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Pancreatic Neoplasms: HELP
Articles from Ohio State University
Based on 185 articles published since 2009
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These are the 185 published articles about Pancreatic Neoplasms that originated from Ohio State University during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
1 Guideline American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines. 2014

Conwell, Darwin L / Lee, Linda S / Yadav, Dhiraj / Longnecker, Daniel S / Miller, Frank H / Mortele, Koenraad J / Levy, Michael J / Kwon, Richard / Lieb, John G / Stevens, Tyler / Toskes, Phillip P / Gardner, Timothy B / Gelrud, Andres / Wu, Bechien U / Forsmark, Christopher E / Vege, Santhi S. ·From the *Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH; †Division of Gastroenterology, Hepatology, and Endoscopy, Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA; ‡Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA; §Department of Pathology, The Geisel School of Medicine at Dartmouth, Hanover, NH; ║Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL; ¶Department of Radiology, Beth Israel Deaconness Hospital, Harvard Medical School, Boston, MA; #Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN; **Division of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI; ††Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, PA; ‡‡Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH; §§Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, University of Florida, Gainesville, FL; ║║Department of Gastroenterology, University of Chicago, Chicago, IL; and ¶¶Division of Gastroenterology, Department of Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA. ·Pancreas · Pubmed #25333398.

ABSTRACT: The diagnosis of chronic pancreatitis remains challenging in early stages of the disease. This report defines the diagnostic criteria useful in the assessment of patients with suspected and established chronic pancreatitis. All current diagnostic procedures are reviewed, and evidence-based statements are provided about their utility and limitations. Diagnostic criteria for chronic pancreatitis are classified as definitive, probable, or insufficient evidence. A diagnostic (STEP-wise; survey, tomography, endoscopy, and pancreas function testing) algorithm is proposed that proceeds from a noninvasive to a more invasive approach. This algorithm maximizes specificity (low false-positive rate) in subjects with chronic abdominal pain and equivocal imaging changes. Furthermore, a nomenclature is suggested to further characterize patients with established chronic pancreatitis based on TIGAR-O (toxic, idiopathic, genetic, autoimmune, recurrent, and obstructive) etiology, gland morphology (Cambridge criteria), and physiologic state (exocrine, endocrine function) for uniformity across future multicenter research collaborations. This guideline will serve as a baseline manuscript that will be modified as new evidence becomes available and our knowledge of chronic pancreatitis improves.

2 Editorial Is Screening for Pancreatic Cancer in High-Risk Individuals One Step Closer or a Fool's Errand? 2019

Hart, Phil A / Chari, Suresh T. ·Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio. · Division of Gastroenterology and Hepatology, Mayo Clinic Hospital, Rochester, Minnesota. ·Clin Gastroenterol Hepatol · Pubmed #30268560.

ABSTRACT: -- No abstract --

3 Editorial What is the Incidence of Malignancy in Resected IPMN? An Analysis of Over 100 U.S. Institutions in a Single Year. 2018

Schmidt, Carl R / Cloyd, Jordan. ·Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA. carl.schmidt@osumc.edu. · Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA. ·Ann Surg Oncol · Pubmed #29675763.

ABSTRACT: -- No abstract --

4 Editorial 8th Edition of the AJCC Cancer Staging Manual: Pancreas and Hepatobiliary Cancers. 2018

Chun, Yun Shin / Pawlik, Timothy M / Vauthey, Jean-Nicolas. ·Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. · Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. jvauthey@mdanderson.org. ·Ann Surg Oncol · Pubmed #28752469.

ABSTRACT: -- No abstract --

5 Editorial Management of pancreatic mucinous cystic neoplasms: surgery or surveillance? 2015

Hart, Phil A / Chari, Suresh T. ·Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA; Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA. Electronic address: chari.suresh@mayo.edu. ·Pancreatology · Pubmed #25841313.

ABSTRACT: -- No abstract --

6 Editorial Therapeutic advances in pancreatic cancer: miles to go before we sleep. 2015

Bekaii-Saab, Tanios / Goldberg, Richard. ·Ohio State University Comprehensive Cancer Center, Columbus, OH (TBS, RG). Tanios.Saab@osumc.edu. · Ohio State University Comprehensive Cancer Center, Columbus, OH (TBS, RG). ·J Natl Cancer Inst · Pubmed #25638250.

