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Pancreatic Neoplasms: HELP
Articles by Tae Jun Song
Based on 22 articles published since 2010
(Why 22 articles?)
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Between 2010 and 2020, Tae Jun Song wrote the following 22 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Article Clinical Outcomes of Second-Line Chemotherapy after Progression on Nab-Paclitaxel Plus Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma. 2020

Lee, Kyoungmin / Bang, Kyunghye / Yoo, Changhoon / Hwang, Inhwan / Jeong, Jae Ho / Chang, Heung-Moon / Oh, Dongwook / Song, Tae Jun / Park, Do Hyun / Lee, Sang Soo / Lee, Sung Koo / Kim, Myung-Hwan / Park, Jin-Hong / Kim, Kyu-Pyo / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ·Cancer Res Treat · Pubmed #31291709.

ABSTRACT: PURPOSE: Since the introduction of nab-paclitaxel plus gemcitabine (nab-P+GEM) as first-line (1L) treatment for metastatic pancreatic adenocarcinoma (mPDAC), optimal second-line (2L) chemotherapy after progression is unclear. We assessed clinical outcomes of 2L chemotherapy for disease that progressed on 1L nab-P+GEM. Materials and Methods: Among the 203 patients previously treated with 1L nab-P+GEM for mPDAC at Asan Medical Center, between February and December 2016, records of 120 patients receiving 2L chemotherapy after progression on nab-P+GEM were retrospectively reviewed. The response rate and survival were evaluated along with analysis of prognostic factors. RESULTS: Fluoropyrimidine-oxaliplatin doublets (FOLFOX or XELOX) were used in 78 patients (65.0%), fluoropyrimidine monotherapy in 37 (30.8%), and liposomal irinotecan plus fluorouracil in two (1.7%). The median progression-free survival (PFS) and overall survival (OS) were 3.29 months and 7.33 months from the start of 2L therapy. Fluoropyrimidine-oxaliplatin regimens and fluoropyrimidine monotherapy did not yield significantly different median PFS (2.89 months vs. 3.81 months, p=0.40) or OS (7.04 months vs. 7.43 months, p=0.86). A high neutrophil-lymphocyte ratio (> 2.2) and a short time to progression with 1L nab-P+GEM (< 6.4 months) were independent prognostic factors of poor OS with 2L therapy. CONCLUSION: 2L fluoropyrimidine-oxaliplatin doublets and fluoropyrimidine monotherapy after failure of 1L nab-P+GEM had modest efficacy, with no differences in treatment outcomes between them. Further investigation is warranted for the optimal 2L chemo-regimens and sequencing of systemic chemotherapy for patients with mPDAC.

2 Article Main duct and mixed type intraductal papillary mucinous neoplasms without enhancing mural nodules: Duct diameter of less than 10 mm and segmental dilatation of main pancreatic duct are findings support surveillance rather than immediate surgery. 2019

Kim, Tae Hyeon / Song, Tae Jun / Lee, Seung Ok / Park, Chang Hwan / Moon, Jong Ho / Pih, Gyu Young / Oh, Dong Wook / Woo, Sang Myoung / Yang, Yun Jung / Kim, Myung Hwan. ·Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, South Korea. · Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Chonbuk National University Medical School, Jeonju, South Korea. · Department of Internal Medicine, Chonnam University College of Medicine, Kwangju, South Korea. · Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon, South Korea. · Pancreatobiliary Cancer Clinic, Center for Liver Cancer, National Cancer Center, Goyang, South Korea. · Institute for Integrative Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, South Korea. · Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. Electronic address: mhkim@amc.seoul.kr. ·Pancreatology · Pubmed #31611130.

