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Pancreatic Neoplasms: HELP
Articles from Turkey
Based on 260 articles published since 2008

These are the 260 published articles about Pancreatic Neoplasms that originated from Turkey during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Editorial Which guidelines should be used for branch-duct intraductal papillary mucinous neoplasms? 2016

Basar, Omer / Brugge, William R. ·Pancreas Biliary Center, Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Gastroenterology, Hacettepe Medical School, Ankara, Turkey. · Pancreas Biliary Center, Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, USA. ·Gastrointest Endosc · Pubmed #27530478.

ABSTRACT: -- No abstract --

2 Review MicroRNA-based Targeted Therapeutics in Pancreatic Cancer. 2019

Gurbuz, Nilgun / Ozpolat, Bulent. ·Department of Medical Biology, School of Medicine, Suleyman Demirel University, Isparta, Turkey. · Department of Experimental Therapeutics, MD Anderson Cancer Center, The University of Texas, Houston, TX, U.S.A. bozpolat@mdanderson.org. ·Anticancer Res · Pubmed #30711926.

ABSTRACT: The discovery during the last decade of microRNAs (miRs, miRNA) and their role in regulating normal physiological processes as well as in the pathogenesis of human tumors has been a revolutionary development in molecular oncology. miRNAs activating or inhibiting oncogenic molecular pathways that are involved in tumorigenesis, cell progression, invasion, angiogenesis and metastasis are now considered of major impact in many cancer types. miRNA-based therapeutics that inhibit the levels of oncogenic miRNAs (oncomiRs) or elevate tumor suppressor miRs have enormous potential as molecular therapeutic targets. Thus, the development of new targeted cancer therapies based on miRNAs promise to revolutionize cancer treatment due to their increased efficacy compared to conventional chemoradiation-based therapies and hopefully to lower levels of adverse effects.

3 Review Targeted Therapies for Pancreatic Cancer and Hurdles Ahead. 2018

Aslan, Minela / Shahbazi, Reza / Ulubayram, Kezban / Ozpolat, Bulent. ·Bioengineering Division, Institute for Graduate Studies in Science and Engineering, Hacettepe University, Ankara, Turkey. · Department of Nanotechnology and Nanomedicine, Faculty of Pharmacy, Institute for Graduate Studies in Science and Engineering, Hacettepe University, Ankara, Turkey. · Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Institute for Graduate Studies in Science and Engineering, Hacettepe University, Ankara, Turkey. · Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A. Bozpolat@mdanderson.org. · Center for RNA Interference and Non-Coding RNA, The University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A. ·Anticancer Res · Pubmed #30504367.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal cancers with a median survival of 6 months after diagnosis. Intrinsic resistance to chemotherapeutics and lack of effective targeted therapies are the major factors contributing to dismal prognosis. Several important genetic alterations (i.e., mutations, deletions) have been identified to be involved in the initiation and progression of pancreatic cancer, including KRAS and inactivation of tumor suppressors, such as TP53, SMAD4 and CDKN2A. Unique tumor microenvironment with excessive stroma due to desmoplastic reaction is one of the major characteristics of PDAC, promoting tumor growth and leading to treatment failures. In addition, tumor stroma represents an important biological barrier for drug delivery and successful treatment of PDAC. Small interfering RNA (siRNA) has recently emerged as a potential and targeted therapeutic approach which is now evaluated in clinical trials. However, siRNA-based therapeutics face important challenges, including rapid serum degradation, poor tumor cell uptake and cellular uptake, leading to off-target effects. Therefore, there is a great need for the development of safe and effective nanoparticles for better tumor-specific delivery of anti-cancer therapeutics. In this article, the main challenges in the treatment of pancreatic cancer and recent advancements on nano delivery systems of chemotherapeutics and gene-targeted agents, used both in preclinical and clinical trials are reviewed.

4 Review Insulin/IGF-driven cancer cell-stroma crosstalk as a novel therapeutic target in pancreatic cancer. 2018

Mutgan, Ayse Ceren / Besikcioglu, H Erdinc / Wang, Shenghan / Friess, Helmut / Ceyhan, Güralp O / Demir, Ihsan Ekin. ·Department of Surgery, Klinikum rechts der Isar, Technical University Munich, München, Germany. · Department of Histology and Embryology, Gazi University Institute of Health Sciences, Ankara, Turkey. · Department of Surgery, Klinikum rechts der Isar, Technical University Munich, München, Germany. ekin.demir@tum.de. ·Mol Cancer · Pubmed #29475434.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is unrivalled the deadliest gastrointestinal cancer in the western world. There is substantial evidence implying that insulin and insulin-like growth factor (IGF) signaling axis prompt PDAC into an advanced stage by enhancing tumor growth, metastasis and by driving therapy resistance. Numerous efforts have been made to block Insulin/IGF signaling pathway in cancer therapy. However, therapies that target the IGF1 receptor (IGF-1R) and IGF subtypes (IGF-1 and IGF-2) have been repeatedly unsuccessful. This failure may not only be due to the complexity and homology that is shared by Insulin and IGF receptors, but also due to the complex stroma-cancer interactions in the pancreas. Shedding light on the interactions between the endocrine/exocrine pancreas and the stroma in PDAC is likely to steer us toward the development of novel treatments. In this review, we highlight the stroma-derived IGF signaling and IGF-binding proteins as potential novel therapeutic targets in PDAC.

