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Pancreatic Neoplasms: HELP
Articles by Miroslav Ryska
Based on 17 articles published since 2010
(Why 17 articles?)
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Between 2010 and 2020, M. Ryska wrote the following 17 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Editorial [Pancreatic resection on carcinoma--importance of staging of the disease]. 2010

Ryska, M. · ·Rozhl Chir · Pubmed #21404510.

ABSTRACT: -- No abstract --

2 Review [Total pancreatectomy for pancreatic malignancy - from history to the present day]. 2016

Ryska, M / Rudiš, J. · ·Rozhl Chir · Pubmed #27879138.

ABSTRACT: Currently, total pancreatectomy (TP) is indicated in approximately one in ten surgical patients with pancreatic cancer. Key role in the decision falls in the competence of the multidisciplinary team, alternatively of the surgeon in the intraoperative period in some cases. Exceptionally, TP is approached in the so-called salvage surgery. Perioperative mortality of TP as an elective procedure does not exceed that of partial resections; however, mortality of up to 50% is associated with salvage surgery in acute postoperative pancreatitis. Postoperatively, patients are afflicted with the so-called brittle diabetes comparable with type 1 diabetes. The aim of our overview is to inform about the current position of TP in the treatment of malignant pancreatic diseases.Key words: pancreatic cancer - total pancreatectomy - multidisciplinary team.

3 Review [Pancreatic cancer - current effective diagnostic and therapeutic approach]. 2016

Ryska, Miroslav. · ·Cas Lek Cesk · Pubmed #26898790.

ABSTRACT: KEY WORDS: pancreatic cancer - diagnosis and therapy, multidisciplinary approach, quality of life.

4 Review [Irreversible electroporation in the treatment of locally advanced pancreatic cancer]. 2015

Záruba, P / Hoskovec, D / Lacman, J / Hořejš, J / Krška, Z / Ryska, M. · ·Rozhl Chir · Pubmed #26767900.

ABSTRACT: INTRODUCTION: Irreversible electroporation (IRE) is a quite novel method of tissue ablation. Its mechanism of action that does not use thermal energy is the most important feature of the method. Current experience with IRE in animal studies and in clinical practice are summarized in the paper. In particular, the paper is focused on using IRE in locally advanced pancreatic carcinoma. METHOD: The basic principle of IRE is that it causes micropores in the phospholipid membrane of cells. This leads to an impairment of cellular homeostasis and programmed cell death - apoptosis. Because of absence of protein denaturation this method spares tubular structures like vessels and ducts. This is the key feature that allows to use IRE in the pancreas where common thermic ablative procedures cannot be used for difficult anatomic circumstances and resulting injury of surrounding structures. PRE-CLINICAL AND CLINICAL STUDIES: The ability to spare vascular structures and ducts was confirmed in many animal studies. Subsequently, IRE was safely utilized also in human liver, pancreas, lung and kidneys. IRE in the treatment of advanced pancreatic cancer: Most experience with IRE ablation has been gathered for locally advanced pancreatic carcinoma where clinical studies published in the recent 5 years have provided encouraging results. CONCLUSION: Irreversible electroporation is a safe method used to decrease tumour mass in pancreatic cancer. Further studies are needed to determine its therapeutic efficiency.

5 Review [Multiple endocrine neoplasia type 1 syndrome with special emphasis on pancreatoduodenal tumours--a case report analysis]. 2013

Menclová, K / Ryska, M. · ·Rozhl Chir · Pubmed #24299284.

ABSTRACT: INTRODUCTION: The syndrome of multiple endocrine neoplasia type 1 (MEN 1) is a relatively rare hereditary disease predisposing to a variety of tumours, some of which may be hormonally active. The main organs affected are the parathyroid, the pituitary and the pancreatoduodenal area. Despite the rarity of MEN 1, its occurrence is not negligible in clinical practice and the clinicians ignorance often leads to delayed diagnosis and inadequate treatment. MATERIAL AND METHODS: The aim of this review is to present contemporary literature on this issue, including the most controversial topic, i.e. recent modalities of treatment of pancreatoduodenal tumours, and to present a case report. The literature review was based on computer searches in PubMed and DynaMed. DISCUSSION: Pancreatoduodenal tumours associated with MEN 1 are relatively slow-growing neoplasias. The development of liver metastases is the main factor of long-term survival. The aim of surgical treatment is the stabilisation of the disease and the prevention of liver metastases. Radical surgical methods may lead to better biochemical curability. The extent of surgical intervention should be selected individually. We discuss our case report in the context of these findings. CONCLUSION: Knowledge of the MEN 1 syndrome has its importance in the clinical practice. Further prospective studies will be needed to evaluate the effectiveness of treatment, especially for pancreatoduodenal tumours.