ABSTRACT: OBJECTIVE: The guidelines for pancreatic intraductal papillary mucinous neoplasms (IPMNs) recommend surgical resection of all main-duct (MD) and mixed-type IPMNs in surgically fit patients. We conducted this study to identify the rates of high-grade dysplasia (HGD) and invasive carcinoma according to the morphological features of the main pancreatic duct (MPD) in patients with MD and mixed IPMN. METHODS: We performed a retrospective study of 259 patients with histologically proven MD and mixed-type IPMNs who underwent surgery at six academic institutions. RESULTS: The rate of HGD and invasive carcinoma was 11.1% (24/216) in patients without enhancing mural nodules (MNs) and 69.8% (30/43) in patients with MNs. Multivariate analysis showed that MPD diameter of ≥10 mm [odds ratio (OR), 2.5; 95% confidence interval (CI), 1.155-5.505; P = 0.02], diffuse MPD dilatation (OR, 3.2; 95% CI, 1.152-8.998; P = 0.02), and presence of enhancing MNs in MPD (OR, 9.6; 95% CI, 3.928-23.833, P < 0.0001) were significant predictors of HGD and invasive carcinoma. Of the 216 patients without enhancing MNs, 79 patients (36.6%) having both segmental MPD dilatation and MPD diameter of <10 mm showed significantly lower rates of HGD and invasive carcinoma (3/79, 3.8%) than patients having both diffuse MPD dilatation and MPD diameter ≥10 mm (9/36, 25%, P = 0.001). CONCLUSIONS: MD and mixed-type IPMNs having segmental MPD dilatation with MPD dilation <10 mm and no enhancing MNs on imaging showed a significantly lower rate of HGD and invasive carcinoma, and watchful follow-up instead of immediate surgical resection might be possible in these patients.

3 Article Stereotactic body radiation therapy for locally advanced pancreatic cancer. 2019

Jung, Jinhong / Yoon, Sang Min / Park, Jin-Hong / Seo, Dong-Wan / Lee, Sang Soo / Kim, Myung-Hwan / Lee, Sung Koo / Park, Do Hyun / Song, Tae Jun / Ryoo, Baek-Yeol / Chang, Heung-Moon / Kim, Kyu-Pyo / Yoo, Changhoon / Jeong, Jae Ho / Kim, Song Cheol / Hwang, Dae Wook / Lee, Jae Hoon / Song, Ki Byung / Jo, Yoon Young / Park, Jongmoo / Kim, Jong Hoon. ·Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Radiation Oncology, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea. ·PLoS One · Pubmed #30978229.

ABSTRACT: PURPOSE: Stereotactic body radiation therapy (SBRT) is a promising treatment modality for locally advanced pancreatic cancer (LAPC). We evaluated the clinical outcomes of SBRT in patients with LAPC. PATIENTS AND METHODS: We retrospectively analyzed the medical records of patients with LAPC who underwent SBRT at our institution between April 2011 and July 2016. Fiducial markers were implanted using endoscopic ultrasound guidance one week prior to 4-dimensional computed tomography (CT) simulation and daily cone beam CT was used for image guidance. Patients received volumetric modulated arc therapy or intensity modulated radiotherapy using respiratory gating technique. A median dose of 28 Gy (range, 24-36 Gy) was given over four consecutive fractions delivered within one week. Survival outcomes including freedom from local disease progression (FFLP), progression-free survival (PFS), and overall survival (OS) were analyzed. Acute and late toxicities related to SBRT were assessed. RESULTS: A total of 95 patients with LAPC were analyzed, 52 of which (54.7%) had pancreatic head cancers. Most (94.7%) had received gemcitabine-based chemotherapy. The 1-year FFLP rate was 80.1%. Median OS and PFS were 16.7 months and 10.2 months, respectively; the 1-year OS and PFS rates were 67.4% and 42.9%, respectively. Among 79 patients who experienced failure, the sites of first failures were isolated local progressions in 12 patients (15.2%), distant metastasis in 55 patients (69.6%), and both in 12 patients (15.2%). Seven patients (7.4%) were able to undergo surgical resection after SBRT and four had margin-negative resections. Three patients (3.2%) had grade 3 nausea/vomiting during SBRT, and late grade 3 toxicity was observed in another three patients. CONCLUSIONS: LAPC patients who received chemotherapy and SBRT had favorable FFLP and OS with minimal treatment-related toxicity. The most common pattern of failure was distant metastasis, which warrants further studies on the optimal scheme of chemotherapy and SBRT.

