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Pancreatic Neoplasms: HELP
Articles by Tom R. Kurzawinski
Based on 4 articles published since 2010
(Why 4 articles?)

Between 2010 and 2020, Tom Kurzawinski wrote the following 4 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Review Dictating genomic destiny: Epigenetic regulation of pancreatic neuroendocrine tumours. 2018

Gundara, Justin S / Jamal, Karim / Kurzawinski, Tom. ·Centre for Endocrine Surgery, University College London Hospital, London, United Kingdom. Electronic address: jgundara@med.usyd.edu.au. · Centre for Endocrine Surgery, University College London Hospital, London, United Kingdom. ·Mol Cell Endocrinol · Pubmed #28385665.

ABSTRACT: Pancreatic neuroendocrine tumours are a diverse group of neoplasms with an increasingly well-defined genomic basis. Despite this, much of what drives this disease is still unknown and epigenetic influences represent the next tier of gene, and hence disease modifiers that are of unquestionable importance. Moreover, they are of arguably more significance than the genes themselves given their malleable nature and potential to be exploited for not only diagnosis and prognosis, but also therapy. This review summarises what is known regarding the key epigenetic modifiers of disease through the domains of diagnosis, prognosis and treatment.

2 Clinical Trial Glucagon-like peptide-1 versus somatostatin receptor targeting reveals 2 distinct forms of malignant insulinomas. 2011

Wild, Damian / Christ, Emanuel / Caplin, Martyn E / Kurzawinski, Tom R / Forrer, Flavio / Brändle, Michael / Seufert, Jochen / Weber, Wolfgang A / Bomanji, Jamshed / Perren, Aurel / Ell, Peter J / Reubi, Jean Claude. ·Institute of Nuclear Medicine, University College Hospital, London, United Kingdom. ·J Nucl Med · Pubmed #21680696.

ABSTRACT: METHODS: Eleven patients with malignant insulinoma were prospectively included. (111)In-[Lys(40)(Ahx-diethylenetriaminepentaacetic acid [DTPA])NH(2)]-exendin-4 SPECT/CT, (68)Ga- DOTATATE PET/CT, and in vitro receptor autoradiography were performed to assess the receptor status and to evaluate the detection rate. RESULTS: GLP-1 receptor targeting was positive in 4 of 11 patients, and sst(2) receptor expression was positive in 8 of 11. In only 1 patient were both receptors expressed. In 1 patient, GLP-1 receptor imaging was the only method that successfully localized the primary tumor in the pancreas. In 3 patients with sst(2)-expressing tumors, DOTATATE radiotherapy was effectively applied. CONCLUSION: As opposed to benign insulinomas, malignant insulinomas often lack GLP-1 receptors. Conversely, malignant insulinomas often express sst(2), which can be targeted therapeutically.

3 Article Clinical presentation and waiting time targets do not affect prognosis in patients with pancreatic cancer. 2010

Raptis, Dimitri A / Fessas, Chris / Belasyse-Smith, Peter / Kurzawinski, Tom R. ·Department of Hepatopancreaticobiliary & Endocrine Surgery, University College London Hospitals, NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK. draptis@btinternet.com ·Surgeon · Pubmed #20709279.

ABSTRACT: INTRODUCTION: The prognosis of patients with pancreatic cancer remains poor despite recent advances in treatment. It is not known whether delays in referring, diagnosing and treating these patients and the way they present can affect their survival. AIMS: In our study we investigated the impact of clinical presentation (jaundice, abdominal pain, weight loss) and delays in management of these patients on their treatment and survival. METHODS: Data on all patients with pancreatic cancer referred to the Pancreatic Unit (1997-2002) were collected prospectively and analysed using SPSS 16((R).) The delay in diagnosis and treatment for each patient was measured by estimating the time from the beginning of symptoms to the date of the referral letter (T1), the time from the referral date to the date of first review at the Unit (T2) and the time from date of review to the date of diagnosis/treatment (T3). Treatments were defined as 1) pancreatic resections, 2) gastric and biliary bypass and 3) biliary stents. The term 'operability' was used to describe patients thought to have a potentially removable tumour and had an operation and 'resectability' applied to the patients whose tumour was actually removed at the operation. Follow-up time and survival were recorded by reviewing the patient's notes, hospital electronic databases and by contacting patients General Practitioners. RESULTS: There were a total of 355 patients with pancreatic cancer. Median age at diagnosis was 64 (i.q.r. 56-71) years and median follow-up was 8 (i.q.r. 4-14) months. The overall 1, 3 and 5 years patient's survival was 26%, 5% and 4% respectively. 1, 3 and 5 years survival of inoperable patients was 24%, 2% and 0% and for operable patients was 35%, 13% and 9% respectively. The median survival time for those patients that underwent operation was significantly higher than those that did not (12 vs 6 months, p < 0.001). The overall median time from initial symptoms to diagnosis/treatment (T1 + T2 + T3) was 102 (i.q.r. 56-182) days, T1 was 65 (i.q.r. 31-143), T2 17 (i.q.r. 8-28) and T3 11 (i.q.r. 6-21) days. The time delay from symptoms to referral (T1) had minimal clinical relevance to survival, with a hazard ratio of only 1.001 (95% CI 0.001-0.002, p = 0.043) per day. Of all 355 patients, 305 (86%) were reviewed and treated within 62 days from the GP referral (T2 + T3). There was no significant difference in operability, resectability and survival of patients that were diagnosed/treated before or after 62 days from referral (T2 + T3) (median months 6.5 and 7.9 respectively, p = 0.134). Patients presenting with jaundice were referred (T1, median 56 vs 103) and diagnosed/treated (T2 + T3, median 96 vs 130) days (p < 0.001) sooner, had a higher operability rate (33% vs 21%, p = 0.035) but not a significantly higher resectability rate of (37% vs 29%) (p = 0.608). Isolated or combined mode of clinical presentation had no significant effect on survival (p = 0.965). On multivariate regression analysis, prognostic factors of survival were a resectable tumour and the time from the beginning of symptoms to referral. CONCLUSION: This study showed that pre-hospital delays in referring patients to a specialist unit, but not hospital related 62 days target, had an no impact on operability, resectability and survival. Clinical presentation also had no impact on the survival. We confirmed that pancreatic resection is the most important factor in determining the length of survival in patients with pancreatic cancer. Our study implies that the successful implementation of the 62 days National Cancer Waits Target across the UK is unlikely to have an impact on prognosis in patients with pancreatic cancer. Focusing on early referral to specialist Pancreatic Units might be more effective.

4 Article 'Running on empty'. 2010

Wild, Damian / Theodoraki, Aikaterini / Kurzawinski, Tom R / Bomanji, Jamshed / Reubi, Jean Claude / Khan, Rehman / Bouloux, Pierre / Khoo, Bernard. ·Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, NW1 2BU, UK. ·Eur J Nucl Med Mol Imaging · Pubmed #20419372.

ABSTRACT: -- No abstract --