@article{pmid33914468,

title = {A Pretreatment Prognostic Score to Stratify Survival in Pancreatic Cancer},

author = {Thomas Hank and Ulf Hinz and Thomas Reiner and Giuseppe Malleo and Anna-Katharina König and Laura Maggino and Giovanni Marchegiani and Jörg Kaiser and Salvatore Paiella and Alessandra Binco and Roberto Salvia and Thilo Hackert and Claudio Bassi and Markus W Büchler and Oliver Strobel},

doi = {10.1097/SLA.0000000000004845},

issn = {1528-1140},

year  = {2021},

date = {2021-03-01},

urldate = {2021-03-01},

journal = {Ann Surg},

abstract = {OBJECTIVE: To develop and validate a pretreatment prognostic score in pancreatic cancer (PDAC).



BACKGROUND: Pretreatment prognostication in PDAC is important for treatment decisions but remains challenging. Available prognostic tools are derived from selected cohorts of patients who underwent resection, excluding up to 20% of patients with exploration only, and do not adequately reflect the pretreatment scenario.



METHODS: Patients undergoing surgery for PDAC in Heidelberg from 07/2006 to 06/2014 were identified from a prospective database. Pretreatment parameters were extracted from the database and the laboratory information system. Parameters independently associated with overall survival by uni- and multivariable analyses were used to build a prognostic score. A contemporary cohort from Verona was used for external validation.



RESULTS: In 1197 patients, multiple pretreatment parameters were associated with overall survival by univariable analyses. ASA-classification, CA19-9, CEA, CRP, albumin, and platelet count were independently associated with survival and were used to create the Heidelberg Prognostic Pancreatic Cancer (HELPP)-score. The HELPP-score was closely associated with overall survival (median survival between 31.3 and 4.8 months; 5-year survival rates between 35% and 0%) and was able to stratify survival in subgroups with or without resection as well as in CA19-9 non-secretors. In the resected subgroup the HELPP-score stratified survival independently of pathological prognostic factors. The HELPP-score was externally validated and was superior to CA19-9 in both the development and validation cohorts.



CONCLUSION: The HELPP-score is a readily available prognostic tool based on pretreatment routine parameters to stratify survival in PDAC independently of resection status and pathological tumor stage.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Magistri20211098,

title = {Robotic vs open distal pancreatectomy: A multi-institutional matched comparison analysis},

author = {Paolo Magistri and Ugo Boggi and Alessandro Esposito and Francesco Maria Carrano and Benedetta Pesi and Roberto Ballarin and Matteo De Pastena and Francesca Menonna and Luca Moraldi and Marcovalerio Melis and Andrea Coratti and Elliot Newman and Niccolò Napoli and Marco Ramera and Fabrizio Di Benedetto},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85100356744&doi=10.1002%2fjhbp.881&partnerID=40&md5=862b4dfc5ade51d96a983412f564f6ea},

doi = {10.1002/jhbp.881},

issn = {18686974},

year  = {2021},

date = {2021-01-01},

urldate = {2021-01-01},

journal = {Journal of Hepato-Biliary-Pancreatic Sciences},

volume = {28},

number = {12},

pages = {1098 – 1106},

publisher = {John Wiley and Sons Inc},

abstract = {Background: Pancreatic surgery is still a challenge even in high-volume centers. Clinically relevant postoperative pancreatic fistula (CR-POPF) represents the greatest contributor to major morbidity and mortality, especially following pancreatic distal resection. In this study, we compared robotic distal pancreatectomy (RDP) to open distal pancreatectomy (ODP) in terms of CR-POPF development and analyzed oncologic efficacy of RDP in the subgroup of patients with pancreatic ductal adenocarcinoma (PDAC). Methods: We collected data from five high-volume centers for pancreatic surgery and performed a matched comparison analysis to compare short and long-term outcomes after ODP or RDP. Patients were matched with a 2:1 ratio according to age, ASA (American Society of Anesthesiologists) score, body mass index (BMI), final pathology, and TNM (Tumour, Node, Metastasis) staging system VIII ed. Results: Two hundred and forty-six patients who underwent 82 RDPs and 164 ODPs were included. No differences were found in the incidence of CR-POPF. In the PDAC group, median DFS and OS were 10.8 months and 14.8 months in the ODP group and 10.4 months and 15 months in the RDP group, respectively. Conclusions: Robotic distal pancreatectomy is a safe surgical strategy for PDAC and incidence of CR-POPF is equivalent between RDP and ODP. RDP should be considered equivalent to ODP in terms of oncological efficacy when performed in high-volume and proficient centers. © 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery},

