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Zhuge X, Zhou H, Chen L, Chen H, Chen X, Guo C. The association between serum ferritin levels and malignant intraductal papillary mucinous neoplasms. BMC Cancer 2021; 21:1253. [PMID: 34800987 PMCID: PMC8606075 DOI: 10.1186/s12885-021-08986-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Serum ferritin levels are elevated in many malignancies. In this study, we showed the performance of serum ferritin in identifying malignant intraductal papillary mucinous neoplasms (IPMNs). METHODS A total of 151 patients with pathologically confirmed IPMNs were enrolled. Serum tumor biomarker (carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA)) levels and serum ferritin levels were recorded. Lesion location, tumor size, diameter of the main pancreatic duct (MPD), mural nodule, and IPMN type, were collected from imaging examinations. IPMNs with high grade dysplasia and associated invasive carcinoma were considered malignant IPMNs. RESULTS Serum ferritin levels in patients with malignant IPMNs were higher than those in patients with nonmalignant IPMNs (p < 0.05). Serum ferritin was an independent factor for the occurrence of malignant IPMNs (odds ratio (OR) = 1.18, 95% confidence interval (CI):1.01-1.39). A similar trend was found between high serum ferritin (> 149 ng/ml) and malignant IPMNs (OR = 5.64, 95% CI:1.78-17.92). The area under the curve (AUC) of serum ferritin was higher than that of CEA and CA19-9 in identifying malignant IPMNs (AUC = 0.67 vs. AUC = 0.58, 0.65). The combination of serum ferritin with IPMN type showed a similar performance to MPD diameter and the combination of serum CA19-9 with IPMN types in identifying malignant IPMNs (AUC = 0.78 vs. AUC = 0.79, 0.77) and invasive carcinoma (AUC = 0.77 vs. AUC = 0.79, 0.79). CONCLUSIONS Elevated serum ferritin is a factor associated with malignant IPMNs. Serum ferritin may be a useful marker for identifying malignancy in IPMNs.
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Affiliation(s)
- Xiaoling Zhuge
- Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun road, Hangzhou, 310003, China
| | - Hao Zhou
- Department of Radiology, the Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China
| | - Liming Chen
- Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun road, Hangzhou, 310003, China
| | - Hui Chen
- Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun road, Hangzhou, 310003, China
| | - Xiao Chen
- Department of Radiology, the Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, Nanjing, 210029, China.
| | - Chuangen Guo
- Department of Radiology, the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun road, Hangzhou, 310003, China.
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Ramírez-Carmona W, Díaz-Fabregat B, Yuri Yoshigae A, Musa de Aquino A, Scarano WR, de Souza Castilho AC, Avansini Marsicano J, Leal do Prado R, Pessan JP, de Oliveira Mendes L. Are Serum Ferritin Levels a Reliable Cancer Biomarker? A Systematic Review and Meta-Analysis. Nutr Cancer 2021; 74:1917-1926. [PMID: 34607491 DOI: 10.1080/01635581.2021.1982996] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although serum ferritin (SF) has been shown in several studies to be a potential cancer biomarker, the results are inconsistent. Herein, a systematic review was performed to investigate the clinical SF levels in different types of tumors in order to verify the role of SF levels as a biomarker for cancer diagnosis. The search was performed using the PubMed/Medline, Cochrane Library, and Scopus databases. Observational studies comparing SF levels between healthy adults and patients with cancer were included. The meta-analysis was carried out according to the inverse variance and random effects model. The standardized mean differences (SMDs) were assessed at 95% confidence intervals (CIs). We found that SF was higher in patients with cancer (SMD 3.07; CI 1.96,4.17), especially for head and neck cancer (SMD 3.88; CI 0.42,7.34), lung cancer (SMD 1.72; CI 0.67,2.78), pancreatic cancer (SMD 6.79; CI 5.66,7.91), and renal cell carcinoma (SMD 1.77; CI 0.48,3.05). Moreover, in the advanced stages (Stages III and IV), ferritin levels were higher than in healthy adults (SMD 4.89; CI 2.72,7.06, and SMD 8.40; CI 6.99,9.82, respectively). SF acts as a biomarker for pancreatic cancer, renal cell carcinoma, lung cancer, and head and neck cancer and is a sensitive biomarker for the detection of advanced stages of tumors.