ABSTRACT: -- No abstract --

7 Editorial Will detection of microRNA biomarkers in blood improve the diagnosis and survival of patients with pancreatic cancer? 2014

Buchsbaum, Donald J / Croce, Carlo M. ·Division of Radiation Biology, Department of Radiation Oncology, University of Alabama, Birmingham. · Comprehensive Cancer Center, Department of Molecular Virology, Immunology and Medical Genetics, Ohio State University, Columbus. ·JAMA · Pubmed #24449314.

ABSTRACT: -- No abstract --

8 Review The emerging role of targeted therapies for advanced well-differentiated gastroenteropancreatic neuroendocrine tumors. 2019

Cloyd, Jordan M / Konda, Bhavana / Shah, Manisha H / Pawlik, Timothy M. ·a Surgery Division of Surgical Oncology , The Ohio State University Wexner Medical Center , Columbus , OH , USA. · b Internal Medicine , Division of Medical Oncology , Columbus , OH , USA. · c Internal Medicine , Division of Medical Oncology , Columbus , OH , USA. · d Department of Surgery The Urban Meyer III and Shelley Meyer Chair for Cancer Research Professor of Surgery, Oncology, and Health Services Management and Policy , The Ohio State University, Wexner Medical Center , Columbus , OH , USA. ·Expert Rev Clin Pharmacol · Pubmed #30582383.

ABSTRACT: INTRODUCTION: Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) are unique and complex neoplasms, exhibiting a wide spectrum of diverse clinical behaviors. The contemporary management of well-differentiated GEP-NETs is marked by the availability of a wide range of targeted therapies. Areas Covered: For patients with localized or oligometastatic disease, surgical resection remains the preferred approach and is associated with excellent long-term outcomes. For patients with unresectable but isolated liver metastases, multiple liver-directed therapies, including hepatic arterial based therapies and ablative techniques, exist. For patients with metastatic and progressive disease, a number of systemic therapies exist: molecular targeted agents, peptide receptor radionuclide therapy (PRRT), and systemic chemotherapy. Furthermore, somatostatin analogs (SSA) are an important component of therapy, both effectively controlling symptoms of hormonal overproduction and contributing to slowing tumor progression. Expert Opinion: In the near future, advances in our understanding of tumor biology, genetics, immunology, nanotechnology, and radiation pharmacology should only continue to expand the availability of targeted therapies, improving the outcomes of patients with GEP-NETs. We herein review the management of advanced well-differentiated GEP-NETS with a particular emphasis on the role of targeted therapies.

9 Review A review of cutaneous manifestations within glucagonoma syndrome: necrolytic migratory erythema. 2018

Tolliver, Starling / Graham, Jaqueline / Kaffenberger, Benjamin H. ·Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA. ·Int J Dermatol · Pubmed #29450880.

ABSTRACT: Necrolytic migratory erythema (NME) is a rare skin disorder that is a cutaneous manifestation of the glucagonoma syndrome. It presents with annular eruptions of migrating erythematous papules and plaques with superficial epidermal necrosis, central flaccid bullae, and crusted erosions located primarily in the intertriginous areas. Treatment with the long-acting somatostatin analog Octreotide is a potential therapy to help ameliorate skin symptoms. We present a case of a patient with a 1-year history of a pancreatic glucagonoma that developed an ulcerated, plaque-like, weeping rash over multiple areas of their body despite current treatment with Octreotide and stable pancreatic tumor staging. The patient had a similar rash when initially diagnosed with a glucagonoma, and it quickly improved after Octreotide treatment. Clinical examination and biopsy were consistent with necrolytic migratory erythema due to an underlying glucagonoma. This rare case adds to our understanding of the clinical presentation of NME, as well as highlights the relapsing and remitting course, even if the underlying pancreatic tumor is stable and the patient is undergoing treatment.

10 Review Exosomes in Pancreatic Cancer: from Early Detection to Treatment. 2018

Armstrong, Emily A / Beal, Eliza W / Chakedis, Jeffery / Paredes, Anghela Z / Moris, Demetrios / Pawlik, Timothy M / Schmidt, Carl R / Dillhoff, Mary E. ·The Ohio State University College of Medicine, Columbus, OH, 43210, USA. · Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 320 W 10th Ave. M256 Starling Loving Hall, Columbus, OH, 43210, USA. Eliza.Beal@osumc.edu. · Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 320 W 10th Ave. M256 Starling Loving Hall, Columbus, OH, 43210, USA. ·J Gastrointest Surg · Pubmed #29423813.

