Subjects -> MEDICAL SCIENCES (Total: 8642 journals)
    - ANAESTHESIOLOGY (120 journals)
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    - SURGERY (406 journals)

GASTROENTEROLOGY AND HEPATOLOGY (188 journals)                     

Showing 1 - 188 of 188 Journals sorted alphabetically
Abdominal Radiology     Hybrid Journal   (Followers: 21)
ACG Case Reports Journal     Open Access  
Acta Endoscopica     Hybrid Journal   (Followers: 1)
Acta Gastroenterologica Latinoamericana     Open Access   (Followers: 2)
Actualités Odonto-Stomatologiques     Open Access   (Followers: 4)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
Advances in Diabetes and Metabolism     Open Access   (Followers: 30)
Advances in Digestive Medicine     Open Access   (Followers: 15)
Advances in Hepatology     Open Access   (Followers: 3)
AJP Gastrointestinal and Liver Physiology     Hybrid Journal   (Followers: 8)
Akademik Gastroenteroloji Dergisi / Turkish Journal of Academic Gastroenterology     Open Access  
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 33)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 2)
American Journal of Gastroenterology Supplements     Full-text available via subscription   (Followers: 7)
American Journal of Gastroenterology, The     Hybrid Journal   (Followers: 172)
Annals of Gastroenterological Surgery     Open Access   (Followers: 1)
Annals of Gastroenterology     Open Access   (Followers: 1)
Arab Journal of Gastroenterology     Full-text available via subscription   (Followers: 3)
Archives of Clinical Gastroenterology     Open Access   (Followers: 2)
Archives of Hepatitis Research     Open Access   (Followers: 2)
Arquivos de Gastroenterologia     Open Access   (Followers: 1)
Australian and New Zealand Continence Journal     Full-text available via subscription   (Followers: 3)
Avances en Odontoestomatologia     Open Access   (Followers: 1)
Best Practice & Research Clinical Gastroenterology     Full-text available via subscription   (Followers: 7)
BMC Gastroenterology     Open Access   (Followers: 15)
BMJ Open Diabetes Research & Care     Open Access   (Followers: 32)
BMJ Open Gastroenterology     Open Access   (Followers: 10)
Canadian Journal of Gastroenterology & Hepatology     Open Access   (Followers: 4)
Case Reports in Gastroenterology     Open Access   (Followers: 4)
Case Reports in Gastrointestinal Medicine     Open Access   (Followers: 3)
Case Reports in Hepatology     Open Access   (Followers: 2)
Cellular and Molecular Gastroenterology and Hepatology     Open Access   (Followers: 4)
Clinical and Experimental Gastroenterology     Open Access  
Clinical and Molecular Hepatology     Open Access   (Followers: 2)
Clinical and Translational Gastroenterology     Open Access  
Clinical Diabetes     Full-text available via subscription   (Followers: 44)
Clinical Gastroenterology and Hepatology     Hybrid Journal   (Followers: 32)
Clinical Journal of Gastroenterology     Hybrid Journal   (Followers: 9)
Clinics and Research in Hepatology and Gastroenterology     Hybrid Journal   (Followers: 9)
Clinics and Research in Hepatology and Gastroenterology : X     Open Access   (Followers: 1)
Clinics in Liver Disease     Full-text available via subscription   (Followers: 12)
Colon & Rectum     Hybrid Journal   (Followers: 5)
coloproctology     Hybrid Journal   (Followers: 3)
Colorectal Disease     Hybrid Journal   (Followers: 12)
Comparative Hepatology     Open Access   (Followers: 3)
Current Bladder Dysfunction Reports     Hybrid Journal  
Current Colorectal Cancer Reports     Hybrid Journal   (Followers: 2)
Current Diabetes Reports     Hybrid Journal   (Followers: 30)
Current Gastroenterology Reports     Hybrid Journal   (Followers: 4)
Current Hepatitis Reports     Hybrid Journal   (Followers: 8)
Current Hepatology Reports     Hybrid Journal  
Current Opinion in Gastroenterology     Hybrid Journal   (Followers: 15)
Current Treatment Options in Gastroenterology     Hybrid Journal   (Followers: 6)
Der Gastroenterologe     Hybrid Journal  
Diabetes     Full-text available via subscription   (Followers: 567)
Diabetes Internacional     Open Access  
Diabetes Spectrum     Full-text available via subscription   (Followers: 17)
Diagnostic and Therapeutic Endoscopy     Open Access  