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Affiliation(s)
| | - Beatriz Díaz-Fabregat
- Department of Pediatric Dentistry and Public Heatlhy, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| | | | - Ariana Musa de Aquino
- Department of Structural and Functional Biology, Institute of Biosciences, Univ. Estadual Paulista (UNESP), Botucatu, SP, Brazil
| | - Wellerson Rodrigo Scarano
- Department of Structural and Functional Biology, Institute of Biosciences, Univ. Estadual Paulista (UNESP), Botucatu, SP, Brazil
| | | | | | | | - Juliano Pelim Pessan
- Department of Pediatric Dentistry and Public Heatlhy, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
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Lin S, Fang Y, Lin Y, Mo Z, Hong X, Jian Z, Ji C. Meta-analysis of the prognostic value of pretreatment serum ferritin in hepatobiliary and pancreas (HBP) cancers. BMJ Open 2021; 11:e040801. [PMID: 34049899 PMCID: PMC8166605 DOI: 10.1136/bmjopen-2020-040801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Studies have shown that serum ferritin (SF) has unfavourable prognostic value in hepatobiliary and pancreas (HBP) cancers. This meta-analysis aimed to comprehensively assess the prognostic role of pretreatment SF in patients with HBP cancers. METHODS Eligible studies published before January 2020 were obtained through a comprehensive search in the PubMed, Web of Science, Cochrane Library and EMBASE databases. Pooled HRs and 95% CIs were then employed as effect sizes. RESULTS Seven studies comprising 1244 patients were pooled. Elevated pretreatment SF was associated with worse overall survival (OS) (HR 1.60, 95% CI 1.36 to 1.88, p<0.001) and recurrence-free survival/progression-free survival/time to recurrence (HR 1.70, 95% CI 1.15 to 2.52, p=0.008). Significant prognostic value of elevated pretreatment SF on OS was detected in the subgroups regardless of the cancer type, race, SF cut-off value, tumour-node-metastasis stage and Newcastle-Ottawa Scale score. CONCLUSION Elevated pretreatment SF was associated with worse survival outcome of patients with HBP cancers. As such, it may serve as a novel prognostic biomarker for HBP cancers.
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Affiliation(s)
- Shuwen Lin
- General Surgery, Binhaiwan Central Hospital of Dongguan, Dongguan, China
| | - Yinghua Fang
- Pain, Binhaiwan Central Hospital of Dongguan, Dongguan, China
| | - Ye Lin
- General Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Zhikang Mo
- General Surgery, Binhaiwan Central Hospital of Dongguan, Dongguan, China
| | - Xiaocheng Hong
- General Surgery, Binhaiwan Central Hospital of Dongguan, Dongguan, China
| | - Zhixiang Jian
- General Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Chenggang Ji
- General Surgery, Binhaiwan Central Hospital of Dongguan, Dongguan, China
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4
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Willumsen N, Ali SM, Leitzel K, Drabick JJ, Yee N, Polimera HV, Nagabhairu V, Krecko L, Ali A, Maddukuri A, Moku P, Ali A, Poulose J, Menon H, Pancholy N, Costa L, Karsdal MA, Lipton A. Collagen fragments quantified in serum as measures of desmoplasia associate with survival outcome in patients with advanced pancreatic cancer. Sci Rep 2019; 9:19761. [PMID: 31875000 PMCID: PMC6930304 DOI: 10.1038/s41598-019-56268-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/08/2019] [Indexed: 02/07/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) patients have poor prognosis and poor response to treatment. This is largely due to PDAC being associated with a dense and active stroma and tumor fibrosis (desmoplasia). Desmoplasia is characterized by excessive degradation and formation of the extracellular matrix (ECM) generating collagen fragments that are released into circulation. We evaluated the association of specific collagen fragments measured in pre-treatment serum with outcome in patients with PDAC. Matrix metalloprotease (MMP)-degraded type I collagen (C1M), type III collagen (C3M), type IV collagen (C4M) and a pro-peptide of type III collagen (PRO-C3) were measured by ELISA in pre-treatment serum from a randomized phase 3 clinical trial of patients with stage III/IV PDAC treated with 5-fluorouracil based therapy (n = 176). The collagen fragments were