ABSTRACT: BACKGROUND: Pancreatic cancer (PC) remains one of the most fatal forms of cancer worldwide with incidence nearly equal to mortality. This is often attributed to the fact that diagnosis is often not made until later disease stages when treatment proves difficult. Efforts have been made to reduce the mortality of PC through improvements in early screening techniques and treatments of late-stage disease. Exosomes, small extracellular vesicles involved in cellular communication, have shown promise in helping understand PC disease biology. METHODS: In this review, we discuss current studies of the role of exosomes in PC physiology, and their potential use as diagnostic and treatment tools. RESULTS: Exosomes have a role in diagnosing pancreatic cancer and in understanding tumor biology including migration, proliferation, chemoresistance, immunosuppression, cachexia and diabetes, and have a potential role in therapy for pancreatic cancer. CONCLUSIONS: Exosomal analysis is beneficial in demonstrating mechanisms behind PC growth and metastasis, immunosuppression, drug resistance, and paraneoplastic conditions. Furthermore, the use of exosomes can be beneficial in detecting early-stage PC and exosomes have potential applications as therapeutic targets.

11 Review Updates and Critical Evaluation on Novel Biomarkers for the Malignant Progression of Intraductal Papillary Mucinous Neoplasms of the Pancreas. 2017

Moris, Demetrios / Damaskos, Christos / Spartalis, Eleftherios / Papalampros, Alexandros / Vernadakis, Spyridon / Dimitroulis, Dimitrios / Griniatsos, John / Felekouras, Evangelos / Nikiteas, Nikolaos. ·Department of Surgery, The Ohio State University Comprehensive Cancer Center, Columbus, OH, U.S.A. dimmoris@yahoo.com. · 2nd Department of Propedeutic Surgery, University of Athens Medical School, Athens, Greece. · Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens, Greece. · First Department of Surgery, University of Athens Medical School, Athens, Greece. · Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital and Research Cancer, Riyadh, Kingdom of Saudi Arabia. ·Anticancer Res · Pubmed #28476781.

ABSTRACT: Intraductal papillary mucinous neoplasms (IPMNs) are presumed to evolve from low-grade dysplasia to high-grade dysplasia to invasive carcinoma. Resection of lesions before the development of pancreatic cancer may prevent the development of an incurable process as, once IPMNs progress to invasive cancer, the prognosis may be as poor as resected conventional pancreatic ductal adenocarcinoma. Resection of IPMNs, particularly in the setting of high-grade dysplasia, is presumed to provide a survival benefit. IPMNs also present many challenges as the identification of high-grade dysplasia and early invasive carcinoma and the timing and frequency of malignant progression are not yet established. The limited predictive accuracy presents a challenge as pancreatic resection is associated with a risk of substantial morbidity and mortality; 20-30% and 2-4%, respectively. Diagnostic armamentarium contains pancreas-protocol computed tomography (CT) scan, gadolinium-enhanced magnetic resonance imaging (MRI) with or without magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS). The most promising method is endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as this technique allows analysis of cyst fluid using biomarkers. Until now, in clinical practice, we utilize two biomarkers, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9); however, DNA analysis of pancreatic cystic fluid and genomic analysis could offer new tools to the diagnosis and administration of IPMNs. Novel genomic and serum biomarkers could play an important future role to identify those individuals who will benefit from an early operation and those who will benefit from watchful waiting approach. More prospective studies are needed.

12 Review Total robotic pancreaticoduodenectomy: a systematic review of the literature. 2017

Kornaropoulos, Michail / Moris, Demetrios / Beal, Eliza W / Makris, Marinos C / Mitrousias, Apostolos / Petrou, Athanasios / Felekouras, Evangelos / Michalinos, Adamantios / Vailas, Michail / Schizas, Dimitrios / Papalampros, Alexandros. ·1st Department of Surgery, "G. Genimatas" General Hospital, Athens, Greece. · Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave., NE60, Cleveland, OH, 44195, USA. dimmoris@yahoo.com. · Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA. · Hepatobiliary and Surgical Oncology Department, Nicosia Teaching Hospital, Nicosia, Cyprus. · 1st Department of Surgery, Laikon General Hospital, Athens, Greece. ·Surg Endosc · Pubmed #28389798.