6 Review [Surgical treatment of pancreatic carcinoma]. 2012

Záruba, P / Ryska, M. ·Chirurgická klinika 2. LF UK a ÚVN Praha. pavel.zaruba@uvn.cz ·Rozhl Chir · Pubmed #23448711.

ABSTRACT: -- No abstract --

7 Article [Laparoscopic versus open left pancreatectomy: surgical stress response comparison in the porcine model]. 2018

Pohnán, R / Ryska, M / Kalvach, J / Hána, L / Henlín, T / Pejchal, J. · ·Rozhl Chir · Pubmed #29792722.

ABSTRACT: INTRODUCTION: Although several techniques of laparoscopic left pancreatectomy have already been developed through experiments on animals and human patients, there is still insufficient information about their pathophysiological mechanisms, especially the impact on surgical stress. METHOD: In a group of 10 pigs, open left pancreatectomy was performed, and the other group of 10 pigs underwent laparoscopic left pancreatectomy. Postoperative stress was compared by determining serum levels of leukocytes, interleukin 1, 6 and CRP from peripheral venous blood collection. The blood was collected prior to incision, 1 and 2 hours after incision, 24 hours after the beginning of the procedure, and on the 7th postoperative day. RESULTS: No statistically significant difference was found between open and laparoscopic left pancreatectomy in the measured values of leukocytes, IL-1 and 6 and CRP.Key words: laparoscopy - left pancreatectomy surgical stress response interleukin 1 interleukin 6.

8 Article [Current status regarding surgical treatment of pancreatic cancer in the Czech Republic]. 2016

Loveček, M / Skalický, P / Ryska, M / Gürlich, R / Hlavsa, J / Čečka, F / Krška, Z / Strnad, R / Peteja, M / Klein, J / Šiller, J / Zajak, J / Krejčí, T / Rupert, K / Kočík, M / Šefr, R / Straka, M / Dušek, L / Jarkovský, J / Havlík, R / Neoral, Č. · ·Rozhl Chir · Pubmed #27226268.

ABSTRACT: INTRODUCTION: The aim is to map the current situation in the surgical treatment of pancreatic cancer in the Czech Republic. This information has been obtained from surgical treatment providers using a simple questionnaire and by identifying the so called high volume centres. The information has been collected in the interest of organizing and planning research projects in the field of pancreatic cancer treatment. METHOD: We addressed centres known to provide surgical treatment of pancreatic cancer. A simple questionnaire formulated one question about the total number of pancreatic resections, also separately for the diagnoses PDAC - C25, in the last two years (2014 and 2015). Other questions focused on the use of diagnostic methods, neoadjuvant therapy, preoperative assessment of risks, the possibility of rapid intraoperative histopathology examination, Leeds protocol, monitoring of morbidity and mortality including long-term results, and the method of postoperative follow-up and treatment. ÚZIS (Institute of Health Information and Statistics of the Czech Republic) was addressed with a request to analyze the frequency of reported total numbers for DPE, LPE, TPE and to do the same with respect to diagnosis C 25 for the last two years, available for the entire Czech Republic (2013, 2014). RESULTS: Altogether 19 institutions were identified by the preceding audit, which reported more than 10 pancreatic resections annually; these institutions were addressed with the questionnaire. Sixteen institutions responded to the questions, 13 of them completely. CONCLUSION: The majority of potentially radical surgeries for PDAC in the Czech Republic are carried out at 6 institutions. All of the institutions that participated in the survey collect data about morbidity and mortality and monitor their results. KEY WORDS: pancreas cancer outcomes surgery.

