Time-varying impact of established prognostic factors in resected pancreatic ductal adenocarcinoma.

Background: Prognostic factors in resected pancreatic ductal adenocarcinoma (PDAC) have been determined under the assumption that hazard ratios (HRs) remain static. However, PDAC is a dynamic disease with evolving conditional survival. The aim of this study was to determine if the impact of prognostic factors in PDAC is time-varying.

Transitional Subtype of Circulating Tumor Cells in Early Post-Operative Period of 5-Year Survivors Following Resection of Pancreatic Ductal Adenocarcinoma.

Objectives: The objective was to assess the ability of circulating tumor cells (CTCs) to predict long-term survival (LTS, >5 y after resection) in pancreatic ductal adenocarcinoma (PDAC).

Summary Of Background Data: Predictors of LTS remain poorly understood in PDAC.

Methods: Patients enrolled in the prospective CLUSTER Trial for serial assessment of CTCs, undergoing PDAC resection were included (2016-2018).

The impact of perioperative chemotherapy in patients with pancreatic adenosquamous carcinoma.

Background: Pancreatic adenosquamous carcinoma has historically poor overall survival, and the impact of perioperative chemotherapy remains unclear. We aimed to evaluate the impact of various chemotherapy regimens in patients with resected adenosquamous carcinoma.

Methods: Patients with resected adenosquamous carcinoma were identified from 3 high-volume programs between 2001 and 2022.

Ensuring Reproducibility and Deploying Models with the Image2Radiomics Framework: An Evaluation of Image Processing on PanNET Model Performance.

Background/objectives: To evaluate the importance of image processing in a previously validated model for detecting pancreatic neuroendocrine tumors (PanNETs) and to introduce Image2Radiomics, a new framework that ensures reproducibility of the image processing pipeline and facilitates the deployment of radiomics models.

Methods: A previously validated model for identifying PanNETs from CT images served as the reference. Radiomics features were re-extracted using Image2Radiomics and compared to those from the original model using performance metrics.

Incidence and Outcomes of Intraductal Oncocytic Papillary Neoplasm-Derived Pancreatic Cancer Compared with Tubular and Colloid Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Cancer: An International Multicenter Retrospective Study.

Background: Intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer was previously categorized into tubular, colloid, and oncocytic subtypes. Intraductal oncocytic papillary neoplasms (IOPN) has long been associated with superior prognosis/indolent behavior, however, there is discordant emerging evidence. This study aimed to investigate this conflicting literature.

The APROVE (Anti-coagulation/Platelet Treatment in Pancreatic Resections Involving Vascular Reconstruction) Study: Results from a Worldwide Survey.

Background: Antithrombotic therapy (AT) aims to strike a balance between preventing thromboembolic and hemorrhagic complications. However, evidence for AT management after pancreatectomy with vascular reconstruction is lacking. We aimed to provide an overview of the current use of AT for pancreatic surgery with vascular reconstructions.

The Impact of Social Determinants on Pancreatic Cancer Care in the United States.

With a rising annual incidence, pancreatic cancer is now the third leading cause of cancer-related mortality in American men and women [...

Adjuvant therapy after resection of intraductal papillary mucinous neoplasm-derived pancreatic cancer: A systematic review and meta-analysis.

Introduction: The management of intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer is extrapolated from pancreatic intraepithelial neoplasm (PanIN)-derived pancreatic cancer. However, these cancers are biologically and clinically distinct and evidence regarding the role of adjuvant therapy (AT) is unclear. The aim of this systematic review and meta-analysis was to consolidate current evidence regarding survival benefit of AT for IPMN-derived pancreatic cancer.

Association Between Adjuvant Therapy and Survival in Resected Pancreatic Ductal Adenocarcinoma After Different Types and Durations of Neoadjuvant Therapy.

Background: Neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma (PDAC) is increasingly being used. The aim of this study was to evaluate the association between type, duration, and sequencing of adjuvant therapy (AT) after NAT and overall survival (OS) in patients with resected PDAC.

Methods: Patients receiving NAT and resection for PDAC (2010-2019) at two high-volume pancreatic surgery centers were included and stratified into groups on the basis of NAT regimen: gemcitabine-based NAT, 5-fluorouracil (5FU)-based NAT, or switched NAT regimen.

Surgical Resection of Murine PDAC Alters Hepatic Metastases and Immune Microenvironment.

Objective: Identify how surgical resection of pancreatic ductal adenocarcinoma (PDAC) affects systemic minimal residual disease (MRD).

Methods: Pancreatic tumors were generated by orthotopic implantation of tumor cells into the pancreas of immunocompetent mice. Tumor resection was carried out via distal pancreatectomy and splenectomy.

Survival after neoadjuvant and induction FOLFIRINOX versus gemcitabine-nab-paclitaxel in patients with resected localised pancreatic adenocarcinoma: an international multicentre study.

Background: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel.

Methods: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018).

Carbohydrate Antigen 19-9 Delta Function for Survival Prediction in Borderline Pancreatic Cancer. A PANC-PALS Consortium International Multicenter Derivation and Validation Study.