ABSTRACT: BACKGROUND: Pancreaticoduodenectomy (PD) is a complex operation with high perioperative morbidity and mortality, even in the highest volume centers. Since the development of the robotic platform, the number of reports on robotic-assisted pancreatic surgery has been on the rise. This article reviews the current state of completely robotic PD. MATERIALS AND METHODS: A systematic literature search was performed including studies published between January 2000 and July 2016 reporting PDs in which all procedural steps (dissection, resection and reconstruction) were performed robotically. RESULTS: Thirteen studies met the inclusion criteria, including a total of 738 patients. Data regarding perioperative outcomes such as operative time, blood loss, mortality, morbidity, conversion and oncologic outcomes were analyzed. No major differences were observed in mortality, morbidity and oncologic parameters, between robotic and non-robotic approaches. However, operative time was longer in robotic PD, whereas the estimated blood loss was lower. The conversion rate to laparotomy was 6.5-7.8%. CONCLUSIONS: Robotic PD is feasible and safe in high-volume institutions, where surgeons are experienced and medical staff are appropriately trained. Randomized controlled trials are required to further investigate outcomes of robotic PD. Additionally, cost analysis and data on long-term oncologic outcomes are needed to evaluate cost-effectiveness of the robotic approach in comparison with the open technique.

13 Review Diagnosing clear cell neuroendocrine tumors on cytological specimens: Report of two cases and brief literature review. 2017

Buckley, Kaila / Li, Zaibo. ·Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio. ·Diagn Cytopathol · Pubmed #28387021.

ABSTRACT: Although many of the common manifestations of Von Hippel-Lindau (VHL) disease are relatively well known, there is one particular entity which is quite rare, but which appears to show a specific predilection for VHL patients. This entity is clear cell neuroendocrine tumor (NET). It is a difficult diagnosis to make due to its cytomorphologic similarities to other entities, such as metastatic clear cell renal cell carcinoma and paraganglioma, amongst others. These tumors, however, are characteristically positive for neuroendocrine markers such as synaptophysin and chromogranin, as well as cytokeratins. Emerging evidence also suggests that clear cell NETs in VHL patients are specifically positive for inhibin, when compared to their counterparts in non-VHL patients, which may assist in the diagnosis in as yet undiagnosed patients with VHL disease. Herein, we present two cases of inhibin-positive clear cell NETs, one in a VHL patient, and the other in a non-VHL patient. These cases propose a potential warning to those relying on inhibin positivity to incite an expedition down a rabbit hole for a diagnosis of VHL. Diagn. Cytopathol. 2017;45:757-760. © 2017 Wiley Periodicals, Inc.

14 Review Diagnostic performance of endoscopic ultrasound for detection of pancreatic malignancy following an indeterminate multidetector CT scan: a systemic review and meta-analysis. 2017

Krishna, Somashekar G / Rao, Bhavana B / Ugbarugba, Emmanuel / Shah, Zarine K / Blaszczak, Alecia / Hinton, Alice / Conwell, Darwin L / Hart, Phil A. ·Section of Advanced Endoscopy, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, Columbus, OH, 43210, USA. sgkrishna@gmail.com. · Section of Pancreatic Disorders, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. sgkrishna@gmail.com. · Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA. · Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA. · Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA. · The Ohio State University College of Medicine, Columbus, OH, USA. · Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA. · Section of Pancreatic Disorders, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. ·Surg Endosc · Pubmed #28378082.

ABSTRACT: BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis in part due to delayed diagnosis. Even with advances in cross-sectional imaging, small pancreatic malignancies can be missed. We sought to determine the performance of endoscopic ultrasound (EUS) in those without an obvious mass on multi-detector CT scan (MDCT), but with clinical suspicion for pancreatic malignancy. METHODS: Multiple databases were systematically searched to identify studies that assessed the diagnostic performance of EUS after negative or inconclusive pancreatic protocol MDCT for detection of pancreatic malignancy when clinically suspected. A total of four studies met the inclusion criteria. The point estimates in each study were compared to the summary pooled estimates of sensitivity and specificity with the aid of forest plots. Funnel plots and Egger's test were employed to evaluate possible publication bias. RESULTS: EUS-guided fine needle aspiration was performed in all studies. EUS was performed in 206 subjects with a clinical suspicion of a pancreatic mass but with an indeterminate MDCT. A pancreatic mass (mean size 21 ± 1.2 mm) was identified in 70% (n = 144) of the subjects, and 42.2% (n = 87) were diagnosed with PDAC. The pooled estimates of EUS for diagnosing pancreatic malignancy in the setting of an indeterminate MDCT were a sensitivity of 85% (95% CI 69-94%), specificity of 58% (95% CI 40-74%), positive predictive value of 77% (69-84%), negative predictive value of 66% (95% CI 53-77%), and an accuracy of 75% (95% CI 67-82). The summary area under the ROC curve was 0.80 (95% CI 0.52-0.89). The funnel plots and Egger's test did not show a significant publication bias. CONCLUSIONS: The yield of EUS is comparatively higher for the diagnosis of a pancreatic malignancy in patients with suspected cancer, but a non-diagnostic MDCT. Importantly, the majority of the lesions missed on CT represent PDAC, in which early diagnosis is essential.

