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Pancreatic Neoplasms: HELP
Articles by V. Procházka
Based on 8 articles published since 2010
(Why 8 articles?)

Between 2010 and 2020, V. Procházka wrote the following 8 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Article Radiofrequency ablation in pancreatic cancer. 2019

Hlavsa, J / Procházka, V / Andrasina, T / Pavlík, T / Penka, I / Kala, Z. · ·Rozhl Chir · Pubmed #31948242.

ABSTRACT: INTRODUCTION: Clinical study evaluating the impact of intraoperative radiofrequency ablation in pancreatic cancer. METHODS: Patients with histologically proved pancreatic cancer were included. Two groups were defined. In the RFA group (n=24) intraoperative RFA of the pancreatic tumour was performed. In the control group (n=24) only the bypass procedure was indicated (gastroenteric and hepaticojejunal anastomosis). No patient received neoadjuvant chemotherapy. Three-month morbidity and mortality, overall survival, quality of life, pain relief and radiological response were studied. RESULTS: Overall three-month morbidity and mortality were 41.7% and 8.3%, respectively. RFA related morbidity and mortality reached 16.6% and 8.3%, respectively. The overall median survival time was 9.9 and 8.3 months in the RFA group and in the control group, respectively. The survival difference was not of statistical significance (p=0.758). QoL improvement after RFA was not proved. There was no statistically significant analgesic effect of RFA. Postoperative CT scan assessed as per RECIST criteria displayed progressive disease, stable disease, partial response and complete response in 41.6%, 45.8%, 8.3% and 0% cases, respectively. CONCLUSION: Intraoperative RFA of locally advanced and metastatic pancreatic cancer is a feasible palliative method. A survival benefit of this method remains doubtful, even though some positive results have been achieved in patients with localized, well-differentiated tumours. Although RFA was not associated with any impairment of the quality of life, no convincing evidence of a positive impact thereof on QoL was shown, either, during the three-month postoperative period. Pain relief was not achieved during the first 3 months after RFA.

2 Article Analysis of Blood Plasma MicroRNAs to Enable Identification of Patients with Pancreatic Ductal Adenocarcinoma Who Will Benefit from Surgical Resection 2019

Gablo N., A / Procházka, V / Hlavsa, J / Kiss, I / Srovnal, J / Kala, Z / Slabý, O. · ·Klin Onkol · Pubmed #31064193.

ABSTRACT: BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is the most common malignancy of pancreas, characterized by extremely poor prognosis largely due to problem with early diagnosis and lack of progress in personalization of therapy. Of all available treatment strategies, radical surgical resection of the tumour in its early stage remains the only possibility how to reach long-term survival. However, even a technically perfect surgical resection may still not provide a survival benefit for all PDAC patients. Appropriate selection of patients for surgical resection is one the important medical needs in management of PDAC patients. MATERIAL AND METHODS: To this study we enrolled 24 PDAC patients who underwent surgical resection and preoperatively collected their blood plasma specimends. Patients were divided into to two prognostic groups according to their overall survival - 12 patients with poor prognosis (median overall survival 10 months) and 12 patients with good prognosis (median overall survival 25 months). Small RNA sequencing technology was applied to screen for microRNAs (miRNA) with differential levels between both PDAC patients group. cDNA libraries were prepared using QIAseq miRNA Library Kit (Qiaqen) and sequencing by NextSeq500 instrument (Illumina). RESULTS: When miRNA expression profiles of the PDAC patients from good and poor prognostic groups were compared, 61 miRNAs were identified to have significantly different plasma levels between the two groups (p < 0.05). A total of 21 miRNAs showed increased expression and 40 miRNAs showed decreased expression in a group of patients with poor prognosis compared to patients with good prognosis. CONCLUSION: This study demonstrated differences in miRNA expression profiles in preoperative plasma specimens of PDAC patients with short and long overall survival. Our observations indicate that after independent validations plasma miRNAs might become useful biomarkers for identification of PDAC patients having clinical benefit from surgical resection of the tumour. This work was supported by Czech Ministry of Health, grant No. 16-31314A. All rights reserved. The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 8. 3. 2019 Accepted: 9. 3. 2019.

