UI - 12003425
AU - Arguedas MR; Heudebert GH; Stinnett AA; Wilcox CM
Biliary stents in malignant obstructive jaundice due to pancreatic
carcinoma: a cost-effectiveness analysis.
SO - Am J Gastroenterol 2002 Apr;97(4):898-904
AD - Division of Gastroenterology & Hepatology, School of Public Health,
University of Alabama at Birmingham, 35294-0007, USA.
OBJECTIVES: Obstructive jaundice frequently complicates pancreatic
carcinoma and is associated with complications such as malabsorption,
coagulopathy, progressive hepatocellular dysfunction, and cholangitis in
addition to disabling pruritus, which greatly interferes with terminal
patients' quality of life. Endoscopic placement of biliary stents
decreases the risk of these complications and is considered the
procedure of choice for palliation for patients with unresectable
tumors. We used decision analysis with Markov modeling to compare the
cost-effectivenesses of plastic stents and metal stents in patients with
unresectable pancreatic carcinoma. METHODS: A model of the natural
history of unresectable pancreatic carcinoma was constructed using
probabilities derived from the literature. Cost estimates were obtained
from Medicare reimbursement rates and supplemented by the literature.
Two strategies were evaluated: 1) initial endoscopic plastic stent
placement and 2) initial endoscopic metal stent placement. We compared
total costs and performed cost-effectiveness analysis in these
strategies. The outcome measures were quality-adjusted life months.
Sensitivity analyses were performed on selected variables. RESULTS: Our
baseline analysis showed that initial plastic stent placement was
associated with a total cost of $13,879/patient and 1.799
quality-adjusted life months. Initial placement of a metal stent cost
$13,466/patient and conferred 1.832 quality-adjusted life months. Among
the variables examined, expected patient survival was demonstrated by
sensitivity analyses to have the most influence on the results of the
model. CONCLUSION: Initial endoscopic placement of a metal stent is a
cost-saving strategy compared to initial plastic stent placement,
particularly in patients expected to survive longer than 6 months.
UI - 11819842
AU - Shankar A; Russell RC
Recent advances in the surgical treatment of pancreatic cancer.
SO - World J Gastroenterol 2001 Oct;7(5):622-6
AD - Department of Surgery, The Middlesex Hospital, Mortimer Street, London,
UI - 11819814
AU - Ghaneh P; Slavin J; Sutton R; Hartley M; Neoptolemos JP
Adjuvant therapy in pancreatic cancer.
SO - World J Gastroenterol 2001 Aug;7(4):482-9
AD - Department of Surgery, University of Liverpool, 5th Floor UCD Building,
Daulby Street, Liverpool, L69 3GA, UK.
The outlook for patients with pancreatic cancer has been grim. There
have been major advances in the surgical treatment of pancreatic cancer,
leading to a dramatic reduction in post-operative mortality from the
development of high volume specialized centres. This stimulated the
study of adjuvant and neoadjuvant treatments in pancreatic cancer
including chemoradiotherapy and chemotherapy. Initial protocols have
been based on the original but rather small GITSG study first reported
in 1985. There have been two large European trials totalling over 600
patients (EORTC and ESPAC-1) that do not support the use of
chemoradiation as adjuvant therapy. A second major finding from the
ESPAC-1 trial (541 patients randomized) was some but not conclusive
evidence for a survival benefit associated with chemotherapy. A third
major finding from the ESPAC-1 trial was that the quality of life was
not affected by the use of adjuvant treatments compared to surgery
alone. The ESPAC-3 trial aims to assess the definitive use of adjuvant
chemotherapy in a randomized controlled trial of 990 patients.
UI - 12011133
AU - Pisters PW; Wolff RA; Janjan NA; Cleary KR; Charnsangavej C; Crane CN;
Lenzi R; Vauthey JN; Lee JE; Abbruzzese JL; Evans DB
Preoperative paclitaxel and concurrent rapid-fractionation radiation for
resectable pancreatic adenocarcinoma: toxicities, histologic response
rates, and event-free outcome.