9 Article TERT gene harbors multiple variants associated with pancreatic cancer susceptibility. 2015

Campa, Daniele / Rizzato, Cosmeri / Stolzenberg-Solomon, Rachael / Pacetti, Paola / Vodicka, Pavel / Cleary, Sean P / Capurso, Gabriele / Bueno-de-Mesquita, H B As / Werner, Jens / Gazouli, Maria / Butterbach, Katja / Ivanauskas, Audrius / Giese, Nathalia / Petersen, Gloria M / Fogar, Paola / Wang, Zhaoming / Bassi, Claudio / Ryska, Miroslav / Theodoropoulos, George E / Kooperberg, Charles / Li, Donghui / Greenhalf, William / Pasquali, Claudio / Hackert, Thilo / Fuchs, Charles S / Mohelnikova-Duchonova, Beatrice / Sperti, Cosimo / Funel, Niccola / Dieffenbach, Aida Karina / Wareham, Nicholas J / Buring, Julie / Holcátová, Ivana / Costello, Eithne / Zambon, Carlo-Federico / Kupcinskas, Juozas / Risch, Harvey A / Kraft, Peter / Bracci, Paige M / Pezzilli, Raffaele / Olson, Sara H / Sesso, Howard D / Hartge, Patricia / Strobel, Oliver / Małecka-Panas, Ewa / Visvanathan, Kala / Arslan, Alan A / Pedrazzoli, Sergio / Souček, Pavel / Gioffreda, Domenica / Key, Timothy J / Talar-Wojnarowska, Renata / Scarpa, Aldo / Mambrini, Andrea / Jacobs, Eric J / Jamroziak, Krzysztof / Klein, Alison / Tavano, Francesca / Bambi, Franco / Landi, Stefano / Austin, Melissa A / Vodickova, Ludmila / Brenner, Hermann / Chanock, Stephen J / Delle Fave, Gianfranco / Piepoli, Ada / Cantore, Maurizio / Zheng, Wei / Wolpin, Brian M / Amundadottir, Laufey T / Canzian, Federico. ·Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD. · Oncology Department, ASL1 Massa Carrara, Massa Carrara, Italy. · Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Science of Czech Republic, Prague, Czech Republic. · Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada. · Digestive and Liver Disease Unit, S. Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy. · Department of Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. · Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Department of General Surgery, University Hospital Heidelberg, Heidelberg, Germany. · Department of Basic Medical Science, Laboratory of Biology, School of Medicine, University of Athens, Athens, Greece. · Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania. · Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN. · Department of Laboratory Medicine, University Hospital of Padua, Padua, Italy. · Surgical and Oncological Department, Pancreas Institute - University and Hospital Trust of Verona, Verona, Italy. · Department of Surgery, Second Faculty of Medicine, Charles University in Prague and Central Military Hospital, Prague, Czech Republic. · 1st Department of Propaedeutic Surgery, School of Medicine, University of Athens, Athens, Greece. · Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA. · Department of Gastrointestinal Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX. · National Institute for Health Research Liverpool Pancreas Biomedical Research Unit, University of Liverpool, Liverpool, United Kingdom. · Department of Surgery, Gastroenterology and Oncology (DISCOG), University of Padua, Padua, Italy. · Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA. · Department of Oncology, Palacky University Medical School and Teaching Hospital in Olomouc, Olomouc, Czech Republic. · Department of Surgery, Unit of Experimental Surgical Pathology, University Hospital of Pisa, Pisa, Italy. · German Cancer Consortium (DKTK), Heidelberg, Germany. · MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. · Divisions of Preventive Medicine and Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. · Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. · Department of Medicine - DIMED, University of Padua, Padua, Italy. · Department of Epidemiology and Public Health, Yale School of Public Health, New Haven, CT. · Department of Epidemiology, Harvard School of Public Health, Boston, MA. · Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA. · Pancreas Unit, Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, Bologna, Italy. · Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY. · Department of Digestive Tract Diseases, Medical University of Łodz, Łodz, Poland. · Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. · Division of Epidemiology, Departments of Obstetrics and Gynecology, Environmental Medicine, and Population Health, New York University School of Medicine, New York, NY. · Surgical Clinic 4, University of Padua, Padua, Italy. · Department of Toxicogenomics, National Institute of Public Health, Prague, Czech Republic. · Division of Gastroenterology and Research Laboratory, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo Della Sofferenza,", San Giovanni Rotondo, Italy. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · ARC-NET: Centre for Applied Research on Cancer, University and Hospital Trust of Verona, Verona, Italy. · Epidemiology Research Program, American Cancer Society, Atlanta, GA. · Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland. · Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD. · Blood Transfusion Service, Azienda Ospedaliero Universitaria Meyer, Florence, Italy. · Department of Biology, University of Pisa, Pisa, Italy. · Department of Epidemiology, University of Washington, Seattle, WA. · Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN. ·Int J Cancer · Pubmed #25940397.