evaluated for their correlation (r, Spearman) with serum CA19-9 and for their association with overall survival (OS) based on Cox-regression analyses. In this phase 3 PDAC trial, pre-treatment serum collagen fragment levels were above the reference range for 67%-98% of patients, with median values in PDAC approximately two-fold higher than reference levels. Collagen fragment levels did not correlate with CA19-9 (r = 0.049–0.141, p = ns). On a continuous basis, higher levels of all collagen fragments were associated with significantly shorter OS. When evaluating degradation (C3M) and formation (PRO-C3) of type III collagen further, higher PRO-C3 was associated with poor OS (>25th percentile cut-point, HR = 2.01, 95%CI = 1.33–3.05) and higher C3M/PRO-C3 ratio was associated with improved OS (>25th percentile cut-point, HR = 0.53, 95%CI = 0.34–0.80). When adjusting for CA19–9 and clinical covariates, PRO-C3 remained significant (HR = 1.65, 95%CI = 1.09–2.48). In conclusion, collagen remodeling quantified in pre-treatment serum as a surrogate measure of desmoplasia was significantly associated with OS in a phase 3 clinical PDAC trial, supporting the link between desmoplasia, tumorigenesis, and response to treatment. If validated, these biomarkers may have prognostic and/or predictive potential in future PDAC trials.
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Affiliation(s)
| | - Suhail M Ali
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA.,Lebanon VA Medical Center, Lebanon, PA, USA
| | - Kim Leitzel
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Joseph J Drabick
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Nelson Yee
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Hyma V Polimera
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Vinod Nagabhairu
- Pinnacle Health System, University of Pittsburgh Medical Center, Harrisburg, PA, USA
| | - Laura Krecko
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Ayesha Ali
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Ashok Maddukuri
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Prashanth Moku
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Aamnah Ali
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Joyson Poulose
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Harry Menon
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Neha Pancholy
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Luis Costa
- Oncology division, Hospital de Santa Maria, Lisboa, Portugal.,Clinical Translational Oncology Research Unit, Institute of Molecular Medicine, Lisboa, Portugal
| | | | - Allan Lipton
- Division of Hematology/Oncology, Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA
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5
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Proteomic biomarkers in body fluids associated with pancreatic cancer. Oncotarget 2018; 9:16573-16587. [PMID: 29662668 PMCID: PMC5893263 DOI: 10.18632/oncotarget.24654] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 02/25/2018] [Indexed: 12/12/2022] Open
Abstract
Pancreatic cancer (PC) is a highly malignant disease that represents the fourth leading cancer-related death worldwide. There has been very little improvement in survival rates over recent years, and surgical resection remains the only reliable curative approach. Factors that contribute to this dismal prognosis for PC include its rapid progression and invasion, the absence of specific symptoms, and the little impact of available chemotherapy. Importantly, the management of this malignancy is also limited by the lack of highly specific and sensitive biomarkers for its diagnosis and follow-up, and their identification is therefore considered a promising strategy to improve outcomes in these patients. Numerous translational studies have explored the usefulness of body fluids as a non-invasive source of PC-specific biomarkers, and innovations in proteomic methods and technologies have provided a myriad of protein biomarkers for different cancers. The adoption of a proteomic approach has improved understanding of the biology of PC and contributed to the potential identification of protein biomarkers for this disease. This review considers the most recent research efforts to develop novel proteomic biomarkers in body fluids for PC.