SO - J Clin Oncol 2002 May 15;20(10):2537-44
AD - Pancreatic Tumor Study Group, University of Texas M.D. Anderson Cancer
Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
PURPOSE: To evaluate the toxicity of a preoperative regimen of
paclitaxel and concurrent external-beam radiation therapy,
pancreaticoduodenectomy, and electron-beam intraoperative radiation
therapy (EB-IORT) for patients with resectable pancreatic
adenocarcinoma. PATIENTS AND METHODS: Patients with localized,
potentially resectable pancreatic adenocarcinoma were treated with 30 Gy
external-beam radiation therapy and concomitant weekly 3-hour infusions
of paclitaxel (60 mg/m(2)). Radiographic restaging was performed 4 to 6
weeks after chemoradiation, and patients with localized disease
underwent pancreatectomy with EB-IORT. RESULTS: Thirty-five patients
completed chemoradiation; 16 (46%) experienced grade 3 toxicity. Four
patients (11%) required hospitalization for dehydration due to grade 3
nausea and vomiting. Twenty (80%) of 25 patients who underwent surgery
underwent pancreatectomy; EB-IORT was used in 13 patients. There were no
histologic complete responses to preoperative therapy; 21% of specimens
demonstrated more than 50% nonviable cells (grade 2b treatment effect).
With a median follow-up period of 46 months, the 3-year overall survival
rate with chemoradiation and pancreatectomy was 28%. CONCLUSION:
Preoperative paclitaxel-based concurrent chemoradiation is feasible. The
toxicity of this regimen seems greater than that with fluorouracil. The
histologic responses and survival are similar, suggesting no advantages
to paclitaxel-based preoperative treatment.
UI - 11854628
AU - Schramm H; Urban H; Arnold F; Penzlin G; Bosseckert H
Intrasurgical pancreas cytology.
SO - Pancreas 2002 Mar;24(2):210-4
AD - Wald-Klinikum gGmbh, Chirurgisches Zentrum, Departement fur Allgemeine,
Viszerale und Kinderchirurgie, Strasse des Friedens 122, D-07548 Gera,
INTRODUCTION: A differential therapy of chronic pancreatitis and
carcinoma calls for evaluation of the validity of findings. Presurgical
suspicion of a carcinoma often requires intrasurgical diagnostics such
as excisional biopsies, punch biopsies, and fine-needle aspiration
cytology (FNAC) for confirmation. AIMS: To evaluate FNAC as an
intraoperative diagnostic method of very high probability. METHODOLOGY:
Intrasurgical fine-needle aspiration biopsy and cytologic assessment
were carried out in 474 patients. The indications for operative therapy
and FNAC were suspicion of pancreatic tumor, chronic pancreatitis even
without suspicion of tumor, and pathologic alterations found during
other surgeries in the upper abdomen. RESULTS: The level of sensitivity
was 93.1%, specificity was 99.1%, predictive value of positive results
was 99.2% and of negative results was 92.1%. CONCLUSION: FNAC is a
suitable method for intrasurgical confirmation of pancreatic carcinoma.
It can be performed safely, effectively, and rapidly.
UI - 12023152
AU - Murphy MJ; Martin D; Whyte R; Hai J; Ozhasoglu C; Le QT
The effectiveness of breath-holding to stabilize lung and pancreas
tumors during radiosurgery.