Dialysis & Transplantation     Hybrid Journal   (Followers: 6)
Digestion     Full-text available via subscription   (Followers: 4)
Digestive and Liver Disease     Hybrid Journal   (Followers: 16)
Digestive and Liver Disease Supplements     Full-text available via subscription   (Followers: 5)
Digestive Disease Interventions     Hybrid Journal  
Digestive Diseases     Full-text available via subscription   (Followers: 18)
Digestive Diseases and Sciences     Hybrid Journal   (Followers: 5)
Digestive Endoscopy     Hybrid Journal   (Followers: 3)
Diseases of the Colon & Rectum     Hybrid Journal   (Followers: 36)
Diseases of the Esophagus     Hybrid Journal  
Dysphagia     Hybrid Journal   (Followers: 201)
EMC - Técnicas Quirúrgicas - Aparato Digestivo     Full-text available via subscription  
Endoscopia     Open Access  
Endoscopy     Hybrid Journal   (Followers: 10)
Endoscopy International Open     Open Access  
Endoskopie heute     Hybrid Journal   (Followers: 1)
Esophagus     Hybrid Journal  
European Journal of Gastroenterology & Hepatology     Hybrid Journal   (Followers: 22)
Expert Review of Gastroenterology and Hepatology     Full-text available via subscription   (Followers: 9)
Frontline Gastroenterology     Hybrid Journal   (Followers: 1)
Gastric Cancer     Hybrid Journal   (Followers: 1)
Gastro-News     Full-text available via subscription   (Followers: 3)
Gastroenterologia Kliniczna. Postępy i Standardy     Open Access  
Gastroenterología y Hepatología     Full-text available via subscription  
Gastroenterología y Hepatología (English Edition)     Hybrid Journal  
Gastroenterología y Hepatología Continuada     Full-text available via subscription  
Gastroenterologie up2date     Hybrid Journal   (Followers: 2)
Gastroenterology     Hybrid Journal   (Followers: 235)
Gastroenterology (Gastroenterologìa)     Open Access   (Followers: 1)
Gastroenterology and Hepatology from bed to bench     Open Access   (Followers: 5)
Gastroenterology Clinics of North America     Full-text available via subscription   (Followers: 9)
Gastroenterology Insights     Open Access   (Followers: 3)
Gastroenterology Report     Open Access   (Followers: 3)
Gastroenterology Research     Open Access   (Followers: 7)
Gastroenterology Research and Practice     Open Access   (Followers: 2)
GastroHep     Hybrid Journal   (Followers: 1)
Gastrointestinal Cancer : Targets and Therapy     Open Access   (Followers: 3)
Gastrointestinal Disorders     Open Access  
Gastrointestinal Endoscopy     Hybrid Journal   (Followers: 26)
Gastrointestinal Endoscopy Clinics of North America     Full-text available via subscription   (Followers: 9)
Gastrointestinal Tumors     Open Access  
GE Portuguese Journal of Gastroenterology     Open Access  
Gut     Hybrid Journal   (Followers: 226)
Gut Microbes     Full-text available via subscription   (Followers: 11)
Gut Pathogens     Full-text available via subscription   (Followers: 5)
Hemodialysis International     Hybrid Journal   (Followers: 3)
Hepatic Medicine: Evidence and Research     Open Access   (Followers: 5)
Hepatitis B Annual     Open Access   (Followers: 3)
Hepatitis Monthly     Open Access   (Followers: 4)
Hepatitis Research and Treatment     Open Access   (Followers: 6)
Hepatobiliary & Pancreatic Diseases International     Full-text available via subscription   (Followers: 1)
Hepatology     Hybrid Journal   (Followers: 43)
Hepatology International     Hybrid Journal   (Followers: 7)
Hepatology Research     Hybrid Journal   (Followers: 15)
Hepatology, Medicine and Policy     Open Access  
Hernia     Hybrid Journal   (Followers: 6)
HPB: The official journal of the International Hepato Pancreato Biliary Association     Hybrid Journal   (Followers: 3)
Indian Journal of Gastroenterology     Open Access   (Followers: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 46)
Inflammatory Intestinal Diseases     Open Access  
Info Diabetologie     Full-text available via subscription   (Followers: 1)
International Journal of Celiac Disease     Open Access   (Followers: 3)
International Journal of Colorectal Disease     Hybrid Journal   (Followers: 10)
International Journal of Hepatology     Open Access   (Followers: 4)
International Journal of Stomatological Research     Open Access  