15 Review Complications of Chronic Pancreatitis. 2017

Ramsey, Mitchell L / Conwell, Darwin L / Hart, Phil A. ·Section of Pancreatic Disorders, Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, 410 West Tenth Avenue, Columbus, OH, 3210, USA. · Section of Pancreatic Disorders, Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, 410 West Tenth Avenue, Columbus, OH, 3210, USA. philip.hart@osumc.edu. ·Dig Dis Sci · Pubmed #28281169.

ABSTRACT: Chronic pancreatitis is a disease that leads to irreversible changes in the pancreatic morphology and function. The loss of function can lead to diabetes mellitus and exocrine pancreatic insufficiency. The inflammation and fibrosis can also lead to other complications including a chronic abdominal pain syndrome, metabolic bone disease, and pancretic cancer. This article reviews our current understanding of the mechanisms and management of these complications of chronic pancreatitis.

16 Review Pharmacological strategies to target oncogenic KRAS signaling in pancreatic cancer. 2017

Chuang, Hsiao-Ching / Huang, Po-Hsien / Kulp, Samuel K / Chen, Ching-Shih. ·Division of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, USA. · Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan. · Division of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, USA; Institute of Biological Chemistry, Academia Sinica, 128 Sec. 2, Academia Road, Nangang, Taipei 115, Taiwan. Electronic address: chencs@gate.sinica.edu.tw. ·Pharmacol Res · Pubmed #28077300.

ABSTRACT: The clear importance of mutated KRAS as a therapeutic target has driven the investigation of multiple approaches to inhibit oncogenic KRAS signaling at different molecular levels. However, no KRAS-targeted therapy has reached the clinic to date, which underlies the intrinsic difficulty in developing effective, direct inhibitors of KRAS. Thus, this article provides an overview of the history and recent progress in the development of pharmacological strategies to target oncogenic KRAS with small molecule agents. Mechanistically, these KRAS-targeted agents can be classified into the following four categories. (1) Small-molecule RAS-binding ligands that prevent RAS activation by binding within or outside the nucleotide-binding motif. (2) Inhibitors of KRAS membrane anchorage. (3) Inhibitors that bind to RAS-binding domains of RAS-effector proteins. (4) Inhibitors of KRAS expression. The advantage and limitation of each type of these anti-KRAS agents are discussed.

17 Review Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. 2016

Hart, Phil A / Bellin, Melena D / Andersen, Dana K / Bradley, David / Cruz-Monserrate, Zobeida / Forsmark, Christopher E / Goodarzi, Mark O / Habtezion, Aida / Korc, Murray / Kudva, Yogish C / Pandol, Stephen J / Yadav, Dhiraj / Chari, Suresh T / Anonymous3191104. ·Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: philip.hart@osumc.edu. · Division of Pediatric Endocrinology and Schulze Diabetes Institute, University of Minnesota Medical Center, Minneapolis, MN, USA. · Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. · Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University, Wexner Medical Center, Columbus, OH, USA. · Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. · Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, USA. · Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA. · Departments of Medicine, Biochemistry, and Molecular Biology, Indiana University School of Medicine, Indiana University Simon Cancer Center, Indianapolis, IN, USA; Pancreatic Cancer Signature Center, Indiana University Simon Cancer Center, Indianapolis, IN, USA. · Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA. · Department of Veterans Affairs, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh and UPMC Medical Center, Pittsburgh, PA, USA; Department of Medicine, University of Pittsburgh and UPMC Medical Center, Pittsburgh, PA, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. ·Lancet Gastroenterol Hepatol · Pubmed #28404095.