SO - Int J Radiat Oncol Biol Phys 2002 Jun 1;53(2):475-82
AD - Department of Radiation Oncology, Stanford University School of
Medicine, Stanford, CA 94305, USA. email@example.com
PURPOSE: To evaluate the effect of breath-holding on the short-term
reproducibility and long-term variability of tumor position during
image-guided radiosurgery. METHOD: Thirteen patients have undergone
single-fraction radiosurgery treatments during which the tumor was
repeatedly imaged radiographically to observe its position. The imaging
data were used to monitor the efficacy of breath-holding and to
periodically readjust the alignment of the treatment beam with the
tumor. These measurements have allowed the effects of breathing,
heartbeat, patient movement, and instrumental uncertainties to be
separately identified in the record of tumor position. RESULTS: During
inspiration breath-holding, the lung tumor position was reproducible to
within 1 mm, on average, in the direction of maximum displacement during
regular breathing, and to within 1.8 mm in three dimensions overall. The
pancreas tumor position in three dimensions was reproducible to within
2.5 mm on average. Some patients showed a slow, steady drift of tumor
position during the extended sequence of breath-holds, which was
compensated by periodic retargeting of the treatment beam. CONCLUSION:
Breath-holding can allow the reduction of tumor motion dosimetry margins
to 2 mm or less for lung cancer treatments, provided that the treatment
system can detect and adapt to long-term variations in the mean tumor
position during a lengthy treatment fraction.
UI - 10787083
AU - Henne-Bruns D; Vogel I; Luttges J; Kloppel G; Kremer B
Surgery for ductal adenocarcinoma of the pancreatic head: staging,
complications, and survival after regional versus extended
SO - World J Surg 2000 May;24(5):595-601; discussion 601-2
AD - Department of General and Thoracic Surgery, University of Kiel, Germany.
The purpose of this study was to evaluate the influence of regional
versus extended lymphadenectomy on survival after partial
72 patients with histologically proven ductal adenocarcinoma of the
pancreatic head were treated. Partial pancreaticoduodenectomy with
regional lymphadenectomy was performed in 26 patients. In 46 patients
lymphadenectomy was expanded to include extended retroperitoneal
lymphatic and connective tissue clearance. Comparing these two groups
and including only patients with R0 resections (n = 58) no significant
differences in long-term survival could be shown. The following
parameters were shown to have a significant or nearly significant
influence on long-term survival: (1) stage of the disease: The 5-year
survival of patients with stage I/II pancreatic head cancer was 63%,
compared to 15% in patients with stage III/IV a + b of the disease (p =
0.0087). (2) Grading: The 1-year survival of patients with well or
moderately differentiated tumors was 55%, compared to 0% for patients
with poorly differentiated ductal adenocarcinoma (p = 0.0022). (3) N
stage: The 5-year survival of patients in N0 stage was 46.9%, compared
with 15% for N1 stage patients. The difference was not quite significant
(p = 0.081). (4) Portal vein involvement: The 1-year survival was 0% in
patients with R0 resections and histologically proven tumor infiltration
of the portal vein, compared to 63% for patients with curative
resections without portal vein involvement (p = 0.0063). In conclusion
our data indicate that extensive retroperitoneal tissue clearance during
pancreaticoduodenectomy for ductal pancreatic cancer does not improve
survival compared to regional lymphadenectomy restricted to the right
side of the mesenteric artery.
UI - 11344412
AU - Pisters PW; Evans DB; Leung DH; Brennan MF
Re: Surgery for ductal adenocarcinoma of the pancreatic head.
SO - World J Surg 2001 Apr;25(4):533-4
UI - 11985973
AU - Sohn TA; Yeo CJ; Cameron JL; Nakeeb A; Lillemoe KD
Renal cell carcinoma metastatic to the pancreas: results of surgical
SO - J Gastrointest Surg 2001 Jul-Aug;5(4):346-51
AD - Department of Surgery, The Johns Hopkins Medical Institutions, 600 N.
Wolfe Street, Baltimore, MD 21287, U.S.A.