ABSTRACT: A small number of common susceptibility loci have been identified for pancreatic cancer, one of which is marked by rs401681 in the TERT-CLPTM1L gene region on chromosome 5p15.33. Because this region is characterized by low linkage disequilibrium, we sought to identify whether additional single nucleotide polymorphisms (SNPs) could be related to pancreatic cancer risk, independently of rs401681. We performed an in-depth analysis of genetic variability of the telomerase reverse transcriptase (TERT) and the telomerase RNA component (TERC) genes, in 5,550 subjects with pancreatic cancer and 7,585 controls from the PANcreatic Disease ReseArch (PANDoRA) and the PanScan consortia. We identified a significant association between a variant in TERT and pancreatic cancer risk (rs2853677, odds ratio = 0.85; 95% confidence interval = 0.80-0.90, p = 8.3 × 10(-8)). Additional analysis adjusting rs2853677 for rs401681 indicated that the two SNPs are independently associated with pancreatic cancer risk, as suggested by the low linkage disequilibrium between them (r(2) = 0.07, D' = 0.28). Three additional SNPs in TERT reached statistical significance after correction for multiple testing: rs2736100 (p = 3.0 × 10(-5) ), rs4583925 (p = 4.0 × 10(-5) ) and rs2735948 (p = 5.0 × 10(-5) ). In conclusion, we confirmed that the TERT locus is associated with pancreatic cancer risk, possibly through several independent variants.

10 Article Pancreatic leakage and acute postoperative pancreatitis after proximal pancreatoduodenectomy. 2014

Rudis, J / Ryska, M. · ·Rozhl Chir · Pubmed #25263473.

ABSTRACT: INTRODUCTION: Acute postoperative pancreatitis (APP) after proximal pancreatoduodenectomy (PDE) is a major and serious complication. The purpose of the the study is early diagnosis of APP, differentiation from pancreatic stump leak and possibilities of surgical treatment. MATERIAL AND METHODS: Of all patients who underwent PDE for ductal adenocarcinoma of the pancreatic head complicated by type C pancreatic leak, who died during primary hospitalization, we used autopsy findings to find patients with histologically confirmed APP. We compared this group to patients with only a pancreatic leak and patients with an uncomplicated clinical course. We retrospectively evaluated the postoperative clinical course, and radiological and laboratory data of all patients. These parameters were statistically compared between the individual groups using Fisher LSD test. We considered p = 0.05 to be statistically significant. Data were analysed using software STATISTICA 10.0 (StatSoft CR s.r.o.). RESULTS: One hundred sixty patients underwent PDE for ductal adenocarcinoma at our institution between 20072011 and were retrospectivaly reviewed. APP with postoperative type C pancreatic leak was observed in 4 (2.5%) patients; none of these patients survived. We found significantly higher levels of serum pancreatic amylase (AMS) on the 1. postoperative day in 3 of these patients compared to the other groups. Significantly increasing levels of CRP during the the first 5 postoperative days were observed in 75% of these patients. Retrospectively analysed contrast CT scans up to the 5th POD did not show APP. Only 1 patient had findings of APP type E according to Balthazar on CT scan performed on the 9th POD. CONCLUSION: The most significant factor in early diagnosis of APP after PDE is an abrupt change in clinical status. We also observed significantly higher levels of serum concentrations of CRP and AMS. Based on our findings, CT scan is not beneficial in the early diagnosis of APP. In cases of early diagnosed APP after PDE, the question of performing a completion pancreatectomy and its timing remains.

11 Article Physical activity and risk of pancreatic cancer in a central European multicenter case-control study. 2014

Brenner, Darren R / Wozniak, Magdalena B / Feyt, Clément / Holcatova, Ivana / Janout, Vladimir / Foretova, Lenka / Fabianova, Eleonora / Shonova, Olga / Martinek, Arnost / Ryska, Miroslav / Adamcakova, Zora / Flaska, Erik / Moskal, Aurelie / Brennan, Paul / Scelo, Ghislaine. ·Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69372, Lyon Cedex 08, France. ·Cancer Causes Control · Pubmed #24695987.

