The indolent nature of pulmonary metastases from ductal adenocarcinoma of the pancreas

Abstract Background Ductal adenocarcinoma of the pancreas (PDAC) remains one of the most lethal malignancies. To date, no guidelines exists for isolated resectable metachronous disease. It is still unknown, which patients may benefit from relapse surgery. The aim of our study was to compare disease free survival (DFS) and post relapse survival (PRS) in patients with isolated local recurrence, metachronous hepatic or pulmonary metastases. Methods Patients with isolated resectable local recurrence, metachronous hepatic or pulmonary metastases were included for survival analyses. PRS of surgically treated patients (local (n = 11), hepatic (n = 6) and pulmonary metastases (n = 9)) was compared to conservatively treated patients (local (n = 17), hepatic (n = 37) and pulmonary metastases (n = 8)). Results Resected PDAC patients suffering from isolated metachronous hepatic metastases initially had a higher T-stage and venous invasion (V1) compared to the other patients. DFS in the metachronous pulmonary metastases group was longer compared to DFS of the hepatic metastases and local recurrence groups. Surgical resection significantly improved PRS in patients with local recurrence and pulmonary metastases, when compared to patients receiving chemotherapy alone. Very-long term survivors (> 5 years) were detected following secondary resection of local recurrence and 45% of these patients were still alive at the end of our study period. Conclusion Although DFS in PDAC patients suffering from isolated local recurrence was dismal and comparable to that of patients with isolated hepatic metastases, very-long term survivors were present only in this group. These results indicate that a surgical approach for isolated local recurrence, if anatomically possible, should be considered.

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Site of Relapse of Ductal Adenocarcinoma of the Pancreas Affects Survival after Multimodal Therapy

10.21203/rs.3.rs-44866/v2 ◽

2020 ◽

Author(s):

Sami Alexander Safi ◽

Nadja Lehwald ◽

Alexander Rehders ◽

Georg Fluegen ◽

Lena Julia Haeberle ◽

...

Keyword(s):

Local Recurrence ◽

Pulmonary Metastases ◽

Hepatic Metastases ◽

Disease Free Survival ◽

Venous Invasion ◽

Ductal Adenocarcinoma ◽

Adenocarcinoma Of The Pancreas ◽

Isolated Local Recurrence ◽

Long Term Survivors

Abstract Background: Ductal adenocarcinoma of the pancreas (PDAC) remains one of the most lethal malignancies. To date, no guidelines exists for isolated resectable metachronous disease. It is still unknown, which patients may benefit from relapse surgery. The aim of our study was to compare disease free survival (DFS) and post relapse survival (PRS) in patients with isolated local recurrence, metachronous hepatic or pulmonary metastases.Methods: Patients with isolated resectable local recurrence, metachronous hepatic or pulmonary metastases were included for survival analyses. PRS of surgically treated patients (local (n=11), hepatic (n=6) and pulmonary metastases (n=9)) was compared to conservatively treated patients (local (n=17), hepatic (n=37) and pulmonary metastases (n=8)).Results: Resected PDAC patients suffering from isolated metachronous hepatic metastases initially had a higher T-stage and venous invasion (V1) compared to the other patients. DFS in the metachronous pulmonary metastases group was longer compared to DFS of the hepatic metastases and local recurrence groups. Surgical resection significantly improved PRS in patients with local recurrence and pulmonary metastases, when compared to patients receiving chemotherapy alone. Very-long term survivors (>5 years) were detected following secondary resection of local recurrence and 45% of these patients were still alive at the end of our study period.Conclusion: Although DFS in PDAC patients suffering from isolated local recurrence was dismal and comparable to that of patients with isolated hepatic metastases, very-long term survivors were present only in this group. These results indicate that a surgical approach for isolated local recurrence, if anatomically possible, should be considered.

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Site of Relapse of the Ductal Adenocarcinoma of the Pancreas affects Survival after Multimodal Therapy

10.21203/rs.3.rs-44866/v1 ◽

2020 ◽

Author(s):

Sami Alexander Safi ◽

Nadja Lehwald ◽

Alexander Rehders ◽

Lena Julia Haeberle ◽

Verena Keitel ◽

...