Metastatic tumors to the pancreas are uncommon. Renal cell carcinoma is
one of the few tumors known to metastasize to the pancreas. The purpose
of the current report is to evaluate the surgical management and
long-term outcome of patients with metastatic renal cell carcinoma. A
retrospective review of patients undergoing pancreatic resection for
renal cell carcinomas metastatic to the pancreas or periampullary region
initial presentation, other metastatic sites, surgical outcomes, and
long-term survival were evaluated. During the 10-year time period, 10
patients underwent pancreatic resection for renal cell carcinoma
metastases. Of those, six underwent pancreaticoduodenectomy and two
underwent distal pancreatectomy, whereas the two remaining patients
underwent total pancreatectomy for extensive tumor involvement
throughout the entire gland. The mean time from nephrectomy for
resection of the primary tumor to reoperation for periampullary
recurrence was 9.8 years (median 8.5 years). The range was 0 to 28
years, with one patient presenting with a synchronous metastasis. The
mean age of the patients was 61.2 years with 60% of patients being male
and 90% being white. Pathologic findings included histologically
negative lymph nodes and negative surgical margins in all patients. One
patient had tumor involving the retroperitoneal soft tissue, but final
margins were negative. The mean live patient follow-up was 30 months
(median = 15 months), with eight patients remaining alive. The
Kaplan-Meier actuarial 5-year survival was 75%, with the longest
survivor still alive 117 months following resection. The patient with
retroperitoneal soft tissue involvement died 4 months after resection.
The pancreas is an uncommon site of metastasis for renal cell carcinoma,
typically occurring years after treatment of the primary tumor. When the
metastatic focus is isolated and the tumor can be resected in its
entirety, patients can experience excellent 5-year survival rates. The
current report suggests that pancreatic metastases from renal cell
carcinoma should be managed aggressively with complete resection when
UI - 11837003
AU - Kokhanenko NIu; Savrasov VM
[Specific features of pancreatoduodenal resection in cancer of the head
and unciform process of the pancreas]
SO - Vestn Khir Im I I Grek 2001;160(5):66-71
Pancreato-duodenal resections (PDR) were made in 134 patients with
cancer of the pancreas, in 31 (23.1%) of them the tumor was localized in
the unciform process of the pancreas. In 7 patients the destructive
pancreatitis which complicated cancer PDR was completed by the external
drainage of the pancreatic duct. Combined PDR were fulfilled in 14
(10.4%) patients including 9 (29.0%) of 31 patients who had cancer of
the unciform process. In 48 (35.8%) patients PDR was followed by
complications. The most frequent of them were acute pancreatitis of the
stump (32.1%) and incompetent pancreatoenteroanastomosis (18.7%).
Postoperative lethality after PDR was 6.7%. During the recent six years
no lethal outcomes have been observed after 45 PDR. Cancer of the
uniform process of the pancreas is the least favorable localization.
Combined PDR are followed by a great number of intraoperative,
postoperative complications and high lethality rate. If the patients had
mechanical jaundice, the use of double step PDR gave better results. If
there were intraoperative signs of acute pancreatitis it was necessary
to drain the pancreatic duct outside. The using of intraoperative
occlusions of the pancreatic ducts is hardly justified because of a high
risk of the development of acute pancreatitis.
UI - 11992799
AU - Sasson AR; Hoffman JP; Ross EA; Kagan SA; Pingpank JF; Eisenberg BL
En bloc resection for locally advanced cancer of the pancreas: is it
SO - J Gastrointest Surg 2002 Mar-Apr;6(2):147-57; discussion 157-8
AD - Department of Surgical Oncology, Temple University School of Medicine,
Philadelphia, PA 19111, USA.
The benefit of radical surgical resection of contiguously involved
structures for locally advanced pancreatic cancer is unclear. The aim of
this study was to examine patient outcome after extended pancreatic
resection for locally advanced tumors and to determine if any subset of
extended resection affected outcome. We retrospectively reviewed the
records of 116 patients with adenocarcinoma of the pancreas, who
underwent extirpative pancreatic surgery between 1987 and 2000. Of the
116 patients, 37 (32%) required resection of surrounding structures
(group I), and 79 patients (68%) underwent standard pancreatic
resections (group II). In all cases, all macroscopic disease was
excised. In group I a total of 46 contiguously involved structures were
resected: vascular in 25 patients (54%), mesocolon in 16 (35%) (colic
vessels in 3, colon in 13), adrenal in three (7%), liver in one (2%),
stomach in one (2%) (for a tumor in the tail of the pancreas), and
multiple structures in four. Excision of regional blood vessels included
the superior mesenteric vein and/or portal vein in 16, hepatic artery in
five, and celiac axis in four. No differences between groups I and II
were detected for any of the following parameters: age, sex, history of
previous operation, estimated blood loss, or hospital stay. For the
entire cohort the morbidity and mortality were 38% and 1.7%,
respectively, and these rates were similar in the two groups. Adjuvant
therapy was administered to more than 90% of patients in both groups.