3 Article IgG4 Sclerosing Cholangitis - an Inflammation Imitating Tumour of the Pancreas and Biliary Tract. 2019

Peňázová, P / Andrašina, T / Novotný, I / Trna, J / Hemmelová, B / Kunovsky, L / Procházka, V / Kala, Z. · ·Klin Onkol · Pubmed #30995856.

ABSTRACT: BACKGROUND: Immunoglobulin (Ig) G4 associated sclerosing cholangitis is a rare inflammatory disease of the biliary tract. Although it is a very progressive condition, it responds to steroid therapy. IgG4 associated sclerosing cholangitis can mimic pancreatic carcinoma, cholangiocarcinoma, and primary sclerosing cholangitis; therefore, it is very important to obtain a differential diagnosis. IgG4 sclerosing cholangitis is a biliary form of IgG4 related systemic disease, in which afflictions of more organs is afflictions of more organs are common, typically biliary form together with pancreatic one. Nonspecific symptoms are obstructive icterus, fatigue, and weight loss. Atypical imaging of the biliary tree and pancreas can be used to distinguish it from other diseases. Laboratory data show elevation of bilirubin, liver enzymes, IgG4 and total IgG concentrations. Sometimes IgE is also elevated with the eosinophilia, oncomarker CA 19-9 and autoimmune antibody is sometimes detected. CASE: This article presents a case of IgG4 sclerosing cholangitis and its related findings. The patient was intially referred for suspected pancreatic tumour, the presumed diagnosis was later changed to cholangiocarcinoma type 4 with concurrent autoimmune pancreatitis. Atypical imaging in cholangiography made us suspect IgG4 inflammation and the diagnostic process began. CONCLUSION: The diagnosis of this disease uses so called HISORt criteria. It is a very complex process in which the success of steroid therapy as a final step can be conclusive, as it was in our case. It is essential to exclude a malign neoplastic growth. The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 5. 12. 2018 Accepted: 10. 1. 2019.

4 Article Evaluation of Dietary Habits in the Study of Pancreatic Cancer. 2016

Azeem, K / Horáková, D / Tomaskova, H / Procházka, V / Shonová, O / Martínek, A / Kysely, Z / Janout, V / Kollárová, H. · ·Klin Onkol · Pubmed #27296404.

ABSTRACT: BACKGROUND: Pancreatic cancer is serious and rapidly progressing condition. Little is known about the role of diet in etiology of pancreatic cancer. The study focused on the role of selected dietary factors related to pancreatic cancer. MATERIAL AND METHODS: The case-control study was performed in the Czech Republic in 2006- 2009, involving three centers in Olomouc, Ostrava and Ceske Budejovice. It comprised a total of 530 persons, of whom 310 had pancreatic cancer and 220 were controls. Data were obtained directly from each participant in an interview with a trained interviewer and entered into a standardized questionnaire. The data were analyzed using a crude odds ratio (OR) and multivariate logistic regression with an adjusted OR and 95% CI. The statistical analysis was performed with the STATA v. 10 software. RESULTS: A very strong protective effect was found in pickled cabbage (OR 0.32; 95% CI 0.19- 0.55), broccoli (OR 0.37; 95% CI 0.25- 0.53), cooked onion (OR 0.14; 95% CI 0.08- 0.27), tomatoes (OR 0.28; 95% CI 0.13- 0.60), raw carrot (OR 0.33; 95% CI 0.20- 0.56), cooked carrot (OR 0.35; 95% CI 0.19- 0.62). In logistic regression model, statistically significant protective associations were found in consumption of more than three portions of cooked vegetables per week (OR 0.16; 95% CI 0.05- 0.55) and high consumption of citrus fruit (OR 0.46; 95% CI 0.23- 0.90). CONCLUSION: The study found statistically significant protective effect of consumption of more than three portions of cooked vegetables per week and high consumption of citrus fruit.

5 Article [A multifactor epidemiological analysis of risk factors for pancreatic cancer in women]. 2015

Azeem, K / Horáková, D / Tomášková, H / Ševčíková, J / Vlčková, J / Pastucha, D / Procházka, V / Shonová, O / Martínek, A / Janout, V / Žídková, V / Kollárová, H. · ·Epidemiol Mikrobiol Imunol · Pubmed #25872994.