ABSTRACT: Diabetes mellitus is a group of diseases defined by persistent hyperglycaemia. Type 2 diabetes, the most prevalent form, is characterised initially by impaired insulin sensitivity and subsequently by an inadequate compensatory insulin response. Diabetes can also develop as a direct consequence of other diseases, including diseases of the exocrine pancreas. Historically, diabetes due to diseases of the exocrine pancreas was described as pancreatogenic or pancreatogenous diabetes mellitus, but recent literature refers to it as type 3c diabetes. It is important to note that type 3c diabetes is not a single entity; it occurs because of a variety of exocrine pancreatic diseases with varying mechanisms of hyperglycaemia. The most commonly identified causes of type 3c diabetes are chronic pancreatitis, pancreatic ductal adenocarcinoma, haemochromatosis, cystic fibrosis, and previous pancreatic surgery. In this Review, we discuss the epidemiology, pathogenesis, and clinical relevance of type 3c diabetes secondary to chronic pancreatitis and pancreatic ductal adenocarcinoma, and highlight several important knowledge gaps.

18 Review The Impact of Obesity on Gallstone Disease, Acute Pancreatitis, and Pancreatic Cancer. 2016

Cruz-Monserrate, Zobeida / Conwell, Darwin L / Krishna, Somashekar G. ·Section of Pancreatic Diseases, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, 2nd Floor, Columbus, OH, USA; The James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA. · Section of Pancreatic Diseases, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, 2nd Floor, Columbus, OH, USA. · Section of Pancreatic Diseases, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, 2nd Floor, Columbus, OH, USA. Electronic address: somashekar.krishna@osumc.edu. ·Gastroenterol Clin North Am · Pubmed #27837777.

ABSTRACT: Obesity is a well-recognized risk factor for gallstone formation and increases the risk for gallstone-related complications. Pancreatic diseases are impacted adversely by obesity. Although weight loss surgery increases the risk of gallstone disease, evidence suggests that bariatric surgery mitigates the obesity-associated adverse prognostication in acute pancreatitis. Obesity is also a significant risk factor for pancreatic cancer. Obesity is a global epidemic and is increasing worldwide and among all age groups. There is an urgent need for focused health policies aimed at reducing the incidence and prevalence of obesity. This article summarizes the current literature highlighting the association between obesity and the pathophysiology and outcome of gallstone disease, pancreatitis, and pancreatic cancer.

19 Review 68Ga-DOTATATE Compared with 111In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis. 2016

Deppen, Stephen A / Blume, Jeffrey / Bobbey, Adam J / Shah, Chirayu / Graham, Michael M / Lee, Patricia / Delbeke, Dominique / Walker, Ronald C. ·Veterans Affairs Hospital, Tennessee Valley Healthcare System, Nashville, Tennessee Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee Vanderbilt-Ingram Cancer Center, Nashville, Tennessee. · Department of Biostatistics, Vanderbilt University, Nashville, Tennessee. · Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio. · Veterans Affairs Hospital, Tennessee Valley Healthcare System, Nashville, Tennessee Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee. · Department of Radiology, University of Iowa, Iowa City, Iowa; and. · Knowledge Management, Eskind Biomedical Library, Vanderbilt University Medical Center, Nashville, Tennessee. · Vanderbilt-Ingram Cancer Center, Nashville, Tennessee Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee. · Veterans Affairs Hospital, Tennessee Valley Healthcare System, Nashville, Tennessee Vanderbilt-Ingram Cancer Center, Nashville, Tennessee Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee ronald.walker@vanderbilt.edu. ·J Nucl Med · Pubmed #26769864.

ABSTRACT: METHODS: Medline, EMBASE, Web of Science, and Cochrane Reviews electronic databases were searched from January 1999 to September 2015. Results were restricted to human studies comparing diagnostic accuracy of (68)Ga-DOTATATE with octreotide or conventional imaging for pulmonary or gastroenteropancreatic NET and for human studies reporting safety/toxicity for (68)Ga-DOTATATE with 10 subjects or more thought to have NETs. Direct communication with corresponding authors was attempted to obtain missing information. Abstracts meeting eligibility criteria were collected by a research librarian and assembled for reviewers; 2 reviewers independently determined whether or not to include each abstract. If either reviewer chose inclusion, the abstract was accepted for review. RESULTS: Database and bibliography searches yielded 2,479 articles, of which 42 were eligible. Three studies compared the 2 radiopharmaceuticals in the same patient, finding (68)Ga-DOTATATE to be more sensitive than octreotide. Nine studies compared (68)Ga-DOTATATE with conventional imaging. (68)Ga-DOTATATE estimated sensitivity, 90.9% (95% confidence interval, 81.4%-96.4%), and specificity, 90.6% (95% confidence interval, 77.8%-96.1%), were high. Five studies were retained for safety reporting only. Report of harm possibly related to (68)Ga-DOTATATE was rare (6 of 974), and no study reported major toxicity or safety issues. CONCLUSION: No direct comparison of octreotide and (68)Ga-DOTATATE imaging for diagnosis and staging in an unbiased population of NETs has been published. Available information in the peer-reviewed literature regarding diagnostic efficacy and safety supports the use of (68)Ga-DOTATATE for imaging of NETs where it is available.

