The impact of neoadjuvant therapy on the histopathological features of pancreatic ductal adenocarcinoma – A systematic review and meta-analysis

2017 ◽  
Vol 55 ◽  
pp. 96-106 ◽  
Author(s):  
Stephan Schorn ◽  
Ihsan Ekin Demir ◽  
Carmen Mota Reyes ◽  
Cemil Saricaoglu ◽  
Nicole Samm ◽  
...  
Pancreatology ◽  
2017 ◽  
Vol 17 (3) ◽  
pp. S79
Author(s):  
Stephan Schorn ◽  
Ihsan Ekin Demir ◽  
Elke Tieftrunk ◽  
Florian Scheufele ◽  
Lenka Calavrezos ◽  
...  

BJS Open ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 52-61 ◽  
Author(s):  
S. Schorn ◽  
I. E. Demir ◽  
N. Samm ◽  
F. Scheufele ◽  
L. Calavrezos ◽  
...  

2020 ◽  
Vol 109 (1) ◽  
pp. 11-17
Author(s):  
B. Kurlinkus ◽  
R. Ahola ◽  
E. Zwart ◽  
A. Halimi ◽  
B. S. Yilmaz ◽  
...  

Background and Aims: A positive resection margin is considered to be a factor associated with poor prognosis after pancreatic ductal adenocarcinoma resection. However, analysis of the resection margin is dependent on the pathological slicing technique. The aim of this systematic review and meta-analysis was to study the impact of resection margin on the survival of pancreatic ductal adenocarcinoma patients whose specimens were analyzed using the axial slicing technique. Material and Methods: A systematic search in the PubMed, Cochrane, and Embase datasets covering the time period from November 2006 to January 2019 was performed. Only studies with axial slicing technique (Leeds Pathology Protocol or Royal College of Pathology Protocol) were included in the final database. Meta-analysis between the marginal distance and survival was performed with the Inverse Variance Method in RevMan. Results: The systematic search resulted in nine studies meeting the inclusion criteria. The median survival for a resection margin 0 mm ranged from 12.3 to 23.4 months, for resection margin <0.5 mm 16 months, for resection margin <1 mm ranged from 11 to 27.5 months, for resection margin <1.5 mm ranged from 16.9 to 21.2 months, and for resection margin >2 mm ranged from 53.9 to 63.1 months. Five studies were eligible for meta-analysis. The pooled multivariable hazard ratio favored resection margin ⩾1 mm (hazard ratio: 1.32 and 95% confidence interval: 1.03–1.68, p = 0.03). Conclusion: Resection margins ⩾1 mm seem to lead to better survival in pancreatic ductal adenocarcinoma patients than resection margin <1 mm. However, there is not enough data to evaluate the effect of oncologic therapy or to analyze the impact of other resection margin distances on survival.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominic O’Connor ◽  
Malcolm Brown ◽  
Martin Eatock ◽  
Richard C. Turkington ◽  
Gillian Prue

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.


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