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Ansari D, Friess H, Bauden M, Samnegård J, Andersson R. Pancreatic cancer: disease dynamics, tumor biology and the role of the microenvironment. Oncotarget 2018; 9:6644-6651. [PMID: 29464100 PMCID: PMC5814240 DOI: 10.18632/oncotarget.24019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/03/2018] [Indexed: 12/20/2022] Open
Abstract
Pancreatic cancer is known for its propensity to metastasize. Recent studies have challenged the commonly held belief that pancreatic cancer is a stepwise process, where tumor cells disseminate late in primary tumor development. Instead it has been suggested that pancreatic tumor cells may disseminate early and develop independently and in parallel to the primary tumor. Circulating tumor cells can be found in most patients with pancreatic cancer, even in those with localized stage. Also, recent phylogenetic analyses have revealed evidence for a branched evolution where metastatic lineages can develop early in tumor development. In this Review, we discuss current models of pancreatic cancer progression and the importance of the tumor microenvironment, in order to better understand the recalcitrant nature of this disease.
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Affiliation(s)
- Daniel Ansari
- Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Helmut Friess
- Department of Surgery, Technical University of Munich, Munich, Germany
| | - Monika Bauden
- Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Johan Samnegård
- Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Roland Andersson
- Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
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7
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Ma XM, Sun X, Yang GW, Yu MW, Zhang GL, Yu J, Zhang Y, Wang XM. The platelet-to-lymphocyte ratio as a predictor of patient outcomes in ovarian cancer: a meta-analysis. Climacteric 2017; 20:448-455. [PMID: 28569074 DOI: 10.1080/13697137.2017.1326894] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The platelet-to-lymphocyte ratio (PLR) is a predictive clinical biomarker for different cancers. However, the results of several studies investigating the association between the PLR and the prognosis of ovarian cancer have been inconclusive. Therefore, there is a need to conduct a meta-analysis to estimate the prognostic value of the PLR in ovarian cancer. METHODS We searched the EMBASE, Medline, PubMed, and Web of Science databases to identify clinical studies that had evaluated the association between the PLR and ovarian cancer prognosis. Outcomes evaluated included overall survival (OS) and progression-free survival (PFS). We also analyzed PLR differences between malignant ovarian masses and the controls. RESULTS Twelve relevant studies that comprised 2340 patients were selected for the meta-analysis. The results revealed that elevated PLR was significantly associated with poor OS (hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.05-2.56, p < 0.01) and PFS (HR 1.61, 95% CI 1.03-2.51, p < 0.01). The PLRs in malignant cases were higher than in controls (mean difference = 63.57, 95% CI 39.47-87.66, p < 0.00001). CONCLUSION An elevated PLR is associated with poor prognosis in patients with ovarian cancer. The PLR could be employed as a prognostic marker in patients with ovarian cancer.
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Affiliation(s)
- X-M Ma
- a School of Graduates , Beijing University of Chinese Medicine , Beijing , China.,b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
| | - X Sun
- b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
| | - G-W Yang
- b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
| | - M-W Yu
- b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
| | - G-L Zhang
- b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
| | - J Yu
- b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
| | - Y Zhang
- b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
| | - X-M Wang
- b Department of Oncology , Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University , Beijing , China
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Lee S, Song A, Eo W. Serum Ferritin as a Prognostic Biomarker for Survival in Relapsed or Refractory Metastatic Colorectal Cancer. J Cancer 2016; 7:957-64. [PMID: 27313786 PMCID: PMC4910588 DOI: 10.7150/jca.14797] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/16/2016] [Indexed: 12/26/2022] Open