JGH Open     Open Access   (Followers: 1)
JMIR Diabetes     Open Access  
Journal Africain d'Hépato-Gastroentérologie     Hybrid Journal   (Followers: 1)
Journal für Gastroenterologische und Hepatologische Erkrankungen     Hybrid Journal  
Journal of Clinical Gastroenterology     Hybrid Journal   (Followers: 11)
Journal of Coloproctology     Open Access  
Journal of Crohn's and Colitis     Hybrid Journal   (Followers: 10)
Journal of Crohn's and Colitis Supplements     Full-text available via subscription   (Followers: 2)
Journal of Diabetes Research     Open Access   (Followers: 14)
Journal of Diabetology     Open Access   (Followers: 1)
Journal of Digestive Diseases     Hybrid Journal   (Followers: 2)
Journal of Digestive Endoscopy     Open Access   (Followers: 4)
Journal of Endometriosis and Pelvic Pain Disorders     Hybrid Journal  
Journal of Gastroenterology     Hybrid Journal   (Followers: 11)
Journal of Gastroenterology and Hepatology     Hybrid Journal   (Followers: 14)
Journal of Gastroenterology and Hepatology Research     Open Access   (Followers: 5)
Journal of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3)
Journal of Gastrointestinal Oncology     Open Access   (Followers: 1)
Journal of Hepato-Biliary-Pancreatic Sciences     Hybrid Journal   (Followers: 4)
Journal of Hepatology     Hybrid Journal   (Followers: 24)
Journal of Obesity and Bariatrics     Open Access   (Followers: 1)
Journal of Obesity and Metabolic Research     Open Access   (Followers: 7)
Journal of Social Health and Diabetes     Open Access   (Followers: 2)
Journal of the Anus, Rectum and Colon     Open Access  
Journal of the Canadian Association of Gastroenterology     Open Access  
Journal of Viral Hepatitis     Hybrid Journal   (Followers: 7)
Kidney Disease and Transplantation     Open Access   (Followers: 4)
Kidney International Supplements     Partially Free   (Followers: 4)
Liver Cancer     Open Access   (Followers: 1)
Liver International     Hybrid Journal   (Followers: 12)
Liver Transplantation     Hybrid Journal   (Followers: 9)
Methods in Enzymology     Full-text available via subscription   (Followers: 12)
Nature Reviews Gastroenterology & Hepatology     Full-text available via subscription   (Followers: 39)
Nederlands Tijdschrift voor Diabetologie     Hybrid Journal  
Neurogastroenterology & Motility     Hybrid Journal   (Followers: 2)
Nigerian Journal of Gastroenterology and Hepatology     Full-text available via subscription  
Obesity Science & Practice     Open Access   (Followers: 1)
Open Diabetes Journal     Open Access  
Open Journal of Gastroenterology     Open Access   (Followers: 3)
Pancreatology     Full-text available via subscription   (Followers: 3)
Revista Brasileira de Coloproctologia     Open Access  
Revista de Gastroenterología de México     Open Access  
Revista de Gastroenterología de México (English Edition)     Open Access  
Revista de Gastroenterología del Perú     Open Access  
Revista Española de Enfermedades Digestivas     Open Access  
Revista Estomatológica Herediana     Open Access  
Revista GEN     Open Access  
Revue de Stomatologie et de Chirurgie Maxillo-faciale     Full-text available via subscription   (Followers: 1)
Saudi Journal of Gastroenterology     Open Access   (Followers: 2)
Saudi Journal of Obesity     Open Access   (Followers: 1)
Scandinavian Journal of Gastroenterology     Hybrid Journal   (Followers: 11)
Seminars in Liver Disease     Hybrid Journal   (Followers: 8)
South African Gastroenterology Review     Full-text available via subscription  
Techniques in Coloproctology     Hybrid Journal   (Followers: 11)
Techniques in Gastrointestinal Endoscopy     Hybrid Journal   (Followers: 2)
The Lancet Diabetes and Endocrinology     Full-text available via subscription   (Followers: 215)
Therapeutic Advances in Gastroenterology     Open Access   (Followers: 6)
Therapeutic Advances in Gastrointestinal Endoscopy     Open Access   (Followers: 2)
Türkiye Diyabet ve Obezite Dergisi     Open Access  
United European Gastroenterology Journal     Hybrid Journal   (Followers: 3)
Visceral Medicine     Full-text available via subscription  
Viszeralmedizin     Full-text available via subscription  
