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Pancreatic Neoplasms: HELP
Articles by Steven C. Agle
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, S. Agle wrote the following 7 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Article Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE). 2017

Martin, R C G / Agle, S / Schlegel, M / Hayat, T / Scoggins, C R / McMasters, K M / Philips, P. ·Division of Surgical Oncology, Department of Surgery and James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY, USA. Electronic address: Robert.martin@louisville.edu. · Division of Surgical Oncology, Department of Surgery and James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY, USA. ·Eur J Surg Oncol · Pubmed #28162818.

ABSTRACT: BACKGROUND: Improved preoperative immunonutrition has been shown to decrease the length of stay (LOS) and complications among patients undergoing elective gastrointestinal cancer surgeries. The purpose of this study was to determine whether preoperative immunonutrition supplementation decreases postoperative LOS, infectious complications, and morbidity in patients undergoing irreversible electroporation (IRE) surgery for locally advanced pancreatic cancer (LAPC). METHODS: At a regional hepatopancreatobiliary referral center within an academic medical center 71 patients receiving IRE treatment of LAPC were included in the study. The participants were divided into those receiving preoperative immunonutrition (n = 44) and those receiving no supplemental preoperative immunonutrition (n = 27). Main outcomes and measures were LOS, postoperative complications, nutritional risk index (NRI), and albumin levels. RESULTS: Patients in both groups were similar for preoperative nutrition parameters and operative therapy. Patients in the immunonutrition group experienced a statistically significant decrease in postoperative complications (p = 0.05) and LOS (10.7 vs. 17.4, p = 0.01), and less of a decrease in nutritional risk index (-12.6 vs. -16.2, p = 0.03) and albumin levels (-1.1 vs. -1.5, p < 0.01). CONCLUSION: Preoperative immunonutrition was clinically significant in decreasing postoperative complications, LOS, and improving post-surgery NRI and albumin levels in patients receiving elective IRE treatment of non-resectable pancreatic cancer. These results indicate that preoperative immunonutrition is effective and feasible in this subset of cancer patients.

2 Article Irreversible electroporation enhances delivery of gemcitabine to pancreatic adenocarcinoma. 2016

Bhutiani, Neal / Agle, Steven / Li, Yan / Li, Suping / Martin, Robert C G. ·Division of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, Kentucky. · Division of Surgical Oncology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas. ·J Surg Oncol · Pubmed #27393627.

ABSTRACT: INTRODUCTION: Irreversible electroporation (IRE) utilizes short, high-voltage pulses to irreversibly permeabilize the cell membrane, resulting in apoptotic cell death. In addition to the irreversible zone, IRE creates a reversible zone that could be utilized for enhanced drug delivery. The hypothesis of this study is that a zone of reversible electroporation exists and allows for increased chemotherapy delivery. METHODS: Ten immunocompromised mice with orthotopic human pancreatic adenocarcinoma tumors (Panc1) were treated with either IRE between two doses of gemcitabine (15 mg/kg) (ECT) (N = 5) or gemcitabine alone (N = 5). Gemcitabine levels in the serum, liver, and pancreas were analyzed with liquid chromatography/mass spectrometry (LC/MS). RESULTS: Concentration of gemcitabine within reversibly electroporated pancreatic tissue was higher in mice receiving ECT compared to those receiving gemcitabine alone (13,567 ng/ml vs.4,126 ng/ml; P = 0.0009). Pancreatic gemcitabine levels were 5.52 and 5.96 times higher than liver and serum levels, respectively, in the ECT group compared to 2.85 and 2.53 times higher (P = 0.117, P = 0.058), respectively, in mice receiving gemcitabine alone. CONCLUSION: IRE can potentially reduce local recurrence by allowing increased drug delivery to the tissue in the reversible electroporation zone. This holds significant potential in augmenting efficacy of gemcitabine in treatment of locally advanced and borderline resectable pancreatic adenocarcinoma. J. Surg. Oncol. 2016;114:181-186. © 2016 Wiley Periodicals, Inc.

