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Pancreatic Neoplasms: HELP
Articles from Illinois
Based on 392 articles published since 2008
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These are the 392 published articles about Pancreatic Neoplasms that originated from Illinois during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16
1 Guideline ACR Appropriateness Criteria 2017

Anonymous7930925 / Qayyum, Aliya / Tamm, Eric P / Kamel, Ihab R / Allen, Peter J / Arif-Tiwari, Hina / Chernyak, Victoria / Gonda, Tamas A / Grajo, Joseph R / Hindman, Nicole M / Horowitz, Jeanne M / Kaur, Harmeet / McNamara, Michelle M / Noto, Richard B / Srivastava, Pavan K / Lalani, Tasneem. ·Principal Author, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: aqayyum@mdanderson.org. · Research Author, University of Texas MD Anderson Cancer Center, Houston, Texas. · Panel Chair, Johns Hopkins University School of Medicine, Baltimore, Maryland. · Memorial Sloan Kettering Cancer Center, New York, New York; American College of Surgeons. · University of Arizona, Banner University Medical Center, Tucson, Arizona. · Montefiore Medical Center, Bronx, New York. · Columbia University, New York, New York; American Gastroenterological Association. · University of Florida College of Medicine, Gainesville, Florida. · New York University Medical Center, New York, New York. · Northwestern University, Chicago, Illinois. · University of Texas MD Anderson Cancer Center, Houston, Texas. · University of Alabama Medical Center, Birmingham, Alabama. · The Warren Alpert School of Medicine at Brown University, Providence, Rhode Island. · University of Illinois College of Medicine, Chicago, Illinois; American College of Physicians. · Specialty Chair, University of Washington, Seattle, Washington. ·J Am Coll Radiol · Pubmed #29101993.

ABSTRACT: Pancreatic adenocarcinoma is associated with poor overall prognosis. Complete surgical resection is the only possible option for cure. As such, increasingly complex surgical techniques including sophisticated vascular reconstruction are being used. Continued advances in surgical techniques, in conjunction with use of combination systemic therapies, and radiation therapy have been suggested to improve outcomes. A key aspect to surgical success is reporting of pivotal findings beyond absence of distant metastases, such as tumor size, location, and degree of tumor involvement of specific vessels associated with potential perineural tumor spread. Multiphase contrast-enhanced multidetector CT and MRI are the imaging modalities of choice for pretreatment staging and presurgical determination of resectability. Imaging modalities such as endoscopic ultrasound and fluorine-18-2-fluoro-2-deoxy-D-glucose imaging with PET/CT are indicated for specific scenarios such as biopsy guidance and confirmation of distant metastases, respectively. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

2 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.

3 Editorial A Glimmer of Hope for Pancreatic Cancer. 2018

Kindler, Hedy L. ·From the Section of Hematology-Oncology, University of Chicago Medicine, Chicago. ·N Engl J Med · Pubmed #30575492.

ABSTRACT: -- No abstract --

4 Editorial Portal-vein blood samples as a new diagnostic entity for pancreatic cancer. 2016

Chapman, Christopher G / Waxman, Irving. ·a Center for Endoscopic Research and Therapeutics (CERT) , The University of Chicago Medicine and Biological Sciences , Chicago , IL , USA. ·Expert Rev Gastroenterol Hepatol · Pubmed #27077275.

ABSTRACT: -- No abstract --

5 Editorial How can next-generation diagnostics aid pancreatic adenocarcinoma treatment? 2016

Zhang, Shuang Qin / Catenacci, Daniel V T. ·Department of Medicine, Section of Hematology & Oncology, University of Chicago, Chicago, IL 60637, USA. ·Future Oncol · Pubmed #26831761.

ABSTRACT: -- No abstract --

6 Editorial More harm than good? 2014

Gnerlich, Jennifer L / Posner, Mitchell C. ·Department of Surgery, University of Chicago, Chicago, Illinois, USA. ·Ann Surg Oncol · Pubmed #25023543.

ABSTRACT: -- No abstract --

7 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.

8 Review Can we better predict the biologic behavior of incidental IPMN? A comprehensive analysis of molecular diagnostics and biomarkers in intraductal papillary mucinous neoplasms of the pancreas. 2018

Tulla, Kiara A / Maker, Ajay V. ·Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL, USA. · Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL, USA. amaker@uic.edu. · Department of Microbiology and Immunology, University of Illinois at Chicago, 835 S. Wolcott Ave. M/C 790, Chicago, IL, 60612, USA. amaker@uic.edu. · Creticos Cancer Center at AIMMC, Chicago, IL, USA. amaker@uic.edu. ·Langenbecks Arch Surg · Pubmed #29218397.

