Pub Date : 2023-12-12DOI: 10.1097/jp9.0000000000000159
Yecheng Xu, Feng Yang, Deliang Fu
Para-aortic lymph node (PALN) metastasis affects approximately 20% of patients with pancreatic ductal adenocarcinoma (PDAC). However, the prognostic significance of PALN metastases and dissection remain unclear. This retrospective cohort study included patients with PDAC of the pancreatic head who had undergone pancreaticoduodenectomy (PD) at our center between January 2017 and December 2020. A total of 234 patients were included in the study. PALN dissection improved the median overall survival (OS) without statistical significance (24.1 vs. 18.1 months, p = 0.156). The median recurrence-free survival was significantly longer in the PALN-dissection group than the group without PALN-dissection (18.2 vs. 11.6 months, p = 0.040). Conversely, there were no significant differences in the long-term prognosis between the PALN-positive and -negative subgroups in the PALN-dissection group. Multivariate analysis showed that PALN metastasis was not an independent risk factor for OS (hazard ratio: 0.831, 95% confidence interval: 0.538-1.285, p = 0.406). For patients with pancreatic head ductal adenocarcinoma, PD with PALN-dissection may achieve survival prolongation and bridge the survival gap between patients with and without PALN metastasis without significantly increasing the perioperative risks.
{"title":"Prognostic value of para-aortic lymph node metastasis and dissection for pancreatic head ductal adenocarcinoma: a retrospective cohort study","authors":"Yecheng Xu, Feng Yang, Deliang Fu","doi":"10.1097/jp9.0000000000000159","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000159","url":null,"abstract":"\u0000 \u0000 Para-aortic lymph node (PALN) metastasis affects approximately 20% of patients with pancreatic ductal adenocarcinoma (PDAC). However, the prognostic significance of PALN metastases and dissection remain unclear.\u0000 \u0000 \u0000 \u0000 This retrospective cohort study included patients with PDAC of the pancreatic head who had undergone pancreaticoduodenectomy (PD) at our center between January 2017 and December 2020.\u0000 \u0000 \u0000 \u0000 A total of 234 patients were included in the study. PALN dissection improved the median overall survival (OS) without statistical significance (24.1 vs. 18.1 months, p = 0.156). The median recurrence-free survival was significantly longer in the PALN-dissection group than the group without PALN-dissection (18.2 vs. 11.6 months, p = 0.040). Conversely, there were no significant differences in the long-term prognosis between the PALN-positive and -negative subgroups in the PALN-dissection group. Multivariate analysis showed that PALN metastasis was not an independent risk factor for OS (hazard ratio: 0.831, 95% confidence interval: 0.538-1.285, p = 0.406).\u0000 \u0000 \u0000 \u0000 For patients with pancreatic head ductal adenocarcinoma, PD with PALN-dissection may achieve survival prolongation and bridge the survival gap between patients with and without PALN metastasis without significantly increasing the perioperative risks.\u0000","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"9 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139009389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-12DOI: 10.1097/jp9.0000000000000163
Jessica Walker, Olivia L. Babyok, Jami L. Saloman, Anna Evans Phillips
Abdominal pain is the most common symptom of chronic pancreatitis (CP), and is often debilitating for patients and very difficult to treat. To date, there exists no cure for the disease. Treatment strategies focus on symptom management and on mitigation of disease progression by reducing toxin exposure and avoiding recurrent inflammatory events. Traditional treatment protocols start with medical management followed by consideration of procedural or surgical intervention on selected patients with severe and persistent pain. The incorporation of adjuvant therapies to treat comorbidities including psychiatric disorders, exocrine pancreatic insufficiency, mineral bone disease, frailty, and malnutrition, are in their early stages. Recent clinical studies and animal models have been designed to improve investigation into the pathophysiology of CP pain, as well as to improve pain management. Despite the array of tools available, many therapeutic options for the management of CP pain provide incomplete relief. There still remains much to discover about the neural regulation of pancreas-related pain. In this review we will discuss research from the last five years that has provided new insights into novel methods of pain phenotyping and the pathophysiology of CP pain. These discoveries have led to improvements in patient selection for optimization of outcomes for both medical and procedural management, and identification of potential future therapies.