5 Review Recent advances in the management of pancreatic adenocarcinoma. 2018

Karakas, Yusuf / Lacin, Sahin / Yalcin, Suayib. ·a Department of Medical Oncology , Cancer Institute, Hacettepe University , Ankara , Turkey. ·Expert Rev Anticancer Ther · Pubmed #29125367.

ABSTRACT: INTRODUCTION: Pancreatic cancer (PC) demonstrates very poor prognosis and its incidence continues to increase, despite developments in chemotherapy, radiotherapy, and targeted therapies. Surgical resection is currently the only curative approach for PC. The role of radiotherapy in adjuvant and locally advanced PC continues to be increasingly controversial. This review article aims to explore the current knowledge of pancreatic adenocarcinoma, focusing on diagnosis, treatment strategies, and the best supportive care. Areas covered: The current literature on pancreatic adenocarcinoma treatment modalities has been summarized, with a focus on clinical trials and reviews. New treatment strategies and their impact on clinical practice have also been discussed. Expert commentary: Despite many therapeutic developments, only modest improvements in survival rates have been achieved. There is an essential need to increase survival by developing more innovative treatment approaches for patients with PC.

6 Review Radiological and endoscopic imaging methods in the management of cystic pancreatic neoplasms. 2017

Aslan, Ahmet / Inan, Ibrahim / Orman, Süleyman / Aslan, Mine / Acar, Murat. ·Department of Radiology, Medical School of Istanbul Medeniyet University, Göztepe Training and Research Hospital, 34722 Kadikoy, Istanbul, Turkey. · Department of Gastrointestinal Surgery, Medeniyet University Faculty of Medicine, Göztepe Training and Research Hospital, 34722 Kadikoy, Istanbul, Turkey. · Department of Radiology, Ümraniye Training and Research Hospital, 34764 Ümraniye, Istanbul, Turkey. · Department of Radiology, Medical School of Istanbul Medeniyet University, Göztepe Training and Research Hospital. · Department of Radiology, King Hamad University Hospital, Bahrain. ·Acta Gastroenterol Belg · Pubmed #29560695.

ABSTRACT: The management of cystic pancreatic neoplasm (CPN) is a clinical dilemma because of its clinical presentations and malignant potential. Surgery is the best treatment choice ; however, pancreatic surgery still has high complication rates, even in experienced centers. Imaging methods have a definitive role in the management of CPN and computed tomography, magnetic resonance imaging, and endoscopic ultrasonography are the preferred methods since they can reveal the suspicious features for malignancy. Therefore, radiologists, gastroenterologists, endoscopists, and surgeons should be aware of the common features of CPN, its discrete presentations on imaging methods, and the limitations of these modalities in the management of the disease. This study aims to review the radiological and endoscopic imaging methods used for the management of CPN.

7 Review Pathologic classification of "pancreatic cancers": current concepts and challenges. 2017

Mostafa, Mohamed E / Erbarut-Seven, Ipek / Pehlivanoglu, Burcin / Adsay, Volkan. ·Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA. · Department of Pathology, School of Medicine, Marmara University, Istanbul, Turkey. · Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA. nadsay@mcw.edu. ·Chin Clin Oncol · Pubmed #29307199.

ABSTRACT: As the most common and most important cancer of the pancreas, with rapid mortality and now also as the third leading cause of cancer-related deaths in the United States, pancreatic ductal adenocarcinoma (PDAC) has become synonymous with "pancreas cancer". PDAC is also the prototype of the "pancreatobiliary-type" adenocarcinomas, along the biliary tract, ampullary and gallbladder cancers with the similar morphology and behavior. Recent molecular profiling studies have identified distinct subsets of PDAC, potentially with different behaviors and targetability. Moreover, while PDAC is by far the most common cancer of the pancreas, there are various other types that occur in this organ and are erroneously classified together with PDAC. Many of these have different molecular and biologic characteristics that warrant their management separately although they are also technically "pancreatic cancers". While some are closely related to PDAC and have as aggressive behavior (such as adenosquamous carcinomas which are recently recognized under "basal" like category in profiling studies, which are actually even worse prognostically than PDACs), in the meantime, others such as colloid carcinoma has a much better behavior than PDAC, and as a carcinoma with intestinal lineage (MUC2/CDX2) colloid carcinoma may require an entirely different treatment approach as well. Similarly, medullary carcinomas also appear to have different biology. Additionally, non-ductal cancers such as acinar, neuroendocrine, solid-pseudopapillary neoplasms and pancreatoblastoma have their respective clinicopathologic and molecular associations and warrant careful elimination in the management and study protocols. Another very problematic aspect in the classification of "pancreas cancer" is its delineation from the cancers of neighboring organs, in particular, ampullary/duodenal and common bile duct (CBD) cancers, for which recently more refined criteria have been provided. Additionally, the possibility of metastasis from another site and lymphomas also need to be considered. In summary, there is a whole host of cancers that occur in the pancreas that ought to be considered carefully before a case is classified as an ordinary "pancreas cancer" (PDAC).