note = {Cited by: 7},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Paolini2021,

title = {Robotic versus open pancreaticoduodenectomy: Is there any difference for frail patients?},

author = {Claudia Paolini and Lapo Bencini and Linda Gabellini and Irene Urciuoli and Sabrina Pacciani and Angela Tribuzi and Luca Moraldi and Massimo Calistri and Andrea Coratti},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85098989962&doi=10.1016%2fj.suronc.2020.12.009&partnerID=40&md5=710c149e71a9c671a504c3b950b49a93},

doi = {10.1016/j.suronc.2020.12.009},

issn = {09607404},

year  = {2021},

date = {2021-01-01},

urldate = {2021-01-01},

journal = {Surgical Oncology},

volume = {37},

publisher = {Elsevier Ltd},

abstract = {Background: Old age and frailty are predictors of early postoperative results after pancreatic surgery. We analysed the results of robotic and open pancreatoduodenectomy in elderly and frail patients. Methods: Data from the local robotic pancreatoduodenectomy database were reviewed and matched with those from open operations during the same period (2014–2020). Both old age and frailty were used to determine any correlation with postoperative outcomes. Elderly patients were defined as patients aged 70 years or more, while frailty was classified according to the validated modified Frailty Index. Results: A total of 118 pancreatoduodenectomies were included in the analysis: 65 (55.1%) robotic and 53 (44.9%) open. More than 50% of patients were frail. Overall, 7.6% of patients experienced grade IV Clavien-Dindo complications, and 3.4% died within 90 days after surgery. Frail patients experienced a similar rate of severe complications after robotic vs. open operations (5.3 vs. 11.6; p = 0.439) but earlier refeeding (3 days vs. 4 days; p = 0.006) and earlier drain removal (6 days vs. 7 days; p = 0.046) when operated on by a robotic approach. The oncological outcomes, including limphnodes retrieval, residual disease, recurrences, and survival, were not influenced by the surgical approach. Non-elderly patients also showed more benefits with the robotic approach (lower complication index, earlier refeeding, and drain removal). Conclusions: Robotic pancreatoduodenectomy is associated with risks of major complications that are comparable to those of open operation in frail patients. Some perioperative parameters (refeeding, drain removal) seem to favour robotics in frail patients and younger patients, although at the price of longer operating times. © 2021 Elsevier Ltd},

note = {Cited by: 3},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Okusaka2020326,

title = {Clinical Practice Guidelines for Pancreatic Cancer 2019 from the Japan Pancreas Society: A Synopsis},

author = {Takuji Okusaka and Masafumi Nakamura and Masahiro Yoshida and Masayuki Kitano and Katsuhiko Uesaka and Yoshinori Ito and Junji Furuse and Keiji Hanada and Kazuichi Okazaki},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85082094118&doi=10.1097%2fMPA.0000000000001513&partnerID=40&md5=2711a0bb237001a4c9b21c33e3fb8145},

doi = {10.1097/MPA.0000000000001513},

issn = {08853177},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {Pancreas},