4 Article Clinical Outcomes of Conversion Surgery after Neoadjuvant Chemotherapy in Patients with Borderline Resectable and Locally Advanced Unresectable Pancreatic Cancer: A Single-Center, Retrospective Analysis. 2019

Yoo, Changhoon / Shin, Sang Hyun / Kim, Kyu-Pyo / Jeong, Jae Ho / Chang, Heung-Moon / Kang, Jun Ho / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Park, Jin-Hong / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Ryoo, Baek-Yeol / Kim, Song Cheol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. cyoo.amc@gmail.com. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. surgeonssh@gmail.com. · Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. surgeonssh@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. kkp1122@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. imdrho@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. changhm@amc.seoul.kr. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. bodle1125@naver.com. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. ssleedr@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. dhparkeus@gmail.com. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. medi01@naver.com. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. dwseoamc@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. sklee@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. mhkim@amc.seoul.kr. · Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. pjhynwie@hanmail.net. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. dwhwang@amc.seoul.kr. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. mtsong21c@naver.com. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. hbpsurgeon@gmail.com. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. ryooby@amc.seoul.kr. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. drksc@amc.seoul.kr. ·Cancers (Basel) · Pubmed #30813624.

ABSTRACT: The clinical benefit and potential risks of conversion surgery after neoadjuvant chemotherapy (NACT) have not been fully investigated in patients with borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC). Therefore, this has been evaluated in a retrospective, prospective cohort-based analysis. Between October 2005 and April 2017, 135 patients (65 with BRPC and 70 with LAPC) received conversion surgery after NACT. Exploratory analysis to assess clinical outcomes in comparison with patients who underwent upfront surgery in the same time period (

5 Article Comparison between groove carcinoma and groove pancreatitis. 2018

Jun, Jae Hyuck / Lee, Sung Koo / Kim, So Yeon / Cho, Dong Hui / Song, Tae Jun / Park, Do Hyun / Lee, Sang Soo / Seo, Dong-Wan / Kim, Myung-Hwan. ·Department of Gastroenterology, Eulji University College of Medicine, Daejeon, Republic of Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: sklee@amc.seoul.kr. · Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. ·Pancreatology · Pubmed #30224296.

ABSTRACT: BACKGROUND/OBJECTIVES: The pancreatoduodenal groove (anatomical groove) is a potential space bordered by the head of the pancreas, duodenum, and common bile duct. Discerning between groove carcinoma (GC) and groove pancreatitis (GP) is often difficult, but clinically important. We retrospectively analyzed and compared the findings of computed tomography (CT), laboratory tests, and endoscopic ultrasound-fine needle aspiration (EUS-FNA) for GC and GP. METHODS: GC (n = 36) and GP (n = 44) patients at Asan Medical Center from January 1, 2000, to May 31, 2017 were retrospectively reviewed. MDCT findings, baseline characteristics, laboratory test results, and EUS and EUS-FNA findings of GC and GP patients were compared. RESULTS: CT showed no significant difference in groove enhancement between the groups. Mass-like lesions, cystic groove lesions, and calcification were observed in 86.1% and 15.9%, 38.9% and 75%, and 2.8% and 29.5% of GC and GP patients, respectively. Patients were tested for total bilirubin (GC: 2.0 vs. GP: 0.6 mg/dL), cancer antigen 19-9 (CA19-9) (GC: 76 vs. GP: 12.5 U/mL), and carcinoembryonic antigen (GC: 2.4 vs. GP: 2 ng/mL). Three GP patients died, and one GP patient was diagnosed with GC. However, among 30 GC patients with at least 1-year follow-up, 20 died. In multivariate logistic regression, CA19-9, and mass-like lesion on multidetector CT (MDCT) were discriminating factors between GC and GP. Among 23 (10 GC, 13 GP) patients who underwent EUS-FNA, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, accuracy of EUS-FNA were 90%, 100%, 100%, 92.86%, and 95.65%, respectively. CONCLUSIONS: Several MDCT and laboratory findings favor GC over GP. EUS-FNA should be considered in patients with elevated CA19-9 levels and mass-like lesions on MDCT.

6 Article Endoscopic ultrasound-guided radiofrequency ablation for management of benign solid pancreatic tumors. 2018

Choi, Jun-Ho / Seo, Dong-Wan / Song, Tae Jun / Park, Do Hyun / Lee, Sang Soo / Lee, Sung Koo / Kim, Myung-Hwan. ·Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Republic of Korea. · Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. ·Endoscopy · Pubmed #29727904.