ABSTRACT: PURPOSE: Predicting the biologic behavior of intraductal papillary mucinous neoplasm (IPMN) remains challenging. Current guidelines utilize patient symptoms and imaging characteristics to determine appropriate surgical candidates. However, the majority of resected cysts remain low-risk lesions, many of which may be feasible to have under surveillance. We herein characterize the most promising and up-to-date molecular diagnostics in order to identify optimal components of a molecular signature to distinguish levels of IPMN dysplasia. METHODS: A comprehensive systematic review of pertinent literature, including our own experience, was conducted based on the PRISMA guidelines. RESULTS: Molecular diagnostics in IPMN patient tissue, duodenal secretions, cyst fluid, saliva, and serum were evaluated and organized into the following categories: oncogenes, tumor suppressor genes, glycoproteins, markers of the immune response, proteomics, DNA/RNA mutations, and next-generation sequencing/microRNA. Specific targets in each of these categories, and in aggregate, were identified by their ability to both characterize a cyst as an IPMN and determine the level of cyst dysplasia. CONCLUSIONS: Combining molecular signatures with clinical and imaging features in this era of next-generation sequencing and advanced computational analysis will enable enhanced sensitivity and specificity of current models to predict the biologic behavior of IPMN.

9 Review The Complexity of Omega-3 Fatty Acid Modulation of Signaling Pathways Related to Pancreatic Cancer. 2018

Torres, Carolina / Diaz, Andrew M / Principe, Daniel R / Grippo, Paul J. ·Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States. · College of Medicine, University of Illinois, Urbana-Champaign, IL, United States. ·Curr Med Chem · Pubmed #28618995.

ABSTRACT: Cancer is a major public health problem worldwide and is the second leading cause of death in the United States. Although cancer death rate has dropped by 23% since 1991, there are certain types of cancer for which death rates are still increasing, such as pancreatic cancer. There is an urgent need to find new therapies that could help improve this dreadful outcome. In this regard, the role of nutrition in health and disease has attracted much attention. Several dietary components are involved in metabolic, physiologic and cell signaling affecting tumor growth and progression. Although lipids, and more specifically polyunsaturated fatty acids, have been traditionally studied due to their health effects in cardiovascular disease, it is now clear that they can impact an extensive array of cellular processes that influence a wide range of diseases such as type II diabetes, inflammatory disorders and cancer. These biological activities may be grouped as regulation of: (1) membrane structure and function, (2) intracellular signaling pathways, (3) transcription factor activity, (4) gene expression, and (5) production of bioactive lipid mediators. The aim of this review is to assimilate the current state of knowledge about these potential mechanism(s) of action and signaling pathways modulated by polyunsaturated fatty acids in pancreatic cancer.

10 Review Less common etiologies of exocrine pancreatic insufficiency. 2017

Singh, Vikesh K / Haupt, Mark E / Geller, David E / Hall, Jerry A / Quintana Diez, Pedro M. ·Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States. vsingh1@jhmi.edu. · Medical Affairs, AbbVie Inc., North Chicago, IL 60064, United States. · Cystic Fibrosis Clinical Development, AbbVie Inc., North Chicago, IL 60064, United States. · CREON Clinical Development, AbbVie Inc., North Chicago, IL 60064, United States. · CREON Development, AbbVie Inc., North Chicago, IL 60064, United States. ·World J Gastroenterol · Pubmed #29093615.