20 Review Adjuvant therapy for pancreas cancer in an era of value based cancer care. 2016

Ahn, Daniel H / Williams, Terence M / Goldstein, Daniel A / El-Rayes, Bassel / Bekaii-Saab, Tanios. ·The Ohio State University Wexner Medical Center, 310 W. 10th Ave, Columbus, OH, United States. · Winship Cancer Institute, Emory University, 1365-C Clifton Rd NE, Atlanta, GA, United States. · The Ohio State University Wexner Medical Center, 310 W. 10th Ave, Columbus, OH, United States. Electronic address: Tanios.saab@osumc.edu. ·Cancer Treat Rev · Pubmed #26620819.

ABSTRACT: In resected pancreas cancer, adjuvant therapy improves outcomes and is considered the standard of care for patients who recover sufficiently post operatively. Chemotherapy or combined chemotherapy and radiation therapy (chemoradiation; CRT) are strategies used in the adjuvant setting. However, there is a lack of evidence to suggest whether the addition of RT to chemotherapy translates to an improvement in clinical outcomes. This is true even when accounting for the subset of patients with a higher risk for recurrence, such as those with R1 and lymph node positive disease. When considering the direct and indirect costs, impact on quality of life and questionable added clinical benefit, the true "net health benefit" from added RT to chemotherapy becomes more uncertain. Future directions, including the utilization of modern RT, integration of novel therapies, and intensifying chemotherapy regimens may improve outcomes in resected pancreas cancer.

21 Review Making sense of current and emerging therapies in pancreatic cancer: balancing benefit and value. 2015

Ahn, Daniel H / Ko, Andrew H / Meropol, Neal J / Bekaii-Saab, Tanios S. ·From the The Ohio State University Wexner Medical Center, Columbus, OH; UCSF Helen Diller Comprehensive Cancer Center, San Francisco, CA; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western University, Cleveland, OH. ·Am Soc Clin Oncol Educ Book · Pubmed #25993177.

ABSTRACT: Pancreatic cancer remains the fourth leading cause of cancer deaths in the United States with a dismal prognosis and a 5-year survival of less than 5% across all stages.(1) In 2014, there were approximately 46,420 new cases of pancreatic cancer with only 9% of patients having localized disease.(2) Given that the vast majority of patients present with advanced disease, much of the focus for drug development has been in the metastatic setting, which is evident with the advent of two combination chemotherapy regimens for this indication. Although conventional cytotoxic chemotherapy remains the standard of care, an ongoing search for novel therapeutic approaches continues. We will highlight several new approaches here, with a particular emphasis on immunotherapeutic strategies. We will also introduce concepts regarding the potential economic effects associated with the development and implementation of new treatments in pancreatic cancer.

22 Review Asynchronous leptomeningeal carcinomatosis from pancreatic cancer: a case report and review of the literature. 2014

Hong, Christopher S / Kurt, Habibe / Elder, J Bradley. ·Department of Neurological Surgery, The Ohio State University Wexner Medical Center, 410 W 10th Ave., Doan Hall, N1052, Columbus, OH, 43210, USA, christopher.hong@osumc.edu. ·Clin J Gastroenterol · Pubmed #26184025.

