General Aspects of Surgical Treatment of Pancreatic Cancer

The aim: To analyze results of surgical treatment of patients with chronic pancreatitis (CP) and to assess the causes of pancreatic cancer after surgical treatment. Materials and methods: 137 patients had duodenum-preserving resections of the pancreas. Results: In the histological examination of the pancreas it was established that the growth of fibrous tissue was registered in patients with CP., which in 19 (13.8%) almost completely replaced the acinar tissue. In the long term after the operation from 6 months to 2 years in 8 patients (5.8%) pancreatic cancer was detected. Possible causes of tumor origin were analyzed, the value of preservation of ductal hypertension, which affects the state of the duct’s epithelium, was established. The most commonly used for treatment of chronic pancreatitis the Frey surgery removed pancreatic hypertension but in two patients during the operation an insufficient volume of the pancreatic head was reconstructed. In the case of the abandonment of a large array of fibrous tissue, local hypertension was retained in the region of the ductal structures of the head, which led to the transformation of the duct epithelium. An essential factor in the problem of the preservation of pancreatic hypertension were the stenosis of pancreatic intestinal anastomoses, they arose in the long term in 4 operated patients. With stenosis of anastomosis after duodenum-preserving resection both the hypertension factor and the regeneration factor could be realized, which under certain circumstances might be significant. Conclusion: After resection of the pancreas for CP cancer was diagnosed in 5.8% of patients. The main method of preventing the risk of cancer was performing the Frey surgery for CP eliminating pancreatic hypertension in the head region of the pancreas. Diagnosis of stenosis in the late period after resection of the pancreas was an important element in the prevention of recurrence of cancer since a timely reconstructive operation could improve the drainage of duct structures.

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MO31-1 Surgical treatment for pulmonary oligometastases in the patients with pancreatic cancer who underwent pancreatectomy

Annals of Oncology ◽

10.1016/j.annonc.2021.05.641 ◽

2021 ◽

Vol 32 ◽

pp. S318

Author(s):

Maeda Shingo ◽

Ryoji Takada ◽

Kenji Ikezawa ◽

Kazuma Daiku ◽

Yutaro Abe ◽

...

Keyword(s):

Pancreatic Cancer ◽

Surgical Treatment

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Surgical Treatment of Resectable Pancreatic Cancer

Clinical Pancreatology for Practising Gastroenterologists and Surgeons ◽

10.1002/9781119570097.ch58 ◽

2021 ◽

pp. 472-476

Author(s):

Jan G. D'Haese ◽

Bernhard W. Renz ◽

Jens Werner

Keyword(s):

Pancreatic Cancer ◽

Surgical Treatment ◽

Resectable Pancreatic Cancer

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Surgical treatment of pancreatic cancer: The role of adjuvant and multimodal therapies

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2007.01.022 ◽

2007 ◽

Vol 33 (7) ◽

pp. 817-823 ◽

Cited By ~ 27

Author(s):

J. Kleeff ◽

C.W. Michalski ◽

H. Friess ◽

M.W. Büchler

Keyword(s):

Pancreatic Cancer ◽

Surgical Treatment

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Variations in Surgical Treatment and Outcomes of Patients With Pancreatic Cancer: A Population-Based Study

Annals of Surgical Oncology ◽

10.1245/s10434-007-9601-7 ◽

2007 ◽

Vol 15 (1) ◽

pp. 175-185 ◽

Cited By ~ 27

Author(s):

Anand Govindarajan ◽

Jensen C. C. Tan ◽

Nancy N. Baxter ◽

Natalie G. Coburn ◽

Calvin H. L. Law

Keyword(s):

Pancreatic Cancer ◽

Surgical Treatment ◽

Population Based ◽

Population Based Study

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CONGENITAL ANOMALIES

PEDIATRICS ◽

10.1542/peds.7.5.607 ◽

1951 ◽

Vol 7 (5) ◽

pp. 607-610

Author(s):

JOSEF WARKANY

Keyword(s):