{"title":"Recent Advances in the Understanding and Management of Chronic Pancreatitis Pain","authors":"Jessica Walker, Olivia L. Babyok, Jami L. Saloman, Anna Evans Phillips","doi":"10.1097/jp9.0000000000000163","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000163","url":null,"abstract":"Abdominal pain is the most common symptom of chronic pancreatitis (CP), and is often debilitating for patients and very difficult to treat. To date, there exists no cure for the disease. Treatment strategies focus on symptom management and on mitigation of disease progression by reducing toxin exposure and avoiding recurrent inflammatory events. Traditional treatment protocols start with medical management followed by consideration of procedural or surgical intervention on selected patients with severe and persistent pain. The incorporation of adjuvant therapies to treat comorbidities including psychiatric disorders, exocrine pancreatic insufficiency, mineral bone disease, frailty, and malnutrition, are in their early stages. Recent clinical studies and animal models have been designed to improve investigation into the pathophysiology of CP pain, as well as to improve pain management. Despite the array of tools available, many therapeutic options for the management of CP pain provide incomplete relief. There still remains much to discover about the neural regulation of pancreas-related pain. In this review we will discuss research from the last five years that has provided new insights into novel methods of pain phenotyping and the pathophysiology of CP pain. These discoveries have led to improvements in patient selection for optimization of outcomes for both medical and procedural management, and identification of potential future therapies.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139009526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-12DOI: 10.1097/jp9.0000000000000158
Yuan Zhou, M. Pan, R. Lin, Heguang Huang
The pancreas is a glandular organ that maintains internal homeostasis through its endocrine and exocrine functions. These functions are vital for overall well-being. However, environmental and lifestyle changes have led to an increasing incidence of pancreatic diseases, including pancreatic cancer, pancreatitis, and pancreatic neuroendocrine tumors. These conditions profoundly impact the health and quality of life of affected individuals. The existing diagnostic and treatment approaches for pancreatic diseases exhibit limitations and shortcomings, necessitating exploring novel strategies. In recent years, advancements in medicine and bioengineering have fostered multidisciplinary and interdisciplinary innovations, introducing fresh avenues for diagnosing and treating pancreatic diseases. Hydrogels, emerging as a biomaterial, represent highly hydrated cross-linked hydrophilic polymer networks. Their exceptional biodegradability and biocompatibility have rendered them instrumental in various medical applications. Hydrogels, with their macromolecular porous structures, are efficient carriers for drug delivery and controlled release. Hydrogel materials have garnered substantial attention for their unique properties and diverse applications in the context of pancreatic diseases. This article aims to provide an overview of the current limitations in diagnosing and treating pancreatic diseases while highlighting the latest trends and advancements in developing hydrogel carrier materials tailored for these conditions, primarily focusing on strategies for pancreatitis, pancreatic cancer, and pancreatic neuroendocrine tumors. The manuscript endeavors to give researchers and clinicians a comprehensive grasp of this field, offering valuable insights into prospective research directions and emerging trends.