World Council of Enterostomal Therapists Journal     Full-text available via subscription  
World Journal of Gastroenterology     Open Access   (Followers: 4)
Zeitschrift für Gastroenterologie     Hybrid Journal   (Followers: 7)


Similar Journals
Journal Cover
Journal of Gastrointestinal Cancer
Journal Prestige (SJR): 0.414
Citation Impact (citeScore): 1
Number of Followers: 3  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1941-6628 - ISSN (Online) 1941-6636
Published by Springer-Verlag Homepage  [2626 journals]
  • Extended Gastrectomy for T4b Gastric Adenocarcinoma: Single-Surgeon
    • Abstract: Purpose This study reports single-surgeon experience with extended gastrectomy including en-bloc resection of adjacent organs/structures for T4b stage gastric adenocarcinoma. Time-related changes in patient selection criteria and outcomes were also analyzed. Methods All consecutive gastrectomies for adenocarcinoma performed between May 2004 and December 2017 were extracted from prospectively collected database to study surgical and oncologic results. Time-related changes in outcomes were examined according to three time periods. Results Five hundred eighty-seven gastrectomies were performed throughout the study period including 87 (14.8%) extended resections. The latter most often included pancreatosplenectomy, colon, and liver resections (21, 16, and 11 patients, respectively) resulting in similar postoperative outcomes and survival. Extended gastrectomy was associated with larger tumor size (8.4 vs 5.6 cm), performing total gastrectomy (55.2 vs 35.2%, p < 0.01) and increased blood loss (375 vs 150 ml, p < 0.01) compared with standard gastrectomy. Larger experience in extended gastrectomy allowed for expanding patient selection criteria, considering complex resections and extensive lymphadenectomy. Median and 3-year survival following extended gastrectomy for T4b adenocarcinoma were 14 months and 18%, respectively, which was comparable to standard gastrectomy for T4a adenocarcinoma (p = 0.48). Obesity, nodal stage and type of gastrectomy were associated with survival in T4b adenocarcinoma in the univariable analysis. Obesity and N3a and N3b stages were independent predictors in the multivariable model. Conclusions Extended gastrectomy for T4b gastric adenocarcinoma provides satisfactory surgical outcomes even with expanded patient selection criteria and regardless of the organ involved. Given its poor prognosis, neoadjuvant therapy should be considered to improve the long-term oncologic results.
      PubDate: 2019-03-21
  • TGF-β Inhibitors in Metastatic Pancreatic Ductal Adenocarcinoma
    • Abstract: Background Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancerrelated mortality in the USA, and the overall incidence of the disease is increasing such that it is expected to be the third leading cause of cancer-related deaths in the next decade. Minimal improvements in therapy have not changed the overall mortality rate over the past decade for patients with PDAC. The purpose of this review is to identify new data regardign the role of Transforming growth factor beta (TGF-β) based therapeuics in patients with PDAC. Methods The literature was searched for peer reviewed manuscripts regarding the use of TGF-β inhibitors in PDAC therapy and the mechanism in which TGF-β intracellular signaling effects patient survival. Results TGF-β plays a vital, context-dependent role as both a tumor suppressor and promoter of PDAC. The downstream effects of this duality play a significant role in the immunologic response of the tumor microenvironment (TME), epithelial-mesenchymal transformation (EMT), and the development of metastatic disease. Immunologic pathways have been shown to be successful targets in the treatment of other diseases, though they have not been shown efficacious in PDAC. TGF-β-mediated EMT does play a critical role in PDAC progression in the development of metastases. The use of anti-TGF-β-based therapies in phase I and II clinical trials for metastatic PDAC demonstrate the importance of understanding the role of TGF-β in PDAC progression. Conclusion This review clarifies the recent literature investigating the role of anti-TGF-β-based therapy in PDAC and areas ripe for targeted investigations and therapies.
