated that the Ki67 cut-offs experience refinement in relation to the type of tumor, its location, and its response to therapy. It is also possible that the prognostic risk of an individual tumor is calculated for each Ki67 unit and not for an "a priori" fixed Ki67 class.

9 Review Calcitonin-Producing Neuroendocrine Neoplasms of the Pancreas: Clinicopathological Study of 25 Cases and Review of the Literature. 2017

Uccella, Silvia / Blank, Annika / Maragliano, Roberta / Sessa, Fausto / Perren, Aurel / La Rosa, Stefano. ·Department of Medicine and Surgery, Unit of Pathology, University of Insubria, 21100, Varese, Italy. silvia.uccella@uninsubria.it. · Institute of Pathology, University of Bern, Bern, Switzerland. · Department of Medicine and Surgery, Unit of Pathology, University of Insubria, 21100, Varese, Italy. · Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland. ·Endocr Pathol · Pubmed #29063495.

ABSTRACT: Increased levels of circulating calcitonin are a clue in the diagnosis of medullary thyroid carcinoma. However, hypercalcitoninemia can also be related to other pathological conditions, including pancreatic neuroendocrine neoplasms (PanNENs). Ectopic hormonal production is not unusual in both functioning and non-functioning PanNENs; however, little is known about the frequency of calcitonin expression in these neoplasms. The aims of this study were to assess the frequency of calcitonin immunoreactivity in PanNENs, independently from serum calcitonin levels, and to evaluate the clinicopathological and prognostic features of calcitonin-immunoreactive (Cal-IR) PanNENs, including a comparison with cases already reported in the literature. We screened 229 PanNENs for the immunohistochemical expression of calcitonin, including both functioning and non-functioning neoplasms, as well as both well-differentiated and poorly differentiated PanNENs. Both the clinicopathological data and the follow-up information were available and were compared with the immunohistochemical results. In addition, we reviewed the features of the calcitonin-producing PanNENs previously reported in the literature. Calcitonin was expressed in 25 of our 229 PanNENs (10.9%). Examples of well- and poorly differentiated, as well as both functioning and non-functioning PanNENs, were found to be calcitonin immunoreactive. Cal-IR PanNENs did not show any significant difference with the whole series of neoplasms included in the study, when the clinicopathological parameters were considered, except for a younger age at diagnosis and for a larger size of the tumor in non-functioning Cal-IR PanNENs. Taken together, our results show that calcitonin immunoreactivity is not an exceptional event in PanNENs. Furthermore, calcitonin expression does not identify a separate clinical entity, in contrast to other PanNENs with ectopic hormone production, such as adrenocorticotropic hormone (ACTH)-producing PanNENs, which show a distinctively more aggressive behavior.

10 Review Imaging of neuroendocrine tumors of the pancreas. 2016

Dromain, C / Déandréis, D / Scoazec, J-Y / Goere, D / Ducreux, M / Baudin, E / Tselikas, L. ·Service de radiodiagnostic et radiologie interventionnelle, bureau CIBM 09-084, rue Bugnon 46, 1011 Lausanne, Switzerland. Electronic address: Clarisse.Dromain@chuv.ch. · Imaging department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. · Anapathology department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. · Surgery department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. · Oncology department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. ·Diagn Interv Imaging · Pubmed #27876341.

ABSTRACT: Pancreatic neuroendocrine tumors (PNETs) are rare and represent a heterogeneous disease. PNET can be functioning or non-functioning with different clinical presentations and different prognosis based on WHO and pTNM classifications. The role of imaging includes the localization of small functioning tumor, differentiation of these tumors from adenocarcinoma, identification of signs of malignancy and evaluation of extent. PNETs have a broad spectrum of appearance. On CT and MRI, most of functioning PNETs are well defined small tumors with intense and homogeneous enhancement on arterial and portal phases. However, some PNETs with a more fibrous content may have a more delayed enhancement that is best depicted on the delayed phase. Other PNETs can present as purely cystic, complex cystic and solid tumors and calcified tumors. Non-functioning PNETs are larger with less intense and more heterogeneous enhancement. Functional imaging is useful for disease staging, to detect disease recurrence or the primary but also to select patient candidate for peptide receptor radiometabolic treatment. Somatostatin receptor scintigraphy (SRS) (Octreoscan