ABSTRACT: BACKGROUND: Radiofrequency ablation (RFA) has been increasingly employed in experimental and clinical settings for the management of pancreatic lesions. This study aimed to assess the safety and efficacy of endoscopic ultrasound (EUS)-guided RFA for benign solid pancreatic tumors. METHODS: In a single-center, prospective study, 10 patients with benign solid pancreatic tumors underwent EUS-RFA. After the RFA electrode had been inserted into the pancreatic mass, the radiofrequency generator was activated to deliver 50 W of ablation power. RESULTS: Among the 10 patients, 16 sessions of EUS-RFA were successfully performed. Diagnoses included nonfunctioning neuroendocrine tumor (n = 7), solid pseudopapillary neoplasm (n = 2), and insulinoma (n = 1); the median largest diameter of the tumors was 20 mm (range 8 - 28 mm). During follow-up (median 13 months), radiologic complete response was achieved in seven patients. Two adverse events (12.4 %; 1 moderate and 1 mild) occurred. CONCLUSIONS: EUS-RFA may be a safe and potentially effective treatment option in selected patients with benign solid pancreatic tumors. Multiple sessions may be required if there is a remnant tumor, and adverse events must be carefully monitored.

7 Article Contrast-Enhanced Endoscopic Ultrasound for Differentially Diagnosing Autoimmune Pancreatitis and Pancreatic Cancer. 2018

Cho, Min Keun / Moon, Sung-Hoon / Song, Tae Jun / Kim, Raymond E / Oh, Dong Wook / Park, Do Hyun / Lee, Sang Soo / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan. ·Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. · Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. · Division of Gastroenterology, Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea. ·Gut Liver · Pubmed #29699060.

ABSTRACT: Background/Aims: Differentially diagnosing focal-type autoimmune pancreatitis (f-AIP) and pancreatic cancer (PC) is challenging. Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) may provide information for differentiating pancreatic masses. In this study, we evaluated the usefulness of CEH-EUS in differentiating f-AIP from PC. Methods: Data were collected prospectively and analyzed on patients who underwent CEH-EUS between May 2014 and May 2015. Eighty consecutive patients were diagnosed with f-AIP or PC. PC and f-AIP were compared for enhancement intensity, contrast agent distribution, and internal vasculature. Results: The study group comprised 53 PC patients and 27 f-AIP patients (17 with type-1 AIP [15 definite and two probable], two with probable type-2 AIP, and eight with AIP, not otherwise specified). Hyper- to iso-enhancement in the arterial phase (f-AIP, 89% vs PC, 13%; p<0.05), homogeneous contrast agent distribution (f-AIP, 81% vs PC, 17%; p<0.05), and absent irregular internal vessels (f-AIP, 85% vs PC, 30%; p<0.05) were observed more frequently in the f-AIP group. The combination of CEH-EUS and enhancement intensity, absent irregular internal vessels improved the specificity (94%) in differentiating f-AIP from PC. Conclusions: CEH-EUS may be a useful noninvasive modality for differentially diagnosing f-AIP and PC. Combined CEH-EUS findings could improve the specificity of CEH-EUS in differentiating f-AIP from PC.

8 Article Nab-paclitaxel plus gemcitabine versus FOLFIRINOX as the first-line chemotherapy for patients with metastatic pancreatic cancer: retrospective analysis. 2018

Kang, Jihoon / Hwang, Inhwan / Yoo, Changhoon / Kim, Kyu-Pyo / Jeong, Jae Ho / Chang, Heung-Moon / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Hong, Seung-Mo / Shin, Sang Hyun / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Kim, Song Cheol / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. · Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. yooc@amc.seoul.kr. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. kkp1122@amc.seoul.kr. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. ·Invest New Drugs · Pubmed #29616439.

ABSTRACT: Purpose nab-paclitaxel plus gemcitabine (AG) and FOLFIRINOX have been established as standard first-line treatment in metastatic pancreatic cancer (mPC). We performed retrospective analysis comparing the efficacies of AG and FOLFIRINOX in daily practice setting. Materials and Methods We analyzed 308 patients who presented initially as mPC and received AG (n = 149) or FOLFIRINOX (n = 159) as first-line treatment between 2013 and 2016. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Result There were no significant differences between the two groups in terms of baseline characteristics, except older age and higher Charlson Comorbidity Index (CCI) score in AG group. The response rates (34% vs 34%) and median PFS (6.8 vs 5.1 months) were comparable between two groups (p = 0.88 and p = 0.19, respectively), while median OS was significantly better with AG than FOLFIRINOX (11.4 vs 9.6 months; p = 0.002). Elevated baseline CA19-9 level and liver metastasis were independent adverse prognostic factors for PFS and OS. In subgroup analyses, PFS with AG was better in patients with age ≥ 65 years, peritoneal metastasis, and higher CCI than that with FOLFIRINOX. Conclusion Both AG and FOLFIRINOX showed comparable efficacy outcomes in daily practice setting. AG might be preferentially considered in patients with peritoneal metastasis, comorbid medical conditions or old age.

