الرئيسية Pancreatology The outpatient activity of a Macmillan pancreatic clinical nurse specialist in a tertiary...
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Abstracts / Pancreatology 13 (2013) S2–S98 PI-113 Abstract id: 59. The outpatient activity of a Macmillan pancreatic clinical nurse specialist in a tertiary pancreatic unit Philip Whelan. S51 Pathologically, ﬁve cases was classiﬁed as intestinal type and 2 as gastric type. The major component in the invasive area was tubular adenocarcinoma in 5, mucinous carcinoma in 2. All cases achieved R0 resection. There were no complications. The 3-year survival rate was 100%. Conclusion: Aggressive curative surgery for IC-IDT could contribute to a good outcome which is superior to that in patients with IDC. Liverpool, United Kingdom Introduction: The Clinical Nurse Specialist (CNS) plays a major role in the management of pancreatic cancer patients at all stages during their cancer journey. Since 2010 the CNS has had their own outpatient clinic template for the review of patients. Aims: To evaluate the outpatient activity of the Macmillan Pancreatic CNS in a tertiary Pancreatic Unit over a 6 month period. Patients & methods: An audit was undertaken of all patients reviewed in clinic by the CNS. Outcome data included demographics, tumour type, type of consultation, time of consultation, medications prescribed, referrals made, written information provided and tests ordered. Data was collected prospectively and analysed using EXCEL. Results: A total of 206 patients (61% male, median time of review 35 minutes, range 10 – 90 minutes) were seen in 42 outpatient clinics between March and August 2012. 155 patients (75%) were seen alone by the CNS. 95 (67%) of these patients were post-operative follow ups. The remaining 60 patients were inoperable, receiving palliative treatment and supportive care. 15 patients had a new inoperable cancer or diagnoses of recurrence. 80 patients (52%) required referrals to other services, 92 (59%) required medication changes and 110 (71%) required further investigations all of which were instigated by the CNS. 51 (25%) patients were seen after a clinician. The majority (72%) being new su; rgical patients. Conclusion: The CNS has been found to take on increased responsibilities for post-operative surgical patients and patients undergoing palliative treatment and supportive care allowing the surgeon to better utilise their own clinic time. PI-114 Abstract id: 33. Signiﬁcance of aggressive surgery for invasive carcinoma derived from intraductal papillary mucinous neoplasm Takayuki Aimoto 1, Akira Matsushita 1, Youichi Kawano 1, Arichika Hoshino 2, Satoshi Mizutani 2, Seiji Yamagishi 2, Akira Muraki 2, Hideyuki Suzuki 2, Tadashi Kobayashi 3, Eiji Uchida 1. 1 Department of Surgery, Nippon Medical School, Japan Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Japan 3 Kobayashi Hospital, Japan 2 Introduction: Although intraductal papillary mucinous neoplasm (IPMN) has a good prognosis, biological malignancy of invasive carcinoma derived from intraductal tumor (IC-IDT) is often reported to be similar to that of invasive ductal carcinoma (IDC). Aims: We discussed signiﬁcance of surgical treatment from a viewpoint of the outcome. Patients & methods: We retrospectively studied 7 patients with ICDIT. Several factors were reviewed: clinical presentation, preoperative imaging, variation of serum CA19-9, periperative factors, pathological ﬁndings, adjuvant chemotherapy and outcome. Results: The mean age was 67 years. Two were men and 5 were women. The mean follow-up period was 40.1 months. Serum level of CA19-9 was elevated in only 2 cases (29%) and showed a rapid decline after surgery. Five lesions were located in the head and 2 in the body. The mean tumor diameter was 38 mm. Accordin to preoperative imaging, all cases had a borderline resectable cancer. Pancreaticoduodenectomy was performed in 5 patients, distal pancreatectomy in 2. Two patients required vascular resection. The mean operative time was 408min and mean blood loss was 1574ml. Four patients received gemcitabine chemotherapy. PI-115 Abstract id: 211. Risk factors, clinical features and outcome of early onset pancreatic cancer patients compared to older patients Matteo Piciucchi 1, Gabriele Capurso 1, Giulia Zerboni 1, Roberto Valente 1, Viola Barucca 2, Marco Cavallini 3, Paolo Marchetti 2, Vincenzo Ziparo 3, Alberto Larghi 4, Gianfranco Delle Fave 1. 1 Digestive and Liver Disease Unit, S. Andrea Hospital, University Sapienza, Rome, Italy 2 Oncology Unit, S. Andrea Hospital, University Sapienza, Rome, Italy 3 Surgery Unit, S. Andrea Hospital, University Sapienza, Rome, Italy 4 Digestive Endoscopy Unit, Gemelli University of Rome, Italy Introduction: The median pancreatic adenocarcinoma (PADC) onset age is>65 years, but some 10% are diagnosed 10 years before, and deﬁned as early onset pancreatic cancer (EOPC). Speciﬁc features of EOPC have poorly been investigated Aims: We aim to analyze the prevalence of EOPC (patients aged<55), risk factors for EOPC occurrence, their clinical and histological features, and outcome compared with “normal onset” (NOPC) Patients & methods: Prospective cohort of incident PDAC patients. Familial, medical, environmental risk factors and clinical presentation registered through a speciﬁc questionnaire. Tumor features and patients’ survival recorded Results: Amongst 291 consecutive PDAC patients, 38 were EOPC (13%). There were no differences between EOPC and NOPC for sex distribution, and risk factors, including PDAC family history. The rate of ever smokers was similar (68.4% vs 60.8% p¼0.29), but EOPC subjects were more frequently current (50% vs 22,1% p¼0.01) smokers, with a slightly higher rate of heavy smokers (47.4% vs 38.1% p¼0.28). Previous diabetes was less frequent in EOPC (p¼0.003). PDAC presentation symptoms, and diagnostic delay (4.2 months vs 3.5) were similar in the two groups. EOPC patients had more frequently a G3 tumour (62.5% vs 7.6%;p<0.005) and advanced disease at diagnosis (78.9% EOPC vs 67.2%;p¼0.18). Median survival estimates were similar (11 months vs 9;p¼0.36) Conclusion: Thirteen percent of PDAC patients have an early onset. Active smoking might play a role in anticipation of PDAC onset. In EOPC patients the neoplasm shows aggressive features (undifferentiated histology and advanced stage), however median survival is not worse, likely due thanks to less comorbidities PI-116 Abstract id: 53. CT-based diagnostics might be insufﬁcient in the determination of pancreatic cancer unresectability Vyacheslav Egorov 1, Roman Petrov 2, Elena Solodinina 3, Gregory Karmazanovsky 3, Natalia Starostina 3, Natalia Kuruschkina 3. 1 Sechenov First State Medical University, Ostroumov 14th City Hospital, Department of Surgical Oncology, Russia 2 Pirogov Russian National Research Medical University, Russia 3 Vishnevsky Institute of Surgery, Russia Introduction: The salient indication of pancreatic cancer (PC) unresectability is superior mesenteric artery (SMA) and celiac artery (CA) encasement, indicating arterial invasion. Computed tomography (CT) is the gold standard for the evaluation of PC resectability. Aims: To compare CT, intraoperative and survival data of patients with borderline-resectable and unresectable PC