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Publications (115)
Background:
The aim was to compare population-based survival for exocrine pancreatic cancer in England in the 23 regions covered by specialist centres. The centres were initiated in 2001, covering populations of 2-4 million.
Methods:
We examined incidence for adults diagnosed with a pancreatic exocrine cancer during 1995-2014 and age-standardise...
Background:
Prognostic prediction had been widely used in various cancer entities, from early screening to end-stage patient caring. Currently, there is hardly any well-validated nomogram which exists for long-term survival prediction in pancreatic adenocarcinoma (PC) patients in a post-surgery setting. Our objectives are to identify possible prog...
Background:
Despite improvements in multidisciplinary management, patients with biliary tract cancer have a poor outcome. Only 20% of patients are eligible for surgical resection with curative intent, with 5-year overall survival of less than 10% for all patients. To our knowledge, no studies have described a benefit of adjuvant therapy. We aimed...
Background & aims:
Changes to the microenvironment of pancreatic ductal adenocarcinomas (PDACs) have been associated with poor outcomes of patients. We studied the associations between composition of the pancreatic stroma (fibrogenic, inert, dormant, or fibrolytic stroma) and infiltration by inflammatory cells and times of progression-free surviva...
In organizing the second edition of this renowned Handbook, Dr. Neoptolemos and his co-editors have produced and updated a revised edition to the distinguished Major Reference Work devoted to pancreatic cancer. Like its preceding edition, the second edition continues to have a widespread appeal among clinicians, pathologists and basic scientists, w...
Background:
Deoxycytidylate deaminase (DCTD) and ribonucleotide reductase subunit M1 (RRM1) are potential prognostic and predictive biomarkers for pyrimidine-based chemotherapy in pancreatic adenocarcinoma.
Methods:
Immunohistochemical staining of DCTD and RRM1 was performed on tissue microarrays representing tumour samples from 303 patients in...
Background:
Dihydropyrimidine dehydrogenase (DPD) tumour expression may provide added value to human equilibrative nucleoside transporter-1 (hENT1) tumour expression in predicting survival following pyrimidine-based adjuvant chemotherapy.
Methods:
DPD and hENT1 immunohistochemistry and scoring was completed on tumour cores from 238 patients with...
Background
Pancreatic cancer diagnosis and staging can be difficult in 10–20% of patients. Positron emission tomography (PET)/computed tomography (CT) adds precise anatomical localisation to functional data. The use of PET/CT may add further value to the diagnosis and staging of pancreatic cancer.
Objective
To determine the incremental diagnostic...
Background:
Human equilibrative nucleoside transporters (hENTs) are transmembranous proteins that facilitate the uptake of nucleosides and nucleoside analogues, such as gemcitabine, into the cell. The abundance of hENT1 transporters in resected pancreatic ductal adenocarcinoma (PDAC) might make hENT1 a potential biomarker of response to adjuvant c...
Pancreatic ductal adenocarcinoma (PDAC) is characterized by very early metastasis, suggesting the hypothesis that metastasis-associated changes may occur prior to actual tumor formation. In this study, we identified miR-192 as an epigenetically regulated suppressor gene with predictive value in this disease. miR-192 was downregulated by promoter me...
Pancreatic Cancer, Cystic Neoplasms and Endocrine Tumors: Diagnosis and Management is a modern, expertly crafted and clinically focused guide to the diagnosis, management and best-practice care of patients suffering from pancreatic cancer, cystic neoplasms and endocrine tumours. Packed with outstanding figures and with reference to the leading soci...
Exocrine pancreatic cancer accounts for almost a quarter of a million deaths worldwide each year with approximately one third arising in Europe [1, 2]. Despite being only the thirteenth most common malignancy worldwide, it is the eighth most frequent cause of cancer mortality [2]. The singularly aggressive nature of this disease is further underlin...
LBA4006 Background: The effect of adjuvant treatment on overall survival (OS) of resected ampullary adenocarcinoma is not known. The aim was to compare the survival effect of adjuvant chemotherapy compared to observation (OBS) after resection and within the chemotherapy group to compare 5-fluorouracil/folinic acid (5-FU/FA) against gemcitabine (GEM...
LBA4006
Background: The effect of adjuvant treatment on overall survival (OS) of resected ampullary adenocarcinoma is not known. The aim was to compare the survival effect of adjuvant chemotherapy compared to observation (OBS) after resection and within the chemotherapy group to compare 5-fluorouracil/folinic acid (5-FU/FA) against gemcitabine (GEM...