8 Review Spinal cord ischemia after endoscopic ultrasound guided celiac plexus neurolysis: case report and review of the literature. 2017

Köker, Ibrahim Hakkı / Aralaşmak, Ayşe / Ünver, Nurcan / Asil, Talip / Şentürk, Hakan. ·a Medicine Faculty, Gastroenterology Department , Bezmialem Vakıf University , Istanbul , Turkey. · b Medicine Faculty, Radiology Department , Bezmialem Vakıf University , Istanbul , Turkey. · c Medicine Faculty, Pathology Department , Bezmialem Vakıf University , Istanbul , Turkey. · d Medicine Faculty, Neurology Department , Bezmialem Vakıf University , Istanbul , Turkey. ·Scand J Gastroenterol · Pubmed #28625083.

ABSTRACT: INTRODUCTION: Endosonography guided celiac plexus neurolysis is efficacious in the management of severe pain due to advanced pancreatic cancer. Although endoscopic ultrasound (EUS) guided celiac neurolysis (CN) is mostly a safer procedure than the percutaneous posterior approach, severe complications such as paraplegia have been reported. CASE REPORT: We describe a patient with advanced adenocarcinoma of the pancreas and severe pain who developed irreversible paraplegia after EUS guided CN. CONCLUSIONS: Endosonography guided celiac plexus neurolysis also might be complicated with paraplegia as already observed with percutaneous approach. The underlying mechanism could not be explained clearly until now. We detected concomitant embolic occlusion of Adamkiewicz and anterior radicularis magna arteries in magnetic resonance angiography. So, this procedure must be considered only for malignancy patients.

9 Review Contemporary strategies to improve the outcome in locally advanced pancreatic cancer. 2017

Schneider, Rick / Späth, Christoph / Nitsche, Ulrich / Erkan, Mert / Kleeff, Jörg. ·Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany. · Department of General Surgery, North Shore Hospital, Auckland, New Zealand. · Department of Surgery, Rechts der Isar Hospital, Technical University of Munich, Munich, Germany. · Department of Surgery, Koç University School of Medicine, Istanbul, Turkey. · Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany - joerg.kleeff@uk-halle.de. ·Minerva Chir · Pubmed #28565894.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with an overall 5-year survival rate of less than 7%. After many years of basic and clinical research efforts, pancreatic cancer patients presenting with locally advanced, unresectable tumors remain a therapeutic challenge. Despite the lack of high quality randomized controlled trials, perioperative/neoadjuvant treatment strategies seem to be beneficial in these patients. At present the FOLFIRINOX regimen, which was established in the palliative setting, is increasingly recognized as the backbone of neoadjuvant therapy for locally advanced PDAC. Surgical resection follows the same principles and guidelines as upfront surgery specifically regarding the extent of resection including lymphadenectomy, vascular resections and multivisceral resections. Because of the limited diagnostic accuracy of restaging after neoadjuvant treatment, an adjusted intraoperative strategy is necessary to minimize the risk of debulking procedures and maximize the chance of a potential curative resection. Locally advanced PDAC requires a multidisciplinary and individualized treatment approach, and further research efforts for novel and innovative therapies. This article provides an updated overview on strategies to improve the outcome in locally advanced PDAC.