11 Review Metabolomics in pancreatic cancer biomarkers research. 2016

Tumas, Jaroslav / Kvederaviciute, Kotryna / Petrulionis, Marius / Kurlinkus, Benediktas / Rimkus, Arnas / Sakalauskaite, Greta / Cicenas, Jonas / Sileikis, Audrius. ·Center of Abdominal Surgery, Vilnius University Hospital, Santariskiu Klinikos Santariskiu str. 2, 08661, Vilnius, Lithuania. · Institute of Biotechnology, Vilnius University, Saulėtekio ave. 7, 01222, Vilnius, Lithuania. · Center of Hepatology, Gastroenterology and Dietology, Vilnius University Hospital, Santariskiu Klinikos Santariskiu str. 2, 08661, Vilnius, Lithuania. · Faculty of Medicine, Vilnius University, Vilnius, Lithuania. · Vetsuisse Faculty, Institute of Animal Pathology, University of Bern, 3012, Bern, Switzerland. j.cicenas@mapkinases.eu. · MAP Kinase Resource, Bioinformatics, Melchiorstrasse 9, 3027, Bern, Switzerland. j.cicenas@mapkinases.eu. · Proteomics Centre, Institute of Biochemistry, Vilnius University, 08662, Vilnius, Lithuania. j.cicenas@mapkinases.eu. · Center of Abdominal Surgery, Vilnius University Hospital, Santariskiu Klinikos Santariskiu str. 2, 08661, Vilnius, Lithuania. audrius.sileikis@santa.lt. · Center of Hepatology, Gastroenterology and Dietology, Vilnius University Hospital, Santariskiu Klinikos Santariskiu str. 2, 08661, Vilnius, Lithuania. audrius.sileikis@santa.lt. ·Med Oncol · Pubmed #27807722.

ABSTRACT: Pancreatic cancer is one of the worst prognoses of all malignancies. More than 40,000 deaths a year from this disease are observed in European Union alone. The only possibly curative treatment of pancreatic cancer is surgery, yet only 15-20% of patients have operable disease and even patients, which go through surgery and adjuvant chemotherapy, survival is less than 30%. The sensitive and specific biomarkers which could be used for the advance of early diagnostics are needed and constantly researched. Metabolomics is a technology which analyzes the concentrations of low-molecular-weight metabolites (the metabolome) has lately effectively developed due to the improvements in analytical technology. Metabolome analysis can be a one of the useful approaches for the biomarker discovery and disease diagnosis. Here we discuss recent discoveries in the field of pancreatic cancer metabolomics as well as the most promising biomarkers for diagnostics, prognosis and prediction.

12 Review None 2016

Ackermann, Christoph Jakob / Güller, Ulrich. ·1 Klinik für Onkologie und Hämatologie, Kantonsspital St. Gallen. · 2 Universitätsklinik für Viszerale Chirurgie und Medizin, Inselspital, Bern. ·Ther Umsch · Pubmed #27805490.

ABSTRACT: -- No abstract --

13 Review None 2016

Worni, Mathias / Gloor, Beat. ·1 Universitätsklinik für Viszerale Chirurgie und Medizin, Universität Bern, Inselspital, Bern. ·Ther Umsch · Pubmed #27805487.

ABSTRACT: -- No abstract --

14 Review None 2016

Stoupis, Christoforos / Wiest, Reiner. ·1 Institut für Radiologie, Spital Männedorf. · 2 Universitätsklinik für Viszerale Chirurgie und Medizin, Universität Bern, Inselspital, Bern. ·Ther Umsch · Pubmed #27805483.

