Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Risk Stratification of Pancreatic Ductal Adenocarcinoma Patients Undergoing Curative-Intent Surgery after Neoadjuvant Therapy: Hyun Kyung Yang, Mi-Suk Park, Kyunghwa Han, Geonsik Eom, Yong Eun Chung, Jin-Young Choi, Seungmin Bang, Chang Moo Kang, Jinsil Seong, Myeong-Jin Kim; Cancer Res Treat. 2024;56(1):247-258. Published online August 22, 2023; DOI: https://doi.org/10.4143/crt.2023.586

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Purpose
Clinical prognostic criteria using preoperative factors were not developed for post–neoadjuvant therapy (NAT) surgery of pancreatic ductal adenocarcinoma (PDAC). We aimed to identify preoperative factors associated with overall survival (OS) in PDAC patients who underwent post-NAT curative-intent surgery and develop risk stratification criteria.
Materials and Methods
Consecutive PDAC patients who underwent post-NAT curative-intent surgeries between 2007 and 2020 were retrospectively analyzed. Demographic, laboratory, surgical, and histopathologic variables were collected. Baseline, preoperative, and interval changes of computed tomography (CT) findings proposed by the Society of Abdominal Radiology and the American Pancreatic Association were analyzed. Cox proportional hazard analysis was used to select preoperative variables associated with OS. We developed risk stratification criteria composed of the significant preoperative variables, i.e., post-NAT response criteria. We compared the discrimination performance of post-NAT response criteria with that of post-NAT pathological (yp) American Joint Cancer Committee TNM staging system.
Results
One hundred forty-five PDAC patients were included. Stable or increased tumor size on CT (hazard ratio [HR], 2.58; 95% confidence interval [CI], 1.58 to 4.21; p < 0.001) and elevated preoperative carbohydrate antigen 19-9 (CA19-9) level (HR, 1.98; 95% CI, 1.11 to 3.55; p=0.021) were independent factors of OS. The OS of the patient groups stratified by post-NAT response criteria which combined changes in tumor size and CA19-9 showed significant difference (p < 0.001). Such stratification was comparable to ypTNM staging in discrimination performance (difference of C-index, 0.068; 95% CI, –0.012 to 0.142).
Conclusion
“Any degree of decrease in tumor size on CT” and CA19-9 normalization or staying normal were independent favorable factors of OS. The combination of the two factors discriminated OS comparably to ypTNM staging.

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Prognostic factors in localized pancreatic ductal adenocarcinoma after neoadjuvant therapy and resection: a systematic review and meta-analysis
Ammar A Javed, Alyssar Habib, Omar Mahmud, Asad Saulat Fatimi, Mahip Grewal, Nabiha Mughal, Jin He, Christopher L Wolfgang, Lois Daamen, Marc G Besselink
JNCI: Journal of the National Cancer Institute.2025; 117(5): 840. CrossRef

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Incremental Role of Pancreatic Magnetic Resonance Imaging after Staging Computed Tomography to Evaluate Patients with Pancreatic Ductal Adenocarcinoma: Hye Jin Kim, Mi-Suk Park, Jin Yong Lee, Kyunghwa Han, Yong Eun Chung, Jin-Young Choi, Myeong-Jin Kim, Chang Moo Kang; Cancer Res Treat. 2019;51(1):24-33. Published online February 5, 2018; DOI: https://doi.org/10.4143/crt.2017.404

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to investigate the impact of contrast enhanced pancreatic magnetic resonance imaging (MRI) in resectability and prognosis evaluation after staging computed tomography (CT) in patients with pancreatic ductal adenocarcinoma (PDA).
Materials and Methods
From January 2005 to December 2012, 298 patients were diagnosed to have potentially resectable stage PDA on CT. Patients were divided into CT+MR (patients underwent both CT and MRI; n=216) and CT only groups (n=82). Changes in resectability staging in the CT+MR group were evaluated. The overall survival was compared between the two groups. The recurrence-free survival and median time to liver metastasis after curative surgery were compared between the two groups.
Results
Staging was changed from resectable on CT to unresectable state on MRI in 14.4% of (31 of 216 patients) patients of the CT+MR group. The overall survival and recurrence-free survival rates were not significantly different between the two groups (p=0.162 and p=0.721, respectively). The median time to liver metastases after curative surgery in the CT+MR group (9.9 months) was significantly longer than that in the CT group (4.2 months) (p=0.011).
Conclusion
Additional MRI resulted in changes of resectability and treatment modifications in a significant proportion of patients who have potentially resectable state at CT and in prolonged time to liver metastases in patients after curative surgery. Additional MRI to standard staging CT can be recommended for surgical candidates of PDA.

