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Hyeong Sik Ahn, Tae Uk Kang, Heather Swan, Min Ji Kang, Nayoung Kim, Hyun Jung Kim, Seon Mee Park
OBJECTIVES: We analyzed the incidence and mortality rates of second pancreatic ductal adenocarcinoma (PDAC) among survivors of digestive cancers in South Korea. METHODS: We evaluated data from the Korea National Health Insurance to identify individuals with digestive cancers in 2005 to 2015. The standardized incidence ratios (SIRs) of second PDACs and survival rates were evaluated. RESULTS: Among 772,534 patients with first digestive cancers, 1696 (0...
February 14, 2019: Pancreas
Namita Gupta, Shailender Singh, Luciano Vargas, Timothy E Moore, Valerie K Shostrom, Brian P Boerner
OBJECTIVES: Patients with chronic pancreatitis (CP) are at increased risk of low bone mineral density (BMD), although the prevalence of low BMD in patients with CP in the United States is lacking. We aimed to determine the prevalence of low BMD and identify potential risk factors, including hypogonadism and use of opioid medications, in subjects with CP in the United States. METHODS: This was a prospective, observational study. Subjects with CP underwent dual-energy x-ray absorptiometry scan...
February 14, 2019: Pancreas
Daniel M Halperin, J Jack Lee, Chaan S Ng, Jonathan R Strosberg, Jeannelyn S Estrella, Cecile G Dagohoy, Arvind Dasari, James C Yao
OBJECTIVES: Therapies for patients with advanced well-differentiated pancreatic neuroendocrine tumors (pNETs) are insufficient, with patients succumbing to disease despite recent treatment advances. Ziv-aflibercept is a fusion protein of portions of the vascular endothelial growth factor (VEGF) receptors 1 and 2, fused to the Fc portion of immunoglobulin G1, forming a VEGF trap. Perfusion computed tomography (CT) has previously defined hyperperfused neuroendocrine tumors, potentially predicting antiangiogenic benefit...
February 14, 2019: Pancreas
Eran Nizri, Shoshi Bar-David, Asaf Aizic, Neta Sternbach, Guy Lahat, Ido Wolf, Joseph Klausner
OBJECTIVES: Pancreatic ductal adenocarcinoma (PDAC) is characterized by a peritumoral proliferation of fibroblasts and extracellular matrix production known as desmoplasia. We aimed to study desmoplasia in PDAC lymph node (LN) metastases. METHODS: We evaluated LNs from 66 patients with PDAC and LN metastases. We used immunohistochemistry and real-time polymerase chain reaction to phenotype the desmoplastic response. RESULTS: Desmoplasia was identified in 57% of patients with LN metastases (Des+)...
February 14, 2019: Pancreas
Eugene A Woltering, Brianne A Voros, David T Beyer, Ramcharan Thiagarajan, Robert A Ramirez, Gregg Mamikunian, J Philip Boudreaux
OBJECTIVES: Elevated pancreastatin (PST) levels have been shown to be associated with poor prognosis in small bowel neuroendocrine tumors (NETs). We hypothesized that plasma PST levels that remain elevated following surgical cytoreduction portend a poor prognosis in well-differentiated small bowel NETs. METHODS: Patients diagnosed with small bowel NETs who underwent surgical cytoreduction at our institution were identified. Demographics, histopathologic characteristics, and biochemical data were collected...
February 14, 2019: Pancreas
David S Vitale, Lindsey Hornung, Tom K Lin, Jaimie D Nathan, Swathi Prasad, Tyler Thompson, Maisam Abu-El-Haija
OBJECTIVE: The natural course of patients who develop acute pancreatitis (AP) can range from mild to severe acute pancreatitis (SAP). The aim of this study was to evaluate for early predictors of developing SAP during the first episode of AP in a prospective pediatric cohort. METHODS: Clinical data were prospectively collected and subsequently analyzed for pediatric patients presenting with their first episode of AP between March 2013 and January 2017 to Cincinnati Children's Hospital Medical Center...
February 14, 2019: Pancreas
Ding Long, Yujun Wang, Hui Wang, Xiaoling Wu, Li Yu
OBJECTIVES: The aim of the study was to investigate the correlation of serum and ascitic fluid soluble form urokinase plasminogen activator receptor (suPAR) levels with patients' complications, disease severity, inflammatory markers, and prognosis in patients with severe acute pancreatitis (SAP). METHODS: Fifty patients with SAP, 47 patients with mild acute pancreatitis, and 50 healthy controls were enrolled. Serum samples were obtained from all participants after enrollment; meanwhile, ascitic fluid samples were collected from 20 patients with SAP who developed ascites...
