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Objective To investigate the risk factors for early recurrence of resectable pancreatic cancer and the establishment and application of a grading system. Methods A retrospective case-control study was conducted among 303 patients with resectable pancreatic cancer who underwent radical resection in Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, from March 2015 to June 2021, and according to the presence or absence of early recurrence (within 6 months after surgery), the 283 patients directly operated on were divided into early recurrence group with 95 patients and non-early recurrence group with 188 patients; 20 patients who received neoadjuvant therapy before surgery were enrolled as neoadjuvant therapy group. Observation indicators included general information, preoperative imaging data, preoperative laboratory data, routine blood test/blood biochemistry and derived indicators, tumor markers, and coagulation markers, and follow-up was conducted to observe recurrence-free survival. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A multivariate Logistic regression analysis was used to investigate the risk factors for early recurrence in patients with pancreatic cancer, and the receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of each indicator. The Kaplan-Meier curve was plotted, and the Log-rank test was used for comparison of recurrence-free survival time between groups. Results The univariate analysis showed that compared with the non-early recurrence group, the early recurrence group had significantly lower body mass index (BMI) and triglyceride and significantly higher CA19-9, CA242, CA125, and plasma fibrinogen (all P < 0.05). The multivariate logistic regression analysis showed that BMI (odds ratio [OR]=1.150, 95% confidence interval [CI]: 1.038-1.273, P=0.007), plasma fibrinogen (OR=2.513, 95%CI: 1.355-4.663, P=0.003), and CA242 (OR=2.482, 95%CI: 1.067-5.774, P=0.035) were independent risk factors for early recurrence in patients with resectable pancreatic cancer. BMI, CA242, and plasma fibrinogen were included in the grading system, with a cut-off value of 23.00 kg/m², 30.0 U/mL, and 4.00 g/L, respectively. BMI < 23.00 kg/m² was counted as 1 point, otherwise it was counted as 0 point; CA242≥30.00 U/mL was counted as 1 point, otherwise it was counted as 0 point; plasma fibrinogen ≥4.00 g/L was counted as 1 point, otherwise it was counted as 0 point; the total score was 0-3 points. The patients in both the early recurrence group and the non-early recurrence group were scored, and the results showed that the early recurrence group had a significantly higher score than the non-early recurrence group [2(0-3) points vs 1(0-3) point, Z=-5.339, P < 0.001]. The Kaplan-Meier curve analysis showed that there was a significant difference in time to recurrence between groups (χ²=28.116, P < 0.001), and the higher the score, the shorter the expected time to recurrence. The patients with 3 points were defined as high-risk group and those with 0-2 points were defined as low-risk group, and the early recurrence rate was 84.6% in the high-risk group and 31.2% in the low-risk group. Conclusion The grading system based on BMI, plasma fibrinogen, and CA242 can reliably predict postoperative recurrence. [ABSTRACT FROM AUTHOR]

Pancreatic cancer is known as the " king of cancer". The incidence and mortality of pancreatic cancer are increasing year by year worldwide. The prognosis of pancreatic cancer is very poor, and the effect of existing diagnosis and treatment methods is limited. The Oncologist Branch of the Chinese Medical Doctor Association, the Pancreatic Disease Special Committee of the China International Exchange and Promotive Association for Medical and Health Care, and the Abdominal Tumor Special Committee of the China Medical Education Association convened relevant experts to put forward useful suggestions for clinical reference on nine aspects of home management of patients with pancreatic cancer, including condition communication, follow-up, nutritional support, cancer pain management, psychological adjustment, ascites management, jaundice management, and daily food management. The aim is to improve the quality of life and prolong the survival time of patients with pancreatic cancer. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Oncology is the property of Chinese Journal of Oncology / Zhonghua Zhongliu Zazhi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pancreatic cancer, with the characteristics of insidious onset, easy metastasis, chemotherapy resistance and poor prognosis, is a common malignant tumor of the digestive system. Early diagnosis and treatment of pancreatic cancer is one of the major problems in modern medicine, and there is an urgent need to find new diagnostic, prognostic biomarkers and therapeutic targets. MicroRNA (miRNA) is a small non-coding RNA which can regulate the expression of various genes. miRNAs have wide abnormal expressions in pancreatic cancer, and are closely related to the occurrence and development of pancreatic cancer. Thereby, miRNAs have the potential to become new diagnostic, prognostic and predictive biomarkers and therapeutic targets of pancreatic cancer. Many studies have initially shown that miRNAs have the application value in the diagnosis, treatment and prognosis evaluation of pancreatic cancer, but there are still some difficulties in the practical application and promotion. The mechanisms of miRNAs in pancreatic cancer remain to be further studied. [ABSTRACT FROM AUTHOR]