10 Review Pancreatic Cancer Stem Cells and Therapeutic Approaches. 2017

Ercan, Gulinnaz / Karlitepe, Ayfer / Ozpolat, Bulent. ·Department of Medical Biochemistry, Ege University Medical School, Izmir, Turkey. · Department of Stem Cell, Institute of Health Sciences, Ege University, Izmir, Turkey. · Department of Experimental Therapeutics, The University of Texas, MD Anderson Cancer Center, Houston, TX, U.S.A. bozpolat@mdanderson.org. · Center for RNA Interference and Non-Coding RNA, The University of Texas, MD Anderson Cancer Center, Houston, TX, U.S.A. ·Anticancer Res · Pubmed #28551612.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is considered one of the deadliest human cancers, with 1-5% 5-year survival rates (~6-month median survival duration) despite therapy; thus, PDAC represents an unmet therapeutic challenge. PDAC is the major histological subtype, comprising 90% of all pancreatic cancers. It is a highly complex and aggressive malignancy, presenting with early local invasion and metastasis, and is resistant to most therapies, all of which are believed to contribute to its extremely poor prognosis. PDAC is characterized by molecular alterations, including mutations of K-RAS (~90% of cases), TP53, transforming growth factor-β, Hedgehog, WNT and NOTCH signaling pathways. Given that cancer stem cells have a crucial role not only in tumor initiation and progression, but also in drug resistance and relapse or recurrence of various cancer types, they may be excellent targets for effective novel therapeutic approaches. Here, we reviewed recent therapeutic strategies targeting pancreatic cancer stem cells using chemotherapeutics and targeted drugs, non-coding RNAs (i.e., siRNA and miRNAs), immunotherapy, and natural compounds.

11 Review A Metabolic Inhibitory Cocktail for Grave Cancers: Metformin, Pioglitazone and Lithium Combination in Treatment of Pancreatic Cancer and Glioblastoma Multiforme. 2016

Elmaci, İlhan / Altinoz, Meric A. ·Department of Neurosurgery, Memorial Hospital, Istanbul, Turkey. · Neuroacademy Group, Istanbul, Turkey. · Department of Immunology, Experimental Medicine Research Center, Istanbul, Turkey. maltinoz@gmail.com. ·Biochem Genet · Pubmed #27377891.

ABSTRACT: Pancreatic cancer (PC) and glioblastoma multiforme (GBM) are among the human cancers with worst prognosis which require an urgent need for efficient therapies. Here, we propose to apply to treat both malignancies with a triple combination of drugs, which are already in use for different indications. Recent studies demonstrated a considerable link between risk of PC and diabetes. In experimental models, anti-diabetogenic agents suppress growth of PC, including metformin (M), pioglitazone (P) and lithium (L). L is used in psychiatric practice, yet also bears anti-diabetic potential and selectively inhibits glycogen synthase kinase-3 beta (GSK-3β). M, a biguanide class anti-diabetic agent shows anticancer activity via activating AMP-activated protein kinase (AMPK). Glitazones bind to PPAR-γ and inhibit NF-κB, triggering cell proliferation, apoptosis resistance and synthesis of inflammatory cytokines in cancer cells. Inhibition of inflammatory cytokines could simultaneously decrease tumor growth and alleviate cancer cachexia, having a major role in PC mortality. Furthermore, mutual synergistic interactions exist between PPAR-γ and GSK-3β, between AMPK and GSK-3β and between AMPK and PPAR-γ. In GBM, M blocks angiogenesis and migration in experimental models. Very noteworthy, among GBM patients with type 2 diabetes, usage of M significantly correlates with better survival while reverse is true for sulfonylureas. In experimental models, P synergies with ligands of RAR, RXR and statins in reducing growth of GBM. Further, usage of P was found to be lesser in anaplastic astrocytoma and GBM patients, indicating a protective effect of P against high-grade gliomas. L is accumulated in GBM cells faster and higher than in neuroblastoma cells, and its levels further increase with chronic exposure. Recent studies revealed anti-invasive potential of L in GBM cell lines. Here, we propose that a triple-agent regime including drugs already in clinical usage may provide a metabolic adjuvant therapy for PC and GBM.

12 Review K-Ras4B/calmodulin/PI3Kα: A promising new adenocarcinoma-specific drug target? 2016

Nussinov, Ruth / Muratcioglu, Serena / Tsai, Chung-Jung / Jang, Hyunbum / Gursoy, Attila / Keskin, Ozlem. ·a Cancer and Inflammation Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research , National Cancer Institute at Frederick , Frederick , MD , USA. · b Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine , Tel Aviv University , Tel Aviv , Israel. · c Department of Chemical and Biological Engineering , Koc University , Istanbul , Turkey. · d Department of Computer Engineering , Koc University , Istanbul , Turkey. ·Expert Opin Ther Targets · Pubmed #26873344.

ABSTRACT: INTRODUCTION: Decades of efforts have yet to yield a safe and effective drug to target KRAS-driven pancreatic, colorectal and lung cancers; particularly those driven by the highly oncogenic splice variant KRAS4B. K-Ras4B's fairly smooth surface, cancer tissue/cell heterogeneity, tolerated lipid post-translational modification exchange, as well as drug-elicited toxicity present a daunting challenge. AREAS COVERED: Within this framework, hee we focus on a new adenocarcinoma-specific drug concept. Calmodulin (CaM) binds to K-Ras4B but not to the H-Ras or N-Ras isoforms. Physiologically, in calcium- and calmodulin-rich environments such as ductal tissues, calmodulin can sequester K-Ras4B from the membrane; in cancer, CaM/Ca(2+) can replace the missing receptor tyrosine kinase (RTK) signal, acting to fully activate PI3Kα. EXPERT OPINION: An oncogenic GTP-bound K-Ras4B/CaM/PI3Kα complex is supported by available experimental and clinical data; therefore, targeting it may address a pressing therapeutic need. High resolution electron microscopy (EM) or crystal structure of the tripartite complex would allow orthosteric or allosteric drug discovery to disrupt the CaM/PI3Kα interface and thus Akt/mTOR signaling. However, since drug resistance is expected to develop, combining it with compensatory pathways, particularly those involved in cell-cycle control, appears a reasonable strategy.