However, patients in group I were more likely to have received
neoadjuvant therapy (76% vs. 42%, P = 0.001). Total pancreatectomy and
distal pancreatectomy were more often performed in group I (P = 0.005).
Additionally, the median operative time was longer (8.5 hours compared
to 6.9 hours (P = 0.0004)). Both groups had similar rates of
microscopically positive margins and involved lymph nodes, as well as
total number of lymph nodes removed. The median survival was 26 months
for patients in group I and 16 months for patients in group II (P =
0.08). The median disease-free survival for groups I and II was 16
months and 14 months, respectively (P = 0.88). In comparing patients in
group I, who underwent vascular resection vs. mesocolon (colon or middle
colic vessels) resection, the median survival was 26 months and 19
months, respectively (P = 0.12). We were unable to detect a difference
in outcome for patients with locally advanced cancers requiring extended
pancreatic resections compared to patients with standard resections. En
bloc resection of involved surrounding structures, to completely
extirpate all macroscopic disease, may be of benefit in selected
patients with locally advanced disease, particularly when combined with
preoperative chemoradiation therapy.
UI - 12017272
AU - Yoshida Y; Tomizawa M; Bahar R; Miyauchi M; Yamaguchi T; Saisho H;
Kadomatsu K; Muramatsu T; Matsubara S; Sakiyama S; Tagawa M
A promoter region of midkine gene can activate transcription of an
exogenous suicide gene in human pancreatic cancer.
SO - Anticancer Res 2002 Jan-Feb;22(1A):117-20
AD - Division of Pathology, Chiba Cancer Center Research Institute, Japan.
We examined a possible application of regulatory regions of the midkine
(MK) gene for suicide gene therapy of pancreatic cancer. The expression
of MK has been demonstrated in human pancreatic cancer tissues but
scarcely in normal adult tissues. Northern blot analysis confirmed that
human pancreatic cancer cell lines expressed the MK gene. A 609-bp
genomic fragment in the 5'-regulatory region of the MK gene, when
transfected into human pancreatic cancer cells, activated the
transcription of a fused reporter gene to an extent greater than the
SV40 promoter. In contrast, the 609-bp fragment-mediated promoter
activity tested in fibroblast cells was significantly weak. Human
pancreatic cancer cells (AsPC-1) that were transduced with the herpes
simplex virus-thymidine kinase gene linked with the 609-bp promoter
markedly increased their sensitivity to a prodrug, ganciclovir, compared
with untransduced cells. The present study suggests that preferential
cytotoxic effects for pancreatic tumors can be achieved by using the MK
UI - 12017337
AU - Anderson KM; Alrefai WA; Anderson CA; Ho Y; Jadko S; Ou D; Wu YB; Harris
A response of Panc-1 cells to cis-platinum, assessed with a cDNA array.
SO - Anticancer Res 2002 Jan-Feb;22(1A):75-81
AD - Department of Medicine, Rush Medical College, Chicago, IL 60612, USA.
BACKGROUND: The problem posed by the lack of response of cells in most
solid cancers to current chemotherapy generally remains intractable.
MATERIALS AND METHODS: The use of cDNA arrays represents one global
approach to identifying reasons for this failure. A messenger RNA
response of pancreatic cancer (Panc-1) cells after culture for 24 hours
with 12 microM cis-platinum was analyzed with a commercial cDNA array.
RESULTS: Major drug-induced events included inhibition of messenger RNAs
associated with cell proliferation and up-regulation of generally
countervailing DNA repair, cellular stress, heat shock protein,
glutathione stress-related and multiple drug resistance enzyme messenger
RNAs, accompanied by a limited programmed cell death response.
