Pub Date : 2022-10-11DOI: 10.1097/JP9.0000000000000106
Jishu Wei, Q. Xu, Yuhua Zhang, Jiabin Jin, Xiaodong Tian, Qiaofei Liu, Zipeng Lu, Zheng-kun Wang, S. Gou, Song Gao, Xianlin Han, Y. Rong, Niandong Ji, Ye Lin, Guolin Li, Shi-You Chen, F. Cao, Hua Chen, Wenming Wu, Yupei Zhao
Background: Pancreaticoduodenectomy (PD) has been widely applied in general hospitals in China; however, there is still a lack of unified standards for each surgical technique and procedure. This survey is intended to investigate the current status of digestive tract reconstruction after PD in university hospitals in China. Method: A cross-sectional survey was conducted among the members of the Young Elite Pancreatic Surgery Club of China by using the Questionnaire for Digestive Tract Reconstruction after Pancreaticoduodenectomy. The questionnaire was disseminated and collected by point-to-point communication via WeChat public platforms. Results: A total of 73 valid questionnaires were returned from 65 university hospitals in 28 provincial divisions of mainland China. The respondents who performed PD surgery with an annual volume of over 100 cases accounted for 63%. Generally, laparoscopic PD was performed less often than open PD. Child and Whipple reconstructions accounted for 70% and 26%, respectively. The sequence of pancreatoenteric, biliary-enteric, and gastrointestinal reconstruction accounted for 84% of cases. In pancreatoenteric anastomosis, double-layer anastomosis is the most commonly employed type, accounting for approximately 67%, while single-layer anastomosis accounts for 30%. Of the double-layer anastomoses, duct-to-mucosa/dunking (94%/4%) pancreatojejunostomy was performed with duct-mucosa using the Blumgart method (39%) and Cattel-Warren (29%), with continuous/interrupted sutures in the inner layer (69%/31%) and continuous/interrupted sutures in the outer layer (53%/23%). In single-layer anastomosis, continuous/interrupted sutures accounted for 41%/45%. In hepatojejunostomy, single-layer/double-layer suture accounted for 79%/4%, and continuous/interrupted suture accounted for 75%/9%. Forty-six percent of the responding units had not applied double-layer biliary-intestinal anastomosis in the last 3 years, 75% of the responding surgeons chose the anastomosis method according to bile duct diameter, with absorbable/non-absorbable suture accounting for 86%/12%. PD/pylorus-preserving PD accounted for 79%/11% of gastrojejunostomy (GJ) cases, the distance between GJ and hepaticojejunostomy < 30, 30–50, and > 50 cm were 11%, 75%, and 14%, respectively. Antecolic/retrocolic GJ accounted for 71%/23% of cases. Twenty-two percent of GJ cases employed Braun anastomosis, while 55% and 19% of GJ cases used linear cutting staplers/tube-type staplers, respectively; 60%/14% were reinforced/not reinforced via manual suturing after stapler anastomosis. Manual anastomosis in GJ surgery employed absorbable/non-absorbable sutures (91%/9%). Significant differences in reconstruction techniques were detected between different volumes of PD procedures (<100/year and >100/year), regions with different economic development levels, and between north and south China. Conclusion: Digestive tract reconstruction following PD exists heterogeneity in Chinese univers
{"title":"Digestive tract reconstruction in pancreaticoduodenectomy in University Hospitals of China: a national questionnaire survey","authors":"Jishu Wei, Q. Xu, Yuhua Zhang, Jiabin Jin, Xiaodong Tian, Qiaofei Liu, Zipeng Lu, Zheng-kun Wang, S. Gou, Song Gao, Xianlin Han, Y. Rong, Niandong Ji, Ye Lin, Guolin Li, Shi-You Chen, F. Cao, Hua Chen, Wenming Wu, Yupei Zhao","doi":"10.1097/JP9.0000000000000106","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000106","url":null,"abstract":"Background: Pancreaticoduodenectomy (PD) has been widely applied in general hospitals in China; however, there is still a lack of unified standards for each surgical technique and procedure. This survey is intended to investigate the current status of digestive tract reconstruction after PD in university hospitals in China. Method: A cross-sectional survey was conducted among the members of the Young Elite Pancreatic Surgery Club of China by using the Questionnaire for Digestive Tract Reconstruction after Pancreaticoduodenectomy. The questionnaire was disseminated and collected by point-to-point communication via WeChat public platforms. Results: A total of 73 valid questionnaires were returned from 65 university hospitals in 28 provincial divisions of mainland