13 Review Endoscopic ultrasound-guided tissue sampling: How can we improve the results? 2016

Alper, Emrah / Onur, İrem / Arabul, Mahmut / Ünsal, Belkıs. ·Department of Gastroenterology, Katip Çelebi University, İzmir Atatürk Training and Research Hospital, İzmir, Turkey. mahmutarabul@gmail.com. ·Turk J Gastroenterol · Pubmed #26728860.

ABSTRACT: Endoscopic ultrasound (EUS) enables a gastroenterologist to sample the masses of the middle and inferior mediastinum, which are adjacent to the esophagus; cystic or solid lesions of the pancreas, which are adjacent to the stomach and duodenum; and perirectal lesions. Needles used for EUS sampling include aspiration (19, 20, and 22 Gauge) or core biopsy needles (ProCore and Trucut) (19, 20, and 22 Gauge). The type and size of EUS needles do not alter the diagnostic results. Rapid on-site cytopathological evaluation will increase the diagnostic efficacy to 100% without prolonging the procedure time. Diagnostic efficacy of EUS-guided fine-needle aspiration or core biopsy depends on the experience of an endoscopist and a cytopathologist. In the presence of an experienced endoscopist and cytopathologist, the size of the needle does not have any significant impact on the diagnostic success.

14 Review The role of hypoxia in pancreatic cancer: a potential therapeutic target? 2016

Erkan, Mert / Kurtoglu, Metin / Kleeff, Jorg. ·a Department of Surgery , Koç University School of Medicine , Istanbul , Turkey. · b Department of Oncology , Koç University School of Medicine , Istanbul , Turkey. · c Department of Surgery , The Royal Liverpool and Broadgreen University Hospitals , Liverpool , UK. · d Department of General-, Visceral- and Pediatric Surgery , University Hospital Düsseldorf, Heinrich Heine University Düsseldorf , Düsseldorf , Germany. ·Expert Rev Gastroenterol Hepatol · Pubmed #26560854.

ABSTRACT: One of the key factors that correlates with poor survival of patients with pancreatic cancer is the extent of hypoxic areas within the tumor tissue. The adaptation of pancreatic cancer cells to limited oxygen delivery promotes the induction of an invasive and treatment-resistant phenotype, triggering metastases at an early stage of tumor development, which resist in most cases adjuvant therapies following tumor resection. In this article, the authors summarize the evidence demonstrating the significance of hypoxia in pancreatic cancer pathogenesis and discuss the possible hypoxia-induced mechanisms underlying its aggressive nature. We then conclude with promising strategies that target hypoxia-adapted pancreatic cancer cells.

15 Review Oral bacteria in pancreatic cancer: mutagenesis of the p53 tumour suppressor gene. 2015

Öğrendik, Mesut. ·Division Physical Therapy and Rheumatology, Selcuk State Hospital Selcuk, Turkey. ·Int J Clin Exp Pathol · Pubmed #26617937.

ABSTRACT: Carcinoma of exocrine pancreas is the fourth leading cause of cancer deaths, worldwide. The prevalence of this disease is very high in patients with chronic pancreatitis. Orodigestive cancers are frequently seen in patients with periodontitis. These findings suggest that this type of cancer may have some bacterial origins. This study hypothesizes that the peptidyl arginine deaminase (PAD) enzymes found in oral bacteria may be responsible for the p53 point mutations that occur in patients with pancreatic cancer. Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola possess the PAD enzyme, and p53 arginine mutations have been detected in patients with pancreatic cancer. Moreover, the Pro allele p53Arg72-Pro is a risk factor for the development of this cancer. Anti-P. gingivalis antibody titers have been found to be higher in patients with pancreatic cancer as compared to healthy controls. The hypothesis in question can be tested if the DNA of P. gingivalis or the antibodies against P. gingivalis can be detected in patients with the p53 arginine mutation.If this hypothesis is true, it could reveal the real cause of pancreatic cancer, which is a fatal disease. Further studies are necessary in order to confirm this hypothesis.