{"title":"Advances in Hydrogel Materials Applied to Pancreatic-Related Diseases","authors":"Yuan Zhou, M. Pan, R. Lin, Heguang Huang","doi":"10.1097/jp9.0000000000000158","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000158","url":null,"abstract":"The pancreas is a glandular organ that maintains internal homeostasis through its endocrine and exocrine functions. These functions are vital for overall well-being. However, environmental and lifestyle changes have led to an increasing incidence of pancreatic diseases, including pancreatic cancer, pancreatitis, and pancreatic neuroendocrine tumors. These conditions profoundly impact the health and quality of life of affected individuals. The existing diagnostic and treatment approaches for pancreatic diseases exhibit limitations and shortcomings, necessitating exploring novel strategies. In recent years, advancements in medicine and bioengineering have fostered multidisciplinary and interdisciplinary innovations, introducing fresh avenues for diagnosing and treating pancreatic diseases. Hydrogels, emerging as a biomaterial, represent highly hydrated cross-linked hydrophilic polymer networks. Their exceptional biodegradability and biocompatibility have rendered them instrumental in various medical applications. Hydrogels, with their macromolecular porous structures, are efficient carriers for drug delivery and controlled release. Hydrogel materials have garnered substantial attention for their unique properties and diverse applications in the context of pancreatic diseases. This article aims to provide an overview of the current limitations in diagnosing and treating pancreatic diseases while highlighting the latest trends and advancements in developing hydrogel carrier materials tailored for these conditions, primarily focusing on strategies for pancreatitis, pancreatic cancer, and pancreatic neuroendocrine tumors. The manuscript endeavors to give researchers and clinicians a comprehensive grasp of this field, offering valuable insights into prospective research directions and emerging trends.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139008589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-11DOI: 10.1097/jp9.0000000000000156
Marcus Steingrüber, Yousef Moulla, Timm Denecke, Hans-Jonas Meyer
This narrative review provides an overview about the current radiological assessment of pancreatic cancer after neoadjuvant treatment. The current literature was searched for evidence of the different radiological quantitative imaging modalities to stage pancreatic cancer. An overview is given in a narrative method. The quantitative imaging modalities comprise CT perfusion, dual energy CT, MRI and FDG-PET/CT. Radiomics analysis can be used to further characterize the tumors and to reflect the complex tumor microstructure before and after neoadjuvant treatment. Exact extension of the tumor and infiltration of the surrounding tissue is of utter importance to decide, whether the neoadjuvant treatment leads to a resectability or not. There is increasing evidence of the importance of quantitative imaging modalities to assess treatment response in patients with pancreatic cancer after neoadjuvant treatment. Prospective studies employing these modalities are needed to further investigate the benefit for the patients.
{"title":"Modern radiological assessment after neoadjuvant therapy in Pancreatic cancer. An overview.","authors":"Marcus Steingrüber, Yousef Moulla, Timm Denecke, Hans-Jonas Meyer","doi":"10.1097/jp9.0000000000000156","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000156","url":null,"abstract":"This narrative review provides an overview about the current radiological assessment of pancreatic cancer after neoadjuvant treatment. The current literature was searched for evidence of the different radiological quantitative imaging modalities to stage pancreatic cancer. An overview is given in a narrative method. The quantitative imaging modalities comprise CT perfusion, dual energy CT, MRI and FDG-PET/CT. Radiomics analysis can be used to further characterize the tumors and to reflect the complex tumor microstructure before and after neoadjuvant treatment. Exact extension of the tumor and infiltration of the surrounding tissue is of utter importance to decide, whether the neoadjuvant treatment leads to a resectability or not. There is increasing evidence of the importance of quantitative imaging modalities to assess treatment response in patients with pancreatic cancer after neoadjuvant treatment. Prospective studies employing these modalities are needed to further investigate the benefit for the patients.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"8 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.1097/jp9.0000000000000153
Lin Gao, Weiqin Li
Hypertriglyceridemia (HTG) is the third most common cause for acute pancreatitis (AP), and the incidence of hypertriglyceridemia induced acute pancreatitis (HTG-AP) is rising worldwide as a result of changes in lifestyle and dietary habits. In China, HTG accounts for 10-20% the causes of AP, even becoming the second leading cause of AP. The presentation and diagnosis of HTG-AP is similar to that of AP from other causes, however, the complication rates and severe AP are significantly higher in patients with HTG-AP than in patients with other etiologies. Regarding the management for HTG-AP, the initial management is similar to that of AP from other causes and mainly includes fluid resuscitation, pain control and nutritional support. In addition to supportive care, it is necessary to take appropriate measures to decrease serum TG levels, in order to alleviate the progression of AP and prevent recurrence. This review aims to summarize existing clinical and basic research evidence of HTG-AP, and seeks to highlight the epidemiology, definition, pathogenesis, clinical course, diagnosis, management, prevention of recurrence and specific clinical scenarios, such as HTG-AP during pregnancy, HTG-AP with diabetic ketoacidosis.