      PubDate: 2019-03-20
  • Computerized Tomography Criteria as a Tool for Simplifying the Assessment
           of Locally Advanced Rectal Cancer
    • Abstract: Background Rectal cancer represents a leading cause of mortality worldwide. Staging defines the local and distant extent of the disease, guides management, and predicts prognosis. Different modalities are available for staging including TRUS (transrectal ultrasound), CT (computed tomography), and MRI (magnetic resonance imaging). Objective The objective of this study was to screen and isolate CT imaging parameters suggestive of advanced rectal cancer and its utility as a tool in simplifying the staging protocol making further imaging studies unnecessary. Design Retrospective, single center study. Patients and Settings Seventy-five patients with rectal carcinoma were included and were divided into two groups according to their T score and nodal involvement status, as diagnosed by TRUS. Group 1 (n = 15) “local disease” (T1/T2 N0) and group 2 (n = 60) “locally advanced disease” are both eligible for neoadjuvant treatment (N/any T or T3/any N). For each patient, three CT imaging parameters that represent locally advanced disease, i.e., perirectal fat infiltration, local lymphadenopathy, and rectal wall thickening, were evaluated and compared between the two groups. Main Outcome Measure The capability of CT imaging to accurately predict locally advanced rectal carcinoma. Results Rectal wall thickening on CT was found to have 92% PPV and perirectal lymphadenopathy 96% PPV for predicting a locally advanced stage. A combination of those two parameters results in a predictive PPV of 98%. Limitations This was a single center retrospective study, with a relatively small cohort. Conclusions CT is a valuable tool in the assessment and management of rectal carcinoma as it can identify locally advanced rectal cancer. This enables treatment without any further unnecessary evaluation.
      PubDate: 2019-03-11
  • Histopathological Examination of Gallbladder Specimens in Kumaon Region of
    • Abstract: Gall stones are one of the major causes of morbidity and mortality all over the world and common health problems throughout in developing countries. Cholecystectomy is one of the most common surgical practices and postoperative analysis of cholecystectomy specimen has a great value since histopathological reports may document some entities with significant clinical significances. Gallbladder carcinomas in cholecystectomy specimens are received in our histopathology laboratory to analyse their clinicopathological features. This was a descriptive study carried out at the histopathology section of the Department of Pathology at our hospital over a period of two years ranging from November 2016 to October 2018. Both intraoperative and postoperative histological examinations of the excised gallbladder facilitated the diagnosis of gallbladder cancer. Surgery-related variables and surgical approaches were evaluated according to the extent of tumor invasion. Twenty five cholecystectomy specimens of the acute and symptomatic chronic cholecystitis patients were analyzed. Standardization of the reporting were examined. Age, gender, presence of gall stone, cholesterolosis, adenomatous hyperplasia, gastric or intestinal metaplasia, dysplasia, histopathological type of gallbladder carcinoma, cellular differentiation, grading, lympho vascular invision, perineural invasion, lymph node invasion, involvement of cystic duct end margin, liver invasion, omental tissue invasion and T.N.M. staging were investigated. Reported rates of histopathological findings were comparable between patients aged twenty six years to seventy six years. Epithelial hyperplasia and metaplasia were found to be related to age. The correlation between cholesterolosis and gender or metaplasia was noted. We suggest that in India and other nations, high incidences of gallbladder carcinoma, all cholecystectomy specimens must be submitted to routine macroscopic and histopathology examination in the laboratory, as this is the only capability through which malignancies can be detected at an early, potentially curable stage. This incidental finding has altered the management and outcome of this dreadful disease.
      PubDate: 2019-03-08
  • Colon Adenocarcinoma Stage IIA—Can We Predict Relapse'
    • Abstract: Purpose To determine prognostic factors for stage IIA colon cancer (CC) recurrence in patients undergoing curative intent surgery without adjuvant treatment. Methods Single-centre cohort study. All patients with stage IIA CC discussed in a multidisciplinary colorectal cancer clinic from January 2010 to December 2012 were evaluated. Clinical data, laboratory data and tumour features, including expression of DNA repair proteins (EDRP), were analysed. Assessment of overall and disease free survival, recurrence, recurrence site and recurrence’s method of diagnosis was performed. The associations between variables were tested through the Fisher’s exact test (SPSS 23). Results Fifty-five patients were included (55% male gender; mean age at diagnosis was 70.3 years (42–88)). CC was in the left colon in 62%, high grade in 7% and had lymphovascular invasion in 7% of the cases. Only one patient was submitted to emergent surgery for obstructive symptoms. In 55% of cases ≥ 12 lymph nodes were collected. There was EDRP loss in nine patients (MLH1/PMS2: six; MSH2/MSH6: three)—only two fulfilled revised Bethesda criteria. Recurrence occurred in five patients (8.9%), and it was diagnosed through surveillance in all of them. No variable showed a statistically significant association with recurrence; however, there were no recurrences in patients with EPRD loss (p = 0.209). Mean follow-up time was 43 months (2–70). In those with recurrence, mean disease-free survival was 23.4 months. Conclusions The overall good prognosis and absence of recurrence predictive factors were confirmed, validating the decision of not to submit stage IIA CC patients to chemotherapy risks.