3 Article Murine mesothelin: characterization, expression, and inhibition of tumor growth in a murine model of pancreatic cancer. 2016

Zervos, Emmanuel / Agle, Steven / Freistaedter, Andrew G / Jones, Gwendolyn J B / Roper, Rachel L. ·Department of Surgery, Brody School of Medicine, East Carolina University, 600 Moye Blvd, Rm 5E106A mailstop 629, Greenville, NC, 27834, USA. ZERVOSE@ecu.edu. · Department of Surgery, Brody School of Medicine, East Carolina University, 600 Moye Blvd, Rm 5E106A mailstop 629, Greenville, NC, 27834, USA. scagle@utmb.edu. · Microbiology & Immunology, East Carolina University Brody School of Medicine, Greenville, USA. drewfrei86@gmail.com. · Microbiology & Immunology, East Carolina University Brody School of Medicine, Greenville, USA. bassg@ecu.edu. · Microbiology & Immunology, East Carolina University Brody School of Medicine, Greenville, USA. roperr@ecu.edu. ·J Exp Clin Cancer Res · Pubmed #26931187.

ABSTRACT: BACKGROUND: Mesothelin has attracted much interest as a tumor specific antigen; it has been reported to promote tumor development and to be a good target for cancer treatment. Most studies to date have used human mesothelin in immunocompromised mice. Since these models do not allow for study of the natural immune response to mesothelin expressing tumors, we have undertaken the characterization of mouse mesothelin so the effects of this protein can be assessed in immunocompetent mouse strains. METHODS: We analyzed mouse mesothelin expression, tissue distribution, shedding and biochemistry. In addition we constructed stable mesothelin overexpressing lines of the pancreatic cancer line Panc02 by two methods and tested them for growth and tumorigencity in vitro and in vivo. RESULTS: We show here that mouse mesothelin is similar to human mesothelin in biochemical characteristics, tumor expression and tissue distribution, suggesting the mouse may be a suitable model for study of mesothelin. Stable overexpression of mesothelin in a pancreatic cancer cell line did not increase cell proliferation or anchorage-independent growth in vitro, suggesting that mesothelin is not necessarily a tumor progression factor. Surprisingly overexpression of mesothelin inhibited tumor formation in vivo in immunocompetent mice. CONCLUSION: The mouse may be a good model for studying mesothelin in the context of an intact immune response. Mesothelin is not necessarily a tumor progression factor, and indeed mesothelin overexpression inhibited tumor growth in immunocompetent mice.

4 Article Restrictive blood transfusion protocol in malignant upper gastrointestinal and pancreatic resections patients reduces blood transfusions with no increase in patient morbidity. 2015

Wehry, John / Agle, Steven / Philips, Prejesh / Cannon, Robert / Scoggins, Charles R / Puffer, Lisa / McMasters, Kelly M / Martin, Robert C G. ·Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA. · Division of Surgical Oncology, Department of Surgery, University of Louisville, 315 East Broadway #312, Louisville, KY, 40202, USA. Electronic address: robert.martin@louisville.edu. ·Am J Surg · Pubmed #26602534.

ABSTRACT: BACKGROUND: The purpose of this study was to determine the impact of a restrictive blood transfusion protocol on the number of transfusions performed and the related effect on patient morbidity. METHODS: A cohort study was performed using our prospective database with information from January 1, 2000, to June 1, 2013. The restrictive blood transfusion protocol was implemented in September 2011, so this date served as the separation point for the date of operation criteria. RESULTS: For the study, 415 patients undergoing operation for an abdominal malignancy were reviewed. After the restrictive blood transfusion protocol, the percentage of patients who received blood dropped from 35.6% to 28.3%. The percentage of patients who experienced perioperative complication was significantly higher in transfused patients compared with those who did not receive blood (P = .0001). There was no statistical significance observed between the 5 groups for the length of stay at the hospital after their procedure. CONCLUSIONS: The restrictive blood transfusion protocol resulted in a reduction of the percentage of patients transfused, and there was no evidence to suggest that it negatively affected the outcomes of patients in this group.

5 Article Manganese superoxide dismutase expression is negatively associated with microRNA-301a in human pancreatic ductal adenocarcinoma. 2015

Pandit, H / Zhang, W / Li, Y / Agle, S / Li, X / Li, S P / Cui, G / Li, Y / Martin, R C G. ·Department of Surgery, Division of Surgical Oncology, University of Louisville School of Medicine, Louisville, KY, USA. · Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, USA. · Department of Hand Surgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China. · Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic/NB40, Cleveland, OH, USA. ·Cancer Gene Ther · Pubmed #26384137.