February 14, 2019: Pancreas
Kazuyoshi Yanagihara, Takanori Kubo, Keichiro Mihara, Takeshi Kuwata, Atsushi Ochiai, Toshio Seyama, Hiroshi Yokozaki
OBJECTIVES: Peritoneal dissemination (PD) is an important cause of morbidity and mortality among patients with pancreatic ductal adenocarcinoma (PDAC). We sought to develop and characterized a novel PD mouse model by using a previously established PDAC cell line TCC-Pan2. METHODS: TCC-Pan2 cell line was characterized for growth rate, tumor markers, histology, and somatic mutations. TCC-Pan2 cells were implanted orthotopically to produce PD. TCC-Pan2 cells from these metastatic foci were expanded in vitro and then implanted orthotopically in mice...
February 8, 2019: Pancreas
Sung Joo Kim, Mi-Ju Kim, Ji-Soo Han, You-Na Sung, Soyeon An, Jae Hoon Lee, Ki Byung Song, Dae Wook Hwang, Sang Soo Lee, HyungJun Cho, Song Cheol Kim, James R Eshleman, Seung-Mo Hong
OBJECTIVE: Although complete surgical resection is the only curative method for pancreatic cancer, the radial resection margins of pylorus-preserving pancreaticoduodenectomy specimens might be underevaluated. METHODS: KRAS mutation was assessed with droplet digital polymerase chain reaction on cells collected from the radial resection margins of 81 patients, and the results were compared with those of conventional pathologic resection margin (pRM) evaluation. RESULTS: KRAS mutation was detected in 76 patients (94%), and molecular resection margin (mRM) positivity defined by a KRAS mutation rate of 4...
February 8, 2019: Pancreas
Jaclyn F Hechtman, David S Klimstra, Gouri Nanjangud, Denise Frosina, Jinru Shia, Achim A Jungbluth
OBJECTIVES: DAXX immunohistochemistry (IHC) is often used as a surrogate for sequencing. We aimed to elucidate the sensitivity of IHC for DAXX mutation. METHODS: All pancreatic neuroendocrine tumors (PanNETs) with DAXX mutations detected by sequencing and a subset of DAXX wild-type PanNETs were analyzed for DAXX expression by IHC. RESULTS: Of 154 PanNETs with MSK-IMPACT testing, 36 (30%) harbored DAXX mutations. DAXX mutations were associated with TSC2 mutations (46% vs 10%, P < 0...
February 8, 2019: Pancreas
Mia Rainio, Outi Lindström, Anne Penttilä, Outi Itkonen, Esko Kemppainen, Ulf-Håkan Stenman, Leena Kylänpää
OBJECTIVES: We explored prediction of severe acute pancreatitis (AP) and development of organ dysfunction (OD). METHODS: Serum concentrations of serine peptidase inhibitor Kazal type 1 (SPINK1), trypsinogen 1, trypsinogen 2, and trypsinogen 3, complex between trypsin 2 and α1-antitrypsin, serum C-reactive protein, creatinine, and pancreatic amylase were measured in 239 AP patients with disease onset within 72 hours. RESULTS: SPINK1 distinguished most accurately patients who later developed severe AP...
February 8, 2019: Pancreas
Temel Tirkes, Christie Y Jeon, Liang Li, Aron Y Joon, Ted A Seltman, Meghana Sankar, Scott A Persohn, Paul R Territo
OBJECTIVE: The aim of this study was to determine the association of the pancreatic steatosis with obesity, chronic pancreatitis (CP), and type 2 diabetes mellitus. METHODS: Patients (n = 118) were retrospectively identified and categorized into no CP (n = 60), mild (n = 21), moderate (n = 27), and severe CP (n = 10) groups based on clinical history and magnetic resonance cholangiopancreatography using the Cambridge classification as the diagnostic standard. Visceral and subcutaneous compartments were manually segmented, and fat tissue was quantitatively measured on axial magnetic resonance imaging...
February 8, 2019: Pancreas
Asma Begum, Ross H McMillan, Yu-Tai Chang, Vesselin R Penchev, N V Rajeshkumar, Anirban Maitra, Michael G Goggins, James R Eshelman, Christopher L Wolfgang, Zeshaan A Rasheed, William Matsui
OBJECTIVE: Cancer-associated fibroblasts (CAFs) play an important role in the progression of pancreatic ductal adenocarcinoma (PDAC) by promoting tumor cell migration and drug resistance. We determined the impact of CAFs on PDAC cancer stem cells (CSCs). METHODS: Fibroblast cell lines from patients' tumors were cocultured with PDAC cells and examined for clonogenic growth and self-renewal using colony-forming assays and migration in vitro. Changes in the frequency of CSCs was determined by flow cytometry...