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Pancreatic ductal adenocarcinoma: the latest on diagnosis, molecular profiling, and systemic treatments
Doaa Bugazia, Ebtesam Al-Najjar, Abdullah Esmail, Saifudeen Abdelrahim, Karen Abboud, Adham Abdelrahim, Godsfavour Umoru, Hashem A. Rayyan, Ala Abudayyeh, Ala-Eddin Al Moustafa, Maen Abdelrahim
Frontiers in Oncology.2024;[Epub] CrossRef
S3-Leitlinie Exokrines Pankreaskarzinom – Version 3.1
Thomas Seufferlein, Julia Mayerle, Stefan Boeck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2024; 62(10): 874. CrossRef
S3-Leitlinie Exokrines Pankreaskarzinom – Version 3.1
Thomas Seufferlein, Julia Mayerle, Stefan Boeck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2024; 62(10): 1724. CrossRef
Additional MRI for initial M-staging in pancreatic cancer: a cost-effectiveness analysis
Felix G. Gassert, Sebastian Ziegelmayer, Johanna Luitjens, Florian T. Gassert, Fabian Tollens, Johann Rink, Marcus R. Makowski, Johannes Rübenthaler, Matthias F. Froelich
European Radiology.2022; 32(4): 2448. CrossRef
Diagnostik beim Pankreaskarzinom – Update in der neuen Leitlinie
L. Grenacher, M. Juchems, A. G. Schreyer, J. Wessling, K. I. Ringe, W. Uhl, J. Mayerle, T. Seufferlein
Der Chirurg.2022; 93(5): 429. CrossRef
Pancreatic adenocarcinoma: imaging techniques for diagnosis and management
Jawaad Farrukh, Ravivarma Balasubramaniam, Anitha James, Sharan S Wadhwani, Raneem Albazaz
British Journal of Hospital Medicine.2022; 83(5): 1. CrossRef
S3-Leitlinie zum exokrinen Pankreaskarzinom – Kurzversion 2.0 – Dezember 2021, AWMF-Registernummer: 032/010OL
Thomas Seufferlein, Julia Mayerle, Stefan Böck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2022; 60(06): 991. CrossRef
S3-Leitlinie zum exokrinen Pankreaskarzinom – Langversion 2.0 – Dezember 2021 – AWMF-Registernummer: 032/010OL
Thomas Seufferlein, Julia Mayerle, Stefan Böck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2022; 60(11): e812. CrossRef
The Role of Imaging in Current Treatment Strategies for Pancreatic Adenocarcinoma
Hyungjin Rhee, Mi-Suk Park
Korean Journal of Radiology.2021; 22(1): 23. CrossRef
A Comparative Study of Survivor Outcomes between Preoperative Evaluation Using CT Alone and Combined CT and MRI in Patients with Pancreatic Ductal Adenocarcinoma
Ji Eun Lee, Seong Hyun Kim, Soon Jin Lee, Seo-Youn Choi, Sunyoung Lee, Bo Ra Lee
Journal of the Korean Society of Radiology.2021; 82(3): 638. CrossRef
СT and MRI in the assessment of resectable and borderline resectable pancreatic tumors
A. V. Kudryavtseva, S. S. Bagnenko, I. I. Dzidzawa, I. S. Zheleznyak, G. E. Trufanov, V. V. Ryazanov, V. A. Krasovskaya, A. B. Kotiv, A. D. Kazakov
Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2021; 26(1): 34. CrossRef
European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Pancreatic Cancer
Stefano Partelli, Francesco Sclafani, Sorin Traian Barbu, Marc Beishon, Pierluigi Bonomo, Graça Braz, Filippo de Braud, Thomas Brunner, Giulia Martina Cavestro, Mirjam Crul, Maria Die Trill, Piero Ferollà, Ken Herrmann, Eva Karamitopoulou, Cindy Neuzillet
Cancer Treatment Reviews.2021; 99: 102208. CrossRef
ISOlation Procedure vs. conventional procedure during Distal Pancreatectomy (ISOP-DP trial): study protocol for a randomized controlled trial
Ken-ichi Okada, Manabu Kawai, Seiko Hirono, Masayuki Sho, Masaji Tani, Ippei Matsumoto, Suguru Yamada, Ryosuke Amano, Hirochika Toyama, Yo-ichi Yamashita, Takeshi Gocho, Kazuto Shibuya, Minako Nagai, Hiromitsu Maehira, Keiko Kamei, Go Ohira, Yoshihiro Shi
Trials.2021;[Epub] CrossRef
Management of Primary Squamous Cell Carcinoma of the Pancreas: A Case Report
Danling Guo, Chao Chen, Sangying Lv, Guanzuan Wu, Wei Shi, Huaifeng Li, Hongjie Hu
Frontiers in Surgery.2021;[Epub] CrossRef
Tumor-Specific miRNA Signatures in Combination with CA19-9 for Liquid Biopsy-Based Detection of PDAC
Min Woo Kim, Hani Koh, Jee Ye Kim, Suji Lee, Hyojung Lee, Young Kim, Ho Kyoung Hwang, Seung Il Kim
International Journal of Molecular Sciences.2021; 22(24): 13621. CrossRef
Imaging and Management of Pancreatic Cancer
Mariya Kobi, Gregory Veillette, Roshni Narurkar, David Sadowsky, Viktoriya Paroder, Chaitanya Shilagani, Anthony Gilet, Milana Flusberg
Seminars in Ultrasound, CT and MRI.2020; 41(2): 139. CrossRef
DUPLICATE: Imaging and Management of Pancreatic Cancer
Mariya Kobi, Gregory Veillette, Roshni Narurkar, David Sadowsky, Viktoriya Paroder, Chaitanya Shilagani, Anthony Gilet, Milana Flusberg
Seminars in Ultrasound, CT and MRI.2019;[Epub] CrossRef

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