ABSTRACT: Exocrine pancreatic insufficiency (EPI), an important cause of maldigestion and malabsorption, results from primary pancreatic diseases or secondarily impaired exocrine pancreatic function. Besides cystic fibrosis and chronic pancreatitis, the most common etiologies of EPI, other causes of EPI include unresectable pancreatic cancer, metabolic diseases (diabetes); impaired hormonal stimulation of exocrine pancreatic secretion by cholecystokinin (CCK); celiac or inflammatory bowel disease (IBD) due to loss of intestinal brush border proteins; and gastrointestinal surgery (asynchrony between motor and secretory functions, impaired enteropancreatic feedback, and inadequate mixing of pancreatic secretions with food). This paper reviews such conditions that have less straightforward associations with EPI and examines the role of pancreatic enzyme replacement therapy (PERT). Relevant literature was identified by database searches. Most patients with inoperable pancreatic cancer develop EPI (66%-92%). EPI occurs in patients with type 1 (26%-57%) or type 2 diabetes (20%-36%) and is typically mild to moderate; by definition, all patients with type 3c (pancreatogenic) diabetes have EPI. EPI occurs in untreated celiac disease (4%-80%), but typically resolves on a gluten-free diet. EPI manifests in patients with IBD (14%-74%) and up to 100% of gastrointestinal surgery patients (47%-100%; dependent on surgical site). With the paucity of published studies on PERT use for these conditions, recommendations for or against PERT use remain ambiguous. The authors conclude that there is an urgent need to conduct robust clinical studies to understand the validity and nature of associations between EPI and medical conditions beyond those with proven mechanisms, and examine the potential role for PERT.

11 Review EUS and related technologies for the diagnosis and treatment of pancreatic disease: research gaps and opportunities-Summary of a National Institute of Diabetes and Digestive and Kidney Diseases workshop. 2017

Lee, Linda S / Andersen, Dana K / Ashida, Reiko / Brugge, William R / Canto, Mimi I / Chang, Kenneth J / Chari, Suresh T / DeWitt, John / Hwang, Joo Ha / Khashab, Mouen A / Kim, Kang / Levy, Michael J / McGrath, Kevin / Park, Walter G / Singhi, Aatur / Stevens, Tyler / Thompson, Christopher C / Topazian, Mark D / Wallace, Michael B / Wani, Sachin / Waxman, Irving / Yadav, Dhiraj / Singh, Vikesh K. ·Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. · Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA. · Departments of Cancer Survey and Gastrointestinal Oncology, Osaka Prefectural Hospital Organization, Osaka International Cancer Institute, Osaka, Japan. · Department of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA. · Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · Comprehensive Digestive Disease Center, Department of Gastroenterology and Hepatology, University of California at Irvine Health, Orange, California, USA. · Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. · Division of Gastroenterology, Indiana University Health Medical Center, Indianapolis, Indiana, USA. · Department of Medicine, University of Washington, Seattle, Washington, USA. · Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. · Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. · Department of Medicine, Stanford University School of Medicine, Stanford, California, USA. · Department of Pathology, University of Pittsburgh Medical Center, Sewickley, Pennsylvania, USA. · Department of Gastroenterology, Cleveland Clinic, Cleveland, Ohio, USA. · Department of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, Florida, USA. · Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. · Department of Medicine, The University of Chicago Comprehensive Cancer Center, University of Chicago School of Medicine, Chicago, Illinois, USA. ·Gastrointest Endosc · Pubmed #28941651.

ABSTRACT: A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to address the research gaps and opportunities in pancreatic EUS. The event occurred on July 26, 2017 in 4 sessions: (1) benign pancreatic diseases, (2) high-risk pancreatic diseases, (3) diagnostic and therapeutics, and (4) new technologies. The current state of knowledge was reviewed, with identification of numerous gaps in knowledge and research needs. Common themes included the need for large multicenter consortia of various pancreatic diseases to facilitate meaningful research of these entities; to standardize EUS features of different pancreatic disorders, the technique of sampling pancreatic lesions, and the performance of various therapeutic EUS procedures; and to identify high-risk disease early at the cellular level before macroscopic disease develops. The need for specialized tools and accessories to enable the safe and effective performance of therapeutic EUS procedures also was discussed.

12 Review Perioperative management of endocrine insufficiency after total pancreatectomy for neoplasia. 2017

Maker, Ajay V / Sheikh, Raashid / Bhagia, Vinita / Anonymous5820913. ·Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, 835 S. Wolcott Ave. MC790, Chicago, IL, 60612, USA. amaker@uic.edu. · Creticos Cancer Center, Advocate Illinois Masonic Medical Center, University of Illinois Metropolitan Group Hospitals Residency Program in General Surgery, Chicago, IL, USA. amaker@uic.edu. · Creticos Cancer Center, Advocate Illinois Masonic Medical Center, University of Illinois Metropolitan Group Hospitals Residency Program in General Surgery, Chicago, IL, USA. · Department of Medicine, Division of Endocrinology, University of Illinois at Chicago and Creticos Cancer Center at Advocate Illinois Masonic Medical Center, Chicago, IL, USA. ·Langenbecks Arch Surg · Pubmed #28733926.

