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Pancreatic Neoplasms: HELP
Articles by John W. C. Chen
Based on 6 articles published since 2010
(Why 6 articles?)
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Between 2010 and 2020, John Chen wrote the following 6 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Ampullary cancer of intestinal origin and duodenal cancer - A logical clinical and therapeutic subgroup in periampullary cancer. 2017

Chandrasegaram, Manju D / Gill, Anthony J / Samra, Jas / Price, Tim / Chen, John / Fawcett, Jonathan / Merrett, Neil D. ·the Prince Charles Hospital, Brisbane, Queensland 4032, Australia. · Sydney Medical School, University of Sydney, New South Wales 2006, Australia. · Queen Elizabeth Hospital, Adelaide, South Australia 5011, Australia. · Flinders Medical Centre, Adelaide, South Australia 5042, Australia. · School of Medicine, University of Queensland, Queensland 4006, Australia. · Department of Upper GI Surgery, Bankstown Hospital, Sydney, New South Wales 2200, Australia. ·World J Gastrointest Oncol · Pubmed #29085567.

ABSTRACT: Periampullary cancers include pancreatic, ampullary, biliary and duodenal cancers. At presentation, the majority of periampullary tumours have grown to involve the pancreas, bile duct, ampulla and duodenum. This can result in difficulty in defining the primary site of origin in all but the smallest tumors due to anatomical proximity and architectural distortion. This has led to variation in the reported proportions of resected periampullary cancers. Pancreatic cancer is the most common cancer resected with a pancreaticoduodenectomy followed by ampullary (16%-50%), bile duct (5%-39%), and duodenal cancer (3%-17%). Patients with resected duodenal and ampullary cancers have a better reported median survival (29-47 mo and 22-54 mo) compared to pancreatic cancer (13-19 mo). The poorer survival with pancreatic cancer relates to differences in tumour characteristics such as a higher incidence of nodal, neural and vascular invasion. While small ampullary cancers can present early with biliary obstruction, pancreatic cancers need to reach a certain size before biliary obstruction ensues. This larger size at presentation contributes to a higher incidence of resection margin involvement in pancreatic cancer. Ampullary cancers can be subdivided into intestinal or pancreatobiliary subtype cancers with histomolecular staining. This avoids relying on histomorphology alone, as even some poorly differentiated cancers preserve the histomolecular profile of their mucosa of origin. Histomolecular profiling is superior to anatomic location in prognosticating survival. Ampullary cancers of intestinal subtype and duodenal cancers are similar in their intestinal origin and form a logical clinical and therapeutic subgroup of periampullary cancers. They respond to 5-FU based chemotherapeutic regimens such as capecitabine-oxaliplatin. Unlike pancreatic cancers,

2 Review Summary and recommendations from the Australasian guidelines for the management of pancreatic exocrine insufficiency. 2016

Anonymous1200855 / Smith, Ross C / Smith, Sarah F / Wilson, Jeremy / Pearce, Callum / Wray, Nick / Vo, Ruth / Chen, John / Ooi, Chee Y / Oliver, Mark / Katz, Tamarah / Turner, Richard / Nikfarjam, Mehrdad / Rayner, Christopher / Horowitz, Michael / Holtmann, Gerald / Talley, Nick / Windsor, John / Pirola, Ron / Neale, Rachel. ·Department of Surgery, University of Sydney, NSW, Australia; Australasian Pancreatic Club, Australia. Electronic address: Ross.smith@sydney.edu.au. · Australasian Pancreatic Club, Australia. · Liverpool Hospital, University of NSW, Australia. · Institute for Immunology and Infectious Diseases, Murdoch University, WA, Australia; Fremantle Hospital, WA, Australia. · Nutrition & Dietetics, School of Health Sciences, Flinders University, Adelaide, SA, Australia. · South Australian Liver Transplant & HPB Unit, RAH & Flinders Medical Centre, SA, Australia. · School of Women's and Children's Health, Dept. of Medicine, University of NSW, Australia; Department of Gastroenterology, Sydney Children's Hospital, Randwick, NSW, Australia. · Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, VIC, Australia. · Sydney Children's Hospital, Randwick, NSW, Australia. · Hobart Clinical School and Dept. Surgery, University of Tasmania, Australia. · Dept. Surgery, University of Melbourne, VIC, Australia; Australasian Pancreatic Club, Australia. · School of Medicine, University of Adelaide, SA, Australia; Centre for Digestive Diseases, Royal Adelaide Hospital, SA, Australia. · Endocrine and Metabolic Unit, University of Adelaide and Royal Adelaide Hospital, SA, Australia. · Faculty of Medicine and Biomedical Sciences, University of Queensland, Australia; Translational Research Institute, Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Qld, Australia. · Faculty of Health and Medicine, University of Newcastle, NSW, Australia; Royal Australasian College of Physicians, Australia. · Dept. of Surgery, University of Auckland, New Zealand. · Faculty of Medicine, SW Sydney Clinical School, University of NSW, Australia. · Cancer Control Laboratory, Queensland Institute of Medical Research, Qld, Australia. ·Pancreatology · Pubmed #26775768.