ABSTRACT: PURPOSE: Findings from epidemiological studies examining physical activity in relation to pancreatic cancer risk have suggested decreased risks for physical activity; however, the results are inconsistent. METHODS: The association between occupational and leisure-time physical activity and risk of pancreatic cancer was examined among 826 pancreatic cancer cases and 930 age-, sex- and center-matched controls from a large multicenter central European study in Czech Republic and Slovakia recruited between 2004 and 2012. Data on physical activity including type and dose (frequency, intensity, and duration) were examined using multivariable-adjusted logistic regression models. RESULTS: Occupational physical activity was not significantly associated with risk of pancreatic cancer [odds ratio (OR) 0.90, 95 % confidence interval (CI) 0.71-1.15]. A 35 % decrease in risk of pancreatic cancer was observed for regular leisure-time physical activity (OR 0.65, 95 % CI 0.52-0.87). The risk estimates were significant for low and moderate intensity of activity with the strongest protective effect among individuals who exercised during more than 40 weeks per year. The results for cumulated leisure-time physical activity assessed 1 year prior to diagnosis achieved the same level of risk reduction. In addition, stronger risk estimates for leisure-time physical activity were observed among women (men: OR 0.74, 95 % CI 0.54-1.01; women: OR 0.53, 95 % CI 0.37-0.75). The findings for female participants were stronger for intensity and frequency of leisure-time physical activity, in particular for light and moderate activity (OR 0.43, 95 % CI 0.25-0.75; and OR 0.57, 95 % CI 0.37-0.88, respectively). CONCLUSION: These results provide evidence for a decreased risk of pancreatic cancer associated with regular leisure-time physical activity.

12 Article [Is accurate preoperative assessment of pancreatic cystic lesions possible?]. 2013

Záruba, P / Dvořáková, T / Závada, F / Bělina, F / Ryska, M. · ·Rozhl Chir · Pubmed #24479516.

ABSTRACT: INTRODUCTION: Cystic lesions of the pancreas (CLP) are of different origin and behaviour. Mucinous lesions with the risk of invasive cancer represent an important subgroup. The key point in differential diagnosis of CLP is to distinguish malignant and benign lesions and also correct indication for surgery in order to minimize the impact of serious complications after resection. Different and unsatisfying predictive values of each of the examinations make proper diagnosis challenging. We focused on overall diagnostic accuracy of preoperative imaging and analytic studies. We studied the accuracy of distinguishing between non-neoplastic vs. neoplastic and bening vs. malignant lesions. MATERIAL AND METHODS: We retrospectively analyzed all of the patients (N=72) with CLP (median of age 58 years, range 22-79) recommended for surgery. CT, EUS, ERCP, MRCP findings, cytology and aspirate analysis were used to establish preoperative diagnosis. Finally, preoperative diagnoses were compared with postoperative pathological findings to establish overall accuracy of preoperative assessment. RESULTS: During 5 years, 72 patients underwent resection for CLP. We performed 66 (92%) resection and 6 (8%) palliative procedures with 32% morbidity and 7% of one hospital stay mortality. All the patients were examined by CT and EUS. FNA was performed in 44 (61%) patients. Cytology was evaluable in 39 (88%) cases. ERCP was done in 40 (55%) patients. Pathology revealed non-neoplastic CLP in 25 (35%) and neoplastic lesions in 47 (65%) specimens. Mucinous lesions accounted for 25%. Malignant or potentially malignant CLP were found in 37 (51%) patients. Sensitivity, specificity and diagnostic accuracy of preoperative diagnosis for distinguishing between inflammatory and neoplastic, and benign and malignant was 100%, 46%, 85% and 61%, 61%, 44%, respectively. CONCLUSION: Correct and accurate preoperative assessment of CLP remains challenging. Despite the wide range of diagnostic modalities, the definitive preoperative identification of malignant or high-risk CLP is inaccurate. Because of this, a significant portion of the patients undergo pancreatic resection for benign or inflammatory lesions that are not potentially life-threatening. Possible serious complications after pancreatic surgery are the main reason for precise selection of patients with cystic affections recommended for surgery.