ABSTRACT: -- No abstract --

15 Review Stereotactic body radiotherapy for renal cell cancer and pancreatic cancer : Literature review and practice recommendations of the DEGRO Working Group on Stereotactic Radiotherapy. 2016

Panje, Cédric / Andratschke, Nikolaus / Brunner, Thomas B / Niyazi, Maximilian / Guckenberger, Matthias. ·Department of Radiation Oncology, Zurich University Hospital, Rämistrasse 100, 8091, Zurich, Switzerland. · Department of Radiation Oncology, Freiburg University Hospital, Freiburg, Germany. · Department of Radiation Oncology, University of Munich, Munich, Germany. · Department of Radiation Oncology, Zurich University Hospital, Rämistrasse 100, 8091, Zurich, Switzerland. matthias.guckenberger@usz.ch. ·Strahlenther Onkol · Pubmed #27778052.

ABSTRACT: PURPOSE: This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a literature review and practice recommendations for stereotactic body radiotherapy (SBRT) of primary renal cell cancer and primary pancreatic cancer. METHODS: A literature search on SBRT for both renal cancer and pancreatic cancer was performed with focus on prospective trials and technical aspects for clinical implementation. RESULTS: Data on renal and pancreatic SBRT are limited, but show promising rates of local control for both treatment sites. For pancreatic cancer, fractionated SBRT should be preferred to single-dose treatment to reduce the risk of gastrointestinal toxicity. Motion-compensation strategies and image guidance are paramount for safe SBRT delivery in both tumor entities. CONCLUSION: SBRT for renal cancer and pancreatic cancer have been successfully evaluated in phase I and phase II trials. Pancreatic SBRT should be practiced carefully and only within prospective protocols due to the risk of severe gastrointestinal toxicity. SBRT for primary renal cell cancer appears a viable option for medically inoperable patients but future research needs to better define patient selection criteria and the detailed practice of SBRT.

16 Review Post-gemcitabine therapy for patients with advanced pancreatic cancer - A comparative review of randomized trials evaluating oxaliplatin- and/or irinotecan-containing regimens. 2016

Vogel, Arndt / Ciardiello, Fortunato / Hubner, Richard A / Blanc, Jean-Frédéric / Carrato, Alfredo / Yang, Yoojung / Patel, Dipen A / Ektare, Varun / de Jong, Floris A / Gill, Sharlene. ·Medical School Hannover, Department of Gastroenterology, Hematology and Endocrinology, Carl-Neubergstr. 1, 30659 Hannover, Germany. Electronic address: vogel.arndt@mh-hannover.de. · Dipartimento di Medicina Clinica e Sperimentale "F. Magrassi", Seconda Università degli Studi di Napoli, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: Fortunato.CIARDIELLO@unina2.it. · Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom. Electronic address: Richard.Hubner@christie.nhs.uk. · Department of Hepato-Gastroenterology and Digestive Oncology, CHU Bordeaux, Hôpital Haut-Lévêque, avenue de Magellan, 33600 Pessac, France. Electronic address: jean-frederic.blanc@chu-bordeaux.fr. · Medical Oncology Department, Ramon y Cajal University Hospital, IRYCIS, Alcala University, Carretera Colmenar Viejo km 9.1, 28034 Madrid, Spain. Electronic address: acarrato@telefonica.net. · Shire, 650 East Kendall Street, Cambridge, MA 02145, United States. Electronic address: Yoojung.yang@baxalta.com. · Pharmerit International, 4350 East West Highway, Suite 430, Bethesda, MD 20814, United States. Electronic address: dpatel@pharmerit.com. · Pharmerit International, 4350 East West Highway, Suite 430, Bethesda, MD 20814, United States. Electronic address: vektare@pharmerit.com. · Shire, Thurgauerstrasse 130, 8152 Glattpark (Opfikon), Zürich, Switzerland. Electronic address: Floris.de.Jong@shire.com. · University of British Columbia, BC Cancer Agency, 600 W. 10th Avenue, Vancouver, BC V5Z 4E6, Canada. Electronic address: sgill@bccancer.bc.ca. ·Cancer Treat Rev · Pubmed #27676174.