16 Review Intraductal Papillary Mucinous Neoplasm of the Pancreas: Current Perspectives. 2015

Dumlu, Ersin Gürkan / Karakoç, Derya / Özdemir, Arif. ·1 Atatürk Training and Research Hospital, Department of General Surgery, Ankara, Turkey. · 2 Hacettepe University Faculty of Medicine, Department of General Surgery, Ankara, Turkey. ·Int Surg · Pubmed #26414828.

ABSTRACT: In this article, we aimed to review the literature on the clinics and management of intraductal papillary mucinous neoplasm (IPMN). Intraductal papillary mucinous neoplasm of the pancreas is a mucin-producing cystic mass originating from the pancreatic ductal system. Approximately 25% of the pancreatic neoplasms resected surgically and 50% of pancreatic cysts detected incidentally are IPMNs. They can be benign or malignant in character, while malignant transformation of benign forms can be encountered. It is important to determine IPMNs in the early stages, implementation of appropriate treatment approaches, and follow-up to provide better prognosis. We reviewed the studies published in the English medical literature through PubMed and summarized the clinical features and current approaches to the treatment and follow-up of the IPMN. Due to the recent advances and widespread implementation of radiological imaging techniques, the incidental detection rate of IPMNs has increased significantly. The effective treatment of the disease is possible via the detailed diagnosis of the disease, determination of the prognostic factors, and a multidisciplinary approach. Recent literature also emphasized the molecular profile determination approaches for assessment of prognosis of patients with IPMN. Current knowledge on IPMN, a clinically important epidemiologic problem, shows that the treatment should be personalized considering the prognostic features and life expectancy of the patient.

17 Review Pancreatic Cancer: Pathogenesis and Diagnosis. 2015

Goral, Vedat. ·Department Gastroenterology, Vedat Goral, Izmir University School of Medicine, Medicalpark Hospital, Izmir/Turkey E-mail : vegoral@hotmail.com. ·Asian Pac J Cancer Prev · Pubmed #26320426.

ABSTRACT: Pancreatic cancer is a fatal malignancies which is predominantly seen in men and at advanced age (40-85 years) and has an aggressive course. Its frequency is gradually increasing over the past years. It accounts for 2% of all cancers and 5% of cancer-related deaths. Pancreatic cancer takes the first place among asymptomatic cancers. Ninety percent of cases are adenocarcinomas. Ten percent of the patients have a familial disposition. The disease is very difficult to detect as it has no early signs and spreads rapidly to surrounding organs is one of the most deadly types of cancer. Pancreatic cancer may result from hereditary germline or somatic acquired mutations in cancer-related genes and mutations also cause cancer progression and metastasis.

18 Review Pancreatic Gastrointestinal Stromal Tumor after Upper Gastrointestinal Hemorrhage and Performance of Whipple Procedure: A Case Report and Literature Review. 2015

Aziret, Mehmet / Çetinkünar, Süleyman / Aktaş, Elife / İrkörücü, Oktay / Bali, İlhan / Erdem, Hasan. ·Department of General Surgery, Kars State Hospital, Kars, Turkey. · Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey. · Department of Pathology, Adana Numune Training and Research Hospital, Adana, Turkey. · Department of General Surgery, Namık Kemal University, Tekirdağ, Turkey. ·Am J Case Rep · Pubmed #26237079.

ABSTRACT: BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal system. These types of tumors originate from any part of the tract as well as from the intestine, colon, omentum, mesentery or retroperitoneum. GIST is a rare tumor compared to other types of tumors, accounting for less than 1% of all gastrointestinal tumors. CASE REPORT: A 56-year-old male patient was hospitalized due to an upper gastrointestinal hemorrhage and the start of abdominal pain on the same day. In the upper gastrointestinal endoscopy that was performed, a solitary mass was found in the second section of the duodenum and a blood vessel (Forrest type 2a) was seen. The extent and location of the mass was detected by abdominal tomography. After hemodynamic recovery, a Whipple procedure was performed without any complications. A subsequent histopathological examination detected a c-kit-positive (CD117) pancreatic GIST with high mitotic index. CONCLUSIONS: The most effective treatment method for GISTs is surgical resection. In patients with a head of pancreatic GIST, the Whipple procedure can be used more safely and effectively.

19 Review Increased incidence of extrapancreatic neoplasms in patients with IPMN: Fact or fiction? A critical systematic review. 2015

Pugliese, Luigi / Keskin, Muharrem / Maisonneuve, Patrick / D'Haese, Jan G / Marchegiani, Giovanni / Wenzel, Patrick / Del Chiaro, Marco / Ceyhan, Güralp O. ·Unit of General Surgery 2, Department of Surgery, IRCCS Policlinico San Matteo, Pavia, Italy. · Division of Gastroenterology, Department of Internal Medicine, Ege University, Izmir, Turkey. · Division of Epidemiology and Statistics, European Institute of Oncology, Milan, Italy. · Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. · Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy. · Department of Gastroenterology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. · Division of Surgery, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. · Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: gueralp.ceyhan@tum.de. ·Pancreatology · Pubmed #25841270.