Abstract
Background: This study investigated the prognostic impact of serum ferritin for survival in patients with relapsed or refractory metastatic colorectal cancer (mCRC). Methods: This retrospective cohort study reviewed clinicopathological characteristics and laboratory biomarkers in 120 mCRC patients being treated with Korean Medicine (KM). The overall survival (OS) of patients was calculated using the Kaplan-Meier method, and statistical significance was assessed using the log-rank test. Univariate and multivariate analyses of Cox proportional hazards regression were used to evaluate the prognostic impact for survival in relapsed or refractory mCRC patients. Results: Of the patients, 62.5% had liver metastases, 74.1% underwent greater than second-line chemotherapy, and 80.8% underwent surgery. Median OS was 7.6 months for all patients after the initiation of KM treatment, which was begun 13.7 months, on average, after mCRC diagnosis. Concerning prognostic factors such as the presence of liver metastasis (p = 0.024), high carcinoembryonic antigen level (CEA > 5 ng/mL, p = 0.044), elevated C-reactive protein (CRP ≥ 10.0 mg/L, p = 0.000), high absolute monocyte count (AMC > 413.3 cells/μL, p = 0.034), elevated serum ferritin (ferritin ≥ 150 ng/mL, p = 0.002), low hemoglobin level (Hb < 12 g/dL, p = 0.026) and low albumin (albumin < 3.5 g/dL, p = 0.003) were associated with increased hazard ratios and poor survival. According to the multivariate proportional hazards model with backward and forward manners, albumin (albumin < 3.5 g/dL; hazard ratio (HR) 2.218, 95% confidence interval (CI) 1.135 - 3.990, p = 0.019), CRP (CRP ≥ 10.0 mg/L; HR 2.506, 95% CI 1.644 - 3.822, p = 0.000), CEA (CEA > 5 ng/mL; HR 2.040, 95% CI 1.203 - 3.460, p = 0.008), and serum ferritin (ferritin ≥ 150 ng/mL; HR 1.763, 95% CI 1.169 - 2.660, p = 0.007) were independent prognostic biomarkers of survival in mCRC patients. Conclusions: These results indicate that serum ferritin acts as an independent prognostic biomarker for survival in relapsed or refractory mCRC patients.
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Affiliation(s)
- Sookyung Lee
- 1. Department of Clinical Oncology, College of Korean Medicine, Kyung Hee University
| | - Anna Song
- 2. Department of Clinical Korean Medicine, Graduate School, Kyung Hee University
| | - Wankyu Eo
- 3. Department of Medical Oncology and Hematology, College of Medicine, Kyung Hee University
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9
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Wong J, Solomon NL, Hsueh CT. Neoadjuvant treatment for resectable pancreatic adenocarcinoma. World J Clin Oncol 2016; 7:1-8. [PMID: 26862486 PMCID: PMC4734931 DOI: 10.5306/wjco.v7.i1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 11/06/2015] [Accepted: 11/17/2015] [Indexed: 02/06/2023] Open
Abstract
Pancreatic adenocarcinoma is the fourth leading cause of cancer mortality in the United States in both men and women, with a 5-year survival rate of less than 5%. Surgical resection remains the only curative treatment, but most patients develop systemic recurrence within 2 years of surgery. Adjuvant treatment with chemotherapy or chemoradiotherapy has been shown to improve overall survival, but the delivery of treatment remains problematic with up to 50% of patients not receiving postoperative treatment. Neoadjuvant therapy can provide benefits of eradication of micrometastasis and improved delivery of intended treatment. We have reviewed the findings from completed neoadjuvant clinical trials, and discussed the ongoing studies. Combinational cytotoxic chemotherapy such as fluorouracil, leucovorin, irinotecan, and oxaliplatin and gemcitabine plus nanoparticle albumin-bound (nab)-paclitaxel, active in the metastatic setting, are being studied in the neoadjuvant setting. In addition, novel targeted agents such as inhibitor of immune checkpoint are incorporated with cytotoxic chemotherapy in early-phase clinical trial. Furthermore we have explored the utility of biomarkers which can personalize treatment and select patients for target-driven therapy to improve treatment outcome. The treatment of resectable pancreatic adenocarcinoma requires multidisciplinary approach and novel strategies including innovative trials to make progress.