ABSTRACT: AIM: Because of increasing awareness of variations in the use of pancreatic exocrine replacement therapy, the Australasian Pancreatic Club decided it was timely to re-review the literature and create new Australasian guidelines for the management of pancreatic exocrine insufficiency (PEI). METHODS: A working party of expert clinicians was convened and initially determined that by dividing the types of presentation into three categories for the likelihood of PEI (definite, possible and unlikely) they were able to consider the difficulties of diagnosing PEI and relate these to the value of treatment for each diagnostic category. RESULTS AND CONCLUSIONS: Recent studies confirm that patients with chronic pancreatitis receive similar benefit from pancreatic exocrine replacement therapy (PERT) to that established in children with cystic fibrosis. Severe acute pancreatitis is frequently followed by PEI and PERT should be considered for these patients because of their nutritional requirements. Evidence is also becoming stronger for the benefits of PERT in patients with unresectable pancreatic cancer. However there is as yet no clear guide to help identify those patients in the 'unlikely' PEI group who would benefit from PERT. For example, patients with coeliac disease, diabetes mellitus, irritable bowel syndrome and weight loss in the elderly may occasionally be given a trial of PERT, but determining its effectiveness will be difficult. The starting dose of PERT should be from 25,000-40,000 IU lipase taken with food. This may need to be titrated up and there may be a need for proton pump inhibitors in some patients to improve efficacy.

3 Review Advances in Molecular Pathology and Treatment of Periampullary Cancers. 2016

Chandrasegaram, Manju D / Chen, John W / Price, Timothy J / Zalcberg, John / Sjoquist, Katrin / Merrett, Neil D. ·From the *NHMRC Clinical Trials Centre; †Department of Surgery, The Prince Charles Hospital, Brisbane; ‡Department of Surgery, Flinders Medical Centre; §Queen Elizabeth Hospital, Adelaide; ∥University of Adelaide, South Australia; ¶School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne; #Cancer Care Centre, Department of Medical Oncology, St George Hospital; **Department of Surgery, Bankstown Hospital; and ††Division of Surgery, University of Western Sydney, Sydney, Australia. ·Pancreas · Pubmed #26348463.

ABSTRACT: OBJECTIVES: Periampullary cancers (PACs) include the following 4 traditional anatomic subtypes: pancreatic, ampullary, biliary, or duodenal cancers. This review was performed to highlight recent advances in the genomic and molecular understanding of each PAC subtype and the advances in chemotherapeutic and molecular trials in these cancer subtypes. RESULTS: Recent advances have highlighted differences in the genomic and molecular features within each PAC subtype. Ampullary cancers can now be further defined accurately into their intestinal and pancreatobiliary subtypes using histomolecular profiling. K-ras mutation, which occurs in most pancreatic cancers, is found to occur less frequently in ampullary (42%-52%), biliary (22%-23%), and duodenal cancers (32%-35%), suggesting crucial differences in targetable mutations in these cancer subtypes.Ampullary cancers of intestinal subtype and duodenal cancers seem to share similarities with colorectal cancer, given that they respond to similar chemotherapeutic regimens. This has potential implications for clinical trials and treatment selection, where PACs are often considered together. CONCLUSIONS: Future trials should be designed in view of our increased understanding of the different anatomic and histomolecularly profiled subtypes of PAC cancers, which respects their individual molecular characteristics, phenotype, and response to treatment.

4 Article An unusual presentation of a rare pancreatic tumour in an atypical population. 2017

Gibson, Edward Lawrence Michael Guy / Cord-Udy, Catherine / Chen, John. ·Surgical Division, Lyell McEwin Hospital, Adelaide, South Australia, Australia. · Paediatric Surgery Unit, Women's and Children's Hospital Adelaide, Adelaide, South Australia, Australia. · Hepatobiliary Surgery Unit, Flinders Medical Centre, Adelaide, South Australia, Australia. ·ANZ J Surg · Pubmed #25598162.

ABSTRACT: -- No abstract --

5 Article Distribution and pathological features of pancreatic, ampullary, biliary and duodenal cancers resected with pancreaticoduodenectomy. 2015