The prognosis of patients diagnosed with ductal adenocarcinoma of the pancreas remains poor. Within the multidisciplinary management of this disease surgeons play an integral role, as surgical resection provides the only chance for cure. Within the past two decades substantial advances have been made in the fields of diagnostic imaging, surgical te...
IntroductionDoes familial pancreatic cancer exist?Recognizing familial pancreatic cancerAssessing risk for individuals within familiesBenefits of primary screeningReferences
IntroductionAgeGenderDemography and raceReligionSocioeconomic factorsGenetic risk factorsChronic pancreatitisDiabetes mellitusPrevious gastric surgeryGallstones and previous cholecystectomyPrimary sclerosing cholangitisObesityDietary and nutritional factorsTobacco smoking and useOccupation and chemical exposureHelicobacter pylori seropositivityAspi...
The encyclopedic guide to the pancreas for practicing clinicians and surgeons In the past decade extraordinary developments in diagnostic and therapeutic radiology and endoscopy have been coupled with major advances in surgical techniques and basic sciences. As a result the management of pancreatic disorders is now handled by a multidisciplinary te...
22056 Background: Cytokeratin 18 (CK18) is a cytoskeletal protein expressed in epithelial cells but not haematopoietic cells. As epithelial cells die they shed CK18 into the periphery where it has clinical potential as a serological biomarker of carcinoma cell death. The M30 ELISA measures caspase-cleaved CK18 and the M65 ELISA detects both full le...
During 2002 the International Association of Pancreatology developed evidenced-based guidelines on the surgical management of acute pancreatitis. There were 11 guidelines, 10 of which were recommendations grade B and one (the second) grade A. (1) Mild acute pancreatitis is not an indication for pancreatic surgery. (2) The use of prophylactic broad-...
In view of the increasing reports of restrictions placed on the publication of scientific data from industry-sponsored clinical trials, the subscribing group of editors of surgical journals adopted a policy for publication ethics. This policy will be included in the next publication of the 'Uniform Requirements for Manuscripts Submitted to Biomedic...
Hereditary pancreatitis is an autosomal-dominant disorder with incomplete penetrance, characterised by recurrent bouts of severe pain which usually begin in childhood. It is currently thought to represent less than 1% of cases of chronic pancreatitis, but recent studies suggest that it is frequently underdiagnosed. We report a British kindred with...
Background: The role of adjuvant measurement for pancreatic cancer is uncertain. The Gastrointestinal Tumour Study Group (GITSG) showed that the survival in 21 patients randomised to radiochemotherapy (40 Gy with 5-fluorouracil - 5FU) followed by two years weekly 5FU was doubled at two years compared to the 22 patients with resection alone (43% vs...
There are conflicting reports concerning the benefits of early endoscopic retrograde cholangiography (ERCP) with endoscopic sphincterotomy (ES) in patients with acute gallstone pancreatitis (AGP). The issue of whether or not to perform early ERCP ± ES is of clinical importance because AGP is associated with significant morbidity and mortality. Aim:...
Over the last 10 years important advances have been made in the treatment of patients with advanced colorectal cancer, particularly with surgery either alone or in combination with radiotherapy. Furthermore, despite early scepticism, several chemotherapy studies have now reported significant clinical benefits with 5-FU-based regimens and promising...
In patients with chronic pancreatitis, surgical treatment is required when conservative approaches are unsuccessful in treating symptoms and complications of the disease. The indications for surgery are 1) recurrent abdominal pain which does not respond to analgesics and 2) duodenal, common bile duct and/or main pancreatic duct obstruction or steno...
The majority of bile duct stones in Western patients originate in the gallbladder. Many patients with bile duct stones are asymptomatic. However, the acute complications of bile duct calculi—jaundice, cholangitis, and pancreatitis— may present in isolation or in combination with each other. Successful treatment of cholangitis and severe biliary pan...
Biliary sludge was first described with the advent of ultrasonography in the 1970s. It is defined as a mixture of particulate matter and bile that occurs when solutes in bile precipitate. Its composition varies, but cholesterol monohydrate crystals, calcium bilirubinate, and other calcium salts are the most common components. The clinical course of...
Technological innovations in the past decade suggest that their systemic utilisation in acute biliary pancreatitis may have a significant impact on diagnosis and treatment. Urgent severity assessment resulting in the use of ERCP in patients with probable gallstones is essential since early endoscopic sphincterotomy may reduce morbidity and mortalit...
The development of acute pancreatitis occurs in 4-8% of patients with symptomatic gallstones. Individuals predisposed to acute pancreatitis tend to have small gallstones (with or without larger gallstones), a wide cystic duct and a common channel between the biliary and pancreatic ducts. The importance of this relationship is demonstrated by the ab...
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