China. The respondents who performed PD surgery with an annual volume of over 100 cases accounted for 63%. Generally, laparoscopic PD was performed less often than open PD. Child and Whipple reconstructions accounted for 70% and 26%, respectively. The sequence of pancreatoenteric, biliary-enteric, and gastrointestinal reconstruction accounted for 84% of cases. In pancreatoenteric anastomosis, double-layer anastomosis is the most commonly employed type, accounting for approximately 67%, while single-layer anastomosis accounts for 30%. Of the double-layer anastomoses, duct-to-mucosa/dunking (94%/4%) pancreatojejunostomy was performed with duct-mucosa using the Blumgart method (39%) and Cattel-Warren (29%), with continuous/interrupted sutures in the inner layer (69%/31%) and continuous/interrupted sutures in the outer layer (53%/23%). In single-layer anastomosis, continuous/interrupted sutures accounted for 41%/45%. In hepatojejunostomy, single-layer/double-layer suture accounted for 79%/4%, and continuous/interrupted suture accounted for 75%/9%. Forty-six percent of the responding units had not applied double-layer biliary-intestinal anastomosis in the last 3 years, 75% of the responding surgeons chose the anastomosis method according to bile duct diameter, with absorbable/non-absorbable suture accounting for 86%/12%. PD/pylorus-preserving PD accounted for 79%/11% of gastrojejunostomy (GJ) cases, the distance between GJ and hepaticojejunostomy < 30, 30–50, and > 50 cm were 11%, 75%, and 14%, respectively. Antecolic/retrocolic GJ accounted for 71%/23% of cases. Twenty-two percent of GJ cases employed Braun anastomosis, while 55% and 19% of GJ cases used linear cutting staplers/tube-type staplers, respectively; 60%/14% were reinforced/not reinforced via manual suturing after stapler anastomosis. Manual anastomosis in GJ surgery employed absorbable/non-absorbable sutures (91%/9%). Significant differences in reconstruction techniques were detected between different volumes of PD procedures (<100/year and >100/year), regions with different economic development levels, and between north and south China. Conclusion: Digestive tract reconstruction following PD exists heterogeneity in Chinese univers","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"151 - 158"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47720097","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 : 2022-10-11DOI: 10.1097/jp9.0000000000000098
U. Ronellenfitsch, A. Rebelo, J. Kleeff
{"title":"Visceral debranching followed by chemotherapy and resection for locally advanced pancreatic cancer with arterial invasion: a case report","authors":"U. Ronellenfitsch, A. Rebelo, J. Kleeff","doi":"10.1097/jp9.0000000000000098","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000098","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49509116","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 : 2022-09-01Epub Date: 2022-08-29DOI: 10.1097/JP9.0000000000000096
Qiang Xu, Tiantong Liu, Xi Zou, Pengyu Li, Ruichen Gao, Menghua Dai, Junchao Guo, Taiping Zhang, Quan Liao, Ziwen Liu, Weibin Wang, Lin Cong, Wenming Wu, Yupei Zhao
Robotic distal pancreatectomy (RDP) has become a routine procedure in many pancreatic centers. This study aimed to describe a single-center experience with RDP since the first case, identify the learning curves of operation time and complication rate, and discuss the safety and feasibility of RDP.
Methods: We collected and retrospectively analyzed the single-center surgical experience of 301 patients undergoing RDP at Peking Union Medical College Hospital (PUMCH) between 2012 and 2022 and described the change in operation proficiency and occurrence of perioperative complications in this observational study. The learning curve was assessed using the cumulative sum method.
Results: We observed a three-phase pattern of RDP learning with operation time, complications, and postoperative pancreatic fistula as indicators and a two-phase pattern for spleening-preserving success. The mean operation time was 3.9 hours. The incidence rate of clinically significant postoperative pancreatic fistula (CRPOPF) was 17.9% and overall Clavien-Dindo complication rate (≥3) was 16.6%. The change of postoperative complicate rate was correlated with percentage of malignant cases.
Conclusion: In the last decade, an evident decrease was seen in operation time, complication rate, and an increase in the spleen-preserving rate of distal pancreatectomy. With proper training, RDP is a safe and feasible procedure.