ABSTRACT: STUDY OBJECTIVE: A multifactor analysis of risk factors for pancreas cancer in women. MATERIAL AND METHODS: A case-control study was conducted in three centres in the Czech Republic (Olomouc, Ostrava, and České Budějovice) in 2006-2009. In total, 226 women (129 pancreas cancer cases, 97 controls) were included in the study. Statistical analysis was performed, the crude odds ratio (OR) was calculated, and logistic regression analysis was used at a 5% level of statistical significance. RESULTS: A statistically significant inverse association was found between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69). Pregnancy and number of pregnancies or gynecological surgical procedures did not show any association with pancreatic cancer. No significant difference in the first menstrual period was found between pancreatic cancer patients and controls. CONCLUSIONS: The study results showed inverse association between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69), controlled alcohol consumption (OR 0.26; 95% CI: 0.12-0.55), and anti-inflamatory drug use (OR 0.10; 95% CI: 0.02-0.41).

6 Article [Standardization of pancreatic cancer specimen pathological examination]. 2014

Hlavsa, J / Procházka, V / Mazanec, J / Hausnerová, J / Pavlík, T / Andrašina, T / Novotný, I / Penka, I / Kala, Z. · ·Rozhl Chir · Pubmed #24720716.

ABSTRACT: INTRODUCTION: The frequency of R1 resections for pancreatic cancer in studies where a non-standardized protocol of pathological evaluation of the specimen is used varies from 17 to 30%. The aim of our study is to apply the standardized (so-called Leeds) protocol of resected pancreatic specimen pathological examination, and to evaluate the frequency of R1 resections for pancreatic cancer using this new protocol. MATERIAL AND METHODS: Ninety-one patients who underwent pancreatoduodenectomy for pancreatic cancer were included in the study. This group was divided into two subgroups: patients examined by the Leeds protocol (n=20) and those examined by a non-standardized pathological protocol (n=71). The R1 resection rate was evaluated separately in each group. The positivity rate of every individual resection margin was specified in the Leeds protocol group. The correlation of R1 resection rate and "tumour - resection margin distance" parameter was evaluated. The tumour infiltration of peripancreatic adipose tissue was assessed in the non-standardized group. RESULTS: In the Leeds protocol subgroup, R1 and R0 resection rate was 60% (12/20) and 40% (8/20), respectively. Resection line positivity rates were as follows: dorsal 45% (9/20), ventral 35% (7/20), VMS 20% (4/20), cervical 20% (4/20), AMS 15% (3/20). The correlation between the tumour - resection line distance and R1 resection frequency was the following: direct infiltration 30% R1, tumour-resection margin border 0.5 mm 50% R1, 1mm 60%, 1.5 mm 75% R1, 2 mm 80% R1, >2 mm 80% R1. If the criterion of resection line positivity ( 1mm) was set, the R1 resection rate difference between the two groups was of statistical significance. In the subgroup where the non-standardized protocol was used (n=71), R1 resection was recorded in 25 (35.2%) patients. The main cancer-positive areas were peripancreatic adipose tissue in 26.8% (19/71) of cases, and VMS, AMS or retroperitoneal line in 8.5% (6/71), respectively. R0 resection was achieved in 46 (64.8%) patients. The statistically significant (p=0.046) difference in R0 and R1 resection rates was detected (Leeds protocol and non-standardized one: R0 40.0% vs. 64.8% and R1 60.0% vs. 35.2%, respectively) in the studied groups. CONCLUSION: The rate of R1 resections for pancreatic cancer increased in all studies, including ours, where the standardized (Leeds) protocol of pancreatic specimen pathological examination was used. The higher R1 resection rate when using the Leeds protocol is approaching to the local recurrence rate of pancreatic cancer. Therefore, the Leeds protocol can provide more realistic evaluation of local radicality of pancreatoduodenectomy and can also offer more accurate evaluation of the surgical and adjuvant therapy of pancreatic cancer.

7 Article [Pancreatic cancer and lifestyle factors]. 2013

Azeem, K / Sevčíková, J / Tomášková, H / Horáková, D / Procházka, V / Martínek, A / Shonová, O / Janout, V / Kollárová, H. ·Ústav preventivního lékařství, LF UP v Olomouci. ·Klin Onkol · Pubmed #23961856.

