Abstract:
BACKGROUND:Patients with locally advanced pancreatic cancer have historically been considered inoperable. The purpose of this report was to determine resectability rates for patients with locally advanced pancreatic cancer based on our recently described definitions of type A and type B locally advanced pancreatic cancer. METHODS:An institutional prospective pancreas cancer database was queried for consecutive patients with locally advanced pancreatic cancer treated between January 2009 and June 2017. All pretreatment imaging was re-reviewed and patients were categorized as locally advanced pancreatic cancer type A or type B. Demographics, induction therapy, resection type, and outcomes were reviewed. RESULTS:We identified 108 consecutive patients; 12 were excluded from analysis due to the absence of available pretreatment imaging or they had not yet completed all intended neoadjuvant therapy. Of the remaining 96 patients (45 type A, 51 type B), disease progression occurred in 19 (20%) during induction therapy and 30 (31%) were deemed inoperable at final preoperative restaging. Therefore, 47 (49%) of 96 patients were taken to surgery and 40 (42%) underwent successful resection (28 [62%] of 45 type A and 12 [24%] of 51 type B); an RO resection was achieved in 32 (80%). Metastatic disease was found intraoperatively (6 at laparoscopy, 1 at laparotomy) in 7 (15%) of 47 patients. There were no mortalities; 6 (15%) patients experienced major postoperative complications. Resected patients had a median overall survival of 38.9 months. CONCLUSION:Locally advanced pancreatic cancer can be dichotomized into type A and B with distinctly different probabilities of completing all therapy to include surgery; thereby allowing goals of therapy to be established at the time of diagnosis. Multimodality therapy that includes surgery can be accomplished in selected patients with locally advanced pancreatic cancer and is associated with a median overall survival that approximates earlier stages of disease. (Surgery 2017;160:XXX-XXX.).
journal_name
Surgeryjournal_title
Surgeryauthors
Chatzizacharias NA,Tsai S,Griffin M,Tolat P,Ritch P,George B,Barnes C,Aldakkak M,Khan AH,Hall W,Erickson B,Evans DB,Christians KKdoi
10.1016/j.surg.2017.09.012subject
Has Abstractpub_date
2018-05-01 00:00:00pages
1053-1062issue
5eissn
0039-6060issn
1532-7361pii
S0039-6060(17)30633-5journal_volume
163pub_type
杂志文章相关文献
SURGERY文献大全abstract:BACKGROUND:Laparoscopy has become an increasingly important diagnostic tool for the staging of intraabdominal malignancies. Some investigators have suggested laparoscopy to be of questionable value in the preoperative staging of gastric cancer because many patients may require palliative surgery despite laparoscopic fi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80184-x
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Patients undergoing ventral hernia repair (VHR) are at risk of an inadvertent enterotomy during surgery. Inadvertent enterotomies potentially contaminate the surgical field presenting a management dilemma for the surgeon. The aim of our study was to define the incidence and risk factors for a recognized inad...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.04.003
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Postoperative ileus, a transient impairment of bowel motility initiated by intestinal inflammation, is common after an abdominal operation and leads to increased hospital stays and costs. Hydrogen has potent anti-inflammatory and antioxidant properties and potential therapeutic value. Solubilized hydrogen ma...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.05.026
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Sclerotherapy is usually effective in controlling acutely bleeding esophageal varices. It may not be as effective as shunt surgery for prevention of rebleeding; therefore we undertook a prospective study comparing interposition mesocaval shunt (MCS) and repeated sclerotherapy. METHODS:Forty-five patients (m...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0039-6060(05)80248-x
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Aggressive screening for blunt cerebrovascular injury (BCVI) and prompt anticoagulation for documented injuries has resulted in a significant reduction in ischemic neurologic events. An association between vertebral artery injuries (VAIs) and specific cervical spine fracture patterns has been suggested; howe...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2006.04.005
更新日期:2007-01-01 00:00:00
abstract::Previous studies in our laboratory established that the intestinal phase of gastric secretion and the acid hypersecretion associated with portacaval shunt are mediated by a potent hormone in both dogs and humans. The present investigation was designed to localize the site of origin of the intestinal phase hormone by m...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1970-07-01 00:00:00
abstract:BACKGROUND:The surgical workforce particularly in rural regions needs novel approaches to reinforce the skills and confidence of health practitioners. Although conventional telementoring systems have proven beneficial to address this gap, the benefits of platforms of augmented reality-based telementoring in the coachin...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.11.008
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Enthusiasm for neoadjuvant therapy is growing from the emerging consensus that pancreatic cancer is a systemic disease at the time of diagnosis. Those who remain in favor of upfront surgery often cite the lack of reported data to support alternative treatment sequencing. We therefore report the results of al...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.09.018
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Regulation of coronary vasomotor tone by serotonin is significantly changed after cardioplegic arrest and reperfusion. The current study investigates whether cardiopulmonary bypass may also affect peripheral arteriolar response to serotonin in patients with or without diabetes. METHODS:Human peripheral micr...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.03.007
更新日期:2018-08-01 00:00:00
abstract::Reliable cancer statistics reveal an unexplained increase in the incidence and rate of death from melanoma. Increased exposure to ultraviolet light does not seem to be a factor. Hormones may affect the incidence but do not influence survival. The recognition of the biologic evolution of different types of melanomas an...