CONCLUSION: Induction of widespread normal stress-induced countervailing
mRNAs by comparatively non-selective agents such as cis-platinum
strongly biases against a successful therapeutic outcome. This
paradoxical result of a therapeutic intent provides a further compelling
argument for the use of specifically-targeted therapy such as growth
factor receptor, tyrosine kinase and other discretely focused agents,
probably employed in combinations based on expression of their targets
in an individual patient's cancer, as identified by cDNA or proteonomic
UI - 11813575
AU - Abdel-Wahab M; Sultan A; elGwalby N; Fathy O; AboElenen A; Zied MA;
Fouad A; Allah TA; el-Ebiedy G; Gad-ElHak N; Elfiky A; Ezzat F
Modified pancreaticoduodenectomy: experience with 81 cases, Wahab
SO - Hepatogastroenterology 2001 Nov-Dec;48(42):1572-6
AD - Gastroenterology Center, Mansoura University, Mansoura, Egypt.
BACKGROUND/AIMS: Now pancreaticoduodenectomy is considered a safe and
acceptable line of treatment for periampullary tumors. In spite of
improvements in the surgical technique it still has a high morbidity
rate. In this study we introduce new technical modifications for the
original procedure aiming to decrease the incidence of morbidity.
METHODOLOGY: Between 1994-2000, 210 pancreaticoduodenectomies were done
in the Gastroenterology Center, Mansoura University, Egypt for
periampullary tumor. Eighty-one of these patients were subjected to
modified pancreaticoduodenectomy. They were 57 men and 34 women with a
mean age of 54 (+/- 8) years. Pancreatic carcinoma represented 54%,
ampullary tumor 30%, bile duct carcinoma 5% and duodenal carcinoma 1.2%.
The mean operative time was 3.7 +/- 0.5 hours and mean estimated blood
loss during surgery was 733 +/- 48 mL. RESULTS: Hospital mortality
occurred in 3.7% with an overall morbidity rate of 32%. The most common
complications were delayed gastric emptying 8.9%, pancreatic fistulae
3.8%, wound infection 6.4%, biliary leakage 3.8% and bleeding 5%. The
mean postoperative hospital stay was 9.4 +/- 1 days, with mean time for
starting oral feeding 6 +/- 0.9 days. Late mortality occurred in 46% for
the entire group with mean follow-up 22 +/- 19 months with actuarial
survival for 1, 2, 3, 4, and 5 years being 80, 45, 25, 15, and 10%,
respectively. CONCLUSIONS: It was found that this new modification made
the operation easier with shorter operative time, less blood
transfusion, low incidence of morbidity and short hospital stay.
Moreover, it takes the advantages of lowering the incidence of biliary
gastritis, cholangitis and peptic ulcer.
UI - 11813619
AU - Kedra B; Popiela T; Sierzega M; Precht A
Prognostic factors of long-term survival after resective procedures for
SO - Hepatogastroenterology 2001 Nov-Dec;48(42):1762-6
AD - Ist Department of General and GI Surgery, Jagiellonian University, Ul.
Kopernika 40, 31-501 Krakow, Poland.
BACKGROUND/AIMS: Five-year survival rates following surgical resection
of pancreatic cancer reported by the leading medical centers do not
exceed 25%. It necessitates further extensive research in this area. The
aim of the study was to determine prognostic factors of long-term
survival after surgical treatment for pancreatic cancer. METHODOLOGY:
From 1980 to 1999, 212 patients underwent surgical resection for
pancreatic carcinoma. Statistical analysis of prognostic factors of
long-term survival after pancreatic cancer surgery estimated by
Kaplan-Meier method was carried out using multiple regression model.