{"title":"The learning curve for robot-assisted distal pancreatectomy: a single-center experience of 301 cases.","authors":"Qiang Xu, Tiantong Liu, Xi Zou, Pengyu Li, Ruichen Gao, Menghua Dai, Junchao Guo, Taiping Zhang, Quan Liao, Ziwen Liu, Weibin Wang, Lin Cong, Wenming Wu, Yupei Zhao","doi":"10.1097/JP9.0000000000000096","DOIUrl":"10.1097/JP9.0000000000000096","url":null,"abstract":"<p><p>Robotic distal pancreatectomy (RDP) has become a routine procedure in many pancreatic centers. This study aimed to describe a single-center experience with RDP since the first case, identify the learning curves of operation time and complication rate, and discuss the safety and feasibility of RDP.</p><p><strong>Methods: </strong>We collected and retrospectively analyzed the single-center surgical experience of 301 patients undergoing RDP at Peking Union Medical College Hospital (PUMCH) between 2012 and 2022 and described the change in operation proficiency and occurrence of perioperative complications in this observational study. The learning curve was assessed using the cumulative sum method.</p><p><strong>Results: </strong>We observed a three-phase pattern of RDP learning with operation time, complications, and postoperative pancreatic fistula as indicators and a two-phase pattern for spleening-preserving success. The mean operation time was 3.9 hours. The incidence rate of clinically significant postoperative pancreatic fistula (CRPOPF) was 17.9% and overall Clavien-Dindo complication rate (≥3) was 16.6%. The change of postoperative complicate rate was correlated with percentage of malignant cases.</p><p><strong>Conclusion: </strong>In the last decade, an evident decrease was seen in operation time, complication rate, and an increase in the spleen-preserving rate of distal pancreatectomy. With proper training, RDP is a safe and feasible procedure.</p>","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 3","pages":"118-124"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/3f/jp9-5-118.PMC9665946.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40702410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Robotic-assisted pancreatoduodenectomy (RPD) has been widely performed in the treatment of pancreatic tumors. The oncologic outcome in the early stage of pancreatic ductal adenocarcinomas (PDAC) operated by RPD has not been evaluated. Methods: Clinical data of pathology confirmed stage I PDAC from January 2015 to December 2020 in Ruijin hospital, Shanghai Jiao Tong University School of Medicine was collected and retrospectively analyzed. Patients were divided into the open pancreaticoduodenectomy (OPD) group and the RPD group. Clinicopathological data and prognosis data were compared and analyzed. Results: A total of 426 patients were enrolled in this study, including 342 patients in the OPD group and 84 patients in the RPD group. The baseline characteristics of both groups were equivalent. Incidence of R1 resection was significantly lower in RPD group (3 [3.6%] vs 40 [11.7%], P = .044). RPD group was associated with better disease-free survival (DFS) and overall survival (OS) (DFS: Haszard Ratio [HR]: 0.681, 95% confidence interval [CI]: 0.491–0.945, P = .022; OS: HR: 0.667, 95% CI: 0.478–0.932, P = .017). T2 stage was associated with poor DFS and OS (DFS: HR: 1.471, 95% CI: 1.092–1.981, P = .011; OS: HR: 1.616, 95% CI: 1.209–2.160, P = .035). R1 resection was associated with poor OS (HR: 1.483, 95% CI: 1.028–2.140, P = .035) while adjuvant therapy was associated with better OS (HR: 0.589, 95% CI: 0.452–0.766, P < .001). Kaplan–Meier estimate showed significantly longer DFS and OS in RPD group (DFS: P = .004; OS: P = .009). Conclusion: For stage I PDAC patients, RPD surgery achieved higher R0 resection rates and better DFS and OS. T1 stage was associated with better DFS. R0 resection and adjuvant therapy were the accesses to better OS.