February 8, 2019: Pancreas
Eric M Wang, Hironari Akasaka, Jun Zhao, Gauri R Varadhachary, Jeffrey E Lee, Anirban Maitra, Jason B Fleming, Mien-Chie Hung, Huamin Wang, Matthew H G Katz
OBJECTIVES: Endoplasmic reticulum stress and subsequent phosphorylation of eukaryotic initiation factor 2α (eIF2α) by protein kinase R-like endoplasmic reticulum kinase (PERK) plays an important role in the development and chemoresistance of pancreatic ductal adenocarcinoma (PDAC). However, the expression and significance of phosphorylated eIF2α (p-eIF2α) and PERK in PDAC have not been examined. METHODS: We examined p-eIF2α and PERK expression in 84 PDAC and paired normal pancreas samples by immunohistochemistry and Western blotting and correlated the results with clinicopathologic parameters and survival...
February 8, 2019: Pancreas
Srikanth Puttaiah Kadyada, Babu Ram Thapa, Narendra Dhaka, Anmol Bhatia, Jagadeesh Menon
OBJECTIVES: Endoscopic ultrasound (EUS) is a minimally invasive pancreatic imaging modality. We evaluated children with idiopathic acute pancreatitis (IAP) and acute recurrent pancreatitis (ARP) for changes of chronicity (Rosemont criteria) and biliary risk factors. Diagnostic yield of simultaneously performed transabdominal ultrasonography (TUS) was compared with EUS. METHODS: This was a prospective observational study. Patients underwent EUS and TUS after 2 months of pancreatitis attack...
February 8, 2019: Pancreas
Chao Lian Xie, Chang Qiang Wu, Yong Chen, Tian Wu Chen, Hua Dan Xue, Zheng Yu Jin, Xiao Ming Zhang
OBJECTIVE: The aim of the study was to study the prevalence and characteristics of sinistral portal hypertension (SPH) in acute pancreatitis (AP) and its correlation with the severity of AP. METHODS: Retrospectively studied 633 patients with AP admitted to our institution and underwent magnetic resonance imaging (MRI). Diagnosis of SPH was based on clinical manifestations, laboratory tests, and MRI. The venous system and pancreatitis were evaluated on T1 weighted imaging, T2 weighted imaging, and dynamic-enhancement MRI...
January 9, 2019: Pancreas
Julie R McSwain, Madeline Nykamp, Bethany J Wolf, Jeffrey D McMurray, Christopher A Skorke, Carlee A Clark
OBJECTIVE: The aim of this retrospective descriptive study was to examine associations with the perioperative management of patients undergoing total pancreatectomy with islet autotransplantation, which may impact complication rate and hospital length of stay. METHODS: We retrospectively collected data on 165 patients, and 161 patients were included in the final analysis. Data collected included preoperative, intraoperative, and postoperative patient and procedural characteristics...
January 9, 2019: Pancreas
Alexis D Vick, Danielle N Hery, Stephen F Markowiak, F Charles Brunicardi
OBJECTIVES: African Americans (AAs) have disproportionately higher incidence and lower survival rates from pancreatic cancer compared with whites. Historically, this disparity has been attributed to modifiable risk factors. Recent studies suggest that nonmodifiable aspects may also play an important role. We review these new contributions as potential targets for closing the disparity. METHODS: A PubMed search was conducted to review studies of nonmodifiable elements contributing to pancreatic cancer disparities in AAs...
January 9, 2019: Pancreas
Julien Péron, Joris Giai, Delphine Maucort-Boulch, Marc Buyse
OBJECTIVES: The benefit-risk balance of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin versus gemcitabine assessed using generalized pairwise comparison was strongly positive. We sought to assess the benefit-risk balance of nab-paclitaxel plus gemcitabine using the data of the MPACT trial, as it is an alternative to 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin. METHODS: This statistical method allows for the simultaneous analysis of several prioritized outcomes...
January 9, 2019: Pancreas
Jordan M Cloyd, Hsiang-Chun Chen, Xuemei Wang, Ching-Wei D Tzeng, Michael P Kim, Thomas A Aloia, Jean-Nicolas Vauthey, Jeffrey E Lee, Matthew H G Katz
OBJECTIVES: Although the use of neoadjuvant therapy for resectable pancreatic ductal adenocarcinoma is increasing, the optimal preoperative treatment regimen remains poorly defined. METHODS: All patients with resectable pancreatic ductal adenocarcinoma who received preoperative chemotherapy alone (12%) or chemoradiation therapy (CRT) alone (88%) before pancreatectomy between 1999 and 2014 were included. Propensity score matching with inverse probability weighting was conducted based on age, baseline carbohydrate antigen 19-9, and procedure type...
January 9, 2019: Pancreas
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