Keyword(s):

Local Recurrence ◽

Pulmonary Metastases ◽

Hepatic Metastases ◽

Disease Free Survival ◽

Ductal Adenocarcinoma ◽

Free Survival ◽

Adenocarcinoma Of The Pancreas ◽

Isolated Local Recurrence ◽

Long Term Survivors

Abstract Background The ductal adenocarcinoma of the pancreas (PDAC) remains one of the most lethal malignancies. To date, no guidelines exists for isolated resectable metachronous disease. It is still unclear, which patients may benefit from relapse surgery. The aim of our study was to compare disease free survival (DFS) and relapse specific survival (RSS) in patients with isolated local recurrence, metachronous hepatic or pulmonary metastases. Methods Patients with isolated resectable metachronous disease of either local recurrence, hepatic or pulmonary metastases were included for survival analyses. RSS of surgically treated patients (local (n = 11), hepatic (n = 6) and pulmonary metastases (n = 11)) were compared to conservative treated patients (local (n = 20), hepatic (n = 49) and pulmonary metastases (n = 14)). Results Patients with isolated metachronous hepatic metastases showed a higher T-stage and hepatic M-stage in the primary staging of the previous resected PDAC when compared to the other patients. DFS before diagnosed pulmonary metastases was longer compared to DFS before diagnosed hepatic metastases or local recurrence. Surgical resection only significantly improved RSS in patients with local recurrence or pulmonary metastases, when compared to patients after chemotherapy. Long-term survivors (> 5 years) were only detected after surgery for isolated local recurrence and 45% of these patients were still alive in our study. Conclusion Although DFS before diagnosed isolated local recurrence was dismal and comparable to patients with isolated hepatic metastases, long-term survivors were only detected in this group, recommending a surgical approach if resectability is provided.

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Prognostic relevance of hTERT mRNA expression in ductal adenocarcinoma of the pancreas

Zeitschrift für Gastroenterologie ◽

10.1055/s-0028-1089530 ◽

2008 ◽

Vol 46 (09) ◽

Author(s):

LF Grochola ◽

T Greither ◽

P Möller ◽

D Henne-Bruns ◽

P Würl

Keyword(s):

Mrna Expression ◽

Ductal Adenocarcinoma ◽

Htert Mrna ◽

Prognostic Relevance ◽

Adenocarcinoma Of The Pancreas ◽

Htert Mrna Expression

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CT Simplified Radiomic Approach to Assess the Metastatic Ductal Adenocarcinoma of the Pancreas

Cancers ◽

10.3390/cancers13081843 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1843

Author(s):

Mirko D’Onofrio ◽

Riccardo De Robertis ◽

Gregorio Aluffi ◽

Camilla Cadore ◽

Alessandro Beleù ◽

...

Keyword(s):

Pancreatic Ductal Adenocarcinoma ◽

Ductal Adenocarcinoma ◽

Newly Diagnosed ◽

Inclusion Criteria ◽

Permeability Index ◽

Metastatic Tumors ◽

Qualitative And Quantitative ◽

Portal Phase ◽

Phase Images ◽

Adenocarcinoma Of The Pancreas

The aim of this study was to perform a simplified radiomic analysis of pancreatic ductal adenocarcinoma based on qualitative and quantitative tumor features and to compare the results between metastatic and non-metastatic patients. A search of our radiological, surgical, and pathological databases identified 1218 patients with a newly diagnosed pancreatic ductal adenocarcinoma who were referred to our Institution between January 2014 and December 2018. Computed Tomography (CT) examinations were reviewed analyzing qualitative and quantitative features. Two hundred eighty-eight patients fulfilled the inclusion criteria and were included in this study. Overall, metastases were present at diagnosis in 86/288 patients, while no metastases were identified in 202/288 patients. Ill-defined margins and a hypodense appearance on portal-phase images were significantly more common among patients with metastases compared to non-metastatic patients (p < 0.05). Metastatic tumors showed a significantly larger size and significantly lower arterial index, perfusion index, and permeability index compared to non-metastatic tumors (p < 0.05). In the management of pancreatic ductal adenocarcinoma, early detection and correct staging are key elements. The study of computerized tomography characteristics of pancreatic ductal adenocarcinoma showed substantial differences, both qualitative and quantitative, between metastatic and non-metastatic disease.