volume = {49},

number = {3},

pages = {326 – 335},

publisher = {Lippincott Williams and Wilkins},

abstract = {Objectives Clinical Practice Guidelines for Pancreatic Cancer were first published in 2006 by the Japan Pancreas Society, and they were revised in 2009, 2013, and 2016. In July 2019, the Clinical Practice Guidelines for Pancreatic Cancer 2019 were newly revised in Japanese. Methods For this version, we developed the new guidelines according to the Minds Manual for Guideline Development 2017, which includes the concepts of GRADE (Grading Recommendations Assessment, Development, and Evaluation), to enable a better understanding of the current guidelines. Results The guidelines show algorithms for the diagnosis, treatment, and chemotherapy of pancreatic cancer and address 7 subjects: diagnosis, surgical therapy, adjuvant therapy, radiation therapy, chemotherapy, stent therapy, and supportive and palliative medicine. They include 56 clinical questions and 84 statements. There are statements corresponding to clinical questions, evidence levels, recommendation strengths, and agreement rates. Conclusions These guidelines represent the most standard clinical and practical management guidelines at this time in Japan. This is the English synopsis of the Clinical Practice Guidelines for Pancreatic Cancer 2019 in Japanese and is an attempt to disseminate the Japanese guidelines worldwide for introducing the Japanese approach for clinical management of pancreatic cancer. © Wolters Kluwer Health, Inc. All rights reserved.},

note = {Cited by: 63; All Open Access, Green Open Access, Hybrid Gold Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Habib20201164,

title = {Synopsis of the UK National Institute for Health and Care Excellence Guidelines on the Diagnosis and Management of Pancreatic Cancer},

author = {Joseph R. Habib and Christopher L. Wolfgang},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85091271207&doi=10.1001%2fjamasurg.2020.3751&partnerID=40&md5=8ab334ab645a8c071623802956cfa7a2},

doi = {10.1001/jamasurg.2020.3751},

issn = {21686254},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {JAMA Surgery},

volume = {155},

number = {12},

pages = {1164 – 1165},

publisher = {American Medical Association},

note = {Cited by: 0},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Mitsuka2020,

title = {Time interval-based indication for liver resection of metastasis from pancreatic cancer},

author = {Yusuke Mitsuka and Shintaro Yamazaki and Nao Yoshida and Masahiro Yan and Tokio Higaki and Tadatoshi Takayama},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85095726042&doi=10.1186%2fs12957-020-02058-5&partnerID=40&md5=c4d4cdda7309065384f4c46367a46925},

doi = {10.1186/s12957-020-02058-5},

issn = {14777819},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {World Journal of Surgical Oncology},

volume = {18},

number = {1},

publisher = {BioMed Central Ltd},

abstract = {Background: Surgical indications for liver metastases from pancreatic ductal adenocarcinoma (PDAC) are lacking because outcomes are usually poor. However, liver resection and the recent progress in perioperative chemotherapy have been observed to improve survival. Methods: We performed liver resection for liver metastases from PDAC only under the following criteria: (1) liver-only metastasis, (2) up to three tumors, and (3) no increase in the number of metastases during the 3-month observation period. No limitations were placed on the location or size of liver metastasis. In this study, we aimed to validate our surgical criteria and analyze factors affecting survival in patients with PDAC. Results: Seventy-nine patients underwent curative resection for PDAC between 2005 and 2015. Seventy-one patients experienced recurrence, with liver-only recurrence in 17 patients. Among these, nine patients underwent liver resection and eight did not. The median survival time was significantly better for patients who underwent liver resection (55 months) than for those with other recurrences (17.5 months},

note = {Cited by: 6; All Open Access, Gold Open Access, Green Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Isaji20182,

title = {International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017},

author = {Shuji Isaji and Shugo Mizuno and John A. Windsor and Claudio Bassi and Carlos Fernández-del Castillo and Thilo Hackert and Aoi Hayasaki and Matthew H. G. Katz and Sun-Whe Kim and Masashi Kishiwada and Hirohisa Kitagawa and Christoph W. Michalski and Christopher L. Wolfgang},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85035246382&doi=10.1016%2fj.pan.2017.11.011&partnerID=40&md5=9e732aecca1d54c1de22d6974f6b4d43},