Chandrasegaram, Manju D / Chiam, Su C / Chen, John W / Khalid, Aisha / Mittinty, Murthy L / Neo, Eu L / Tan, Chuan P / Dolan, Paul M / Brooke-Smith, Mark E / Kanhere, Harsh / Worthley, Chris S. ·HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. manju.chandrasegaram@adelaide.edu.au. · Division of Surgery, School of Medicine, University of Adelaide, Adelaide, SA, 5005, Australia. manju.chandrasegaram@adelaide.edu.au. · HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. suchuenchiam@yahoo.co.uk. · HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. john.chen@flinders.edu.au. · Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia. john.chen@flinders.edu.au. · Flinders University, Sturt Rd, Bedford Park, Adelaide, SA, 5042, Australia. john.chen@flinders.edu.au. · Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia. aisha.khalid000@gmail.com. · School of Population Health, University of Adelaide, 178 North Terrace, Adelaide, SA, 5005, Australia. murthy.mittinty@adelaide.edu.au. · HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. eu.neo@health.sa.gov.au. · Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia. eu.neo@health.sa.gov.au. · HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. tanchuanping@gmail.com. · HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. paul.dolan@health.sa.gov. · HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. mark.brooke-smith@flinders.edu.au. · Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia. mark.brooke-smith@flinders.edu.au. · Flinders University, Sturt Rd, Bedford Park, Adelaide, SA, 5042, Australia. mark.brooke-smith@flinders.edu.au. · Division of Surgery, School of Medicine, University of Adelaide, Adelaide, SA, 5005, Australia. Kanhere.Harsh@health.sa.gov.au. · HPB Surgery Unit, Queen Elizabeth Hospital, 28 Woodville Road, Adelaide, SA, 5011, Australia. Kanhere.Harsh@health.sa.gov.au. · HPB Surgery Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. chris.worthley@health.sa.gov.au. ·World J Surg Oncol · Pubmed #25890023.

ABSTRACT: BACKGROUND: Pancreatic cancer (PC) has the worst survival of all periampullary cancers. This may relate to histopathological differences between pancreatic cancers and other periampullary cancers. Our aim was to examine the distribution and histopathologic features of pancreatic, ampullary, biliary and duodenal cancers resected with a pancreaticoduodenectomy (PD) and to examine local trends of periampullary cancers resected with a PD. METHODS: A retrospective review of PD between January 2000 and December 2012 at a public metropolitan database was performed. The institutional ethics committee approved this study. RESULTS: There were 142 PDs during the study period, of which 70 cases were pre-2010 and 72 post-2010, corresponding to a recent increase in the number of cases. Of the 142 cases, 116 were for periampullary cancers. There were also proportionately more PD for PC (26/60, 43% pre-2010 vs 39/56, 70% post-2010, P = 0.005). There were 65/116 (56%) pancreatic, 29/116 (25%), ampullary, 17/116 (15%) biliary and 5/116 (4%) duodenal cancers. Nodal involvement occurred more frequently in PC (78%) compared to ampullary (59%), biliary (47%) and duodenal cancers (20%), P = 0.002. Perineural invasion was also more frequent in PC (74%) compared to ampullary (34%), biliary (59%) and duodenal cancers (20%), P = 0.002. Microvascular invasion was seen in 57% pancreatic, 38% ampullary, 41% biliary and 20% duodenal cancers, P = 0.222. Overall, clear margins (R0) were achieved in fewer PC 41/65 (63%) compared to ampullary 27/29 (93%; P = 0.003) and biliary cancers 16/17 (94%; P = 0.014). CONCLUSIONS: This study highlights that almost half of PD was performed for cancers other than PC, mainly ampullary and biliary cancers. The volume of PD has increased in recent years with an increased proportion being for PC. PC had higher rates of nodal and perineural invasion compared to ampullary, biliary and duodenal cancers.

6 Article Predicting patient survival after pancreaticoduodenectomy for malignancy: histopathological criteria based on perineural infiltration and lymphovascular invasion. 2010

Chen, John W C / Bhandari, Mayank / Astill, David S / Wilson, Thomas G / Kow, Lilian / Brooke-Smith, Mark / Toouli, James / Padbury, Robert T A. ·Hepatopancreatobiliary Unit, Department of Surgery, Flinders Medical Centre, Bedford Park, SA, Australia. john.chen@flinders.edu.au ·HPB (Oxford) · Pubmed #20495653.

ABSTRACT: BACKGROUND: Accurate and simple prognostic criteria based on histopathology following pancreaticoduodenectomy would be helpful in assessing prognosis and considering and evaluating adjuvant therapy. This study analysed the histological parameters influencing outcome following pancreaticoduodenectomy for periampullary malignancy. METHODS: A total of 110 pancreaticoduodenectomies were performed from 1998 to 2008. The median age of patients was 69 years (range 20-89 years). The median follow-up was 4.9 years. Of the procedures, 87% (96) were performed for malignancies and the remainder (n= 14) for benign aetiologies. Of the 96 malignancies, 60 were pancreatic adenocarcinoma and the rest were ampullary (14), cholangio (9), duodenal (9) carcinomas and others. Statistical analysis was performed using log-rank and Cox regression multivariate analyses. RESULTS: Patients who underwent resection had 1-, 3- and 5-year survival rates of 70%, 46% and 41%, respectively. The 1-, 3- and 5-year survival rates for periampullary cancers other than pancreatic adenocarcinoma were 83%, 69% and 61%, respectively; those for pancreatic adenocarcinoma were 62%, 31% and 27%, respectively (P < 0.003). Poor tumour differentiation (P < 0.02), tumour size >3 cm (P < 0.04), margin The presence of perineural infiltration and lymphovascular invasion on histopathology is highly significant in predicting 5-year outcomes after pancreaticoduodenectomy for periampullary and pancreatic malignancies.