13 Article [Quality of life is an important factor in the indication in patients with advanced pancreatic carcinoma--a prospective multicentric study]. 2012

Ryska, M / Dusek, L / Pohnán, R / Bunganic, B / Bieberová, L / Ryska, O / Lovecek, M / Jon, B / Rupert, K / Krejcí, M / Jarkovský, J. ·Chirurgická klinika 2. LF UK a UVN Praha. miroslav.ryska@uvn.cz ·Rozhl Chir · Pubmed #22880267.

ABSTRACT: INTRODUCTION: The aim of this report is to present results of prospective multicentric study on quality of life (QoL) in advanced ductal pancreatic adenocarcinoma patients. MATERIAL AND METHOD: In 426 patients with advanced ductal pancreatic adenocarcinoma, the following parameters were studied: type of treatment, complication rates, 1, 2 and 3-year survival rates. QoL was assessed in 151 patients, using a generic SF-36 questionnaire prior the therapy and then 3 months after the treatment. Arithmetic mean and standard deviation (SD) were used for the QoL pool analysis. The results were evaluated using SF-36 software, t-test for independent samples, ANOVA, paired t-test and SPSS 19.0.1 (IBM Corporation, 2010). The p value < 0.05 was considered as statistically significant. RESULTS: There was a significant difference in the median, 1,2 and 3-year survival rates in the patients with stage III pancreatic cancer who underwent radical resection (RR) compared to the paliative therapy patients (p < 0.001). The highest initial overal QoL value was observed in 39 stage III patients who underwent RR (60.5 +/- 1.84) and no significant decrease in this value was recorded over a 3-month postoperative period (difference--5.1 +/- 16.6, p = 0.064). Paliative therapy resulted in significant reduction in the overall QoL value (p = 0.020). In the paliative therapy group of patients, BDA resulted in significant reduction in the overall QoL value 3 months after the procedure (p = 0.017 vs. ns.). In the group of stage IV patients, nonsignificant increase in the overall QoL value was recorded in 8 patients 3 months after BDA (46.4 +/- 17.0 vs. 51.1 +/- 9.5 p = 0.525). Nonsignificant increase in the overal QoL values was also observed in 18 patients after stent introduction (30.6 +/- 8.3 vs. 31.5 +/- 8.5 p = 0.783). Nonsignificant deterioration in QoL was recorded in patients undergoing exploration, whose initial QoL values corresponded with those in RR patients, while 3 months after the explorative surgery their QoL values were similar to those recorded in the stent group patients (62.0 +/- 16.1 vs. 41.7 +/- 23.6 s rozdílem -20.3 +/- 16.2 p < 0.001). CONCLUSION: Based on the results of the multicentric prospective study in patients with locally advanced stage III and IV ductal pancreatic adenocarcinoma, the following conclusions can be presented: (1) median and 1, 2 and 3-year survival rates in stage III patients were significantly higher in the RR group compared to the paliative therapy patients, (2) initial QoL in stage III patients was significantly the highest in patients who underwent RR. Significant decrease in QoL was recorded in BDA patients. Paliative stent introduction resulted in nonsignificant improvement in the QoL 3 months after the procedure, while the initial QoL values were the lowest in this group, (3) QoL assessment in stage IV patients showed statistically nonsignificant improvement after BDA or stent procedures, the most significant deterioration was observed in the exploration group, (4) no complication which would result in prolongation of the respective hospitalization times was recorded in 67%, (5) early postoperative complications did not result in significant QoL deterioration 3 months after the procedure, (6) absence of chemotherapy results in significant decrease in QoL.

14 Article Body mass index and body size in early adulthood and risk of pancreatic cancer in a central European multicenter case-control study. 2011

Urayama, Kevin Y / Holcatova, Ivana / Janout, Vladimir / Foretova, Lenka / Fabianova, Eleonora / Adamcakova, Zora / Ryska, Miroslav / Martinek, Arnost / Shonova, Olga / Brennan, Paul / Scélo, Ghislaine. ·International Agency for Research on Cancer, Lyon, France. ·Int J Cancer · Pubmed #21520034.