doi = {10.1016/j.pan.2017.11.011},

issn = {14243903},

year  = {2018},

date = {2018-01-01},

urldate = {2018-01-01},

journal = {Pancreatology},

volume = {18},

number = {1},

pages = {2 – 11},

publisher = {Elsevier B.V.},

abstract = {This statement was developed to promote international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) which was adopted by the National Comprehensive Cancer Network (NCCN) in 2006, but which has changed yearly and become more complicated. Based on a symposium held during the 20th meeting of the International Association of Pancreatology (IAP) in Sendai, Japan, in 2016, the presenters sought consensus on issues related to BR-PDAC. We defined patients with BR-PDAC according to the three distinct dimensions: anatomical (A), biological (B), and conditional (C). Anatomic factors include tumor contact with the superior mesenteric artery and/or celiac artery of less than 180° without showing stenosis or deformity, tumor contact with the common hepatic artery without showing tumor contact with the proper hepatic artery and/or celiac artery, and tumor contact with the superior mesenteric vein and/or portal vein including bilateral narrowing or occlusion without extending beyond the inferior border of the duodenum. Biological factors include potentially resectable disease based on anatomic criteria but with clinical findings suspicious for (but unproven) distant metastases or regional lymph nodes metastases diagnosed by biopsy or positron emission tomography-computed tomography. This also includes a serum carbohydrate antigen (CA) 19–9 level more than 500 units/ml. Conditional factors include the patients with potentially resectable disease based on anatomic and biologic criteria and with Eastern Cooperative Oncology Group (ECOG) performance status of 2 or more. The definition of BR-PDAC requires one or more positive dimensions (e.g. A, B, C, AB, AC, BC or ABC). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumor and vessels, but that biological and conditional dimensions are also important. The aim in presenting this consensus definition is also to highlight issues which remain controversial and require further research. © 2017 IAP and EPC},

note = {Cited by: 265; All Open Access, Hybrid Gold Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ducreux2015v56,

title = {Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up},

author = {M. Ducreux and A. Sa. Cuhna and C. Caramella and A. Hollebecque and P. Burtin and D. Goéré and T. Seufferlein and K. Haustermans and J. L. Van Laethem and T. Conroy and D. Arnold},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84941646402&doi=10.1093%2fannonc%2fmdv295&partnerID=40&md5=526c2e6c86d7844ec67e63fa004aee18},

doi = {10.1093/annonc/mdv295},

issn = {09237534},

year  = {2015},

date = {2015-01-01},

urldate = {2015-01-01},

journal = {Annals of Oncology},

volume = {26},

pages = {v56 – v68},

publisher = {Oxford University Press},

note = {Cited by: 720; All Open Access, Bronze Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Lee201518,

title = {Distal pancreatectomy: A single institution's experience in open, laparoscopic, and robotic approaches},

author = {Ser Yee Lee and Peter J. Allen and Eran Sadot and Michael I. D'Angelica and Ronald P. Dematteo and Yuman Fong and William R. Jarnagin and T. Peter Kingham},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84916917547&doi=10.1016%2fj.jamcollsurg.2014.10.004&partnerID=40&md5=c146150b96526a2d68b235b90308024a},

doi = {10.1016/j.jamcollsurg.2014.10.004},

issn = {10727515},

year  = {2015},

date = {2015-01-01},

urldate = {2015-01-01},

journal = {Journal of the American College of Surgeons},

volume = {220},

number = {1},

pages = {18 – 27},

publisher = {Elsevier Inc.},

abstract = {Background The indications for minimally invasive (MIS) pancreatectomy have slowly increased as experience, techniques, and technology have improved and evolved to manage malignant lesions in selected patients without compromising safety and oncologic principles. There are sparse data comparing laparoscopic, robotic, and open distal pancreatectomy (DP).; Study Design All patients undergoing DP at Memorial Sloan Kettering Cancer Center between 2000 and 2013 were analyzed from a prospective database. Clinicopathologic and survival data were analyzed to compare perioperative and oncologic outcomes in patients who underwent DP via open, laparoscopic, and robotic approaches.; Results Eight hundred five DP were performed during the study period, comprising 37 robotic distal pancreatectomies (RDP), 131 laparoscopic distal pancreatectomies (LDP), and 637 open distal pancreatectomies (ODP). The 3 groups were similar with respect to American Society of Anesthesiologists (ASA) score, sex ratio, body mass index, pancreatic fistula rate, and 90-day morbidity and mortality. Patients in the ODP group were generally older (p = 0.001), had significantly higher intraoperative blood loss (p < 0.001), and had a trend toward a longer hospital stay (p = 0.05). Of the significant preoperative variables, visceral fat was predictive of conversion on multivariate analysis (p = 0.003). Oncologic outcomes in the adenocarcinoma cases were similar for the 3 groups, with high rates of R0 resection (88% to 100%). The ODP group had a higher lymph node yield than the LDP and RDP groups (15.4, [SD 8.7] vs 10.4 [SD 8.0] vs 12[SD 7.2]},