ABSTRACT: Manganese superoxide dismutase (MnSOD) expression has been found to be low in human pancreatic ductal adenocarcinoma (PDAC). Previously, we have reported that microRNA-301a (miR-301a) was found being upregulated via nuclear factor-κB (NF-κB) feedback loop in human PDAC. In this study, we investigate whether the miR-301a expression level is associated with MnSOD expression in human PDAC. We established a xenograft PDAC mouse model using transfected PanC-1 cells (miR-301a antisense or scrambled control) to investigate tumor growth and the interaction between MnSOD and miR-301a. The animal study indicated that miR-301a antisense transfection could significantly decrease the growth rate of inoculated PDAC cells, and this decrease in tumor growth rate is associated with increased MnSOD expression. To evaluate the MnSOD-miR-301a correlation in human PDAC, we have analyzed a total of 60 PDAC specimens, along with 20 normal pancreatic tissue (NPT) specimens. Human specimens confirmed a significant decrease of MnSOD expression in PDAC specimens (0.88±0.38) compared with NPT control (2.45±0.76; P<0.05), whereas there was a significant increase in miR-301a levels in PDAC specimens (0.89±0.28) compared with NPT control (0.25±0.41; P<0.05). We conclude that MnSOD expression is negatively associated with miR-301a levels in PDAC tissues, and lower miR-301a levels are associated with increased MnSOD expression and inhibition of PDAC growth.

6 Article The role of hepatic artery lymph node in pancreatic adenocarcinoma: prognostic factor or a selection criterion for surgery. 2014

Philips, Prejesh / Dunki-Jacobs, Erik / Agle, Steven C / Scoggins, Charles / McMasters, Kelly M / Martin, Robert C G. ·Division of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY, USA. ·HPB (Oxford) · Pubmed #25123504.

ABSTRACT: BACKGROUND: Hepatic artery lymph node (HALN) metastasis in pancreatic adenocarcinoma reportedly confers a survival disadvantage. This has led some authors to propose it as an indicator against pancreaticoduodenectomy (PD). METHODS: Consecutive patients who underwent PD during 2002-2012 were identified from the University of Louisville prospective hepatopancreaticobiliary database. Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-Meier analysis. The log-rank test and multivariate Cox proportional hazards regression were used in further analyses. RESULTS: A total of 420 patients underwent PD during the period of study, of whom 197 had lymph node (LN) metastasis. Among these, 41 (20.8%) patients had disease-positive HALNs. The HALN was the only site of LN metastasis in only three of the 247 patients (1.2%). Median follow-up was 18.5 months (interquartile range: 4.1-28.2 months). Median OS and DFS were 22.7 months [95% confidence interval (CI) 19.0-26.3] and 12.6 months (95% CI 10.2-15.2). There was no significant difference in median OS between HALN-positive patients (18.4 months, 95% CI 12.3-24.0) and HALN-negative patients (19.7 months, 95% CI 16.7-22.6) (P = 0.659). On multivariate analysis, the hazard ratio (HR) of death was highest among patients with an LN ratio of >0.2 (HR 1.2, 95% CI 1.1-1.29; P = 0.012) followed by those with poorly differentiated histology (HR 1.09, 95% CI 1.04-1.11; P = 0.029). CONCLUSIONS: In pancreatic adenocarcinoma patients with LN disease, survival after PD is comparable regardless of HALN status. Therefore, HALN-positive disease should not preclude the performance of PD.

7 Article Impact of pancreatic cancer and subsequent resection on glycemic control in diabetic and nondiabetic patients. 2011

White, Michael A / Agle, Steven C / Fuhr, Hannah M / Mehaffey, James H / Waibel, Brett H / Zervos, Emmanuel E. ·Division of Surgical Oncology, Department of Surgery, East Carolina University, Greenville, North Carolina, USA. ·Am Surg · Pubmed #21944519.

ABSTRACT: The incidence of new onset or worsening diabetes is surprisingly low in patients after partial pancreatectomy for cancer, leading us to question what factors predict diminished glycemic control in those undergoing resection. All patients undergoing pancreatectomy for cancer at a large, rural university teaching hospital between 1996 and 2010 were identified. The incidence of new onset, or worsening, existing diabetes was determined based on pre and postoperative medication requirement. Univariate analysis was undertaken to identify factors that predict worsened glycemic control. One hundred and one (1 total, 79 Whipple, 21 distal) patients were identified, 41 per cent of which had preexisting diabetes. Nearly half of existing diabetics manifested an increased medication requirement prior to their cancer diagnosis. New onset diabetes occurred in 20 per cent of postoperative patients. Of established diabetics, 34 per cent had either improved glycemic control (9/41) or were cured (5/41) despite the reduction of islet cell mass that occurred with surgery. On univariate analysis, only prolonged hospitalization was associated with worsened glycemic control. Diminished glycemic control is a frequent presenting symptom of pancreatic cancer. Worsened or new onset diabetes is associated with length of stay, which can be influenced by a number of factors including complications and comorbidities.