Urinary Tract ◽

Surgical Treatment ◽

American Academy ◽

Experimental Work ◽

Congenital Anomalies ◽

Intestinal Tract ◽

Diagnostic Methods ◽

American Academy Of Pediatrics ◽

General Aspects ◽

Dietary Deficiency

I AM greatly honored by the Award which the American Academy of Pediatrics has bestowed upon me and I am certain that this recognition of our studies will stimulate my co-workers and myself to further efforts in the line of work which we began about 12 years ago. I have repeatedly had the privilege of presenting our experimental work to meetings of the American Academy of Pediatrics and it is not necessary, therefore, to describe to you again in detail the congenital anomalies induced in animals by maternal dietary deficiency. It seems preferable to give you today a brief summary of the general aspects and results of our studies and to present to you some of the conclusions which may be drawn from them. The incentive to our experimental work was a marked interest in congenital anomalies of children. Adverse factors acting in prenatal life contribute appreciably to the mortality of infants and many children go through life deformed or crippled because of unfavorable intrauterine conditions. Congenital anomalies are at the root of many chronic and of some intractable diseases of childhood, a fact which is brought out with increasing certainty by improved diagnostic methods. Without going into details I wish to point out how many congenital anomalies of the urinary tract are now recognized intra vitam, which only one or two decades ago puzzled us by their nonspecific symptoms. Congenital anomalies of the intestinal tract which were previously diagnosed as "vomiting," "malnutrition," etc., are now better understood and often accessible to surgical treatment.

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Surgical treatment of pancreatic cancer

Journal of Gastrointestinal Surgery ◽

10.1016/s1091-255x(99)80035-3 ◽

1999 ◽

Vol 3 (2) ◽

pp. 208-209 ◽

Cited By ~ 1

Keyword(s):

Pancreatic Cancer ◽

Surgical Treatment

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Analysis of the CONKO-001 trial: Is the validity of the study sufficient to recommend adjuvant chemotherapy for pancreatic cancer?

International Journal of Risk & Safety in Medicine ◽

10.3233/jrs-210015 ◽

2021 ◽

pp. 1-12

Author(s):

Katrin Bauer ◽

Doris Henne-Bruns ◽

Giulia Manzini

Keyword(s):

Pancreatic Cancer ◽

Surgical Treatment ◽

Adjuvant Chemotherapy ◽

Pharmaceutical Industry ◽

Statistical Methods ◽

Histological Examination ◽

Conflicts Of Interest ◽

Interdisciplinary Treatment ◽

Recurrence Rates ◽

Current Guidelines

BACKGROUND: Since randomized controlled trials have indicated that adjuvant chemotherapy prolongs survival and reduces recurrence rates after surgical resection of pancreatic adenocarcinoma, a gemcitabine based chemotherapy has become part of the interdisciplinary treatment concept for pancreatic cancer in accordance to current guidelines. OBJECTIVES: The aim of this project was to analyse the validity of the CONKO −001 trial as a basis for the recommendation of adjuvant chemotherapy in many international guidelines. METHODS: We analysed the validity of the CONKO - 001 trial regarding study design, recruitment period, participating institutions, patient selection, randomisation, stratification, standardization of surgical treatment and histological examination, statistical methods and interpretation of results. We additionally analysed the study regarding the risk of bias using the RoB 2 Tool. Finally we reviewed the influence of the pharmaceutical industry and potential conflicts of interest. RESULTS: We identified several shortcomings of the study concerning the study protocol, the participating clinics, the patient recruitment, the randomization pattern, the standardization of surgical treatment and histological examination, the statistical methods, the evaluation of the results and the influence of the pharmaceutical industry. According to the Cochrane RoB 2 Tool the study was judged to raise some concerns in three of the five risk domains for the outcome “overall survival”. CONCLUSIONS: Based on our review, the results of the CONKO-001-study should be revisited and critically reviewed. The recommendation to include adjuvant chemotherapy with gemcitabine deserves a critical appraisal.

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