ABSTRACT: BACKGROUND: To identify potential associations between intraductal papillary mucinous neoplasm of the pancreas (IPMN) and extrapancreatic neoplasms (EPN), a systematic review of the literature has been performed. METHODS: A systematic search of Medline/Pubmed was performed according to the PRISMA guidelines for reporting systematic reviews and meta-analysis for the following search terms: "extrapancreatic", "non pancreatic", "additional pancreatic", "additional primary" and alternatively matched with "neoplasms/tumours/cancers/malignancies/lesions". The results obtained specifically for IPMN were examined one by one by two independent investigators for further data selection and extraction. RESULTS: Fifteen studies were identified to be suitable and included for systematic review. Fourteen reported an elevated risk for extrapancreatic malignancy, particularly gastric and colon cancer, while the largest and only prospective study did not find any association. Most studies were retrospective with a weak level of evidence that was not substantially enhanced even by a recent multicentre case series. CONCLUSIONS: The available data on this clinically relevant question remain inconclusive. Due to lacking evidence on extrapancreatic neoplasms in IPMN patients, only a standard surveillance can be advised.

20 Review Advances in the management of unresectable or metastatic pancreatic neuroendocrine tumors: chemotherapy, targeted therapy, hormonal treatment, and future directions. 2015

Bilici, Ahmet. ·Department of Medical Oncology, Istanbul Medipol University, Medical Faculty, Istanbul, Turkey E-mail : ahmetknower@yahoo.com. ·Asian Pac J Cancer Prev · Pubmed #25824731.

ABSTRACT: Pancreatic neuroendocrine tumors (pNETs) are rare and heterogenous tumors and surgery to remove the primary tumor is the mainstay of treatment for resectable disease. However, curative surgery is often not feasible, because half of patients with pNET have metastases at the time of diagnosis. Palliative dubulking surgery and liver-directed therapies are appropriate options for these patients. Streptozocin-based regimens are standard, although temozolamide-based treatments are rapidly gaining wide clinical application. Somatostatin analogs are mainly indicated in hormonally active tumors to ameliorate symptoms. In addition, anti-tumoral activity has been proven in well-differentiated NETs. Recently, there has been tremendous progress in the molecular biology of pNETs; thereby, the efficacy of sunitinib and everolimus in the treatment of patients with metastatic pNETs has been proven by large placebo-controlled phase III trials. Currently, there are no definitively proven predictive biomarkers to evaluate response to medical therapies in patients with pNET. Therefore, further studies are needed to individualize and optimize their management. This article reviews systemic chemotherapy, targeted therapies, and anti-secretory treatments for the management of patients with unresectable or metastatic pNETs, summarized in the light of recent advances.

21 Review Current adjuvant therapeutic approaches for pancreatic cancer. 2015

Ozmen, Fusun / Şahin, Tevfik Tolga / Ozmen, M Mahir. ·Department of Basic Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey. ·Adv Ther · Pubmed #25595483.

ABSTRACT: Pancreatic cancer continues to be the fourth leading cause of death despite advancements in surgical and adjuvant therapeutic approaches. In the present review, the current cytotoxic therapeutic approaches and advanced targeted therapies are objectively discussed with consideration to the current literature.

22 Review Nonfunctional Pancreatic Neuroendocrine Tumors: Advances in Diagnosis, Management, and Controversies. 2015

Dumlu, Ersin Gürkan / Karakoç, Derya / Özdemir, Arif. ·1 Atatürk Training and Research Hospital, Department of General Surgery, Ankara, Turkey. · 2 Hacettepe University Faculty of Medicine, Department of General Surgery, Ankara, Turkey. ·Int Surg · Pubmed #25590518.

ABSTRACT: In this article, we aimed to review the literature on the clinics and management of nonfunctional pancreatic neuroendocrine tumors (NPNET). Pancreatic neuroendocrine tumors (PNET) are rare tumors with a <1/100,000 incidence and constitute approximately 2 to 10% of all pancreatic tumors. Nonfunctional PNETs are difficult to detect at early stages since they have no symptoms. Except those detected accidentally during different diagnoses, the majority of PNETs are detected in the advanced stages, with symptoms related to tumor size or liver metastasis. We reviewed the studies published in the English medical literature through PubMed and summarized the clinical features and current approaches to the treatment and follow-up of the NPNET. The common imaging techniques used for the detection of tumor localization, size, locoregional, and metastatic involvement are contrasted computed tomography, magnetic resonance imaging, endoscopic ultrasonography, and somatostatin receptor scintigraphy. Surgical resection is the only curative treatment. However, in advanced locoregional disease and liver metastasis, interventive ablative therapies such as palliative reductive surgery, selective hepatic arterial embolization, radiofrequency ablation; and systemic therapies, such as peptide receptor radionuclide therapy, chemotherapy, somatostatin analogous therapy, interferon, VEGF inhibitor, and mTOR inhibitor may be used as symptom relieving or may improve progression-free survival and total survival. Current knowledge on NPNET shows that the treatment should be personalized considering the prognostic features and life expectancy of the patient.