note = {Cited by: 136},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Bockhorn2014977,

title = {Borderline resectable pancreatic cancer: A consensus statement by the International Study Group of Pancreatic Surgery (ISGPS)},

author = {Maximilian Bockhorn and Faik G. Uzunoglu and Mustapha Adham and Clem Imrie and Miroslav Milicevic and Aken A. Sandberg and Horacio J. Asbun and Claudio Bassi and Markus Büchler and Richard M. Charnley and Kevin Conlon and Laureano Fernandez Cruz and Christos Dervenis and Abe Fingerhutt and Helmut Friess and Dirk J. Gouma and Werner Hartwig and Keith D. Lillemoe and Marco Montorsi and John P. Neoptolemos and Shailesh V. Shrikhande and Kyoichi Takaori and William Traverso and Yogesh K. Vashist and Charles Vollmer and Charles J. Yeo and Jakob R. Izbicki},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84901455120&doi=10.1016%2fj.surg.2014.02.001&partnerID=40&md5=ff29b14411d08f19636c8bd70084e5e5},

doi = {10.1016/j.surg.2014.02.001},

issn = {00396060},

year  = {2014},

date = {2014-01-01},

urldate = {2014-01-01},

journal = {Surgery (United States)},

volume = {155},

number = {6},

pages = {977 – 988},

publisher = {Mosby Inc.},

abstract = {Background This position statement was developed to expedite a consensus on definition and treatment for borderline resectable pancreatic ductal adenocarcinoma (BRPC) that would have worldwide acceptability. Methods An international panel of pancreatic surgeons from well-established, high-volume centers collaborated on a literature review and development of consensus on issues related to borderline resectable pancreatic cancer. Results The International Study Group of Pancreatic Surgery (ISGPS) supports the National Comprehensive Cancer Network criteria for the definition of BRPC. Current evidence supports operative exploration and resection in the case of involvement of the mesentericoportal venous axis; in addition, a new classification of extrahepatic mesentericoportal venous resections is proposed by the ISGPS. Suspicion of arterial involvement should lead to exploration to confirm the imaging-based findings. Formal arterial resections are not recommended; however, in exceptional circumstances, individual therapeutic approaches may be evaluated under experimental protocols. The ISGPS endorses the recommendations for specimen examination and the definition of an R1 resection (tumor within 1 mm from the margin) used by the British Royal College of Pathologists. Standard preoperative diagnostics for BRPC may include: (1) serum levels of CA19-9, because CA19-9 levels predict survival in large retrospective series; and also (2) the modified Glasgow Prognostic Score and the neutrophil/lymphocyte ratio because of the prognostic relevance of the systemic inflammatory response. Various regimens of neoadjuvant therapy are recommended only in the setting of prospective trials at high-volume centers. Conclusion Current evidence justifies portomesenteric venous resection in patients with BRPC. Basic definitions were identified, that are currently lacking but that are needed to obtain further evidence and improvement for this important patient subgroup. A consensus for each topic is given. © 2014 Mosby, Inc. All rights reserved.},

note = {Cited by: 558},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hartwig20141,

title = {Extended pancreatectomy in pancreatic ductal adenocarcinoma: Definition and consensus of the International Study Group for Pancreatic Surgery (ISGPS)},

author = {Werner Hartwig and Charles M. Vollmer and Abe Fingerhut and Charles J. Yeo and John P. Neoptolemos and Mustapha Adham and Åke Andrén-Sandberg and Horacio J. Asbun and Claudio Bassi and Max Bockhorn and Richard Charnley and Kevin C. Conlon and Christos Dervenis and Laureano Fernandez-Cruz and Helmut Friess and Dirk J. Gouma and Clem W. Imrie and Keith D. Lillemoe and Miroslav N. Milićević and Marco Montorsi and Shailesh V. Shrikhande and Yogesh K. Vashist and Jakob R. Izbicki and Markus W. Büchler},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84902548300&doi=10.1016%2fj.surg.2014.02.009&partnerID=40&md5=13369c977272015b86a212cc52cde706},