ABSTRACT: A systematic review and critical evaluation of randomized trial evidence for oxaliplatin- or irinotecan-containing regimens in patients with advanced pancreatic cancer previously treated with gemcitabine has not yet been published. We conducted a comparative systematic review of randomized trials evaluating oxaliplatin- or irinotecan-based therapies in patients with advanced pancreatic cancer previously treated with gemcitabine to assess trial similarity and the feasibility of performing an indirect treatment comparison (ITC). Studies were identified through PubMed and key oncology conference abstracts. The following trials met our criteria: NAPOLI-1 (nanoliposomal irinotecan [nal-IRI] or nal-IRI+5-fluorouracil [5-FU]/leucovorin [LV] vs 5-FU/LV), CONKO-003 (oxaliplatin+5-FU/LV [OFF] vs 5-FU/LV), PANCREOX (oxaliplatin+5-FU/LV [mFOLFOX6] vs 5-FU/LV), and Yoo et al. (2009) (irinotecan+5-FU/LV [mFOLFIRI3] vs mFOLFOX). Fundamental differences were identified in study design (i.e., number of study sites, number of countries), patient (i.e., locally advanced vs metastatic disease, stratification variables, prior and subsequent treatments) and treatment (i.e., regimens, dose intensity) characteristics, and primary and secondary outcomes (i.e., primary vs secondary outcomes, overall survival [OS], progression-free survival [PFS]) among the 4 included trials. Our comparative review demonstrated significant dissimilarity across trials, which precluded conducting an ITC. In the absence of head-to-head nal-IRI- and/or oxaliplatin-based therapy trials, clinicians are advised to interpret these studies separately within the context of their individual patient population.

17 Review New Genetics and Genomic Data on Pancreatic Neuroendocrine Tumors: Implications for Diagnosis, Treatment, and Targeted Therapies. 2016

Schmitt, Anja M / Marinoni, Ilaria / Blank, Annika / Perren, Aurel. ·Institute of Pathology, University of Bern, Murtenstrasse 31, 3010, Bern, Switzerland. anja.schmitt@pathology.unibe.ch. · Institute of Pathology, University of Bern, Murtenstrasse 31, 3010, Bern, Switzerland. ·Endocr Pathol · Pubmed #27456058.

ABSTRACT: The recent findings on the roles of death-associated protein 6/α-thalassemia/mental retardation X-linked (DAXX/ATRX) in the development of pancreatic neuroendocrine tumors (PanNETs) have led to major advances in the molecular understanding of these rare tumors and open up completely new therapeutic windows. This overview aims at giving a simplified view on these findings and their possible therapeutic implications. The importance of epigenetic changes in PanNET is also underlined by recent findings of a cross-species study on microRNA (miRNA) and messenger RNA (mRNA) profiles in PanNETs.

18 Review [Grading of neuroendocrine tumors]. 2016

Saeger, W / Schnabel, P A / Komminoth, P. ·Institute für Pathologie und Neuropathologie der Universität Hamburg, UKE, Martinistraße 52, 20246, Hamburg, Deutschland. w.saeger@uke.de. · Institut für Allgemeine und Spezielle Pathologie der Universität des Saarlandes, Homburg/Saar, Deutschland. · Institut für Pathologie am Stadtspital Triemli, Zürich, Schweiz. ·Pathologe · Pubmed #27379621.

ABSTRACT: The current WHO classification of neuroendocrine tumors (NET) differentiates between typical carcinoids (low grade NET), atypical carcinoids (intermediate grade NET) and small cell and large cell carcinomas (high grade NET) according to the prognosis. Neuroendocrine neoplasms (NEN) of the gastrointestinal tract and the pancreas are graded in an identical way. Together with the TNM system this enables a preoperative estimation of the prognosis in biopsies and fine needle aspirates. Well-differentiated tumors are graded into G1 tumors by the number of mitoses, <2 per 10 high-power fields (HPF) and the Ki-67 (index <3 %) and G2 tumors (2-20 mitoses/10 HPF, Ki-67 3-20 %). Discrepancies between the number of mitoses and the Ki-67 index are not uncommon and in these cases the higher value of the two should be applied. The more differentiated tumors of the G3 type have to be differentiated from undifferentiated carcinomas of the small cell type and large cell type with a much poorer prognosis. Prognosis relevant grading of thyroid cancers is achieved by special subtyping so that the G1-G3 system is not applicable. The rare cancers of the parathyroid gland and of the pituitary gland are not graded. Adrenal tumors also have no grading system. The prognosis is dependent on the Ki-67 index and with some reservations on the established scoring systems.

