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  1. Article: Surgical approaches for resection of pancreatic cancer: an overview.

    Liu, Sheng-Li / Friess, Helmut / Kleeff, Jörg / Ji, Zheng-Ling / Büchler, Markus W

    Hepatobiliary & pancreatic diseases international : HBPD INT

    2002  Volume 1, Issue 1, Page(s) 118–125

    Abstract: Objective: To overview the different surgical approaches for the resection of pancreatic cancer ... the progress in the surgical treatment of pancreatic cancer, the overall prognosis after resection remains ... unsatisfied. Surgery is likely to be optional for the treatment of pancreatic cancer. ...

    Abstract Objective: To overview the different surgical approaches for the resection of pancreatic cancer and our experience with these techniques.
    Methods: Surgical procedures including the Whipple resection, Pylorus-preserving resection, total and subtotal panreatectomies, regional pancreatectomy and the extended lymph node resection were discussed.
    Results: Studies have shown that no operation seems to produce significantly improved results in terms of survival, mortality and resection rates compared to the standard Whipple resection and pylorus-preserving duodenopancreatectomy.
    Conclusion: Despite the progress in the surgical treatment of pancreatic cancer, the overall prognosis after resection remains unsatisfied. Surgery is likely to be optional for the treatment of pancreatic cancer.
    MeSH term(s) Humans ; Pancreatectomy/methods ; Pancreatic Neoplasms/surgery
    Language English
    Publishing date 2002-02
    Publishing country Singapore
    Document type Journal Article ; Review
    ZDB-ID 2241386-8
    ISSN 1499-3872
    ISSN 1499-3872
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6313: Show issues Location:
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  2. Article ; Online: Risk of the Watch-and-Wait Concept in Surgical Treatment of Intraductal Papillary Mucinous Neoplasm.

    Tjaden, Christine / Sandini, Marta / Mihaljevic, André L / Kaiser, Jörg / Khristenko, Ekaterina / Mayer, Philipp / Hinz, Ulf / Gaida, Matthias M / Berchtold, Christoph / Diener, Markus K / Schneider, Martin / Mehrabi, Arianeb / Müller-Stich, Beat P / Strobel, Oliver / Hackert, Thilo / Büchler, Markus W

    JAMA surgery

    2021  Volume 156, Issue 9, Page(s) 818–825

    Abstract: ... Objective: To provide an overview of the surgical management of IPMNs, focusing on the time of resection ... and potential risks of a conservative watch-and-wait approach vs a surgical approach must be compared ... all patients with pathologically proven IPMN who received a pancreatic resection at the institution between ...

    Abstract Importance: The natural history of intraductal papillary mucinous neoplasms (IPMNs) remains uncertain. The inconsistencies among published guidelines preclude accurate decision-making. The outcomes and potential risks of a conservative watch-and-wait approach vs a surgical approach must be compared.
    Objective: To provide an overview of the surgical management of IPMNs, focusing on the time of resection.
    Design, setting, and participants: This cohort study was conducted in a single referral center; all patients with pathologically proven IPMN who received a pancreatic resection at the institution between October 2001 and December 2019 were analyzed. Preoperatively obtained images and the medical history were scrutinized for signs of progression and/or malignant features. The timeliness of resection was stratified into too early (adenoma and low-grade dysplasia), timely (intermediate-grade dysplasia and in situ carcinoma), and too late (invasive cancer). The perioperative characteristics and outcomes were compared between these groups.
    Exposures: Timeliness of resection according to the final pathological findings.
    Main outcomes and measures: The risk of malignant transformation at the final pathology.
    Results: Of 1439 patients, 438 (30.4%) were assigned to the too early group, 504 (35.1%) to the timely group, and 497 (34.5%) to the too late group. Radiological criteria for malignant conditions were detected in 53 of 382 patients (13.9%), 149 of 432 patients (34.5%), and 341 of 385 patients (88.6%) in the too early, timely, and too late groups, respectively (P < .001). Patients in the too early group underwent more parenchyma-sparing resections (too early group, 123 of 438 [28.1%]; timely group, 40 of 504 [7.9%]; too late group, 5 of 497 [1.0%]; P < .001), while morbidity (too early group, 112 of 438 [25.6%]; timely group, 117 of 504 [23.2%]; too late group, 158 of 497 [31.8%]; P = .002) and mortality (too early group, 4 patients [0.9%]; timely, 4 [0.8%]; too late, 13 [2.6%]; P = .03) were highest in the too late group. Of the 497 patients in the too late group, 124 (24.9%) had a previous history of watch-and-wait care.
    Conclusions and relevance: Until the biology and progression patterns of IPMN are clarified and accurate guidelines established, a watch-and-wait policy should be applied with caution, especially in IPMN bearing a main-duct component. One-third of IPMNs reach the cancer stage before resection. At specialized referral centers, the risks of surgical morbidity and mortality are justifiable.
    MeSH term(s) Adenocarcinoma, Mucinous/diagnostic imaging ; Adenocarcinoma, Mucinous/surgery ; Aged ; Carcinoma, Pancreatic Ductal/diagnostic imaging ; Carcinoma, Pancreatic Ductal/surgery ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/surgery ; Female ; Germany ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/surgery ; Prospective Studies ; Risk Factors ; Watchful Waiting
    Language English
    Publishing date 2021-05-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2021.0950
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Surgical treatment of pancreatic cancer.

    Loos, Martin / Kleeff, Jörg / Friess, Helmut / Büchler, Markus W

    Annals of the New York Academy of Sciences

    2008  Volume 1138, Page(s) 169–180

    Abstract: ... to date, surgical resection represents the basis of treatment for localized pancreatic cancer and remains ... standard procedures and summarizes new strategies in the surgical treatment of pancreatic cancer. ... rates for experienced surgeons in high-volume centers. Recently, more aggressive approaches including ...