{"title":"Hypertriglyceridemia and acute pancreatitis: clinical and basic research-a narrative review","authors":"Lin Gao, Weiqin Li","doi":"10.1097/jp9.0000000000000153","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000153","url":null,"abstract":"Hypertriglyceridemia (HTG) is the third most common cause for acute pancreatitis (AP), and the incidence of hypertriglyceridemia induced acute pancreatitis (HTG-AP) is rising worldwide as a result of changes in lifestyle and dietary habits. In China, HTG accounts for 10-20% the causes of AP, even becoming the second leading cause of AP. The presentation and diagnosis of HTG-AP is similar to that of AP from other causes, however, the complication rates and severe AP are significantly higher in patients with HTG-AP than in patients with other etiologies. Regarding the management for HTG-AP, the initial management is similar to that of AP from other causes and mainly includes fluid resuscitation, pain control and nutritional support. In addition to supportive care, it is necessary to take appropriate measures to decrease serum TG levels, in order to alleviate the progression of AP and prevent recurrence. This review aims to summarize existing clinical and basic research evidence of HTG-AP, and seeks to highlight the epidemiology, definition, pathogenesis, clinical course, diagnosis, management, prevention of recurrence and specific clinical scenarios, such as HTG-AP during pregnancy, HTG-AP with diabetic ketoacidosis.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"11 15","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136227605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-14DOI: 10.1097/jp9.0000000000000152
Xue Sun, Siyuan Wang, Catherine C.L. Wong
Pancreatic ductal adenocarcinoma (PDAC) has become a significant health concern with increasing incidence and mortality rates over the past few decades. Researchers have turned their attention to cutting-edge mass spectrometry (MS) technology due to its high-throughput and accurate detection capacity, which plays a vital role in understanding the mechanisms and discovering biomarkers for pancreatic diseases. In this review, we comprehensively investigate various methodologies of quantitative and qualitative proteomics MS technologies, alongside bioinformatical platforms employed in pancreatic cancer research. The integration of these optimized approaches provides novel insights into the molecular mechanisms underlying tumorigenesis and disease progression, ultimately facilitating the discovery of potential diagnostic, prognostic biomarkers, and therapeutic targets. The robust MS-based strategy shows promise in paving the way for early diagnosis and personalized medicine for pancreatic cancer patients.
{"title":"Mass Spectrometry-based Proteomics Technology in Pancreatic Cancer Research","authors":"Xue Sun, Siyuan Wang, Catherine C.L. Wong","doi":"10.1097/jp9.0000000000000152","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000152","url":null,"abstract":"Pancreatic ductal adenocarcinoma (PDAC) has become a significant health concern with increasing incidence and mortality rates over the past few decades. Researchers have turned their attention to cutting-edge mass spectrometry (MS) technology due to its high-throughput and accurate detection capacity, which plays a vital role in understanding the mechanisms and discovering biomarkers for pancreatic diseases. In this review, we comprehensively investigate various methodologies of quantitative and qualitative proteomics MS technologies, alongside bioinformatical platforms employed in pancreatic cancer research. The integration of these optimized approaches provides novel insights into the molecular mechanisms underlying tumorigenesis and disease progression, ultimately facilitating the discovery of potential diagnostic, prognostic biomarkers, and therapeutic targets. The robust MS-based strategy shows promise in paving the way for early diagnosis and personalized medicine for pancreatic cancer patients.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"53 29","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134902493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-02DOI: 10.1097/jp9.0000000000000151
Chibueze Onyemkpa, Danielle Dougherty, Sajjaad Samat, Tolutope Oyasiji, Michael McLeod
Background: Pancreatic cancer is the fourth leading cause of cancer death in the US. There has been postulates of racial disparities. Based on this, we primarily examined the presence of race, for the diagnosis and treatment of pancreatic cancer. Methods: A retrospective review was conducted on patients with pancreatic cancers using the Surveillance Epidemiology, and End Results - Medicare registry. Univariate and multivariate analyses were performed. Overall Survival analysis was done using the Kaplan-Meier curve. Comparison of survival curves was done using the log rank test. Cox proportional hazards regression model was used to determine independent predictors of survival. Other areas focused on were Time interval from diagnosis to treatment”, “Predictors of Surgery of the primary site”, “Predictors for recommending surgery of the primary site”, “Predictors for oncologic resection”, “Predictors of performance and refusal of surgery of primary site if recommended”, and “Predictors for any other therapy (all therapies excluding surgery). Results: A total of 52,951 patients were identified from the database. 24, 523 were males and 26, 715 were females. 81.9% were Caucasian, 10.9% were black and 7.2% were other races. There was approximately equal distribution of the different stages between both genders. 10.2% of the females were diagnosed at stage I, 28.9%, 9.3% and 51.6% at stages I, Ill and IV respectively compared to males with 8.4% 28.3%, 9.2% and 54.1% for stages I, II, Ill and IV respectively. 9.5% of the black patients were diagnosed at stage I, 24.2% at stage II, 10.1% at stage III and 56.2% at stage IV. A similar distribution was noted in the other races. Black patients had worse overall survival when compared to Caucasians (p=0.004) and other races (p = 0.001). Conclusion: Compared to Caucasian patients, black patients with pancreatic cancer had worse overall survival.
