The Role of the Appleby Operation and Arterial Resection in the Multimodality Management of Borderline Resectable Pancreatic Cancer

2016 ◽  
pp. 247-264 ◽  
Author(s):  
Ken-ichi Okada ◽  
Hiroki Yamaue
Keyword(s):  
Pancreatic Cancer ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Borderline Resectable Pancreatic Cancer ◽  
Arterial Resection

scholarly journals The Role of MRI Pancreatic Protocol in Assessing Response to Neoadjuvant Therapy for Patients With Borderline Resectable Pancreatic Cancer

2022 ◽  
Vol 11 ◽  
Author(s):  
Nervana Hussien ◽  
Rasha S. Hussien ◽  
Darine Helmy Amin Saad ◽  
Mohamed El Kassas ◽  
Walid F. Elkhatib ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Neoadjuvant Therapy ◽  
Operative Procedure ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Borderline Resectable Pancreatic Cancer ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Post Therapy

BackgroundBorderline Resectable Pancreatic Cancer (BRPC) remains a unique entity that is difficult to categorize due to variance in definitions and the small number of patients. The ultimate goal is to achieve a free resection (R0) after a favorable response to neoadjuvant therapy that is somewhat difficult to assess by current radiological parameters.AimTo evaluate the role of Magnetic Resonance Imaging (MRI) pancreatic protocol, including Diffusion-Weighted Imaging (DWI), in patients with BRPC receiving neoadjuvant therapy, and further compare it to RECIST criteria and outcome.MethodsHistologically confirmed BRPC patients were prospectively included. DWI-MRI was performed pre- and post-therapy. Clinical characteristics with ensuing operability were recorded and correlated to radiological RECIST/apparent diffusion coefficient (ADC) change, preoperative therapy administrated, surgical resection status, and survival.ResultsOut of 30 BRPC cases, only 11 (36.7%) ultimately underwent pancreaticoduodenectomy. Attaining a stationary or stable disease via ADC/RECIST was achieved in the majority of cases (60%/53.3% respectively). Of the 12 patients (40%) who achieved a regression by ADC, 11 underwent surgery with an R0 status. These surgical cases showed variable RECIST responses (PR=5, SD=4, PD=3). Responders by ADC to neoadjuvant therapy were significantly associated to presenting with abdominal pain (p =0.07), a decline in post-therapy CA19-9 (p<0.001), going through surgery (p<0.001), and even achieving better survival (p<0.001 vs. 0.66).ConclusionDWI-MRI ADC picked up patients most likely to undergo a successful operative procedure better than traditional RECIST criteria. An algorithm incorporating novel radiological advances with CA19-9 deserves further assessment in future studies.

Borderline Resectable Pancreatic Cancer: Definitions, Management, and Role of Preoperative Therapy

2006 ◽  
Vol 13 (8) ◽  
pp. 1035-1046 ◽  
Author(s):  
Gauri R. Varadhachary ◽  
Eric P. Tamm ◽  
James L. Abbruzzese ◽  
Henry Q. Xiong ◽  
Christopher H. Crane ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Preoperative Therapy ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Borderline Resectable Pancreatic Cancer

scholarly journals A PARADIGM SHIFT IN THE TREATMENT OF PATIENTS WITH RESECTABLE PANCREATIC CANCER

2020 ◽  
Vol 19 (3) ◽  
pp. 156-163
Author(s):  
E. Yu. Antonova ◽  
I. S. Bazin ◽  
A. M. Garin ◽  
I. A. Pokataev ◽  
I. B. Sagaidak ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Clinical Trials ◽  
Paradigm Shift ◽  
Literature Search ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Borderline Resectable Pancreatic Cancer ◽  
Medical Oncologists ◽  
The Russian Federation

Purpose of the study was to provide medical oncologists and surgeons specializing in the treatment of pancreatic cancer patients with the most recent information on the importance and role of chemotherapy in the treatment of patients with resectable and borderline resectable pancreatic cancer.Material and Methods. Pubmed and COSMIC databases were used for literature search. Reports of the executive authorities in the field of Health Care of the Russian Federation, as well as worldwide data regarding morbidity and mortality of patients with pancreatic cancer were analyzed. The data of retrospective and prospective clinical trials were studied.Results. Based on the analysis of the most recent publications, the authors provided data on modern approaches to the treatment of operable pancreatic cancer.Conclusion. The data presented in the article summarize results of recent clinical trials. This will allow oncologists to choose the most correct and personalized tactics for the management of patients with resectable and borderline resectable pancreatic cancer. 

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