The current situation of pancreatic cancer is that the etiology is not clear and prevention is impossible. The sensitivity and specificity of the auxiliary detection methods are low,and early diagnosis is a worldwide problem. The efficacy of existing treatment methods is not satisfactory,and it is difficult to break through in a short time. The overall 5-year survival rate is only 7. 2%. In the face of the current situation of pancreatic cancer,the solution to the key problems is to strengthen basic research,explore its etiology and pathogenesis,remove the cause,cut off the path of occurrence and development,which is the only correct way to overcome pancreatic cancer. It is an important way to significantly improve the efficacy by developing peripheral blood,urine detection technology with high sensitivity and specificity,imaging diagnosis technology,and improving the early diagnosis rate. However,the research on basic and early diagnostic techniques takes a long time and costs a lot,which makes it difficult to achieve results in a short time. Therefore,the problem to be solved urgently is to develop a personalized treatment plan through standardized MDT,optimized combination of existing diagnosis and treatment methods,so as to achieve the purpose of improving the efficacy. This expert consensus is developed from the first edition,which is based on the diagnosis and treatment status of pancreatic cancer and the dilemma that is difficult to break through in a short time,with reference to the successful diagnosis and treatment experience at home and abroad,combined with the national conditions of our country,after repeated deliberation,discussion and revison by many well-known experts in the domestic industry. This consensus discusses the meaning and purpose,the main tasks,the necessary objective conditions for carrying out,workflows,precautions,relevant clinical and basic research of MDT,multi-center MDT and eMDT mode exploration in detail. Through the formulation and publication of this consensus,we hope that it can help to promote the standardized development of pancreatic cancer MDT and improve the efficacy of pancreatic cancer in China,to summarize successful experience and promote international exchanges,to strengthen personnel training and echelon construction,to formulate relevant policies and promote the development of MDT in the whole country. This consensus is expert consensus on the MDT model developed in China,which is not only applicable to pancreatic cancer,but also can be used as a reference for other tumors. [ABSTRACT FROM AUTHOR]

Pancreatic cancer(PC) remains one of the most challenging malignant tumor in gastrointestinal cancer, and the incidence and mortality rates are significantly increased in the past decades. The 5-years survival rate of PC is less than 8% since its dormant clinical symptoms and lacking of sensibility and specificity markers in early diagnosis. The early diagnosis of pancreatic cancer is a worldwide problem, and the early diagnosis rate is only 5%. Increasing early diagnosis rate is the key to improve the overall prognosis of pancreatic cancer. The key of early diagnosis and treatment of pancreatic cancer is to identify the high-risk population of pancreatic cancer, improve the sensitivity and specificity of early diagnosis technology, standardize the process of early diagnosis of pancreatic cancer, and standardize the treatment of early pancreatic cancer. To this end, this expert consensus is formulated. [ABSTRACT FROM AUTHOR]