{"title":"Retrospective review paper identification racial disparities in patients with pancreatic cancer","authors":"Chibueze Onyemkpa, Danielle Dougherty, Sajjaad Samat, Tolutope Oyasiji, Michael McLeod","doi":"10.1097/jp9.0000000000000151","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000151","url":null,"abstract":"Background: Pancreatic cancer is the fourth leading cause of cancer death in the US. There has been postulates of racial disparities. Based on this, we primarily examined the presence of race, for the diagnosis and treatment of pancreatic cancer. Methods: A retrospective review was conducted on patients with pancreatic cancers using the Surveillance Epidemiology, and End Results - Medicare registry. Univariate and multivariate analyses were performed. Overall Survival analysis was done using the Kaplan-Meier curve. Comparison of survival curves was done using the log rank test. Cox proportional hazards regression model was used to determine independent predictors of survival. Other areas focused on were Time interval from diagnosis to treatment”, “Predictors of Surgery of the primary site”, “Predictors for recommending surgery of the primary site”, “Predictors for oncologic resection”, “Predictors of performance and refusal of surgery of primary site if recommended”, and “Predictors for any other therapy (all therapies excluding surgery). Results: A total of 52,951 patients were identified from the database. 24, 523 were males and 26, 715 were females. 81.9% were Caucasian, 10.9% were black and 7.2% were other races. There was approximately equal distribution of the different stages between both genders. 10.2% of the females were diagnosed at stage I, 28.9%, 9.3% and 51.6% at stages I, Ill and IV respectively compared to males with 8.4% 28.3%, 9.2% and 54.1% for stages I, II, Ill and IV respectively. 9.5% of the black patients were diagnosed at stage I, 24.2% at stage II, 10.1% at stage III and 56.2% at stage IV. A similar distribution was noted in the other races. Black patients had worse overall survival when compared to Caucasians (p=0.004) and other races (p = 0.001). Conclusion: Compared to Caucasian patients, black patients with pancreatic cancer had worse overall survival.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"9 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135875709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.1097/jp9.0000000000000149
Ali Jaan, Sheza Malik, Joel E. McFarland, Erik T. Olson, Byron Cryer
{"title":"Impact of Ethnicity on the Outcomes of Acute Pancreatitis: Insights from USNational Inpatient Sample","authors":"Ali Jaan, Sheza Malik, Joel E. McFarland, Erik T. Olson, Byron Cryer","doi":"10.1097/jp9.0000000000000149","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000149","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136107059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: As a systemic disease, pancreatic cancer (PC) can be treated systemically to raise the R 0 resection rate and enhance patient prognosis. The best ways to assess the treatment response to systemic treatment of patients with PC are still lacking. Methods: A total of 122 PC patients were enrolled; 25 of these patients were used as an independent testing set. According to the pathologic response, PC patients were classified into the responder and non-responder groups. The whole tumor, core, edge, and peritumoral were segmented from the enhanced CT images. Machine learning models were created by extracting the variations in radionics features before and after therapy (delta radiomics features). Finally, we compared the performance of models based on radiomics features, changes in tumor markers, and radiologic evaluation. Results: The model based on the core (Area under Curve, AUC=0.864) and edge features (AUC=0.853) showed better performance than that based on the whole tumor (AUC=0.847) or peritumoral area (AUC=0.846). Moreover, the tumor core_edge combination model (AUC=0.899) could better increase confidence in treatment response than using either of them alone. The accuracies of models based on changes in tumor markers and radiologic evaluation were relatively poorer than of the radiomics model. Moreover, Patients predicted to respond to therapy using the radiomics model showed a relatively longer overall survival (43 months vs 27 months), although there were no significant differences (p=0.063). Conclusions: The tumor core_edge combination delta radiomics model is an effective approach to evaluate pathologic response in PC patients with systemic treatment.