RESULTS: A group of 212 patients underwent surgery, where 98 had
Whipple's resection, 50 Traverso, 35 total pancreatic resections, 25
left subtotal resections, and the remaining 4 segmental pancreatic body
resections. Perioperative mortality was below 8%, 5-year survival
approximately 15%, increasing to 65% in patients with early cancer. It
was observed, that the following prognostic factors influenced the
long-term survival rate: tumor size, localization, histopathologic type,
and metastases to lymph nodes. The type and extent of surgery was of
significance in the case of small neoplasms. CONCLUSIONS: Based on the
analysis carried out, the authors conclude that the main prognostic
factors for long-term survival after pancreatic cancer surgery are
related to the tumor itself and show associations with the natural
UI - 12014658
AU - Mohiuddin M; Chendil D; Dey S; Alcock RA; Regine W; Mohiuddin M; Ahmed
Influence of p53 status on radiation and 5-flourouracil synergy in
pancreatic cancer cells.
SO - Anticancer Res 2002 Mar-Apr;22(2A):825-30
AD - Department of Radiation Medicine, University of Kentucky Medical Center,
Lexington 40536-0293, USA.
BACKGROUND: While p53 protein plays an important role in the regulation
of radiosensitivity and chemosensitivity in many tumors, the role of p53
in the combined management of tumors that harbor mutations in the p53
gene have not been fully defined. This study was undertaken to evaluate
the impact of wild-type or mutant p53 status on the synergistic effects
of 5-Fluorouracil (5-FU) and radiation (XRT) in pancreatic tumors.
MATERIALS AND METHODS: Three pancreatic tumor cell lines, one containing
wild-type functional p53 (Capan-2) and two containing mutant p53 (Panc-1
and MIA PaCa-2), were used in this study. Radiation-induced p53 and
p21(waf1/cip1) protein expression was determined by Western blot
analysis. Radiation induced Thymidylate Synthase (TS) mRNA expression
was determined by 32P-RT-PCR. The effect of 5-FU, radiation, and
radiation +5-FU on the growth and colony-forming ability of Capan-2,
Panc-1 and MIA PaCa-2 was determined by clonogenic assays respectively.
RESULTS: Radiation elevated p53 and p21(waf1/cip1) levels in Capan-2
cells. No elevation of p53 and p21(waf1/cip1) was evident in Panc-1. MIA
PaCa-2 cells showed down-regulation of p21(waf1/cip1) with no elevation
of p53 protein. Clonogenic assays showed enhanced radiosensitizing
effect when 5-Fluorouracil was added to cell lines lacking functional
p53. In wild-type p53 Capan-2 cells, radiation up-regulated TS mRNA
levels. High basal levels of TS mRNA were detected in p53 mutant cell
lines with no evident induction by radiation. CONCLUSION: Our results
confirm that p53 status has a significant impact on radiation
sensitivity with wild-type p53 cells being significantly more
radiosensitive than mutant cell lines. When XRT and 5-FU were combined,
this led only to an additive effect in wild-type cell lines and a
synergistic effect in mutant cell lines.
UI - 12067219
AU - Chu QD; Al-kasspooles MF; Smith JL; Nava HR; Douglass HO Jr; Driscoll D;
Is glucagonoma of the pancreas a curable disease?
SO - Int J Pancreatol 2001;29(3):155-62
AD - Department of Surgical Oncology, Roswell Park Cancer Institute, State
University of New York at Buffalo, 14263-0001, USA.
BACKGROUND: Glucagonomas are rare neuroendocrine tumors of the pancreas.
Because of its rarity, its natural history is not well understood. AIM:
We evaluated the natural history of glucagonomas treated at a tertiary
care cancer center. METHODS: A retrospective analysis of 12 patients
during 1970 to 2000 was performed. Six patients (50%) had a tumor
located in the head of the pancreas. RESULTS: Abdominal pain (83%) and
weight loss (75%) were the most common symptoms. Median tumor size was 6
cm (range 0.04-10). Seven patients (58%) had liver metastases. Five
patients (42%) underwent curative resection. Overall median survival was
66 mo, and 5-yr overall survival was 66%. Five-yr overall survival was
83% for patients who had resection versus 50% for the non-resected
patients (p = 0.04). Patients who were disease-free had a complete
resection of the primary tumor and no liver involvement. CONCLUSIONS:
Glucagonomas generally present with liver metastases at the time of
diagnosis. Cure is only possible if the disease is localized and
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