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T1916 Differentiation, Origin and Mesothelial Adhesive Potential Affect Growth and Metastasis of Ductal Adenocarcinoma of the Pancreas

Gastroenterology ◽

10.1016/s0016-5085(08)64201-8 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-895

Author(s):

Soeren Torge Mees ◽

Christina Schleicher ◽

Mario Colombo-Benkmann ◽

Norbert Senninger ◽

Joerg Haier

Keyword(s):

Ductal Adenocarcinoma ◽

Adenocarcinoma Of The Pancreas

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Gastric- and intestinal-type marker expression in invasive ductal adenocarcinoma of the pancreas

Hepatobiliary & Pancreatic Diseases International ◽

10.1016/s1499-3872(12)60202-1 ◽

2012 ◽

Vol 11 (4) ◽

pp. 424-428 ◽

Cited By ~ 2

Author(s):

Yuichi Takano ◽

Nobuyuki Ohike ◽

Takuma Tajiri ◽

Kunio Asonuma ◽

Kenji Harada ◽

...

Keyword(s):

Intestinal Type ◽

Ductal Adenocarcinoma ◽

Invasive Ductal Adenocarcinoma ◽

Marker Expression ◽

Adenocarcinoma Of The Pancreas

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Strategy of Surgical Management for Invasive Ductal Adenocarcinoma of the Pancreas by Clinical Analysis of the Long-term Survivors.

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.32.1089 ◽

1999 ◽

Vol 32 (4) ◽

pp. 1089-1093 ◽

Cited By ~ 1

Author(s):

Takashi Hatori ◽

Toshihide Imaizumi ◽

Tatsuya Yoshikawa ◽

Toshiaki Nakasako ◽

Nobuhiko Harada ◽

...

Keyword(s):

Surgical Management ◽

Clinical Analysis ◽

Ductal Adenocarcinoma ◽

Invasive Ductal Adenocarcinoma ◽

Adenocarcinoma Of The Pancreas ◽

Long Term Survivors

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Paraneoplastic Opsoclonus Myoclonus in a Patient with Pancreatic Adenocarcinoma

Case Reports in Neurological Medicine ◽

10.1155/2019/3601026 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Divine C. Nwafor ◽

Ashley B. Petrone ◽

Joseph M. Collins ◽

Amelia K. Adcock

Keyword(s):

Saccadic Eye Movements ◽

Small Cell ◽

Ductal Adenocarcinoma ◽

Small Cell Lung ◽

The Third ◽

Pancreatic Malignancy ◽

Underlying Malignancy ◽

Published Report ◽

Opsoclonus Myoclonus Syndrome ◽

Adenocarcinoma Of The Pancreas

Opsoclonus myoclonus syndrome (OMS) is an extremely rare neurological syndrome typically affecting as few as 1 in 10,000,000 people annually. OMS is characterized by the presence of involuntary, saccadic eye movements, as well as ataxia, including gait incoordination, rigidity, and tremor. The origin of OMS is unclear, but a significant percentage of OMS cases are indicative of an underlying malignancy, most commonly neuroblastoma and small cell lung cancer. Here we describe an adult patient with OMS, who was ultimately diagnosed with a small ductal adenocarcinoma of the pancreas. To our knowledge, this is the third published report of an association between OMS and pancreatic malignancy, and the only case where the pancreatic malignancy was detected prior to metastasis or autopsy at death. This case report highlights the importance of careful, aggressive malignancy screening with OMS, as the pancreatic duct cut-off sign may be overlooked if pancreatic malignancy is not suspected.

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