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Pancreatic Neoplasms: HELP
Articles by V. J. Gebski
Based on 2 articles published since 2010
(Why 2 articles?)

Between 2010 and 2020, V. Gebski wrote the following 2 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Review Meta-analysis of radical resection rates and margin assessment in pancreatic cancer. 2015

Chandrasegaram, M D / Goldstein, D / Simes, J / Gebski, V / Kench, J G / Gill, A J / Samra, J S / Merrett, N D / Richardson, A J / Barbour, A P. ·National Health and Medical Research Clinical Trials Centre, University of Sydney, New South Wales, Australia. · Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia. · Department of Surgery, Prince Charles Hospital, Queensland, Australia. · Department of Medical Oncology, Prince of Wales Hospital, Prince of Wales Clinical School University of New South Wales, New South Wales, Australia. · Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, New South Wales, Australia. · Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. · Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research, University of Sydney, New South Wales, Australia. · Department of Surgery, Royal North Shore Hospital, New South Wales, Australia. · Discipline of Surgery, School of Medicine, University of Western Sydney, New South Wales, Australia. · Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia. · University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia. ·Br J Surg · Pubmed #26350029.

ABSTRACT: BACKGROUND: R0 resection rates (complete tumour removal with negative resection margins) in pancreatic cancer are 70-80 per cent when a 0-mm margin is used, declining to 15-24 per cent with a 1-mm margin. This review evaluated the R0 resection rates according to different margin definitions and techniques. METHODS: Three databases (MEDLINE from 1946, PubMed from 1946 and Embase from 1949) were searched to mid-October 2014. The search terms included 'pancreatectomy OR pancreaticoduodenectomy' and 'margin'. A meta-analysis was performed with studies in three groups: group 1, axial slicing technique (minimum 1-mm margin); group 2, other slicing techniques (minimum 1-mm margin); and group 3, studies with minimum 0-mm margin. RESULTS: The R0 rates were 29 (95 per cent c.i. 26 to 32) per cent in group 1 (8 studies; 882 patients) and 49 (47 to 52) per cent in group 2 (6 studies; 1568 patients). The combined R0 rate (groups 1 and 2) was 41 (40 to 43) per cent. The R0 rate in group 3 (7 studies; 1926 patients) with a 0-mm margin was 72 (70 to 74) per cent The survival hazard ratios (R1 resection/R0 resection) revealed a reduction in the risk of death of at least 22 per cent in group 1, 12 per cent in group 2 and 23 per cent in group 3 with an R0 compared with an R1 resection. Local recurrence occurred more frequently with an R1 resection in most studies. CONCLUSION: Margin clearance definitions affect R0 resection rates in pancreatic cancer surgery. This review collates individual studies providing an estimate of achievable R0 rates, creating a benchmark for future trials.

2 Clinical Trial The GOFURTGO Study: AGITG phase II study of fixed dose rate gemcitabine-oxaliplatin integrated with concomitant 5FU and 3-D conformal radiotherapy for the treatment of localised pancreatic cancer. 2012

Goldstein, D / Spry, N / Cummins, M M / Brown, C / van Hazel, G A / Carroll, S / Selva-Nayagam, S / Borg, M / Ackland, S P / Wratten, C / Shapiro, J / Porter, I W T / Hruby, G / Horvath, L / Bydder, S / Underhill, C / Harvey, J / Gebski, V J / Anonymous660712. ·Department of Medical Oncology, Prince of Wales Hospital, High Street, Randwick, New South Wales 2031, Australia. david.goldstein@sesiahs.health.nsw.gov.au ·Br J Cancer · Pubmed #22134511.

ABSTRACT: BACKGROUND: Locally advanced inoperable pancreatic cancer (LAPC) has a poor prognosis. By increasing intensity of systemic therapy combined with an established safe chemoradiation technique, our intention was to enhance the outcomes of LAPC. In preparation for phase III evaluation, the feasibility and efficacy of our candidate regimen gemcitabine-oxaliplatin chemotherapy with sandwich 5-fluorouracil (5FU) and three-dimensional conformal radiotherapy (3DCRT) needs to be established. METHODS: A total of 48 patients with inoperable LAPC without metastases were given gemcitabine (1000 mg m(-2) d1 + d15 q28) and oxaliplatin (100 mg m(-2) d2 + d16 q28) in induction (one cycle) and consolidation (three cycles), and 5FU 200 mg m(-2) per day over 6 weeks during 3DCRT 54 Gy. RESULTS: Median duration of sustained local control (LC) was 15.8 months, progression-free survival (PFS) was 11.0 months, and overall survival was 15.7 months. Survival rates for 1, 2, and 3 years were 70.2%, 21.3%, and 12.8%, respectively. Global quality of life did not significantly decline from baseline during treatment, which was associated with modest treatment-related toxicity. CONCLUSION: Fixed-dose gemcitabine and oxaliplatin, combined with an effective and safe regimen of 5FU and 3DCRT radiotherapy, was feasible and reasonably tolerated. The observed improved duration of LC and PFS with more intensive therapy over previous trials may be due to patient selection, but suggest that further evaluation in phase III trials is warranted.