doi = {10.1016/j.surg.2014.02.009},

issn = {00396060},

year  = {2014},

date = {2014-01-01},

urldate = {2014-01-01},

journal = {Surgery (United States)},

volume = {156},

number = {1},

pages = {1 – 14},

publisher = {Mosby Inc.},

abstract = {Background Complete macroscopic tumor resection is one of the most relevant predictors of long-term survival in pancreatic ductal adenocarcinoma. Because locally advanced pancreatic tumors can involve adjacent organs, "extended" pancreatectomy that includes the resection of additional organs may be needed to achieve this goal. Our aim was to develop a common consistent terminology to be used in centers reporting results of pancreatic resections for cancer. Methods An international panel of pancreatic surgeons working in well-known, high-volume centers reviewed the literature on extended pancreatectomies and worked together to establish a consensus on the definition and the role of extended pancreatectomy in pancreatic cancer. Results Macroscopic (R1) and microscopic (R0) complete tumor resection can be achieved in patients with locally advanced disease by extended pancreatectomy. Operative time, blood loss, need for blood transfusions, duration of stay in the intensive care unit, and hospital morbidity, and possibly also perioperative mortality are increased with extended resections. Long-term survival is similar compared with standard resections but appears to be better compared with bypass surgery or nonsurgical palliative chemotherapy or chemoradiotherapy. It was not possible to identify any clear prognostic criteria based on the specific additional organ resected. Conclusion Despite increased perioperative morbidity, extended pancreatectomy is warranted in locally advanced disease to achieve long-term survival in pancreatic ductal adenocarcinoma if macroscopic clearance can be achieved. Definitions of extended pancreatectomies for locally advanced disease (and not distant metastatic disease) are established that are crucial for comparison of results of future trials across different practices and countries, in particular for those using neoadjuvant therapy. © 2014 Mosby, Inc. All rights reserved.},

note = {Cited by: 173},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Tol2014591,

title = {Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: A consensus statement by the International Study Group on Pancreatic Surgery (ISGPS)},

author = {Johanna A. M. G. Tol and Dirk J. Gouma and Claudio Bassi and Christos Dervenis and Marco Montorsi and Mustapha Adham and Ake Andrén-Sandberg and Horacio J. Asbun and Maximilian Bockhorn and Markus W. Büchler and Kevin C. Conlon and Laureano Fernández-Cruz and Abe Fingerhut and Helmut Friess and Werner Hartwig and Jakob R. Izbicki and Keith D. Lillemoe and Miroslav N. Milicevic and John P. Neoptolemos and Shailesh V. Shrikhande and Charles M. Vollmer and Charles J. Yeo and Richard M. Charnley},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84907598225&doi=10.1016%2fj.surg.2014.06.016&partnerID=40&md5=6a50e3dd76405d21e33e07a0e91f959c},