journal_title:Surgery
pub_type: 杂志文章,评审
doi:
更新日期:1983-04-01 00:00:00
abstract::To compare estrogen and progesterone receptor values between biopsy and mastectomy specimens, we prospectively studied 29 patients with breast cancer treated by incisional biopsy followed by mastectomy. The average tumor size was 5.4 +/- 0.5 cm and the mean age was 57.6 +/- 3.0 years. Nine patients were premenopausal ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::Between 1978 and 1985, 88 patients underwent insertion of the Greenfield vena cava filter. In 21 of the 88 patients (23.9%) the filter was inserted prophylactically. Sixteen of the 21 prophylactic insertions were performed before total joint replacement in patients with a history of venous thromboembolism. Operative m...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Improvement of renal allograft survival by induction of immunologic unresponsiveness was attempted in 24 patients by the pretransplant administration of donor-specific whole blood or buffy coat under continuous azathioprine immunosuppression. All patients and their donors had one or two disparate HLA haplotypes. Cross...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1982-08-01 00:00:00
abstract::Seven surgically proven cases of a traumatic rupture of the right hemidiaphragm with a hepatic herniation were preoperatively diagnosed by radionuclide liver-spleen imagings, and they were retrospectively analyzed. All injuries resulted from blunt traumatic injury including automobile accidents, and there were associa...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract::Alternate methods of aortic reconstruction for aortoiliac occlusive disease were reviewed in one author's (R.C.D.) personal series of 582 patients (1,105 limbs) during the 15 year period from 1963 to 1977. To illustrate certain trends, separate analysis was done for periods 1963 to 1969 (interval I) and 1970 to 1977 (...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Surgical wrapping (SW) of the pancreas causes islet neogenesis in rodents. Pancreatic duodenal hoemobox-1 (PDX-1) is one of the transcriptional factors needed by pancreatic stem cells to develop a mature pancreas. The purpose of this study was to determine whether islet neogenesis arises from ductal cells an...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(03)00394-5
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Evidence indicates that sentinel node (SN) biopsy can accurately predict axillary nodal status. Debate exists as to the optimal method of SN identification. METHODS:Patients with clinical T1 or T2 tumors and negative axillae were randomized to SN localization with blue dye (B) alone (n = 50) or blue dye plu...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1999-10-01 00:00:00
abstract::Pathological fibrinolysis due to pseudoaneurysms was observed in a patient 4 years after aortobifemoral bypass graft. The patient presented with a pulsatile abdominal mass and ischemic changes in the legs. Excessive bleeding from venipuncture sites prompted coagulation screening, which disclosed rapid clot lysis, fibr...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:Hypoparathyroidism is the most frequent permanent complication of thyroid surgery. Our hypothesis is that human precursor cells in culture can be differentiated into parathyroid cells and used to reconstitute function. Human embryonic stem cells (hESCs) are a stable model to study differentiation into parath...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.09.021
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Resection for hepatocellular carcinoma in patients with cirrhosis and impaired liver function is usually unjustified because of higher surgical risks and poorer long-term prognosis. METHODS:A retrospective comparison of the background and resectional results of patients with cirrhosis and hepatocellular car...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80238-8
更新日期:1996-07-01 00:00:00
abstract::In an effort to identify factors in primary tumors that would predict liver metastases, we retrospectively reviewed 102 patients with gastric cancer, and their tissue blocks were restained. New staining methods for elastin and endothelium were used to identify intratumoral vessels. Blood vessel invasion, thus detected...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:Adenosine released by cells during ischemia typically serves as a feedback inhibitor of further organ work. However, in ischemic intestine, adenosine appears to act via stimulatory A2b receptors to increase work in the form of chloride ion (Cl-) secretion. This unusual response may contribute to luminal flui...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80295-9
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Health care costs continue to spiral; aggregate costs for 1992 are $850 billion, 13.6% of the U.S. gross national product. The issue has assumed national proportions, and change appears to be on the federal agenda. Great interest in surgical expenditures exists, which comprise 30.1% of all health care outlay...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to review our 15-year experience in the treatment of blunt splenic injury in adults. Our hypothesis was that the implementation of a change in practice, with stress on splenic preservation and splenic artery embolization for the management of splenic injury, would result in impr...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2006.07.005
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Activated factor X (FXa) is involved in hemostasis, thrombogenesis, inflammation, and cellular immune response. Tissue factor (TF) is an initiator of blood coagulation. We investigated whether FXa induces TF expression in human peripheral monocytes and whether treatment with FXa inhibitor reduces TF expressi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2001.116452
更新日期:2001-11-01 00:00:00
abstract::The hydrogen gas clearance technique was evaluated to estimate regional hepatic blood flow. Initially, the H2 gas method was compared to the indocyanine green clearance in mini pigs. The blood flow measured by the H2 gas method (0.49 +/- 0.03 ml/min/gm) was only 39% of the calculated blood flow by the indocyanine gree...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Most severe pain occurs within the first 72 hours after an operation, and current local anesthetics have a limited duration of action. HTX-011 is a dual-acting, local anesthetic containing bupivacaine, and low-dose meloxicam in an extended-release polymer. In a prior phase 3 inguinal herniorrhaphy study, HTX...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.06.036
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Interleukin (IL)-10 is a potent antiinflammatory cytokine inhibiting the release of tumor necrosis factor--alpha (TNF-alpha) and IL-8 by activated macrophages and polymorphonuclear leukocytes. Cardiopulmonary bypass (CPB) represents a unique situation where an inflammatory reaction is predictably induced. Th...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80217-0
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Sudden massive release of serotonin, histamine, kallikrein, and bradykinin is postulated to cause an intraoperative carcinoid crisis. The exact roles of each of these possible agents, however, remain unknown. Optimal treatment will require an improved understanding of the pathophysiology of the carcinoid cri...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.04.093
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the effects of treating human thyroid cancer cell lines with demethylating agents and histone deacetylase (HDAC) inhibitors to see if they would downregulate expression and activity of the matrix metalloproteinases (MMP)-2 and MMP-9, resulting in inhibition of gro...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.10.007
更新日期:2011-04-01 00:00:00