9 Article Outcomes after endoscopic ultrasound-guided ethanol-lipiodol ablation of small pancreatic neuroendocrine tumors. 2018

Choi, Jun-Ho / Park, Do Hyun / Kim, Myung-Hwan / Hwang, Hee Sang / Hong, Seung-Mo / Song, Tae Jun / Lee, Sang Soo / Seo, Dong-Wan / Lee, Sung Koo. ·Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Korea. · Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ·Dig Endosc · Pubmed #29575213.

ABSTRACT: BACKGROUND AND AIM: Little is known about the standard care of small (<2 cm in diameter) pancreatic neuroendocrine tumors (PNET). The aim of the present study was to determine the clinical outcomes of small PNET after endoscopic ultrasound (EUS)-guided ethanol-lipiodol ablation (EUS-ELA). METHODS: In this prospective cohort study, consecutive patients who underwent EUS-ELA for PNET were enrolled and were followed for ≥3 years. Treatment efficacy was the primary outcome measure. RESULTS: In total, 33 patients who had 40 pathologically confirmed PNET (<2 cm in diameter) were enrolled for final analysis. A total of 63 EUS-ELA sessions were successfully carried out (mean, 1.9 sessions per patient, 1.6 sessions per tumor), which included 40 initial sessions and 23 repeated sessions owing to incomplete ablation. Median actual volume of ethanol-lipiodol mixture injected per session was 1.1 mL (IQR 0.8-1.9 mL). Complete ablation was achieved in 24 of 40 tumors (60%) with one (18 tumors, 45%) or two (24 tumors, 60%) sessions of EUS-ELA. Lipiodol retention within tumor had better treatment outcomes (P = 0.004). Rate of procedure-related adverse events was 3.2%. No malignancy or lymph node metastasis was discovered during a median follow up of 42 months (IQR 39-46 months). CONCLUSIONS: We found that EUS-ELA was a safe and effective alternative option in the management of PNET <2.0 cm in diameter; 60% of patients achieved complete ablation. Lipiodol retention within tumor may be a useful early predictor of treatment effectiveness. Trial registered at ClinicalTrials.gov (NCT 01902238).

10 Article Simple Detection of Telomere Fusions in Pancreatic Cancer, Intraductal Papillary Mucinous Neoplasm, and Pancreatic Cyst Fluid. 2018

Hata, Tatsuo / Dal Molin, Marco / McGregor-Das, Anne / Song, Tae Jun / Wolfgang, Christopher / Eshleman, James R / Hruban, Ralph H / Goggins, Michael. ·Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. · Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. · Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Oncology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. · Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Oncology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: mgoggins@jhmi.edu. ·J Mol Diagn · Pubmed #29229290.

ABSTRACT: Telomere end-to-end fusions are an important source of chromosomal instability that arise in cells with critically shortened telomeres. We developed a nested real-time quantitative PCR method for telomere fusion detection in pancreatic ductal adenocarcinomas, intraductal papillary mucinous neoplasms (IPMNs), and IPMN cyst fluids. Ninety-one pancreatic cancer cell lines and xenograft samples, 93 IPMNs, and 93 surgically aspirated IPMN cyst fluid samples were analyzed. The association between telomere shortening, telomerase activity, and telomere fusion detection was evaluated. Telomere fusions were detected in 56 of 91 pancreatic cancers (61.5%). Telomere fusion-positive cell lines had significantly shorter telomere lengths than fusion-negative lines (P = 0.003). Telomere fusions were undetectable in normal pancreas or IPMNs with low-grade dysplasia (0.0%) and were detected in IPMN with high-grade dysplasia (HGD; 48.0%) (P < 0.001). In IPMN cyst fluids, telomere fusions were more frequent in IPMNs with HGD (26.9%) or associated invasive cancer (42.9%) than IPMN with intermediate-grade dysplasia (15.4%) or low-grade dysplasia (0%) (P = 0.025). Telomerase activity levels were higher in cyst fluids with fusions than in those without (P = 0.0414). Cyst fluid telomere fusion status was an independent predictor of HGD/invasive cancer by multivariate analysis (odds ratio, 6.23; 95% CI, 1.61-28.0). Telomere fusions are detected in later stages of IPMN progression and can serve as a marker for predicting the presence of HGD and/or invasive cancer.