      PubDate: 2019-03-04
  • Acknowledgment of Reviewers 2016 and 2017
    • PubDate: 2019-03-01
  • Giant Hepatic Adenoma in a 12-Year-Old Girl
    • PubDate: 2019-03-01
  • Acinar Cell Carcinoma of Pancreas: a Case Report and Review of Literature
    • PubDate: 2019-03-01
  • Posterior Reversible Encephalopathy Syndrome During Treatment with
           Aflibercept, 5-Fluorouracil, Leucovorin, and Irinotecan for Metastatic
           Colorectal Cancer
    • PubDate: 2019-03-01
  • Surprising Twist in the Plot – Sister Mary Joseph’s Nodule of
    • PubDate: 2019-03-01
  • Primary Squamous Cell Carcinoma of the Pancreas: a Case Report and
           Literature Review
    • PubDate: 2019-03-01
  • Gallbladder Adenocarcinoma as the First Manifestation of Germline BRCA1
    • PubDate: 2019-03-01
  • Hemostatic Radiotherapy Used Twice for Inoperable Progressive Gastric
           Cancer with Bleeding
    • PubDate: 2019-03-01
  • Isolated Metachronous Splenic Metastasis from Colon Cancer: Possible
           Explanations for This Rare Entity
    • PubDate: 2019-03-01
  • Colon Metastasis, 8 years after Gastrectomy, for Stage I Gastric
    • PubDate: 2019-03-01
  • Malignant Duodenal GIST in a Patient with Situs Inversus Totalis—a Rare
           Association and Brief Review of Literature
    • PubDate: 2019-03-01
  • Identification of Educational Gaps Among Oncologists Who Manage Patients
           with Pancreatic Cancer
    • Abstract: Introduction Pancreatic ductal adenocarcinoma (PDA) is associated with poor outcomes and presents oncologists with a myriad of clinical challenges. This study was conducted to assess oncologists’ practice patterns and to identify the greatest areas of need for future PDA continuing medical education (CME) programs. Methods Case vignettes have been validated as an effective tool to assess how physicians approach and treat a wide array of diseases. In order to assess practice patterns for resectable, locally advanced unresectable, and metastatic PDA, an online case vignette survey was distributed to practicing medical oncologists. Results Responses from 150 US-practicing oncologists were analyzed, and several key opportunities for future CME programs were identified. For case 1 (patient with resectable PDA), 44% of oncologists did not select an evidence-based adjuvant chemotherapy regimen. For case 2 (patient with locally advanced PDA who develops metastases and neuropathy after first-line nab-paclitaxel/gemcitabine followed by chemoradiation), 57% of oncologists did not select an evidence-based second-line chemotherapy regimen, and 35% selected a regimen containing oxaliplatin, a chemotherapeutic known to cause neuropathy. For case 3 (patient with a pancreatic mass and liver metastases), only 34% of oncologists recommended a biopsy, chest imaging, and liver function tests which should be standard of care assessments with this presentation. For all three cases, clinical trial referral was selected by fewer than 5% of respondents. Conclusions This study identified appreciable discrepancies between oncologists’ recommendations and standard evidence-based guidelines. Well-designed CME programs may help to bridge the educational gaps identified and improve adherence to practice guidelines.