ABSTRACT: PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions. This article aims to define the disease, describe the cause for its occurrence, review the anatomy of the endocrine pancreas, and explain how this condition differs from diabetes mellitus in the setting of post-operative management. The morbidity and mortality of post-TP endocrine insufficiency and practical treatment strategies are systematically reviewed from the literature. Finally, an evidence-based treatment algorithm is created for the practicing pancreatic surgeon and their care team of endocrinologists to aid in managing these complex patients. METHODS: A PubMed, Science Citation Index/Social sciences Citation Index, and Cochrane Evidence-Based Medicine database search was undertaken along with extensive backward search of the references of published articles to identify studies evaluating endocrine morbidity and treatment after TP and to establish an evidence-based treatment strategy. RESULTS: Indications for TP and the etiology of pancreatogenic diabetes are reviewed. After TP, ~80% patients develop hypoglycemic episodes and 40% experience severe hypoglycemia, resulting in 0-8% mortality and 25-45% morbidity. Referral to a nutritionist and endocrinologist for patient education before surgery followed by surgical reevaluation to determine if the patient has the appropriate understanding, support, and resources preoperatively has significantly reduced morbidity and mortality. The use of modern recombinant long-acting insulin analogues, continuous subcutaneous insulin infusion, and glucagon rescue therapy has greatly improved management in the modern era and constitute the current standard of care. A simple immediate post-operative algorithm was constructed. CONCLUSION: Successful perioperative surgical management of total pancreatectomy and resulting pancreatogenic diabetes is critical to achieve acceptable post-operative outcomes, and we review the pertinent literature and provide a simple, evidence-based algorithm for immediate post-resection glycemic control.

13 Review Paraduodenal pancreatitis: benign and malignant mimics at MRI. 2017

Mittal, Pardeep K / Harri, Peter / Nandwana, Sadhna / Moreno, Courtney C / Muraki, Takashi / Adsay, Volkan / Cox, Kelly / Pehlivanoglu, Burcin / Alexander, Lauren F / Chatterjee, Argha / Miller, Frank H. ·Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Road NE, Building A, Suite AT-627, Atlanta, GA, 30322, USA. pmittal@emory.edu. · Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Road NE, Building A, Suite AT-627, Atlanta, GA, 30322, USA. · Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA. · Department of Radiology Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. ·Abdom Radiol (NY) · Pubmed #28660333.

ABSTRACT: Paraduodenal pancreatitis, also known as groove pancreatitis, is a rare form of chronic pancreatitis that masquerades as pancreatic adenocarcinoma affecting the pancreaticoduodenal groove, a potential space between the head of the pancreas, duodenum, and common bile duct. Two forms of groove pancreatitis have been described. The segmental form involves the pancreatic head with development of scar tissue within the groove, whereas the pure form affects the groove only, sparing the pancreatic head. Imaging findings of groove pancreatitis often overlap with primary duodenal, ampullary, or pancreatic neoplasms, which often results in a diagnostic challenge. In addition, paraduodenal pancreatitis can be mistaken for cystic pancreatic lesions, especially when there is involvement of the duodenal wall. Preoperative recognition of this entity is very important in order to avoid unnecessary procedures, although surgery, such as pancreaticoduodenectomy, may still be required to relieve obstructive symptoms. In this article, the pathophysiology and magnetic resonance imaging characteristics of paraduodenal pancreatitis and important benign and malignant mimics are discussed.

14 Review ACR Appropriateness Criteria® Resectable Pancreatic Cancer. 2017

Jones, William E / Suh, W Waren / Abdel-Wahab, May / Abrams, Ross A / Azad, Nilofer / Das, Prajnan / Dragovic, Jadranka / Goodman, Karyn A / Jabbour, Salma K / Konski, Andre A / Koong, Albert C / Kumar, Rachit / Lee, Percy / Pawlik, Timothy M / Small, William / Herman, Joseph M / Anonymous5660897. ·*University of Texas Health Science Center at San Antonio, San Antonio ¶University of Texas MD Anderson Cancer Center, Houston, TX †Cancer Center of Santa Barbara, Santa Barbara §§Stanford Cancer Institute, Stanford ¶¶University of California Los Angeles, Los Angeles, CA ‡Cleveland Clinic, Cleveland, OH ***Stritch School of Medicine Loyola University Chicago, Maywood §Rush University Medical Center, Chicago, IL ∥Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, American Society of Clinical Oncology †††Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University ##Johns Hopkins University, Baltimore, MD, American College of Surgeons #Henry Ford Hospital, Detroit, MI **University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO ††Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ ‡‡University of Pennsylvania, The Chester County Hospital, West Chester, PA ∥∥Banner MD Anderson Cancer Center, Gilbert, AZ. ·Am J Clin Oncol · Pubmed #28230650.