The current situation of pancreatic cancer is that the etiology is not clear and prevention is difficult. The sensitivity and specificity of the auxiliary detection method are low, and early diagnosis is a worldwide problem. The efficacy of existing treatment method is not satisfied and is difficult to break through in a short time. The 5-year overall survival rate is only 7.2%. In face of the current situation of pancreatic cancer, the key solution is to strengthen basic research, explore its etiology and pathogenesis, prevent carcinogenesis and development. Developments of the efficacy of peripheral blood and urine detection technology, imaging diagnosis technology are the critical manners to improve the early diagnosis rate. However, the research on basic and early diagnosis techniques takes a long time and costs a lot, which makes it difficult to achieve result in a short time. Therefore, the problem to be solved urgently is to develop a personalized treatment plan through standardized multi-disciplinary treatment (MDT), optimized combination of existing diagnosis and treatment methods, which may achieve the purpose of improving efficacy. This expert consensus is developed from the first edition, which is based on the diagnosis and treatment status of pancreatic cancer and the dilemma that is difficult to break through in a short time, with reference to the successful diagnosis and treatment experience at home and abroad, combined with the national condition of our country, repeated deliberation, discussion and revision by many domestic well-known experts. This consensus discusses the meaning and purpose, the main tasks, the necessary objective conditions for carrying out, workflows, precautions, relevant clinical and basic research of MDT, explorations of multi-center MDT mode and internet MDT (eMDT) mode in detail. Through the formulation and publication of this consensus, we hope that it can promote the development of standardized pancreatic cancer MDT and improve the therapeutic efficacy of pancreatic cancer in China, summarize successful experience and promote international exchanges, strengthen personnel training and echelon construction, formulate relevant policy and promote the development of MDT in the whole country. This is an expert consensus on the MDT model developed in China, which is not only applied to pancreatic cancer, but also can be used as a reference for other tumors. [ABSTRACT FROM AUTHOR]

Objective To investigate the prognostic values of three different staging schemes including the number of lymph node metastasis ( N stage), lymph node ratio ( LNR) and log odd of positive lymph nodes ( LODDS) in pancreatic cancer patients after RO resection. Methods The clinical and pathological data of 307 pm1ereatic cm1eer patients who 1mderwent RO resection at Cancer Hospital of Chinese Academy of Medical Sciences from January 2010 to December 2018 were retrospectively analyzed. Kaplan-Meier and Cox propm1ional hazard regression models were used to analyze the indepedent prognostic factors. The area under the receiver operator characteristic curve ( A UC) was used to compare the prognostic efficacy of different lymph node staging systems. Results The median survival was 24. 0 months, I-year, 3-year and 5-year- survival rates were 72.0%,, 35.5% and 24.0%, respectively. Multivariate analysis showed that CA 199, differentiation, T stage, adjuvant therapy, N stage, LNR stage, and LODDS stage were independent prognostic factors for pancreatic cancer patients after RO resection (P<0.05). The A.UC values of the I-year survival rate for N stage, LNR stage, and LODDS stage were 0.591, 0.592 and 0.609, respectively. The A.UC values of the 3-ycar survival rate for N stage, LNR stage, and LODDS stage were 0.585, 0.588 and 0.593, respectively. The AUC values of the 5-ye,u- survival rate for N stage, LNR stage,,md LODDS stage were 0.554, 0.557 and 0.589, respectively. The AUC values of the LODDS stage were the highest while the N stage were the lowest, but there was no significant difference among these three systems (P>0. 05). For all patients, the LODDS staging system was slightly better than the N and LNR staging systems, but the difference was not statistically significant ( P > 0. 05). For patients with NO stage, the LODDS staging system showed better prediction performance than the N stage and LNR staging systems ( P< 0.05). Conclusions The N stage, LNR stage,,md LODDS stage arc independent prognostic factors for pancreatic cancer patients after R0 resection. For patients without lymph node metastasis., LODDS staging system is superior to N and LNR staging systems in predicting prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Oncology is the property of Chinese Journal of Oncology / Zhonghua Zhongliu Zazhi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The morbidity and mortality of pancreatic cancer has been increasing year by year, however, the treatment progress and prevention effect were minimal. With the development of basic research, especially the advances of gene sequencing technology, it was possible to clarify the etiology and pathogenesis of pancreatic cancer, and achieve the first stage prevention. The discovery of pancreatic cancer exosomes of high sensitivity and specificity made early diagnosis of pancreatic cancer (the second stage prevention) no longer a worldwide problem. The build of pancreatic cancer genotyping with clinical applicability made the precision treatment of pancreatic cancer (the third stage prevention) possible. Thus, the precision medicine which is based on advances of gene sequencing, popularity of the Internet and the big data technology has brought a ray of hope for the prevention and treatment of pancreatic cancer. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Oncology is the property of Chinese Journal of Oncology / Zhonghua Zhongliu Zazhi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)