ABSTRACT: The relationship between two measures of excess body weight, body mass index (BMI) and body size score, and risk of pancreatic cancer was examined among 574 pancreatic cancer cases and 596 frequency-matched controls from the Czech Republic and Slovakia enrolled between 2004 and 2009. Analyses using multivariable logistic regression showed an increased risk of pancreatic cancer associated with elevated quartiles of BMI at ages 20 [fourth quartile: odds ratio (OR) = 1.79, 95% confidence interval (CI): 1.23, 2.61] and 40 (fourth quartile: OR = 1.57, 95% CI: 1.09, 2.27) compared to the lowest quartile. Consistent results were observed for body size score at ages 20 (high versus low: OR = 1.66, 95% CI: 1.08, 2.57) and 40 (medium versus low: OR = 1.36, 95% CI: 1.00, 1.86), but no association was found for BMI and body size score at 2 years before the interview. Stronger risk estimates for BMI were observed in males than females, particularly at age 20, but the analysis of body size yielded similar estimates by sex. When considering excess body weight at both ages 20 and 40 jointly, the highest risk estimates were observed among subjects with elevated levels at both time periods in the analysis of BMI (OR = 1.86, 95% CI: 1.32, 2.62) and body size (OR = 1.53, 95% CI: 1.09, 2.13). These findings, based on two different measures, provide strong support for an increased risk of pancreatic cancer associated with excess body weight, possibly strongest during early adulthood.

15 Article Superoxide dismutase and nicotinamide adenine dinucleotide phosphate: quinone oxidoreductase polymorphisms and pancreatic cancer risk. 2011

Mohelnikova-Duchonova, Beatrice / Marsakova, Lenka / Vrana, David / Holcatova, Ivana / Ryska, Miroslav / Smerhovsky, Zdenek / Slamova, Alena / Schejbalova, Miriam / Soucek, Pavel. ·Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic. ·Pancreas · Pubmed #20966810.

ABSTRACT: OBJECTIVES: Pancreatic carcinoma etiology and molecular pathogenesis is weakly understood. According to the assumption that genetic variation in carcinogen metabolism further modifies the risk of exposure-related cancers, an association of functional polymorphisms in oxidative stress-modifying genes superoxide dismutase 2 (SOD2 [Ala16Val, rs4880]), SOD3 (Arg231Gly, rs1799895), nicotinamide adenine dinucleotide phosphate:quinone oxidoreductase (NQO1 [Pro187Ser, rs1800566], and NQO2 (Phe47Leu, rs1143684) with pancreatic cancer risk was studied. METHODS: Polymorphisms were studied by allelic discrimination. RESULTS: In a hospital-based case-control study on 500 individuals (235 cases and 265 controls) of Czech white origin, SOD2, SOD3, NQO1, and NQO2 polymorphisms showed no significant association with pancreatic cancer risk. Major lifestyle factors such as smoking and alcohol, coffee, or tea consumption did not modify the effect of the studied polymorphisms. CONCLUSIONS: The first European study of the SOD2, SOD3, NQO1, and NQO2 roles in pancreatic cancer etiology did not find significant associations. Despite this observation, other populations with different lifestyle(s) may be at risk and should be further studied.

16 Article [Radical procedures in patients with pancreatic cancer--impact on prolongation and quality of life]. 2010

Ryska, M. ·Chirurgická klinika 2. LF UK a UVN Praha. miroslav.ryska@uvn.cz ·Rozhl Chir · Pubmed #21404511.