Objective: To establish a novel method for evaluating carbohydrate antigen 19-9 (CA19-9) during neoadjuvant therapy (NAT) and assess its role in predicting overall (OS) and disease-free (DFS) survival in borderline resectable pancreatic adenocarcinoma (BR-PC).

Summary Background Data: Static CA19-9 values or percentage changes often fail to capture therapeutic responses in patients with BR-PC undergoing NAT. Improved evaluation methods are essential for guiding the treatment.

Pancreatic cancer.

Pancreatic cancer is frequently a lethal disease with an aggressive tumour biology often presenting with non-specific symptoms. Median survival is approximately 4 months with a 5-year survival of 13%. Surveillance is recommended in individuals with familial pancreatic cancer, specific mutations, and high-risk intraductal papillary mucinous neoplasm, as they are at high risk of developing pancreatic cancer.

Diagnostic Performance of Combined Conventional CT Imaging Features and Radiomics Signature in Differentiating Grade 1 Tumors from Higher-Grade Pancreatic Neuroendocrine Neoplasms.

Background/objectives: Accurate identification of grade 1 (G1) pancreatic neuroendocrine tumors (PanNETs) is crucial due to their rising incidence and emerging nonsurgical management strategies. This study evaluated whether combining conventional CT imaging features, CT radiomics features, and clinical data improves differentiation of G1 PanNETs from higher-grade tumors (G2/G3 PanNETs and pancreatic neuroendocrine carcinomas [PanNECs]) compared to using these features individually.

Methods: A retrospective analysis included 133 patients with pathologically confirmed PanNETs or PanNECs (70 males, 63 females; mean age, 58.

Risk of pancreatic cancer and high-grade dysplasia in resected main-duct and mixed-type intraductal papillary mucinous neoplasms: A prevalence meta-analysis.

Background: Current guidelines recommend the resection of main duct- (MD) and mixed-type (MT) intraductal papillary mucinous neoplasms (IPMN) based on specific risk criteria to prevent or treat pancreatic cancer in selected patients. This paradigm follows high rates of malignancy observed in published surgical series. The aim of this systematic review and meta-analysis was to provide robust, pooled rates of invasive carcinoma (IC) and high-grade dysplasia (HGD) in resected MD- and MT-IPMNs of the pancreas.

Neoadjuvant Chemotherapy for Intraductal Papillary Mucinous Neoplasm-derived Pancreatic Cancer.

Summary Of Background Data: Intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer is typically managed like pancreatic intraepithelial neoplasia (PanIN)-derived pancreatic cancer. However, in IPMN-derived pancreatic cancer, the role of chemotherapy remains controversial, particularly in the neoadjuvant setting (NAT).

Objective: To evaluate the role of neoadjuvant chemotherapy in IPMN-derived pancreatic cancer.

Implications of Neoadjuvant Therapy on Prognostic Factors in Pancreatic Ductal Adenocarcinoma: A Path Towards Personalized Prognostication.

Objective: The aim of the study was to investigate prognostic factors in context of neoadjuvant therapy (NAT) and develop tools that can allow for accurate and personalized patient prognostication.

Summary Of Background Data: NAT might impact the prognostic ability of well-established clinicopathological factors in resected pancreatic ductal adenocarcinoma (PDAC).

Methods: Patients after resection for PDAC were identified from the Dutch Pancreatic Cancer Group Recurrence Database and institutional databases at NYU Langone Health and the Johns Hopkins Hospital (2014-2019).

Robotic Distal Pancreatectomy with Celiac Axis Resection and SMA Divestment: A Step-by-Step Educational Video.

Introduction: En-bloc celiac axis resection (CAR) was first proposed by Lyon H. Appleby in 1952 for gastric cancer and later modified for pancreatic resections with gastric preservation by Nimura et al. in 1976.

Validation of the PANAMA Score for Survival and Benefit of Adjuvant Therapy in Patients With Resected Pancreatic Cancer after Neoadjuvant FOLFIRINOX.

Objective: To validate the prognostic value of the PAncreatic NeoAdjuvant MAssachusetts (PANAMA) score and to determine its predictive ability for survival benefit derived from adjuvant treatment in patients after resection of pancreatic ductal adenocarcinoma (PDAC) following neoadjuvant FOLFIRINOX.

Background: The PANAMA score was developed to guide prognostication in patients after neoadjuvant therapy and resection for PDAC. As this score focuses on the risk for residual disease after resection, it might also be able to select patients who benefit from adjuvant after neoadjuvant therapy.

Can CT Image Reconstruction Parameters Impact the Predictive Value of Radiomics Features in Grading Pancreatic Neuroendocrine Neoplasms?

The WHO grading of pancreatic neuroendocrine neoplasms (PanNENs) is essential in patient management and an independent prognostic factor for patient survival. Radiomics features from CE-CT images hold promise for the outcome and tumor grade prediction. However, variations in reconstruction parameters can impact the predictive value of radiomics.