ABSTRACT: Management of resectable pancreatic adenocarcinoma continues to present a challenge due to a paucity of high-quality randomized studies. Administration of adjuvant chemotherapy is widely accepted due to the high risk of systemic spread associated with pancreatic adenocarcinoma, but the role of radiation therapy is less clear. This paper reviews literature associated with resectable pancreatic cancer to include prognostic factors to aid in the selection of patients appropriate for adjuvant therapies. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

15 Review Surgical Management of Pancreatic Neuroendocrine Tumors. 2016

Liu, Jason B / Baker, Marshall S. ·Department of Surgery, University of Chicago Hospitals, Chicago, IL, USA. · Department of Surgery, University of Chicago Hospitals, Chicago, IL, USA; Division of Surgical Oncology, Department of Surgery, NorthShore University Health System, Evanston, IL, USA. Electronic address: mbaker3@northshore.org. ·Surg Clin North Am · Pubmed #27865287.

ABSTRACT: Pancreatic neuroendocrine tumors (PNETs) are a rare, heterogeneous group of neoplasms infamous for their endocrinopathies. Up to 90% of PNETs, however, are nonfunctional and are frequently detected incidentally on axial imaging during the evaluation of vague abdominal symptoms. Surgery remains the mainstay of therapy for patients diagnosed with both functional and nonfunctional PNETs. However, the multifaceted nature of PNETs challenges treatment decision making. In general, resection is recommended for patients with acceptable perioperative risk and amenable lesions.

16 Review Neuroendocrine Tumors and Lanreotide Depot: Clinical Considerations and Nurse and Patient Preferences. 2016

Ryan, Pamela / Phan, Alexandria T / Adelman, Daphne T / Iwasaki, Michiko. ·Ochsner Medical Center. · Houston Methodist Hospital. · Northwestern University. · University of Texas MD Anderson Cancer Center. ·Clin J Oncol Nurs · Pubmed #27857269.

ABSTRACT: BACKGROUND: Somatostatin analogs (SSAs) are a mainstay therapy for the treatment of carcinoid syndrome associated with neuroendocrine tumors (NETs). They are effective for a range of gastroenteropancreatic NETs (GEP-NETs). Lanreotide depot (Somatuline®) is an SSA that is approved for the treatment of GEP-NETs to improve progression-free survival (PFS). OBJECTIVES: The article reviews the efficacy, safety, and administration of lanreotide depot and relates those attributes to considerations and preferences of oncology nurses and their patients. METHODS: A review of the literature on the use of lanreotide for the treatment of NETs and carcinoid syndrome was conducted. In addition, the literature on drug delivery and routes of administration was surveyed to provide context for comparative studies related to clinical and patient preferences. FINDINGS: Lanreotide depot prolongs PFS and is well tolerated by patients who expressed satisfaction in the ability to control symptoms related to carcinoid syndrome. Nurses cited several benefits to using lanreotide depot in the clinical setting, including more time saved to address other patient care issues. Attributes of lanreotide depot-including its efficacy, safety and tolerability, dosing and administration, and cost-may contribute to healthcare decisions regarding the treatment and management of NETs.

17 Review Covered versus uncovered self-expandable metal stents for malignant biliary strictures: A meta-analysis and systematic review. 2016

Moole, Harsha / Bechtold, Matthew L / Cashman, Micheal / Volmar, Fritz H / Dhillon, Sonu / Forcione, David / Taneja, Deepak / Puli, Srinivas R. ·Division of General Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA. harsha1778@yahoo.co.in. · Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA. · Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA. · Interventional Endoscopy Services, Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Department of Medicine, Division of Pulmonary Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA. ·Indian J Gastroenterol · Pubmed #27566620.

