Objective: To evaluate the feasibility and safety of total mesopancreas excision (TMpE) in the treatment of pancreatic head cancer. Methods: The clinical and pathological data of 120 patients with pancreatic head ...Objective: To evaluate the feasibility and safety of total mesopancreas excision (TMpE) in the treatment of pancreatic head cancer. Methods: The clinical and pathological data of 120 patients with pancreatic head cancer who had undergone TMpE in our center from May 2010 to January 2014 were retrospectively analyzed. Results: The mean operative time was (275.0±50.2) min and the average intra-operative blood loss was (390.0±160.5) mL. Post-operative complications were reported in 45 patients, while no peri-operative death was noted. The specimen margins were measured in three dimensions, and 86 patients (71.6%) achieved R0 resection. Conclusions: TMpE is safe and feasible for pancreatic head cancer and is particularly helpful to increase the R0 resection rate.展开更多
Background:Hepatopancreatoduodenectomy(HPD)has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers(GBCs).However,HPD has not yet been included in...Background:Hepatopancreatoduodenectomy(HPD)has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers(GBCs).However,HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates.The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies.Methods:The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved.A case-control analysis was conducted at our department.Patients with advanced GBC who underwent HPD(HPD-GBC group)were compared with a control group(None-HPD-GBC group).Baseline characteristics,preoperative treatments,tumor pathologic features,operative results,and prognosis were assessed.Results:Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department.Significant postoperative complications(grade III or greater)and postoperative pancreatic fistula were observed in 24(42.1%)and 15(26.3%)patients,respectively.One postoperative death occurred in the present study.Overall survival(OS)was longer in patients with advanced cholangiocarcinoma than in those with GBC(median survival time[MST],31 months vs.11 months;P<0.001).In the subgroup analysis of patients with advanced GBC,multivariate analysis demonstrated that T4 stage tumors(P=0.012),N2 tumors(P=0.001),and positive margin status(P=0.004)were independently associated with poorer OS.Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors(P<0.001).Conclusion:HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced highvolume center.For patients with advanced GBC without an N2 or T4 tumor,HPD can be a preferable treatment option.展开更多
Dear Editor,Gallbladder cancer(GBC),the most common malignant tumor of the biliary tract,is a highly invasive form of cancer.Surgical resection is currently the first line approach to effectively treat GBC;however,ver...Dear Editor,Gallbladder cancer(GBC),the most common malignant tumor of the biliary tract,is a highly invasive form of cancer.Surgical resection is currently the first line approach to effectively treat GBC;however,very few patients have the opportunity to receive radical surgical treatment due to lack of obvious symptoms.1 The median survival of patients with GBC is only 12 months and 5-year survival rate is<5%,indicating GBC is extremely poor prognosis.Therefore,it is urgent to identify novel key molecules that can potentially serve as early diagnostic biomarkers and/or therapeutic targets.The current study focused on the potential role of bone morphogenetic protein 2 inducible kinase(BMP2K),a serine/threonine kinase,which was recently identified as clathrin-coated vesicle-associated protein in the development of GBC;the outcome may hold diagnostic and therapeutic promising for clinical practice.展开更多
基金Supported by Shanghai municipal hospital burgeoning and leading edge technology projects No.SHDC12014109
文摘Objective: To evaluate the feasibility and safety of total mesopancreas excision (TMpE) in the treatment of pancreatic head cancer. Methods: The clinical and pathological data of 120 patients with pancreatic head cancer who had undergone TMpE in our center from May 2010 to January 2014 were retrospectively analyzed. Results: The mean operative time was (275.0±50.2) min and the average intra-operative blood loss was (390.0±160.5) mL. Post-operative complications were reported in 45 patients, while no peri-operative death was noted. The specimen margins were measured in three dimensions, and 86 patients (71.6%) achieved R0 resection. Conclusions: TMpE is safe and feasible for pancreatic head cancer and is particularly helpful to increase the R0 resection rate.
基金the Shanghai Key Laboratory of Biliary Tract Disease Research Foundation(No.17DZ2260200)the National Natural Science Foundation of China(Nos.81502433,81773043,91440203,81702315)+3 种基金the Clinical research program of Xinhua Hospital(No.19XHCR3D)the Multi-center clinical research project of Shanghai Jiaotong University School of Medicine(No.DLY201507)the Project of Excellent Young Scholars from Shanghai Municipal Health and Family Planning Commission(No.2018YQ10)the Talent Development Fund from Shanghai Municipal Human Resources and Social Security Bureau(No.2018048).
文摘Background:Hepatopancreatoduodenectomy(HPD)has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers(GBCs).However,HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates.The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies.Methods:The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved.A case-control analysis was conducted at our department.Patients with advanced GBC who underwent HPD(HPD-GBC group)were compared with a control group(None-HPD-GBC group).Baseline characteristics,preoperative treatments,tumor pathologic features,operative results,and prognosis were assessed.Results:Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department.Significant postoperative complications(grade III or greater)and postoperative pancreatic fistula were observed in 24(42.1%)and 15(26.3%)patients,respectively.One postoperative death occurred in the present study.Overall survival(OS)was longer in patients with advanced cholangiocarcinoma than in those with GBC(median survival time[MST],31 months vs.11 months;P<0.001).In the subgroup analysis of patients with advanced GBC,multivariate analysis demonstrated that T4 stage tumors(P=0.012),N2 tumors(P=0.001),and positive margin status(P=0.004)were independently associated with poorer OS.Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors(P<0.001).Conclusion:HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced highvolume center.For patients with advanced GBC without an N2 or T4 tumor,HPD can be a preferable treatment option.
基金supported by Shanghai Key Laboratory of Biliary Tract Disease Research Foundation(17DZ2260200)the National Natural Science Foundation of China(Nos.81572819,91940305,81773043,91440203,81702315)+4 种基金the Peak Plateau Discipline Construction Project of Shanghai Jiao Tong University School of medicine(No.20181808)the development fund for Shanghai talents(No.201608)Shanghai Sailing Program(17YF1411700)the Program of Shanghai Academic Research Leader(No.19XD1422700)the Precision Medicine Research Program of Shanghai Jiao Tong University School of Medicine(Nos.15ZH4003,DKY201507)。
文摘Dear Editor,Gallbladder cancer(GBC),the most common malignant tumor of the biliary tract,is a highly invasive form of cancer.Surgical resection is currently the first line approach to effectively treat GBC;however,very few patients have the opportunity to receive radical surgical treatment due to lack of obvious symptoms.1 The median survival of patients with GBC is only 12 months and 5-year survival rate is<5%,indicating GBC is extremely poor prognosis.Therefore,it is urgent to identify novel key molecules that can potentially serve as early diagnostic biomarkers and/or therapeutic targets.The current study focused on the potential role of bone morphogenetic protein 2 inducible kinase(BMP2K),a serine/threonine kinase,which was recently identified as clathrin-coated vesicle-associated protein in the development of GBC;the outcome may hold diagnostic and therapeutic promising for clinical practice.
基金supported by the National Natural Science Foundation of China(2019XH004,81874181,82073206,21705108,and 81773043)the Emerging Frontier Program of Hospital Development Centre(SHDC12018107)+4 种基金the Key Program of Shanghai Science and Technology Commission(YDZX20193100004049)the State Key Laboratory of Oncogenes and Related Genes(KF2120)the National Key Research and Development Program of China(2021YFE0203300)the Shuguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission(20SG14)he Program of Shanghai Academic Research Leader(19XD1422700)。