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De Rosa A, Cameron IC, Gomez D. Indications for staging laparoscopy in pancreatic cancer. HPB (Oxford) 2016; 18:13-20. [PMID: 26776846 PMCID: PMC4750228 DOI: 10.1016/j.hpb.2015.10.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/26/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND To identify indications for staging laparoscopy (SL) in patients with resectable pancreatic cancer, and suggest a pre-operative algorithm for staging these patients. METHODS Relevant articles were reviewed from the published literature using the Medline database. The search was performed using the keywords 'pancreatic cancer', 'resectability', 'staging', 'laparoscopy', and 'Whipple's procedure'. RESULTS Twenty four studies were identified which fulfilled the inclusion criteria. Of the published data, the most reliable surrogate markers for selecting patients for SL to predict unresectability in patients with CT defined resectable pancreatic cancer were CA 19.9 and tumour size. Although there are studies suggesting a role for tumour location, CEA levels, and clinical findings such as weight loss and jaundice, there is currently not enough evidence for these variables to predict resectability. Based on the current data, patients with a CT suggestive of resectable disease and (1) CA 19.9 ≥150 U/mL; or (2) tumour size >3 cm should be considered for SL. CONCLUSION The role of laparoscopy in the staging of pancreatic cancer patients remains controversial. Potential predictors of unresectability to select patients for SL include CA 19.9 levels and tumour size.
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Affiliation(s)
- Antonella De Rosa
- Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Iain C Cameron
- Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Dhanwant Gomez
- Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
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Wang SL, Cao S, Wu R, Chi F, Tang MY, Jin XY, Chen XD. Serum ferritin predicted prognosis in patients with locally advanced pancreatic cancer. Future Oncol 2015; 11:2905-10. [PMID: 26436474 DOI: 10.2217/fon.15.186] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AIM The present study evaluated the value of serum ferritin (SF) level for the prognosis of patients with locally advanced pancreatic cancer (LAPC). PATIENTS & METHODS A total of 79 patients with LAPC treated by chemoradiotherapy were reviewed retrospectively. Pretreatment and post-treatment levels of SF were obtained. RESULTS Median progression-free survival (PFS) was 11.8 months; median overall survival was 18.3 months. A total of 36 patients with elevated SF level showed significantly worse overall survival and PFS than patients with low SF level (p = 0.002 and p = 0.004, respectively). In total, 17 patients showed normal SF level after chemoradiotherapy, and their median PFS was 3.2 months longer than that of patients whose SF levels were not restored after chemoradiotherapy. CONCLUSION SF may serve as a valuable tool to assess prognosis and monitor chemoradiotherapy response in patients with LAPC.
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Affiliation(s)
- Si-Liang Wang
- Department of Medical Oncology, Shengjing Hospital of China Medical University, 36 Sanhao Road, Shenyang 110004, China
| | - Shuo Cao
- Department of Medical Oncology, Shengjing Hospital of China Medical University, 36 Sanhao Road, Shenyang 110004, China
| | - Rong Wu
- Department of Medical Oncology, Shengjing Hospital of China Medical University, 36 Sanhao Road, Shenyang 110004, China
| | - Feng Chi
- Department of Medical Oncology, Shengjing Hospital of China Medical University, 36 Sanhao Road, Shenyang 110004, China
| | - Mei-Yue Tang
- Department of Medical Oncology, Shengjing Hospital of China Medical University, 36 Sanhao Road, Shenyang 110004, China
| | - Xue-Ying Jin
- Department of Medical Oncology, Shengjing Hospital of China Medical University, 36 Sanhao Road, Shenyang 110004, China
| | - Xiao-Dong Chen
- Department of Medical Oncology, Shengjing Hospital of China Medical University, 36 Sanhao Road, Shenyang 110004, China
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12
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Assessing novel prognostic serum biomarkers in advanced pancreatic cancer: the role of CYFRA 21-1, serum amyloid A, haptoglobin, and 25-OH vitamin D3. Tumour Biol 2014; 36:2631-40. [DOI: 10.1007/s13277-014-2885-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 11/21/2014] [Indexed: 12/19/2022] Open
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