Title | When, What, and Why of Perioperative Treatment of Potentially Curable Pancreatic Adenocarcinoma. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Perez K, Clancy TE, Mancias JD, Rosenthal MH, Wolpin BM |
Journal | J Clin Oncol |
Volume | 35 |
Issue | 5 |
Pagination | 485-489 |
Date Published | 2017 Feb 10 |
ISSN | 1527-7755 |
Keywords | Adenocarcinoma, Antineoplastic Combined Chemotherapy Protocols, Female, Fluorouracil, Humans, Leucovorin, Middle Aged, Organoplatinum Compounds, Pancreatic Neoplasms, Practice Guidelines as Topic, Preoperative Period, Review Literature as Topic |
Abstract | The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 64-year-old woman with a history of hypertension and type 2 diabetes had been in her usual state of health until she developed symptoms of diarrhea, abdominal bloating, and discomfort in the midepigastrium. Evaluation with a contrast-enhanced abdominopelvic computed tomography (CT) scan demonstrated a mass in the pancreatic body that was approximately 3.1 cm × 2 cm × 2.1 cm in size with abutment of the portal vein-superior mesenteric vein confluence for less than 180°. The confluence was narrowed but without thrombosis. No tumor-vessel interface was noted at the superior mesenteric artery, celiac artery, or common hepatic artery. Several peripancreatic lymph nodes were observed that measured up to 11 mm × 5 mm. No evidence for distant spread of disease was identified. An upper endoscopy with endoscopic ultrasound was performed and fine-needle aspirates of the pancreas mass were positive for malignant cells that were consistent with adenocarcinoma. Chest CT scan without intravenous contrast demonstrated no evidence of metastatic disease. The patient came to the clinic to discuss management of her newly diagnosed malignancy. |
DOI | 10.1200/JCO.2016.70.2134 |
Alternate Journal | J. Clin. Oncol. |
PubMed ID | 28029328 |
PubMed Central ID | PMC5455317 |
Grant List | KL2 TR001100 / TR / NCATS NIH HHS / United States P50 CA127003 / CA / NCI NIH HHS / United States U01 CA210171 / CA / NCI NIH HHS / United States |
Submitted by kej2006 on June 6, 2018 - 4:11pm