ABSTRACT: BACKGROUND: Pancreatic cancer is a serious cancer with unfavorable prognosis. Due to differences in the incidence of pancreatic cancer in different regions, it is clear that factors associated with lifestyle play an important role in the etiology. The aim of this study was to evaluate the impact of selected lifestyle factors in relation to pancreatic cancer. MATERIALS AND METHODS: The study included a total of 529 subjects, including 309 cases and 220 control subjects. Cases of newly diagnosed patients with pancreatic cancer who lived in the region were selected in hospitals in three centers (University Hospital Olomouc, University Hospital Ostrava, Hospital Ceske Budejovice). The control group was obtained in cooperation with selected general practitioners for adults, and it is a population control group. RESULTS: Analyses compared persons who reported consuming alcohol with those who do not consume alcohol. Results showed a statistically significant inverse association, even after adjustment for the other studied factors (OR = 0.57, 95% CI 0.36 to 0.89). When assessing leisure time physical activity, results showed statistically significant inverse association and 35% decrease in the risk (crude OR = 0.65, 95% CI 0.45 to 0.93), and this inverse association was confirmed after adjustment for other studied factors although the result is on the border of statistical significance (adjusted OR = 0.68, 95% CI 0.44 to 1.04). Drinking coffee and tea has only a marginal impact on the occurrence of pancreatic cancer, although the medium and high consumption of black tea was found increased risk by 90 or 44%, respectively. Smoking is considered a causal risk factor for pancreatic cancer, but in this study, a positive association was not found. The study found no statistically significant association between overweight and obesity. CONCLUSION: Physical activity, dietary measures that will lead to weight loss and education to non-smoking can have a significant impact on the primary prevention of cancer.

8 Article [Radiofrequency ablation of pancreatic neuroendocrine tumor]. 2011

Hlavsa, J / Procházka, V / Kala, Z / Man, M / Andrasina, T / Cíhalová, M / Válek, V / Crha, M / Svobodová, I / Urbanová, L. ·Chirurgická klinika, LF MU a FN Brno-Bohunice. hlavsjan@seznam.cz ·Klin Onkol · Pubmed #21717790.

ABSTRACT: BACKGROUNDS: Pancreatic neuroendocrine tumors (PNETs) include a broad range of neoplasms spanning from relatively benign to malignant. Radical resection has been advocated as the only curative method. Debulking (R2) resection can be indicated for locally unresectable PNETs. Debulking surgery improves the quality of life and prolongs overall survival. The disadvantages of this approach include bleeding, pancreatic fistula and tumor spread. No alternative method that would eliminate these complications has been published yet. Considering the encouraging results of the studies describing radiofrequency ablation (RFA) of locally advanced pancreatic cancer, a question arises, whether it might be possible to use RFA as a R2 resection alternative in PNETs. CASE: A 73-year-old gentleman had been admitted due to abdominal pain and hyperglycaemic syndrome. Contrast-enhanced CT showed a tumor of pancreatic head invading portal vein (PV) and superior mesenteric vein (VMS). A surgery was indicated on the basis of EUS-guided FNAB that verified a PNET of uncertain biological behaviour. The surgery confirmed a locally advanced tumor of pancreatic head invading the PV and SMV. Due to the polymorbidity, radical pancreatoduodenectomy with SMV resection was not indicated. Because of the presence of symptoms, RFA of the PNET using ValleyLab generator with cooltip cluster electrode, was performed. Postoperative course was uneventful. Final immunohistochemical examination verified a well-differentiated grade 1 PNET. The patient was regularly monitored during a three-year follow-up. The quality of life was evaluated using standardized EORT QLQ-30 questionnaire. Pain was assessed by a ten-point visual analogue scale (VAS). Ablated area was evaluated annually by contrast-enhanced CT. Postoperatively, abdominal pain ceased (pain decrease from 2 to 0 on VAS). Insulin dose was reduced from 46 IU (international units) to 20 IU of Humulin-R per day. CT verified tumor regression according to RECIST (response evaluation criteria in solid tumors). During the three-year follow-up, no local progression or tumor dissemination was observed. CONCLUSION: We present the first case report of a patient with locally advanced symptomatic pancreatic neuroendocrine tumor successfully treated by intraoperative radiofrequency ablation. More clinical studies are needed to evaluate the clinical relevance of this cytoreductive method in the PNET indication.