doi = {10.1016/j.surg.2014.06.016},

issn = {00396060},

year  = {2014},

date = {2014-01-01},

urldate = {2014-01-01},

journal = {Surgery (United States)},

volume = {156},

number = {3},

pages = {591 – 600},

publisher = {Mosby Inc.},

abstract = {Background The lymph node (Ln) status of patients with resectable pancreatic ductal adenocarcinoma is an important predictor of survival. The survival benefit of extended lymphadenectomy during pancreatectomy is, however, disputed, and there is no true definition of the optimal extent of the lymphadenectomy. The aim of this study was to formulate a definition for standard lymphadenectomy during pancreatectomy. Methods During a consensus meeting of the International Study Group on Pancreatic Surgery, pancreatic surgeons formulated a consensus statement based on available literature and their experience. Results The nomenclature of the Japanese Pancreas Society was accepted by all participants. Extended lymphadenectomy during pancreatoduodenectomy with resection of Ln's along the left side of the superior mesenteric artery (SMA) and around the celiac trunk, splenic artery, or left gastric artery showed no survival benefit compared with a standard lymphadenectomy. No level I evidence was available on prognostic impact of positive para-aortic Ln's. Consensus was reached on selectively removing suspected Ln's outside the resection area for frozen section. No consensus was reached on continuing or terminating resection in cases where these nodes were positive. Conclusion Extended lymphadenectomy cannot be recommended. Standard lymphadenectomy for pancreatoduodenectomy should strive to resect Ln stations no. 5, 6, 8a, 12b1, 12b2, 12c, 13a, 13b, 14a, 14b, 17a, and 17b. For cancers of the body and tail of the pancreas, removal of stations 10, 11, and 18 is standard. Furthermore, lymphadenectomy is important for adequate nodal staging. Both pancreatic resection in relatively fit patients or nonresectional palliative treatment were accepted as acceptable treatment in cases of positive Ln's outside the resection plane. This consensus statement could serve as a guide for surgeons and researchers in future directives and new clinical studies.},

note = {Cited by: 362; All Open Access, Green Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Allen20142014,

title = {Pasireotide for postoperative pancreatic fistula},

author = {Peter J. Allen and Mithat Gon̈en and Murray F. Brennan and Adjoa A. Bucknor and Lindsay M. Robinson and Marisa M. Pappas and Kate E. Carlucci and Michael I. D'Angelica and Ronald P. DeMatteo and T. Peter Kingham and Yuman Fong and William R. Jarnagin},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84901049496&doi=10.1056%2fNEJMoa1313688&partnerID=40&md5=52906645b7327940f46c750b0937bf44},

doi = {10.1056/NEJMoa1313688},

issn = {00284793},

year  = {2014},

date = {2014-01-01},

urldate = {2014-01-01},

journal = {New England Journal of Medicine},

volume = {370},

number = {21},

pages = {2014 – 2022},

publisher = {Massachussetts Medical Society},

abstract = {BACKGROUND: Postoperative pancreatic fistula is a major contributor to complications and death associated with pancreatic resection. Pasireotide, a somatostatin analogue that has a longer half-life than octreotide and a broader binding profile, decreases pancreatic exocrine secretions and may prevent postoperative pancreatic fistula. METHODS: We conducted a single-center, randomized, double-blind trial of perioperative subcutaneous pasireotide in patients undergoing either pancreaticoduodenectomy or distal pancreatectomy. We randomly assigned 300 patients to receive 900 μg of subcutaneous pasireotide (152 patients) or placebo (148 patients) twice daily beginning preoperatively on the morning of the operation and continuing for 7 days (14 doses). Randomization was stratified according to the type of resection and whether the pancreatic duct was dilated at the site of transection. The primary end point was the development of pancreatic fistula, leak, or abscess of grade 3 or higher (i.e., requiring drainage). RESULTS: The primary end point occurred in 45 of the 300 patients (15%). The rate of grade 3 or higher postoperative pancreatic fistula, leak, or abscess was significantly lower among patients who received pasireotide than among patients who received placebo (9% vs. 21%; relative risk, 0.44; 95% confidence interval [CI], 0.24 to 0.78; P=0.006). This finding was consistent among 220 patients who underwent pancreaticoduodenectomy (10% vs. 21%; relative risk, 0.49; 95% CI, 0.25 to 0.95) and 80 patients who underwent distal pancreatectomy (7% vs. 23%; relative risk, 0.32; 95% CI, 0.10 to 0.99), as well as among 136 patients with a dilated pancreatic duct (2% vs. 15%; relative risk, 0.11; 95% CI, 0.02 to 0.60) and 164 patients with a nondilated pancreatic duct (15% vs. 27%; relative risk, 0.55; 95% CI, 0.29 to 1.01). CONCLUSIONS: Perioperative treatment with pasireotide decreased the rate of clinically significant postoperative pancreatic fistula, leak, or abscess. Copyright © 2014 Massachusetts Medical Society.},

note = {Cited by: 270; All Open Access, Bronze Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}