{"title":"Computed tomography-based delta-radiomics of tumor core_edge combination for systemic treatment response evaluation in pancreatic cancer","authors":"Xiang Li, Na Lu, Peijun Hu, Yiwen Chen, Liying Liu, Xinyuan Liu, Chengxiang Guo, Wenbo Xiao, Ke Sun, Jingsong Li, Xueli Bai, Tingbo Liang","doi":"10.1097/jp9.0000000000000148","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000148","url":null,"abstract":"Background: As a systemic disease, pancreatic cancer (PC) can be treated systemically to raise the R 0 resection rate and enhance patient prognosis. The best ways to assess the treatment response to systemic treatment of patients with PC are still lacking. Methods: A total of 122 PC patients were enrolled; 25 of these patients were used as an independent testing set. According to the pathologic response, PC patients were classified into the responder and non-responder groups. The whole tumor, core, edge, and peritumoral were segmented from the enhanced CT images. Machine learning models were created by extracting the variations in radionics features before and after therapy (delta radiomics features). Finally, we compared the performance of models based on radiomics features, changes in tumor markers, and radiologic evaluation. Results: The model based on the core (Area under Curve, AUC=0.864) and edge features (AUC=0.853) showed better performance than that based on the whole tumor (AUC=0.847) or peritumoral area (AUC=0.846). Moreover, the tumor core_edge combination model (AUC=0.899) could better increase confidence in treatment response than using either of them alone. The accuracies of models based on changes in tumor markers and radiologic evaluation were relatively poorer than of the radiomics model. Moreover, Patients predicted to respond to therapy using the radiomics model showed a relatively longer overall survival (43 months vs 27 months), although there were no significant differences (p=0.063). Conclusions: The tumor core_edge combination delta radiomics model is an effective approach to evaluate pathologic response in PC patients with systemic treatment.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136107045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.1097/jp9.0000000000000150
Haikuan Liu, Hang Yu, Dequan Yang, Wang Yao, Yu Wang
Pancreatic neuroendocrine neoplasm (PNEN) is the second most common malignant tumor of the pancreas. It has the characteristic of high metastases rate, and liver is the most common site for metastasis. Metastasis affects prognosis and survival seriously. A number of earlier studies have shown that the interventional therapy via hepatic artery could reduce hepatic tumor burden and hormone secretion safely and rapidly, significantly improve objective response rate (ORR), and enhance the efficacy and prolong the survival time when combined with system therapy. The interventional therapy via hepatic artery plays an important role in the treatment of PNEN liver metastases. Interventional therapy via hepatic artery could possibly increase ORR, prolong progression-free survival, and even overall survival for appropriate patients.
{"title":"Application of interventional therapy via hepatic artery in pancreatic neuroendocrine neoplasms liver metastases","authors":"Haikuan Liu, Hang Yu, Dequan Yang, Wang Yao, Yu Wang","doi":"10.1097/jp9.0000000000000150","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000150","url":null,"abstract":"Pancreatic neuroendocrine neoplasm (PNEN) is the second most common malignant tumor of the pancreas. It has the characteristic of high metastases rate, and liver is the most common site for metastasis. Metastasis affects prognosis and survival seriously. A number of earlier studies have shown that the interventional therapy via hepatic artery could reduce hepatic tumor burden and hormone secretion safely and rapidly, significantly improve objective response rate (ORR), and enhance the efficacy and prolong the survival time when combined with system therapy. The interventional therapy via hepatic artery plays an important role in the treatment of PNEN liver metastases. Interventional therapy via hepatic artery could possibly increase ORR, prolong progression-free survival, and even overall survival for appropriate patients.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"35 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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