ABSTRACT: INTRODUCTION: In conjunction with adjuvant chemotherapy, radical resections are the only treatment modality, which significantly prolongs survival in pancreatic cancer (CaP) patients. The author aims to define current standards of radical pancreatic resections in CaP patients and to assess benefits of the surgical procedure based on literature data, as well as to evaluate current options for objective assessment of the quality of life in these patients. METHODS: Employing Pubmed and Ebscohost databases, the author compares radical pancreatic resections depending on the tumor location, performed in conjunction with standard lymphadenectomy in patients with CaP, with the extended version of the resection procedure. The radical procedure is then put into relationship with potential prolongation of survival times, with early mortality incidence rates and with rates of perioperative complications. Based on literature data, the author evaluates current options for objective assessment of the quality of life in these patients. OUTCOMES: Radical resection with lymphadenectomy in N1-2 diseases followed by adjuvant chemotherapy is currently considered a standard treatment procedure, the only one which significantly prolongs survival in patients with CaP, with the disease stage T1-3, N0-1M0. Angioinvasion into the portomesenteric segment is not a contraindication for the resection procedure. In cases where R0 resection is achieved, the outcomes are similar to those in subjects without vascular segment resections. Views on arterial resections--a. hepatica, truncus coeliacus, a. mesenterica sup. are not uniform and, to date, resections of tumor-infiltrated arteries have not been shown to result in life prolongation. Angioinvasion into arteries is considered a sign of the disease stage and the need for extended procedures is associated with increased complication rates. The quality of life following resection procedures is not commonly assessed and its improvement is usually expected, rather than objectively assessed. At the present time, no questionnaire on the quality of life, which would specifically address CaP patients, is being used on a routine basis. DISCUSSION AND CONCLUSIONS: Radical resection R0 and administration of adjuvant chemotherapy is the only current treatment modality in patients with ductal pancreatic adenocarcinoma, which results in significant life prolongation with 7-25% five-year survival rates (median of 15-18.5 months). The tumor's biological characteristics and the fact that the real disease staging is difficult to establish, are the reasons for early relapses after so called R0 resections. Resections of the portomesenteric segment in cases with adherence or penetration of the CaP into the vascular wall is indicated as a part of the radical PDE and do not result in shorter survival times. Extended radical procedures with arterial resections (a. hepatica, truncus coeliacus, a. mesenterica sup.) do not result in prolonged survival times even in cases where the procedures were assessed as R0 procedures, and cannot be thought of as standard procedures. By using invasive resection procedures, the number of resecable patients would increase, however, the prize of this treatment decision may need to paid off by higher complication rates, compared to those in standard procedures, as well as by lower postoperative quality of life of the patients, while achieving comparable survival time outcomes.

17 Article Genotype and haplotype analysis of TP53 gene and the risk of pancreatic cancer: an association study in the Czech Republic. 2010

Naccarati, A / Pardini, B / Polakova, V / Smerhovsky, Z / Vodickova, L / Soucek, P / Vrana, D / Holcatova, I / Ryska, M / Vodicka, P. ·Department of Molecular Biology of Cancer, Institute of Experimental Medicine, Academy of Sciences of Czech Republic, Videnska 1083, 14200 Prague, Czech Republic. ·Carcinogenesis · Pubmed #20110284.

ABSTRACT: Pancreatic carcinoma is the fourth leading cause of cancer-related deaths in the Czech Republic, with only a minimum of patients surviving 5 years. The aetiology and molecular pathogenesis are still weakly understood. TP53 has a fundamental role in cell cycle and apoptosis and is frequently mutated in solid tumours, including pancreatic cancer. Based on the assumption that genetic variation may affect susceptibility to cancer development, the role of TP53 polymorphisms in modulating the risk of pancreatic cancer may be of major importance. We investigated four selected polymorphisms in TP53 (rs17878362:A(1)>A(2), rs1042522:G>C, rs12947788:C>T and rs17884306:G>A) in association with pancreatic cancer risk in a case-control study, including 240 cases and controls (for a total of 1827 individuals) from the Czech Republic. Carriers of the variant C allele of rs1042522 polymorphism were at an increased risk of pancreatic cancer [odds ratio (OR) 1.73; 95% confidence interval (CI) 1.26-2.39; P = 0.001]. Haplotype analysis showed that in comparison with the most common haplotype (A(1)GCG), the A(2)CCG haplotype was associated with an increased risk (OR 1.39; 95% CI 1.02-1.88; P = 0.034) and the A(1)CCG with a reduced risk (OR 0.30; 95% CI 0.12-0.76; P = 0.011) for this cancer. These results reflect previous findings of a recent association study, where haplotypes constructed on the same TP53 variants were associated with colorectal cancer risk [Polakova et al. (2009) Genotype and haplotype analysis of cell cycle genes in sporadic colorectal cancer in the Czech Republic. Hum. Mutat., 30, 661-668.]. Genetic variation in TP53 may contribute, alone or in concert with other risk factors, to modify the inherited susceptibility to pancreatic cancer, as well as to other gastrointestinal cancers.