23 Review Influence of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma: a systematic review. 2015

Ozola Zalite, I / Zykus, R / Francisco Gonzalez, M / Saygili, F / Pukitis, A / Gaujoux, S / Charnley, R M / Lyadov, V. ·Pauls Stradins Clinical University Hospital, Riga, Latvia. · Hospital of Lithuanian University of Health Sciences Kaunas, Lithuania. · Complexo Hospitalario Universitario de Ourense, Ourense, Spain. · Department of Gastroenterology Pamukkale University, Denizli, Turkey. · Pauls Stradins Clinical University Hospital, Riga, Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia. · Department of Digestive and Endocrine Surgery, Cochin Hospital, APHP, Paris, France; Faculté de Medecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France. · North East's Hepato-Pancreato-Biliary Centre at the Freeman Hospital, Newcastle, United Kingdom. · Department of Surgical Oncology, Medical and Rehabilitation Center under the Ministry of Health of Russian Federation, Moscow, Russia. Electronic address: vlyadov@gmail.com. ·Pancreatology · Pubmed #25524484.

ABSTRACT: BACKGROUND/OBJECTIVES: Cachexia affects ∼ 80% of pancreatic cancer patients. An international consensus defines cachexia as an ongoing loss of skeletal muscle mass (sarcopenia) with or without loss of fat, which impairs body functioning and cannot be reversed by conventional nutritional measures. Weight loss percentage and elevated inflammation markers have been employed to define this condition earlier. This review aimed to assess the prevalence and consequences of cachexia and sarcopenia on survival in patients with pancreatic ductal adenocarcinoma. METHODS: The systematic review was performed by searching the articles with preset terms published in PubMed and Cochrane Database until December 2013. After identifying relevant titles, abstracts were read and eligible articles data retrieved on preformatted sheets. The prevalence and impact of sarcopenia/cachexia on survival was evaluated. RESULTS: In total 1145 articles were retrieved, only 10 were eligible. Definitions of cachexia and sarcopenia were heterogeneous. In patients with normal weight (BMI 18.5-24.9 kg/m(2)) the prevalence of sarcopenia ranged from 29.7 to 65%. In overweight or obese patients (BMI >25 kg/m(2)) were 16.2%-67%. Sarcopenia alone was not demonstrated to be an independent factor of decreased survival, although obese sarcopenic patients were shown to have significantly worse survival in two studies. CONCLUSIONS: Impact of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma is currently understudied in the available literature. Definitive association between cachexia and survival cannot be drawn from available studies, although weight loss and sarcopenic obesity might be considered as poor prognostic factors. Further prospective trials utilizing the consensus definition of cachexia and including other confounding factors are needed to investigate the impact of cachexia and sarcopenia on survival in pancreatic adenocarcinoma.

24 Review Prognostic factors related with survival in patients with pancreatic adenocarcinoma. 2014

Bilici, Ahmet. ·Ahmet Bilici, Department of Medical Oncology, Medical Faculty, Istanbul Medipol University, 34214 Bagcilar, Istanbul, Turkey. ·World J Gastroenterol · Pubmed #25152583.

ABSTRACT: The prognosis in patients with pancreatic cancer is poor and this cancer is the fourth leading cause of cancer-related death worldwide. Although surgical resection is the only curative treatment of choice for pancreatic cancer, the majority of patients are diagnosed at an advanced stage, thus only 10%-15% of them are suitable for curative resection and the overall survival is less than 5%. Chemotherapy for metastatic disease is to palliate symptoms of patients and to improve survival. Therefore, prognostic factors are important and a correct definition of poor prognostic factors may help to guide more aggressive adjuvant or aggressive treatment protocols in patients with pancreatic cancer. This article reviews the prognostic factors affecting survival of patients with pancreatic cancer in the light of recent advances in the literature.

25 Review Management of cystic diseases of the pancreas. 2014

Sentürk, Hakan. ·Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey. ·Turk J Gastroenterol · Pubmed #24918124.

ABSTRACT: Pancreatic cysts are challenging to the gastroenterologist. Detection rate is increasing and neither criteria for a definitive diagnosis, nor a validated surveillance strategy is available. Pancreatic endosonography with or without sampling is necessary in most of the cases. However this technique requires expertise and is not widely available. While some cysts have a malignant potential or already malign at the diagnosis, most are benign and remain so for decades. We are going to review the existing data on this controversial subject.