19 Review Cerebral ischemic events in patients with pancreatic cancer: A retrospective cohort study of 17 patients and a literature review. 2016

Bonnerot, Mathieu / Humbertjean, Lisa / Mione, Gioia / Lacour, Jean-Christophe / Derelle, Anne-Laure / Sanchez, Jean-Charles / Riou-Comte, Nolwenn / Richard, Sébastien. ·aDepartment of Neurology, Stroke Unit bDepartment of Neuroradiology, University Hospital of Nancy, Nancy, France cDepartment of Human Protein Sciences, University Medical Center, Geneva, Switzerland dCentre d'Investigation Clinique Plurithématique Pierre Drouin, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France. ·Medicine (Baltimore) · Pubmed #27368015.

ABSTRACT: Stroke is a dramatic complication of pancreatic cancer with mechanisms related to oncological disease. A better description of the characteristics of cerebrovascular events would help better understand the pathogeny and protect vulnerable patients. We thus conducted a descriptive analysis of clinical, biological, and radiological features of patients from our centers and literature.We reviewed consecutive cases of patients who presented cerebrovascular events and pancreatic cancer in 4 stroke units in Lorrain (France) between January 1, 2009 and March 31, 2015, and all reported cases of literature. We identified 17 cases in our centers and 18 reported cases. Fifty-seven per cent of patients were male. Median age was 63 ± 14 years and ranged from 23 to 81 years. All cerebral events were ischemic. At the onset of stroke, pancreatic cancer had already been diagnosed in 59% of the patients in our centers for a mean time of 5.4 months. Five of them (29%) were being treated with gemcitabine and 2 (12%) with folfirinox. Adenocarcinoma at metastatic stage was reported in 82% of cases overall. Brain imaging revealed disseminated infarctions in 64%. High median levels of D-dimer (7600 ± 5 × 10 μg/L), C-reactive protein (63 ± 43 mg/L), and elevated prothrombin time (19 ± 6 seconds) were found. Thirty-six per cent of patients explored with echocardiography were diagnosed with nonbacterial thrombotic endocarditis. Ten of our patients received anticoagulant therapy as secondary stroke prevention without any documented recurrence. Nevertheless, outcome was poor with a median survival time of 28 ± 14 days after stroke onset. Cerebral ischemic events occur at advanced stages of pancreatic cancer, most likely by a thromboembolic mechanism. Disseminated infarctions and high D-dimer, C-reactive protein levels, and a high prothrombin time are the most constant characteristics found in this context. All patients should be screened for nonbacterial thrombotic endocarditis as this etiology supports the use of anticoagulant therapy.

20 Review Hypofractionated radiotherapy in pancreatic cancer: Lessons from the past in the era of stereotactic body radiation therapy. 2016

De Bari, Berardino / Porta, Laetitia / Mazzola, Rosario / Alongi, Filippo / Wagner, Anna Dorothea / Schäfer, Markus / Bourhis, Jean / Ozsahin, Mahmut. ·Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland. Electronic address: berardino.de-bari@chuv.ch. · Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland. · Radiation Oncology Department, Sacro Cuore Hospital, Negrar, Verona, Italy; Radiation Oncology Department, Palermo University, Palermo, Italy. · Radiation Oncology Department, Sacro Cuore Hospital, Negrar, Verona, Italy. · Medical Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland. · Visceral Surgery Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland. ·Crit Rev Oncol Hematol · Pubmed #27233119.