背景:机器人辅助胰十二指肠切除术(RPD)已广泛应用于胰腺肿瘤的治疗。早期胰管腺癌(PDAC)经RPD手术的肿瘤预后尚未得到评价。方法:收集上海交通大学医学院瑞金医院2015年1月至2020年12月病理证实的I期PDAC患者的临床资料并进行回顾性分析。患者分为开放式胰十二指肠切除术(OPD)组和RPD组。比较分析临床病理资料和预后资料。结果:共纳入426例患者，其中OPD组342例，RPD组84例。两组的基线特征相同。RPD组R1切除发生率显著低于RPD组(3例[3.6%]vs 40例[11.7%]，P = 0.044)。RPD组无病生存期(DFS)和总生存期(OS)较好(DFS:风险比[HR]: 0.681, 95%可信区间[CI]: 0.491-0.945, P = 0.022;Os: hr: 0.667, 95% ci: 0.478-0.932, p = 0.017)。T2期与较差的DFS和OS相关(DFS: HR: 1.471, 95% CI: 1.092 ~ 1.981, P = 0.011;Os: hr: 1.616, 95% ci: 1.209-2.160, p = 0.035)。R1切除术与较差的OS相关(HR: 1.483, 95% CI: 1.028-2.140, P = 0.035)，而辅助治疗与较好的OS相关(HR: 0.589, 95% CI: 0.452-0.766, P < 0.001)。Kaplan-Meier估计显示，RPD组的DFS和OS显著延长(DFS: P = 0.004;Os: p = 0.009)。结论:对于I期PDAC患者，RPD手术获得更高的R0切除率和更好的DFS和OS。T1期与较好的DFS相关。R0切除和辅助治疗是获得较好OS的途径。
{"title":"Advantage of oncological outcome of robotic-assisted pancreatoduodenectomy (RPD) in stage I pancreatic ductal adenocarcinomas (PDAC)","authors":"Jingfeng Li, Shulin Zhao, Jiabin Jin, Yusheng Shi, Yuanchi Weng, Mengmin Chen, Haoda Chen, Zhiwei Xu, Xiaxing Deng, Baiyong Shen, C. Peng","doi":"10.1097/JP9.0000000000000102","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000102","url":null,"abstract":"Background: Robotic-assisted pancreatoduodenectomy (RPD) has been widely performed in the treatment of pancreatic tumors. The oncologic outcome in the early stage of pancreatic ductal adenocarcinomas (PDAC) operated by RPD has not been evaluated. Methods: Clinical data of pathology confirmed stage I PDAC from January 2015 to December 2020 in Ruijin hospital, Shanghai Jiao Tong University School of Medicine was collected and retrospectively analyzed. Patients were divided into the open pancreaticoduodenectomy (OPD) group and the RPD group. Clinicopathological data and prognosis data were compared and analyzed. Results: A total of 426 patients were enrolled in this study, including 342 patients in the OPD group and 84 patients in the RPD group. The baseline characteristics of both groups were equivalent. Incidence of R1 resection was significantly lower in RPD group (3 [3.6%] vs 40 [11.7%], P = .044). RPD group was associated with better disease-free survival (DFS) and overall survival (OS) (DFS: Haszard Ratio [HR]: 0.681, 95% confidence interval [CI]: 0.491–0.945, P = .022; OS: HR: 0.667, 95% CI: 0.478–0.932, P = .017). T2 stage was associated with poor DFS and OS (DFS: HR: 1.471, 95% CI: 1.092–1.981, P = .011; OS: HR: 1.616, 95% CI: 1.209–2.160, P = .035). R1 resection was associated with poor OS (HR: 1.483, 95% CI: 1.028–2.140, P = .035) while adjuvant therapy was associated with better OS (HR: 0.589, 95% CI: 0.452–0.766, P < .001). Kaplan–Meier estimate showed significantly longer DFS and OS in RPD group (DFS: P = .004; OS: P = .009). Conclusion: For stage I PDAC patients, RPD surgery achieved higher R0 resection rates and better DFS and OS. T1 stage was associated with better DFS. R0 resection and adjuvant therapy were the accesses to better OS.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"125 - 131"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42253694","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 : 2022-06-10DOI: 10.1097/JP9.0000000000000078
Ming Lu, Panpan Zhang, Jianwei Zhang, Jie Li
Neuroendocrine neoplasms (NENs) include well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Somatostatin receptors (SSTRs) are highly expressed on NETs cells, and somatostatin analogs (SSAs) could bind to SSTRs with high affinities, regulating cell proliferation and hormone secretion. As many clinical trials have demonstrated the antiproliferative efficacy and safety of SSAs in metastatic gastroenteropancreatic NETs (GEP-NETs), SSAs have been recommended by multiple NEN guidelines as the first-line therapy of GEP-NETs. In recent years, more and more researches have been exploring new therapeutic possibilities of SSA in GEP-NETs, such as high-dose SSA as second-line therapy, SSA in metastatic GEP-NETs with Ki-67 > 10%, SSA as adjuvant therapy for postoperative pancreatic NETs patients, and combinations of SSA with chemotherapy or targeted therapy. In this review, we summarized the latest published or released researches and discussed new application attempts of SSA in GEP-NETs.