    Abstract Pancreatic cancer is an aggressive disease with an overall 5-year survival rate of less than 5%. Up to date, surgical resection represents the basis of treatment for localized pancreatic cancer and remains the only chance for cure. Due to continuous improvements in surgical techniques and perioperative care, pancreatic resections have evolved into safe surgical procedures with low mortality and acceptable morbidity rates for experienced surgeons in high-volume centers. Recently, more aggressive approaches including extended lymphadenectomy, vascular resection, surgery for metastastic or recurrent disease, and multimodal regimens have been suggested to improve long-term outcome. This article provides an overview on current standard procedures and summarizes new strategies in the surgical treatment of pancreatic cancer.
    MeSH term(s) Digestive System Surgical Procedures/methods ; Humans ; Pancreatic Neoplasms/surgery
    Language English
    Publishing date 2008-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 211003-9
    ISSN 1749-6632 ; 0077-8923
    ISSN (online) 1749-6632
    ISSN 0077-8923
    DOI 10.1196/annals.1414.024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Fate of the Pancreatic Remnant Following Curative Intent Surgical Resection for Intraductal Pancreatic Mucinous Neoplasms

    Alessandro Paniccia / Richard D Schulick / Barish H Edil / Martin D McCarter / Csaba Gajdos

    JOP Journal of the Pancreas, Vol 16, Iss 5, Pp 417-

    An Overview of Current Literature

    2008  Volume 424

    Abstract: ... curative intent surgical resection. Objective Overview of the current literature describing approaches ... invasive pancreatic cancer. Management of resection margin is dictated by the location of the lesion ... to pancreatic preservation, local-regional and systemic recurrences following curative intent surgical ...

    Abstract Importance Intraductal Pancreatic Mucinous Neoplasms have been recognized with increasing frequency in clinical practice; however, several aspects of their clinical management are poorly defined. Few studies have ever focused on the intra- and post-operative management of the pancreatic remnant following curative intent surgical resection. Objective Overview of the current literature describing approaches to pancreatic preservation, local-regional and systemic recurrences following curative intent surgical interventions for intraductal pancreatic mucinous neoplasms. Findings Intraductal pancreatic mucinous neoplasms carry a variable risk of developing into noninvasive (high-grade dysplasia to carcinoma in situ) or invasive pancreatic cancer. Management of resection margin is dictated by the location of the lesion, by the grade of residual cellular dysplasia, and by patient’s overall health. In the majority of surgical series to date, the risk of recurrence of non-invasive intraductal pancreatic mucinous neoplasms seems to be lower when compared to invasive intraductal pancreatic mucinous neoplasms as the extent of the invasive component seems to predict outcome. The presence of adenoma or low-grade dysplasia at the transected pancreatic margin does not affect long-term survival. The role of adjuvant therapy in the setting of resected invasive intraductal pancreatic mucinous neoplasms is unclear, however, treatment regimens used to treat pancreatic adenocarcinoma seem reasonable. Pancreatic remnants should undergo surveillance with computed tomography scan or gadolinium enhanced magnetic resonance imaging following surgery. Conclusion Current knowledge of the management of pancreatic remnant in the setting of resected intraductal pancreatic mucinous neoplasms comes from retrospective series and is limited by small sample size and short follow-up. Additional studies with long term follow-up, focusing separately on main-duct intraductal pancreatic mucinous neoplasms and branchduct intraductal pancreatic mucinous neoplasm are needed to define the natural history of this disease and guide intraoperative and postoperative management.
    Keywords Pancreatic Neoplasms ; Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2008-09-01T00:00:00Z
    Publisher E S Burioni Ricerche Bibliografiche
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Updates on adjuvant and neoadjuvant treatment strategies for surgically resectable and borderline resectable pancreatic ductal adenocarcinoma.

    Iyengar, Siddharth / Nevala-Plagemann, Christopher / Garrido-Laguna, Ignacio

    Therapeutic advances in medical oncology

    2021  Volume 13, Page(s) 17588359211045861

    Abstract: ... for patients with pancreatic cancer are poor as curative approaches are only available to the minority ... in resectable pancreatic cancer and will provide an overview of emerging evidence supporting the use ... Pancreatic cancer is the third leading cause of cancer-related mortality in the US. Outcomes ...

    Abstract Pancreatic cancer is the third leading cause of cancer-related mortality in the US. Outcomes for patients with pancreatic cancer are poor as curative approaches are only available to the minority of patients who have localized tumors for which surgery may be an option. The past decade has established fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) as the new standard of care following resection for fit patients with resectable pancreatic tumors. However, most patients will relapse and a large number of patients treated with upfront resection are unable to receive or complete adjuvant chemotherapy. There is therefore considerable interest in neoadjuvant treatment strategies for patients with resectable and borderline resectable pancreatic cancer as a way to provide early systemic treatment of micrometastatic disease, facilitate lymph node downstaging, and increase the likelihood of negative resection margins (R0). This review will focus on key aspects of completed trials evaluating adjuvant therapy in resectable pancreatic cancer and will provide an overview of emerging evidence supporting the use of neoadjuvant treatment strategies for both resectable and borderline resectable pancreatic cancer.
    Language English
    Publishing date 2021-09-18
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2503443-1
    ISSN 1758-8359 ; 1758-8340
    ISSN (online) 1758-8359
    ISSN 1758-8340
    DOI 10.1177/17588359211045861
    Database MEDical Literature Analysis and Retrieval System OnLINE

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