ABSTRACT: The role of neoadjuvant and definitive radiotherapy combined or not to chemotherapy in the therapeutic approach to pancreatic cancer has not been yet elucidated. There is some evidence in favour of neoadjuvant local and/or systemic approaches that enable surgical resection in patients initially considered to be "borderline resectable". Nevertheless, most of these studies have been conducted using schedules of radiotherapy (treatment volumes, total doses, dose/fraction) that are nowadays considered not efficient enough and/or too toxic. Recently, stereotactic body radiation therapy (SBRT) has been proposed as a new therapeutic option for pancreatic cancer, both in the neoadjuvant and in the definitive setting. The aim of this study is to review the radiobiological and clinical evidences supporting hypofractionation in pancreatic cancer. Moreover, we performed an extensive review of available clinical and dosimetric data on SBRT in pancreatic cancer.

21 Review Ablation Strategies for Locally Advanced Pancreatic Cancer. 2016

Linecker, Michael / Pfammatter, Thomas / Kambakamba, Patryk / DeOliveira, Michelle L. ·Department of Surgery and Transplantation, Swiss Hepato-Pancreato-Biliary (HPB) Center, University Hospital Zurich, Zurich, Switzerland. ·Dig Surg · Pubmed #27216160.

ABSTRACT: With the advent of novel and somewhat effective chemotherapy against pancreas cancer, several groups developed a new interest on locally advanced pancreatic cancer (LAPC). Unresectable tumors constitute up to 80% of pancreatic cancer (PC) at the time of diagnosis and are associated with a 5-year overall survival of less than 5%. To control those tumors locally, with perhaps improved patients survival, significant advances were made over the last 2 decades in the development of ablation methods including cryoablation, radiofrequency ablation, microwave ablation, high intensity focused ultrasound and irreversible electroporation (IRE). Many suggested a call for caution for possible severe or lethal complications in using such techniques on the pancreas. Most fears were on the heating or freezing of the pancreas, while non-thermal ablation (IRE) could offer safer approaches. The multimodal therapies along with high-resolution imaging guidance have created some enthusiasm toward ablation for LAPC. The impact of ablation techniques on primarily non-resectable PC remains, however, unclear.

22 Review Gastroenteropancreatic neuroendocrine tumours (GEP-NET) - Imaging and staging. 2016

Baumann, Tobias / Rottenburger, Christof / Nicolas, Guillaume / Wild, Damian. ·Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland. · Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland; Center of Neuroendocrine and Endocrine Tumors, University of Basel Hospital, Basel, Switzerland. · Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland; Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK. · Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland; Center of Neuroendocrine and Endocrine Tumors, University of Basel Hospital, Basel, Switzerland. Electronic address: damian.wild@usb.ch. ·Best Pract Res Clin Endocrinol Metab · Pubmed #26971843.

ABSTRACT: Detection of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) and monitoring of treatment response relies mainly on morphological imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). Molecular imaging techniques also in combination with CT (hybrid imaging) greatly benefit patient management, including better localization of occult tumours and better staging. Somatostatin receptor scintigraphy (SRS) and somatostatin receptor (SSTR) positron emission tomography (PET) play a central role in the diagnostic work-up of patients with well-differentiated GEP-NETs. SSTR PET/CT is superior to SRS and should be used whenever available. (18)F-DOPA and (18)F-FDG PET/CT is inferior to SSTR PET/CT at least in patients with well-differentiated GEP-NETs. Both SSTR PET/CT and SRS have limitations, such as relatively low detection rate of benign insulinomas, poorly differentiated GEP-NETs and liver metastases. New innovations such as SSTR PET/MRI, radiolabelled SSTR antagonists and glucagon-like peptide-1 receptor (GLP-1R) agonists might further improve imaging of GEP-NETs.