{"title":"Advances in the treatment of gastroenteropancreatic neuroendocrine neoplasms with somatostatin analogs","authors":"Ming Lu, Panpan Zhang, Jianwei Zhang, Jie Li","doi":"10.1097/JP9.0000000000000078","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000078","url":null,"abstract":"Neuroendocrine neoplasms (NENs) include well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Somatostatin receptors (SSTRs) are highly expressed on NETs cells, and somatostatin analogs (SSAs) could bind to SSTRs with high affinities, regulating cell proliferation and hormone secretion. As many clinical trials have demonstrated the antiproliferative efficacy and safety of SSAs in metastatic gastroenteropancreatic NETs (GEP-NETs), SSAs have been recommended by multiple NEN guidelines as the first-line therapy of GEP-NETs. In recent years, more and more researches have been exploring new therapeutic possibilities of SSA in GEP-NETs, such as high-dose SSA as second-line therapy, SSA in metastatic GEP-NETs with Ki-67 > 10%, SSA as adjuvant therapy for postoperative pancreatic NETs patients, and combinations of SSA with chemotherapy or targeted therapy. In this review, we summarized the latest published or released researches and discussed new application attempts of SSA in GEP-NETs.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"6 1","pages":"23 - 27"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41394501","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 : 2022-06-10DOI: 10.1097/jp9.0000000000000089
P. Szatmary, J. Kleeff
{"title":"Registry study outcomes from surgical management of pancreatic ductal adenocarcinoma in China","authors":"P. Szatmary, J. Kleeff","doi":"10.1097/jp9.0000000000000089","DOIUrl":"https://doi.org/10.1097/jp9.0000000000000089","url":null,"abstract":"","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47763423","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 : 2022-06-01DOI: 10.1097/JP9.0000000000000090
Meixi Liu, M. Hacker, L. Huo, Xiang Li
Pancreatic cancer is one of the most lethal malignancies in the world. Cancer-associated fibroblasts are one of the main components of tumor microenvironment in pancreatic cancer and play an essential role in tumor progression. Fibroblast activation protein that is expressed in specific subtypes of cancer-associated fibroblasts promotes tumor growth and is related to poor survival. Recent researches have preliminarily demonstrated a promising potential of radiopharmaceuticals targeting fibroblast activation protein in diagnosis and therapy of pancreatic cancer. This article comprehensively reviews the current development and clinical translation of fibroblast activation protein inhibitor-targeting radiopharmaceuticals in pancreatic cancer and provides significant perspectives for future investigations.
{"title":"The application of FAPI-targeted theranostics in pancreatic cancer: a narrative review","authors":"Meixi Liu, M. Hacker, L. Huo, Xiang Li","doi":"10.1097/JP9.0000000000000090","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000090","url":null,"abstract":"Pancreatic cancer is one of the most lethal malignancies in the world. Cancer-associated fibroblasts are one of the main components of tumor microenvironment in pancreatic cancer and play an essential role in tumor progression. Fibroblast activation protein that is expressed in specific subtypes of cancer-associated fibroblasts promotes tumor growth and is related to poor survival. Recent researches have preliminarily demonstrated a promising potential of radiopharmaceuticals targeting fibroblast activation protein in diagnosis and therapy of pancreatic cancer. This article comprehensively reviews the current development and clinical translation of fibroblast activation protein inhibitor-targeting radiopharmaceuticals in pancreatic cancer and provides significant perspectives for future investigations.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"78 - 86"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47516455","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 : 2022-06-01DOI: 10.1097/JP9.0000000000000093
Zhihang Xu, Wenquan Wang, W. Lou, Liang Liu
Pancreatic cancer is one of the most malignant digestive system tumors. The effectiveness of pancreatic cancer treatment is still dismal, and the 5-year survival rate is only about 10%. Further improving the diagnosis and treatment of pancreatic cancer is the top priority of oncology research and clinical practice. Based on the existing clinical and scientific research experience, the review provides insight into the hotspots and future directions for pancreatic cancer, which focuses on early detection, early diagnosis, molecular typing and precise treatment, new drug development and regimen combination, immunotherapy, database development, model establishment, surgical technology and strategy change, as well as innovation of traditional Chinese medicine and breakthrough of treatment concept.
