Ghourir

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0019 Aging stage IV and no surgery were independent predictors of poor overall survival Conclusions For pancreatic acinar cell carcinoma surgery is a potentially curative treatment contributing to longterm survival and suggested even in advanced diseases Chemotherapy improved survival for metastatic patientsObjectives The objective of this study was to evaluate potential safety and clinical benefit of lowmolecularweight dextran dextran use in patients undergoing total pancreatectomy with islet auto transplantation TPIAT Methods We evaluated 124 children undergoing TPIAT at a single institution either with n 72 or without n 52 perioperative dextran infusion Data on islet graft function and postoperative complications were collected through electronic medical records and patientreported outcomes from research questionnaires Results Islet graft failure was less likely at 1 year odds ratio 0186 95 confidence interval 004065 and 2 years odds ratio 0063 95 confidence interval 0003035 postTPIAT in the dextran group This finding remained significant at 2 years in multivariate logistic regression modeling adjusting for islet mass body surface area and sex Likewise in multivariate regression the odds of partial islet graft function were higher at 1 and 2 years in the dextran group Dextran use was overall safe although it did lead to a higher incidence of postoperative bleeding requiring blood transfusions P less then 0001 Conclusions These findings suggest that dextran use may increase the likelihood for sustained postTPIAT islet graft function potentially mitigating severity of postoperative diabetes for these childrenObjective The aim of the study was to clarify the diagnostic impact of measuring serum antip53 antibody Sp53Ab in predicting the histological grades of intraductal papillary mucinous neoplasms IPMNs of the pancreas Methods We compared the measured values and positive prevalence of Sp53Ab across the different histological grades of 111 resected IPMN cases We also evaluated the TP53 alterations using immunohistochemistry and nextgeneration sequencing Results Serum antip53 antibody were detected in 6 of 111 cases all of their histological grades were highgrade dysplasia HGD and invasive carcinoma INV Positive prevalence of Sp53Ab was higher in cases with INV 435 cases 114 than those with HGD 238 cases 53 whereas Sp53Abs were undetectable in cases with lowgrade dysplasia Measured Sp53Ab values were not correlated with either carcinoembryonic antigen CEA or carbohydrate antigen 199 CA 199 buy DPCPX In 4 of 6 Sp53Abpositive cases the TP53 alterationssomatic pathogenic mutations or aberrant immunoreactivitywere identified in their IPMN lesions A combination assay of Sp53Ab CEA and CA 199 revealed a 384 sensitivity and 816 specificity for predicting HGDINV Conclusions Serum antip53 antibody can serve as a surrogate marker for TP53 alterations and help predict the presence of HGDINV in cases with IPMN in combination with CEA and CA 199Objectives This analysis investigated nomogram use to evaluate metastatic pancreatic cancer prognosis Methods Thirtyfour baseline factors were examined in the Metastatic Pancreatic Adenocarcinoma Clinical Trial MPACT nabpaclitaxel plus gemcitabine vs gemcitabine data set Factors significantly P less then 01 associated with overall survival OS in a univariable model or with known clinical relevance were tested further In a multivariable model factors associated with OS P less then 01 were selected to generate the primary nomogram which was internally validated using bootstrapping a concordance index and calibration plots Results Using data from 861 patients 6 factors were retained multivariable analysis neutrophillymphocyte ratio albumin level Karnofsky performance status sum of longest diameter of target lesions presence of liver metastases and previous Whipple procedure The nomogram distinguished low medium and highrisk groups concordance index 067 95 confidence interval 065069 median OS 117 80 and 33 months respectively Conclusions This nomogram may guide estimates of the range of OS outcomes and contribute to patient stratification in future prospective metastatic pancreatic cancer trials however external validation is required to improve estimate reliability and applicability to a general patient population Caution should be exercised in interpreting these results for treatment decisions patient characteristics could differ from those included in the nomogram developmentObjectives Type 2 diabetes mellitus T2DM has been associated with several types of cancers but the role of T2DM in pancreatic neuroendocrine tumors pNETs has not been systematically studied Methods In this study 299 patients with pNETs were recruited and the clinicopathologic characteristics and prognosis of the diabetic and nondiabetic patients were compared The association between metformin use and survival was assessed to examine whether metformin impacts the prognosis of pNETs patients Results The prevalence of T2DM in the cohort was 207 n 62 The proportions of grade 3 tumors distant metastases and nerve invasion in pNET patients with T2DM were higher than those in patients without T2DM and as a result the survival was worse in patients with T2DM After adjusting for the tumor stage diabetic status was not associated with poor survival in the univariate analysis The results of logistic regression showed that pNET patients with T2DM were at high risk for tumor metastasis odds ratio OR 281 P 0001 nerve invasion OR 243 P 0029 and grade 3 tumors OR 497 P 0010 Conclusions Type 2 diabetes mellitus is associated with pNET metastasis and not an independent risk factor for poor prognosis in pNETsObjectives Because infected pancreatic necrosis IPN has multiple presentations not all patients are likely to benefit from the same firstline treatment Our objective was to evaluate morbidity and mortality in a series of patients treated with a multimodal therapeutic approach Methods Between May 2012 and May 2019 51 patients diagnosed with IPN were treated The 5 initial treatment alternatives were as follows percutaneous drainage minimally invasive necrosectomy antibiotics alone transgastric necrosectomy and temporizing percutaneousendoscopic drainage Initial treatment selection depended on evolution clinical condition and extension of pancreatic necrosis Success morbidity and mortality rates were determined Results In terms of determinantbased classification 37 were classified as severe and 14 as critical Percutaneous temporizing drainage minimally invasive necrosectomy antibiotics alone and transgastric necrosectomy approaches were used in 21 10 11 4 and 5 patients respectively