ABSTRACT: Central nervous system (CNS) metastases from pancreatic cancer are an exceedingly rare occurrence and have been predominantly described as focal lesions within the brain parenchyma. Even fewer reports exist of tumor spread to the leptomeninges, and most cases are discovered at autopsy. No report of leptomeningeal carcinomatosis without brain parenchymal involvement has been described to date. We describe a 72-year-old female diagnosed with inoperable, stage IV pancreatic cancer. She was treated with combination chemotherapy comprising Reolysin (reovirus serotype-3 Dearing strain), carboplatin, and paclitaxel. After 4 months of treatment, her tumor had decreased in size by 55 %, and CA19-9 levels had dropped 25-fold. However, 7 months after her initial cancer diagnosis, she presented with clinical symptoms and radiographic findings consistent with leptomeningeal carcinomatosis. Lumbar puncture did not reveal malignant cells in the cerebrospinal fluid (CSF), and biopsy was requested for tissue diagnosis. This confirmed pancreatic leptomeningeal carcinomatosis. Our case report demonstrates that leptomeningeal spread from pancreatic tumors may develop independent of focal brain parenchymal involvement and in the setting of controlled systemic disease. Furthermore, the present study describes the first case of CNS progression in the setting of systemic response to Reolysin therapy, suggesting this newly developing treatment may not prevent neurological spread of disease. If repeat cytology of CSF fails to detect malignant cells, biopsy should be pursued for definitive diagnosis. Surgery may also concurrently provide an opportunity to place an intraventricular catheter for delivery of intrathecal chemotherapies.

23 Review Biomarkers as predictors of recurrence following curative resection for pancreatic ductal adenocarcinoma: a review. 2014

Osayi, Sylvester N / Bloomston, Mark / Schmidt, Carl M / Ellison, E Christopher / Muscarella, Peter. ·Department of Surgery and Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA. ·Biomed Res Int · Pubmed #25050350.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDA) is the fourth most common cancer causing death in the United States. Early tumor recurrence is an important contributor to the dismal prognosis. The availability of an accurate prognostic biomarker for predicting disease recurrence following curative resection will be beneficial for patient care. Most of the currently studied biomarkers remain in the investigational phase, with CA 19-9 being the only biomarker currently approved by the FDA. Herein, we review the utility of CA 19-9 and other investigational cellular, gene, and molecular tumor markers for predicting PDA recurrence following curative surgical resection.

24 Review Clinical application of microRNA testing in neuroendocrine tumors of the gastrointestinal tract. 2014

Vicentini, Caterina / Fassan, Matteo / D'Angelo, Edoardo / Corbo, Vincenzo / Silvestris, Nicola / Nuovo, Gerard J / Scarpa, Aldo. ·ARC-Net Research Centre, University and Hospital Trust of Verona, Verona 37134, Italy. · ARC-Net Research Centre, University and Hospital Trust of Verona, Verona 37134, Italy. matteo.fassan@gmail.com. · Medical Oncology Unit, National Cancer Institute "Giovanni Paolo II", Bari 70124, Italy. · Comprehensive Cancer Centre, Ohio State University, Columbus, OH 43210, USA. ·Molecules · Pubmed #24566314.

ABSTRACT: It is well documented that dysregulation of microRNAs is a hallmark of human cancers. Thus, this family of small non-coding regulatory molecules represents an excellent source of sensitive biomarkers. Unique microRNAs expression profiles have been associated with different types and subsets of gastrointestinal tumors including gastroenteropancreatic neuroendocrine tumors (GEP-NETs). GEP-NETs are a heterogeneous group of epithelial neoplasms with neuroendocrine differentiation. At present, early detection and surgical resection of GEP-NETs represent the best chance for a cure. Thus, clinically useful biomarkers for GEP-NETs that strongly correlate with early detection are urgently needed. The purpose of this review is to summarize the role of miRNAs in GEP-NET carcinogenesis and their possible use as novel diagnostic, prognostic and predictive biomarkers.

25 Review Regulation of pancreatic function by connective tissue growth factor (CTGF, CCN2). 2013

Charrier, Alyssa / Brigstock, David R. ·Center for Clinical and Translational Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA. ·Cytokine Growth Factor Rev · Pubmed #22884427.

ABSTRACT: Connective tissue growth factor (CTGF/CCN2) is a cysteine-rich matricellular secreted protein that regulates diverse cell functions including adhesion, migration, proliferation, differentiation, survival, senescence and apoptosis. In the pancreas, CTGF/CCN2 regulates critical functions including β cell replication during embryogenesis, stimulation of fibrogenic pathways in pancreatic stellate cells during pancreatitis, and regulation of the epithelial and stromal components in pancreatic ductal adenocarcinoma. This article reviews the evidence establishing CTGF/CCN2 as an important player in pancreatic physiology and pathology, highlighting the specific cell types that are involved in each process and the importance of CTGF/CCN2 as a component of autocrine or paracrine signaling within or between these various cells. Translational applications, including the potential for CTGF/CCN2-based therapies in diabetes, fibrosis, or cancer, are discussed.

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