{"title":"Insight of pancreatic cancer: recommendations for improving its therapeutic efficacy in the next decade","authors":"Zhihang Xu, Wenquan Wang, W. Lou, Liang Liu","doi":"10.1097/JP9.0000000000000093","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000093","url":null,"abstract":"Pancreatic cancer is one of the most malignant digestive system tumors. The effectiveness of pancreatic cancer treatment is still dismal, and the 5-year survival rate is only about 10%. Further improving the diagnosis and treatment of pancreatic cancer is the top priority of oncology research and clinical practice. Based on the existing clinical and scientific research experience, the review provides insight into the hotspots and future directions for pancreatic cancer, which focuses on early detection, early diagnosis, molecular typing and precise treatment, new drug development and regimen combination, immunotherapy, database development, model establishment, surgical technology and strategy change, as well as innovation of traditional Chinese medicine and breakthrough of treatment concept.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"58 - 68"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49460524","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 : 2022-06-01DOI: 10.1097/JP9.0000000000000091
Chengfang Wang, Yingsheng Wu, Weilin Wang
The use of neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma remains controversial and limited. Therefore, this literature review aimed to assess the feasibility, safety, and efficacy of this treatment. A database search of peer-reviewed articles published in English between January 1990 and June 2021 in PubMed, MEDLINE, and the Web of Science was performed. Original articles, review articles, and meta-analyses relevant to the topic were selected. We found 2 to 4 cycles with FOLFIRINOX, gemcitabine plus nab-paclitaxel, gemcitabine plus S-1, or gemcitabine alone were the most acceptable treatments. Considering the risk of adverse events and cancer progression, NAT is considered safe and tolerable, with a comparable resection rate. Although NAT can result in moderate tumor responses and some extent of local control (improvement of complete resection rate and negative lymph node metastases), no obvious survival benefit is observed. To date, the survival benefits of NAT for resectable pancreatic ductal adenocarcinoma have been very limited. It is too early to say that NAT is the best treatment option for resectable pancreatic cancer.
胰腺导管腺癌的新辅助治疗(NAT)仍然存在争议和局限性。因此，本文献综述旨在评估这种治疗的可行性、安全性和有效性。对1990年1月至2021年6月在PubMed、MEDLINE和Web of Science上发表的同行评议的英文文章进行数据库搜索。选择与主题相关的原创文章、综述文章和元分析。我们发现2 - 4个周期的FOLFIRINOX、吉西他滨联合nab-紫杉醇、吉西他滨联合S-1或吉西他滨单独是最可接受的治疗。考虑到不良事件和癌症进展的风险，NAT被认为是安全和耐受的，具有相当的切除率。虽然NAT可以导致中度肿瘤反应和一定程度的局部控制(完全切除率和淋巴结转移阴性的改善)，但没有明显的生存获益。迄今为止，NAT对可切除胰腺导管腺癌的生存效益非常有限。现在说NAT是可切除胰腺癌的最佳治疗选择还为时过早。
{"title":"Neoadjuvant therapy for resectable pancreatic cancer: a narrative review","authors":"Chengfang Wang, Yingsheng Wu, Weilin Wang","doi":"10.1097/JP9.0000000000000091","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000091","url":null,"abstract":"The use of neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma remains controversial and limited. Therefore, this literature review aimed to assess the feasibility, safety, and efficacy of this treatment. A database search of peer-reviewed articles published in English between January 1990 and June 2021 in PubMed, MEDLINE, and the Web of Science was performed. Original articles, review articles, and meta-analyses relevant to the topic were selected. We found 2 to 4 cycles with FOLFIRINOX, gemcitabine plus nab-paclitaxel, gemcitabine plus S-1, or gemcitabine alone were the most acceptable treatments. Considering the risk of adverse events and cancer progression, NAT is considered safe and tolerable, with a comparable resection rate. Although NAT can result in moderate tumor responses and some extent of local control (improvement of complete resection rate and negative lymph node metastases), no obvious survival benefit is observed. To date, the survival benefits of NAT for resectable pancreatic ductal adenocarcinoma have been very limited. It is too early to say that NAT is the best treatment option for resectable pancreatic cancer.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"69 - 77"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46358036","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 : 2022-06-01DOI: 10.1097/JP9.0000000000000092