      PubDate: 2019-03-01
  • Pancreatic Cancer and Immunotherapy: Resistance Mechanisms and Proposed
    • Abstract: Background Pancreatic ductal adenocarcinoma (PDAC) continues to be one of the most aggressive and lethal diseases in the world. The success of immunotherapy in other types of malignancy has led to further trials to understand better the role of immunotherapy in PDAC. However, initial studies with immunotherapy, namely, the checkpoint inhibitors, in PDAC have not been met with the same outcomes. The purpose of this review is to identify and discuss the various resistance mechanisms of PDAC to immunotherapy (pancreatic stroma, genetic predisposition/epigenetics, and the immune inhibitory cells, cytokines, soluble factors, and enzymes that comprise the tumor microenvironment) and the solutions currently being studied to overcome them. Conclusions Various preclinical and early clinical studies have shown that immunotherapy, especially checkpoint inhibitors, in PDAC may be efficacious as part of a multi-modal treatment, in combination with other therapies that target these resistance mechanisms. Several clinical trials are ongoing to explore this concept further.
      PubDate: 2019-03-01
  • Hepatocellular Carcinoma Surveillance—Experience from Croatian Referral
           Centre for Chronic Liver Diseases
    • Abstract: Purpose For patients at high-risk of developing hepatocellular carcinoma (HCC), biannual ultrasound surveillance has long been recommended, in order to detect the tumor in the early, potentially curative stages. However, globally reported HCC surveillance rates vary greatly, ranging from as low as 1.7 to as high as 80%. Our aim was to assess the utilization of surveillance with biannual ultrasound in high-risk Croatian patients and to identify the factors that impact the implementation of the recommended protocol. Methods This retrospective study included 145 newly diagnosed HCC patients in the period from January 2010 to September 2015. We identified low-risk and high-risk patients. The latter were further subdivided into the regular biannual ultrasound surveillance group and the non-surveillance group. The groups were compared according to demographic characteristics and BCLC stage at the time of HCC diagnosis. Results Among 145 patients, 80 patients were classified as high-risk according to EASL criteria. During the relevant period, 28.7% underwent regular surveillance, while 71.25% did not. Younger patients were more likely to undergo surveillance (OR 0.935 CI 0.874–0.999; p = 0.05). The patients who underwent regular surveillance had a higher chance of being diagnosed at a curative stage (BCLC 0 or A) (OR 3.701 CI 1.279–10.710; p < 0.05).Gender was not a predictor of participation in the regular surveillance protocol. Among the high-risk patients who did not undergo regular surveillance, 56.1% were not aware of the chronic liver disease prior to the HCC diagnosis. Conclusion HCC surveillance is still underutilized in high-risk Croatian patients despite its obvious benefits possibly due to the untimely diagnosis of the chronic liver disease.
      PubDate: 2019-03-01
  • Progression-Free Survival in Patients Receiving Chemotherapy Alone (C) or
           Chemotherapy with Bevacizumab (CB) for First-Line Treatment of KRAS Mutant
           Metastatic Colorectal Cancer in Community Oncology Settings
    • Abstract: Purpose Bevacizumab is a standard first-line (L1) treatment for metastatic colorectal cancer (mCRC) patients regardless of RAS status. This retrospective study examined treatment patterns and outcomes in a community oncology sample of KRAS mutant mCRC patients treated with chemotherapy (C) or C plus bevacizumab (CB) in L1. Methods This study used medical records from the Vector Oncology Data Warehouse. Eligible patients were confirmed KRAS mutant mCRC and received L1 C or CB. Kaplan-Meier analysis assessed L1 progression-free survival (PFS) and overall survival (OS). Cox regression models examined the interaction of tumor location (R/L) with treatment. Results CB (n = 264) compared to C (n = 109) patients were younger, less likely performance status (PS) impaired, and more likely with liver metastases. Median unadjusted PFS was 10.41 months (95% CI 9.0–11.3) in CB and 7.66 months (95% CI 6.5–9.1) in C patients (p = 0.174). Median unadjusted OS was 26.91 months (95% CI 24.3–29.3) in CB and 23.33 months (95% CI 19.7–29.2) in C patients (p = 0.571). For patients with right- vs. left-sided tumors, C (but not CB)-treated patients had higher adjusted risk for progression (HR = 1.715, 95% CI 1.108, 2.653; p = 0.015). Conclusions CB- vs. C-treated KRAS mutant mCRC patients may have a meaningful PFS benefit. Patients with right-sided tumors treated with C were at higher risk for disease progression than patients with left-sided tumors. Tumor location had no significant effect on outcomes in the CB cohort.
      PubDate: 2019-03-01
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Heriot-Watt University
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