23 Review Targeting cancer cell metabolism in pancreatic adenocarcinoma. 2015

Cohen, Romain / Neuzillet, Cindy / Tijeras-Raballand, Annemilaï / Faivre, Sandrine / de Gramont, Armand / Raymond, Eric. ·INSERM U728, Beaujon University Hospital (AP-HP - PRES Paris 7 Diderot), Clichy La Garenne, France. · Department of Medical Oncology, Henri Mondor University Hospital, Créteil, France. · AAREC Filia Research, Translational Department, Boulogne-Billancourt, France. · Medical Oncology, Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. · New Drug Evaluation Laboratory, Centre of Experimental Therapeutics and Medical Oncology, Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. ·Oncotarget · Pubmed #26164081.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is expected to become the second leading cause of cancer death by 2030. Current therapeutic options are limited, warranting an urgent need to explore innovative treatment strategies. Due to specific microenvironment constraints including an extensive desmoplastic stroma reaction, PDAC faces major metabolic challenges, principally hypoxia and nutrient deprivation. Their connection with oncogenic alterations such as KRAS mutations has brought metabolic reprogramming to the forefront of PDAC therapeutic research. The Warburg effect, glutamine addiction, and autophagy stand as the most important adaptive metabolic mechanisms of cancer cells themselves, however metabolic reprogramming is also an important feature of the tumor microenvironment, having a major impact on epigenetic reprogramming and tumor cell interactions with its complex stroma. We present a comprehensive overview of the main metabolic adaptations contributing to PDAC development and progression. A review of current and future therapies targeting this range of metabolic pathways is provided.

24 Review [What is new in the pathology of pancreatic neuroendocrine tumors?]. 2015

Komminoth, P / Perren, A. ·Institut für Pathologie, Stadtspital Triemli, Birmensdorferstr. 497, 8063, Zürich, Schweiz, paul.komminoth@triemli.zuerich.ch. ·Pathologe · Pubmed #25941099.

ABSTRACT: The diagnostics of pancreatic neuroendocrine tumors (PanNEN) have changed in recent years especially concerning the World Health Organization (WHO) classification, TNM staging and grading. Furthermore, some new prognostic and predictive immunohistochemical markers have been introduced. Most progress, however, has been made in the molecular pathogenesis of these neoplasms. Using next generation sequencing techniques, the mammalian target of rapamycin (mTOR) pathway, hypoxia and epigenetic changes were identified as key players in tumorigenesis. In this article the most important developments of morphological as well as immunohistochemical diagnostics together with the molecular background of PanNEN are summarized.

25 Review A meta-analysis of extended versus standard lymphadenectomy in patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma. 2015

Orci, Lorenzo A / Meyer, Jeremy / Combescure, Christophe / Bühler, Leo / Berney, Thierry / Morel, Philippe / Toso, Christian. ·Division of Abdominal Surgery, Department of Surgery, Faculty of Medicine, University of Geneva, Geneva, Switzerland. · Hepato-Pancreato-Biliary Centre, Geneva University Hospitals, Geneva, Switzerland. · Division of Clinical Epidemiology, Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland. · Centre de Recherche Clinique, Geneva University Hospitals, Geneva, Switzerland. ·HPB (Oxford) · Pubmed #25913578.

ABSTRACT: BACKGROUND: Lymph node involvement in pancreatic adenocarcinoma is a key prognostic factor. Therefore, extending the number of lymph node stations excised in pancreatoduodenectomy may be beneficial to patients with pancreatic adenocarcinoma. This systematic review and meta-analysis examines the outcomes of extended versus standard lymphadenectomy in the published literature. METHODS: A meta-analysis of randomized controlled trials (RCTs) comparing extended with standard lymphadenectomy in patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma was performed. Perioperative outcomes were assessed as pooled odds ratios (ORs) and weighted mean differences. Overall survival was analysed for patients with positive and negative lymph nodes. Results were reported according to the PRISMA statement. RESULTS: Five RCTs were included, accounting for 724 patients. Extended lymphadenectomy was associated with greater operative time [mean difference: 63 min, 95% confidence interval (CI) 29-96; P < 0.001], increased need for blood transfusions (mean difference: 0.20, 95% CI 0.01-0.30; P = 0.030) and greater postoperative morbidity (OR 1.5, 95% CI 1.25-2.00; P = 0.030), as well as with prolonged diarrhoea after circumferential autonomic nerve dissection around major vessels (OR 12.2, 95% CI 5.3-28.5; P < 0.001). Median survival was similar across the groups in the whole cohort, as well as in subgroups of patients with, respectively, positive and negative lymph nodes. CONCLUSIONS: Extended lymphadenectomy has a harmful impact on patients undergoing oncological pancreatoduodenectomy compared with standard lymphadenectomy.

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