Cheng Li, Wenyi Guo, Shihong Chen, Jianwei Xu, Feng Li, Lei Wang
Chemotherapy is the mainstay of treatment for advanced pancreatic cancer (stage III/IV). However, conventional systemic intravenous chemotherapy (SIC) has been unsatisfactory for pancreatic cancer. In recent years, regional arterial infusion chemotherapy (RAIC) has been clinically used as a new chemotherapy regimen for the treatment of advanced pancreatic cancer, but its efficacy is controversial. The purpose of this study was to evaluate the clinical efficacy and safety of RAIC. We searched literatures in databases such as PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI. After screening, this meta-analysis finally included 9 randomized controlled trials (RCTs) with 444 patients (230 RAIC and 214 SIC). We used the Cochrane Risk of Bias 2.0 tool to assess risk of bias for included RCTs. Outcomes were overall survival (OS), overall response rate (ORR), adverse events rate (AER), and pain remission rate. Outcome indicators used relative risk (RR) and its 95% confidence interval (CI) as effect analysis statistics. The results showed that RAIC had some advantages over SIC in terms of ORR, OS, incidence of leukopenia, and pain remission. In conclusion, compared with SIC, RAIC has better clinical efficacy and lower toxicity in the treatment of advanced pancreatic cancer.
化疗是晚期胰腺癌(III/IV期)的主要治疗方法。然而，传统的全身静脉化疗(SIC)对胰腺癌的治疗效果并不理想。近年来，局部动脉输注化疗(RAIC)作为一种新的化疗方案被临床应用于晚期胰腺癌的治疗，但其疗效存在争议。本研究的目的是评价RAIC的临床疗效和安全性。我们在PubMed、EMBASE、Cochrane Library、Web of Science、CNKI等数据库中检索文献。筛选后，该荟萃分析最终纳入9项随机对照试验(rct)，共444例患者(230例RAIC和214例SIC)。我们使用Cochrane风险偏倚2.0工具评估纳入的随机对照试验的偏倚风险。结果包括总生存期(OS)、总缓解率(ORR)、不良事件发生率(AER)和疼痛缓解率。结局指标采用相对危险度(RR)及其95%置信区间(CI)作为效果分析统计。结果显示，RAIC在ORR、OS、白细胞减少发生率和疼痛缓解方面优于SIC。综上所述，与SIC相比，RAIC治疗晚期胰腺癌具有更好的临床疗效和更低的毒性。
{"title":"Comparison of regional arterial chemotherapy and systemic intravenous chemotherapy for advanced pancreatic cancer: a systematic review and meta-analysis","authors":"Cheng Li, Wenyi Guo, Shihong Chen, Jianwei Xu, Feng Li, Lei Wang","doi":"10.1097/JP9.0000000000000092","DOIUrl":"https://doi.org/10.1097/JP9.0000000000000092","url":null,"abstract":"Chemotherapy is the mainstay of treatment for advanced pancreatic cancer (stage III/IV). However, conventional systemic intravenous chemotherapy (SIC) has been unsatisfactory for pancreatic cancer. In recent years, regional arterial infusion chemotherapy (RAIC) has been clinically used as a new chemotherapy regimen for the treatment of advanced pancreatic cancer, but its efficacy is controversial. The purpose of this study was to evaluate the clinical efficacy and safety of RAIC. We searched literatures in databases such as PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI. After screening, this meta-analysis finally included 9 randomized controlled trials (RCTs) with 444 patients (230 RAIC and 214 SIC). We used the Cochrane Risk of Bias 2.0 tool to assess risk of bias for included RCTs. Outcomes were overall survival (OS), overall response rate (ORR), adverse events rate (AER), and pain remission rate. Outcome indicators used relative risk (RR) and its 95% confidence interval (CI) as effect analysis statistics. The results showed that RAIC had some advantages over SIC in terms of ORR, OS, incidence of leukopenia, and pain remission. In conclusion, compared with SIC, RAIC has better clinical efficacy and lower toxicity in the treatment of advanced pancreatic cancer.","PeriodicalId":92925,"journal":{"name":"Journal of pancreatology","volume":"5 1","pages":"49 - 57"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42014405","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：