Current topics regarding the treatment of pancreas
- VernacularTitle:Нойр булчирхайн сувгийн булчирхайлаг өмөнгийн
- Author:
Tomohiko Adachi
;
Tamotsu Kuroki
;
Amane Kitasato
;
Akihiko Soyama
;
Masaaki Hidaka
;
Mitsuhisa Takatsuki
;
Susumu Eguchi
- Collective Name:Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences,Nagasaki, Japan
- Publication Type:journal article
- From:Innovation
2014;8(4):98-99
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Pancreas ductal adenocarcinoma (PDAC) remains the most
malignant digestive disease, but several treatment strategies for PDAC have been
developed. Here we describe some current topics regarding the treatment of
PDACs in Nagasaki, Japan.
1: Prevention of pancreas fistula (PF) after pancreas resection
Adjuvant chemotherapy for PDAC was demonstrated to be useful to prolong
patients’ survival after the resection of PDAC. To introduce adjuvant chemotherapy
for PDAC quickly, it is important to prevent the development of a PF after
pancreas resection. We evaluated the safety and efficacy of early drain removal
on postoperative day 1 after distal pancreatectomy (DP; n=71), and we found that
early drain removal was safe and effective for preventing grade B/C PFs (0% vs.
late removal 16%; p<0.001).
2: Laparoscopic surgery for PDAC
Laparoscopic distal pancreatectomy (Lap-DP) for low-grade malignant tumors at
the left side of the pancreas has been recognized to be safe and feasible, and a
few studies have already obtained similar findings for PDAC compared to open
DP. We have been performing the Lap-DP for PDACs without invasion beyond
the pancreas, and the modified radical antegrade modular pancreatosplenectomy
(mRAMPS) is conducted at our institute. The plexus around the celiac artery or
superior mesenteric artery is dissected to a limited extent. Histologically, all of our
PDAC patients who underwent a Lap-DP (n=5) achieved an R0 resection.
3: Dendritic cell-based therapeutic vaccination for PDAC
The treatment of unresectable or recurrent PDAC is not promising. We started
administering a dendritic cell-based therapeutic vaccination in such cases along
with the use of the anticancer drugs gemcitabine and/or S-1. A total of eight
patients received this therapy, and it seemed that the patients with recurrence
after resection and those who had strong delayed-type hypersensitivity around
the injected lesion had a favorable prognosis, although the results were obtained
with a small number of patients.
Conclusions:
Our recent treatments for PDAC are feasible and useful. It is important to develop
various ways to prolong the survival of PDAC patients.