ABSTRACT: Self-expandable metal stents (SEMS) are used for palliating inoperable malignant biliary strictures. It is unclear if covered metal stents are superior to uncovered metal stents in these patients. We compared clinical outcomes in patients with covered and uncovered stents. Studies using covered and uncovered metallic stents for palliation in patients with malignant biliary stricture were reviewed. Articles were searched in MEDLINE, PubMed, and Ovid journals. Fixed and random effects models were used to calculate the pooled proportions. Initial search identified 1436 reference articles, of which 132 were selected and reviewed. Thirteen studies (n = 2239) for covered and uncovered metallic stents which met the inclusion criteria were included in this analysis. Odds ratio for stent occlusion rates in covered vs. uncovered stents was 0.79 (95 % CI = 0.65 to 0.96). Survival benefit in patients with covered vs. uncovered stents showed the odds ratio to be 1.29 (95 % CI = 0.95 to 1.74). Pooled odds ratio for migration of covered vs. uncovered stents was 9.9 (95 % CI = 4.5 to 22.3). Covered stents seemed to have significantly lesser occlusion rates, increased odds of migration, and increased odds of pancreatitis compared to uncovered stents. There was no statistically significant difference in the survival benefit, overall adverse event rate, and patency period of covered vs. uncovered metal stents in patients with malignant biliary strictures.

18 Review Efficacy of preoperative biliary drainage in malignant obstructive jaundice: a meta-analysis and systematic review. 2016

Moole, Harsha / Bechtold, Matthew / Puli, Srinivas R. ·Division of General Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA. harsha1778@yahoo.co.in. · Department of Medicine, University of Illinois College of Medicine Peoria, 530 NE Glen Oak Ave, Peoria, IL, 61637, USA. harsha1778@yahoo.co.in. · Department of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA. · Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA. ·World J Surg Oncol · Pubmed #27400651.

ABSTRACT: BACKGROUND: In patients requiring surgical resection for malignant biliary jaundice, it is unclear if preoperative biliary drainage (PBD) would improve mortality and morbidity by restoration of biliary flow prior to operation. This is a meta-analysis to pool the evidence and assess the utility of PBD in patients with malignant obstructive jaundice. The primary outcome is comparing mortality outcomes in patients with malignant obstructive jaundice undergoing direct surgery (DS) versus PBD. The secondary outcomes include major adverse events and length of hospital stay in both the groups. METHODS: Studies using PBD in patients with malignant obstructive jaundice were included in this study. For the data collection and extraction, articles were searched in MEDLINE, PubMed, Embase, Cochrane Central Register of Controlled Trials & Database of Systematic Reviews, etc. Pooled proportions were calculated using both Mantel-Haenszel method (fixed effects model) and DerSimonian-Laird method (random effects model). RESULTS: Initial search identified 2230 reference articles, of which 204 were selected and reviewed. Twenty-six studies (N = 3532) for PBD in malignant obstructive jaundice which met the inclusion criteria were included in this analysis. The odds ratio for mortality in PBD group versus DS group was 0.96 (95 % CI = 0.71 to 1.29). Pooled number of major adverse effects was lower in the PBD group at 10.40 (95 % CI = 9.96 to 10.83) compared to 15.56 (95 % CI = 15.06 to 16.05) in the DS group. Subgroup analysis comparing internal PBD to DS group showed lower odds for major adverse events (odds ratio, 0.48 with 95 % CI = 0.32 to 0.74). CONCLUSIONS: In patients with malignant biliary jaundice requiring surgery, PBD group had significantly less major adverse effects than DS group. Length of hospital stay and mortality rate were comparable in both the groups.

19 Review State-of-the-art endoscopic procedures for pancreatic cancer. 2016

Coronel, Emmanuel / Waxman, Irving. ·University of Chicago Medicine, Gastroenterology, Hepatology & Nutrition, Chicago, IL, USA. · University of Chicago Medicine, Center for Endoscopic Research & Therapeutics, Chicago IL, USA. ·Future Oncol · Pubmed #27339021.

ABSTRACT: Pancreatic cancer is the twelfth most common cancer worldwide, taking the fourth place in cancer-related mortality in western countries. Despite significant efforts in understanding the tumor biology of pancreatic cancer and introducing new technologies and therapies to improve the detection, staging and treatment of this disease, pancreatic cancer continues to have a high and almost unchanged mortality. In the last few decades, the development of techniques such as endoscopic retrograde cholangio pancreatography and endoscopic ultrasound have allowed us to directly access the pancreaticobiliary system and fight pancreatic cancer and its complications from different fronts. Our goal with this review is to discuss the most cutting-edge endoscopic techniques available in our armamentarium to diagnose, stage and treat pancreatic cancer.

20 Review Stereotactic body radiotherapy for pancreatic cancer: recent progress and future directions. 2016

Myrehaug, Sten / Sahgal, Arjun / Russo, Suzanne M / Lo, Simon S / Rosati, Lauren M / Mayr, Nina A / Lock, Michael / Small, William / Dorth, Jennifer A / Ellis, Rodney J / Teh, Bin S / Herman, Joseph M. ·a Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre , University of Toronto , Toronto , ON , Canada. · b Department of Radiation Oncology , University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center , Cleveland , OH , USA. · c Department of Radiation Oncology & Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center , Johns Hopkins University , Baltimore , MD , USA. · d Department of Radiation Oncology , University of Washington , Seattle , WA , USA. · e Department of Radiation Oncology, London Regional Cancer Program , University of Western Ontario , London , ON , Canada. · f Department of Radiation Oncology , Loyola University Medical Center , Maywood , IL , USA. · g Department of Radiation Oncology , Houston Methodist Hospital, Weill Cornell Medical College , Houston , TX , USA. ·Expert Rev Anticancer Ther · Pubmed #26999329.

ABSTRACT: Despite advances in surgical, medical, and radiation therapy for pancreatic cancer, the prognosis remains poor. At this time, the only chance for long-term survival is surgical resection. More challenging is the optimal management of unresectable locally advanced pancreatic cancer, which has historically been treated with concurrent chemoradiation or chemotherapy alone. However, the survival and local control benefit of conventional radiotherapy in addition to chemotherapy was unclear. More recently, stereotactic body radiotherapy (SBRT) is emerging as a viable approach to maximizing local tumor control with a tolerable side effect profile. SBRT achieves sharp dose fall-off facilitating safe delivery of highly focused radiation to the tumor over 1-5 days. Although the optimal regimen of pancreas SBRT has not yet been established, its short treatment course limits the delay of additional. Future directions involve prospective study of pancreas SBRT and exploration of biomarkers and imaging technology in order to adopt a personalized management paradigm.

21 Review The 'SPARC' of life: Analysis of the role of osteonectin/SPARC in pancreatic cancer (Review). 2016

Rossi, Monica K / Gnanamony, Manu / Gondi, Christopher S. ·Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL 61605, USA. ·Int J Oncol · Pubmed #26983777.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is one of the most clinically challenging cancers to manage. An estimated 48,960 people will be diagnosed with pancreatic cancer in 2015, of that population, 94% are projected to perish within 5 years. These dismal survival rates can be attributed, in part, to an advanced diagnosis occurring in 80% of cases. The heterogeneous and dynamic microenvironment of pancreatic cancer, and the lack of both specific risk factors and efficacious screening tools contribute to the challenge of diagnosing pancreatic cancer in its early stages. These clinical challenges have directed research into the unique characteristics that define PDAC. Recently, there has been an increased focus on the interaction of tumor cells with their microenvironment in the hope of identifying new therapeutic targets. One of the most promising avenues in this new vein of research is targeting protein communication between the cancer cells and the extracellular matrix. The secreted protein acidic and rich in cysteine (SPARC) is one such extracellular matrix protein that has shown potential as a therapeutic target due to its influence on PDAC invasion and metastasis. In this review, we discuss the complex interaction of SPARC with PDAC cells and its potential to guide treatment and eventually improve the survival of patients diagnosed with this devastating disease.

22 Review FAK and paxillin, two potential targets in pancreatic cancer. 2016

Kanteti, Rajani / Batra, Surinder K / Lennon, Frances E / Salgia, Ravi. ·Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA. · Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA. · Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA. ·Oncotarget · Pubmed #26980710.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is a devastating cancer in large part due to late diagnosis and a lack of effective screening tests. In spite of recent progress in imaging, surgery and new therapeutic options for pancreatic cancer, the overall five-year survival still remains unacceptably low. Numerous studies have shown that focal adhesion kinase (FAK) is activated in many cancers including PDAC and promotes cancer progression and metastasis. Paxillin, an intracellular adaptor protein that plays a key role in cytoskeletal organization, connects integrins to FAK and plays a key role in assembly and disassembly of focal adhesions. Here, we have reviewed evidence in support of FAK as a potential therapeutic target and summarized related combinatorial therapies.

23 Review Magnetic resonance imaging of pancreatic metastases from renal cell carcinoma. 2015

Sikka, Amrita / Adam, Sharon Z / Wood, Cecil / Hoff, Frederick / Harmath, Carla B / Miller, Frank H. ·Department of Radiology, Northwestern University, Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL 60611. · Department of Radiology, Northwestern University, Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL 60611. Electronic address: fmiller@northwestern.edu. ·Clin Imaging · Pubmed #26324216.

ABSTRACT: Pancreatic metastases are rare but are thought to be most commonly from renal cell carcinoma (RCC). These metastases can present many years after the initial tumor is resected, and accordingly, these patients require prolonged imaging follow-up. Although the computed tomographic findings of these metastases have been extensively reviewed in the literature, little has been written about the magnetic resonance imaging appearance of these metastases. Pancreatic metastases from RCC are typically T1 hypointense and T2 hyperintense. After intravenous administration of gadolinium, they are typically hypervascular and less commonly hypovascular. Chemical shift and diffusion-weighted imaging can aid in the diagnosis of these metastases.

24 Review Perioperative Blood Transfusion and the Prognosis of Pancreatic Cancer Surgery: Systematic Review and Meta-analysis. 2015

Mavros, Michael N / Xu, Li / Maqsood, Hadia / Gani, Faiz / Ejaz, Aslam / Spolverato, Gaya / Al-Refaie, Waddah B / Frank, Steven M / Pawlik, Timothy M. ·Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA. · Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. · Alfa Institute of Biomedical Sciences, Marousi, Athens, Greece. · Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China. · State Key Laboratory of Oncology in Southern China, Guangzhou, China. · Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA. · Department of Surgery, MedStar Georgetown University Hospital Center, Washington, DC, USA. · Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. · Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. tpawlik1@jhmi.edu. ·Ann Surg Oncol · Pubmed #26293837.

ABSTRACT: BACKGROUND: Perioperative blood transfusion (PBT) is common in pancreatic surgery. Recent studies have suggested that PBT may be associated with worse long-term outcomes. METHODS: A systematic review and meta-analysis of studies comparing long-term clinical outcomes of cancer patients undergoing curative-intent pancreatic surgery with regard to occurrence of PBT was performed. RESULTS: A total of 23 studies (4339 patients) were included in the systematic review, and 19 studies (3646 patients) were included in the meta-analysis. Nearly half (45.8 %) of all patients were female (range 25-60 %), and median age ranged from 59 to 72 years. About half (46.5 %, range 19-72 %) of the patients were transfused. Most had pancreatic ductal adenocarcinoma (69.5 %), while others had ampullary carcinoma (15.0 %), cholangiocarcinoma (7.4 %), or exocrine tumors of pancreas (8.1 %). Most (91.1 %) underwent pancreaticoduodenectomy, while the remaining patients underwent a total or distal pancreatectomy. The 5-year overall survival for all patients ranged from 0 to 65 %. Thirteen and nine of 19 studies reported a detrimental effect of PBT on survival on univariable and multivariable analysis, respectively. Overall, PBT was associated with shorter overall survival (pooled odds ratio 2.43, 95 % confidence interval 1.90-3.10); this finding was reproduced in sensitivity analysis. CONCLUSIONS: Patients receiving PBT had significantly lower 5-year survival after curative-intent pancreatic surgery. Further research should focus on implementing guidelines for and discerning factors associated with the poor outcomes after PBT.

25 Review Biomarkers for personalized medicine in GI cancers. 2015

Zhang, Shuang Yin / Zhang, Shuang Qin / Nagaraju, Ganji Purnachandra / El-Rayes, Bassel F. ·Department of Hematology Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA. · Department of Medicine, Section of Hematology and Oncology, University of Chicago, Chicago, IL, USA. · Department of Hematology Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA. Electronic address: bassel.el-rayes@emoryhealthcare.org. ·Mol Aspects Med · Pubmed #26054566.

ABSTRACT: Gastrointestinal malignancies are a major health care challenge due to the high incidence and overall poor outcome. A biomarker is a molecular characteristic of a tumor that may be utilized in the initial risk assessment and the subsequent management of the patient. This review focuses on the most pertinent prognostic and predictive biomarkers used in the clinical management of gastric, pancreas, and colon cancer. The available assays, limitations and clinical use for each biomarker are reviewed. The clinical trials evaluating novel biomarkers in GI cancers are discussed.

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