11 Article Germline BRCA mutations in Asian patients with pancreatic adenocarcinoma: a prospective study evaluating risk category for genetic testing. 2018

Lee, Kyoungmin / Yoo, Changhoon / Kim, Kyu-Pyo / Park, Kyoung-Jin / Chang, Heung-Moon / Kim, Tae Won / Lee, Jae-Lyun / Lee, Woochang / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Shin, Sang Hyun / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Kim, Song Cheol / Ryoo, Baek-Yeol. ·Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. yooc@amc.seoul.kr. · Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. · Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. ryooby@amc.seoul.kr. ·Invest New Drugs · Pubmed #28782087.

ABSTRACT: Introduction Germline BRCA mutations may have therapeutic implications as surrogate markers of DNA-damage repair status in pancreatic ductal adenocarcinoma (PDAC). We performed a prospective study to evaluate the efficiency of risk criteria based on personal or family history of breast and ovarian cancer for determining germline BRCA mutations in PDAC patients with Asian ethnicity. Methods Between November 2015 and May 2016, we screened consecutive PDAC patients with locally advanced unresectable or metastatic disease who were referred for systemic chemotherapy. Analyses for germline BRCA mutations were performed if patients had one or more first-degree or second-degree relatives with breast or ovarian cancers or had a personal medical history of these diseases. DNA was extracted from whole blood, and all coding exons and their flanking intron regions of BRCA1 and BRCA2 were sequenced. Results A total of 175 patients were screened for personal and family history and 10 (5.7%) met the inclusion criteria for genetic sequencing. Pathogenic germline BRCA2 mutation [c.7480C>T (p.Arg2494*)] was identified in one male patient, resulting in a frequency of 10% for the risk-stratified patients and 0.6% for the unselected PDAC population. Two patients had germline BRCA2 variants of uncertain significance [c.1744A>C (p.Thr582Pro) and c.68-7T>A]. Conclusion Personal or family history of breast or ovarian cancers is a feasible, cost-effective risk categorization for screening germline BRCA mutations in Asian PDAC patients as 10% of this population had the pathogenic mutation herein. Future validation from a large, prospective cohort is needed.

12 Article Deleterious Germline Mutations in Patients With Apparently Sporadic Pancreatic Adenocarcinoma. 2017

Shindo, Koji / Yu, Jun / Suenaga, Masaya / Fesharakizadeh, Shahriar / Cho, Christy / Macgregor-Das, Anne / Siddiqui, Abdulrehman / Witmer, P Dane / Tamura, Koji / Song, Tae Jun / Navarro Almario, Jose Alejandro / Brant, Aaron / Borges, Michael / Ford, Madeline / Barkley, Thomas / He, Jin / Weiss, Matthew J / Wolfgang, Christopher L / Roberts, Nicholas J / Hruban, Ralph H / Klein, Alison P / Goggins, Michael. ·All authors: The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD. ·J Clin Oncol · Pubmed #28767289.

ABSTRACT: Purpose Deleterious germline mutations contribute to pancreatic cancer susceptibility and are well documented in families in which multiple members have had pancreatic cancer. Methods To define the prevalence of these germline mutations in patients with apparently sporadic pancreatic cancer, we sequenced 32 genes, including known pancreatic cancer susceptibility genes, in DNA prepared from normal tissue obtained from 854 patients with pancreatic ductal adenocarcinoma, 288 patients with other pancreatic and periampullary neoplasms, and 51 patients with non-neoplastic diseases who underwent pancreatic resection at Johns Hopkins Hospital between 2000 and 2015. Results Thirty-three (3.9%; 95% CI, 3.0% to 5.8%) of 854 patients with pancreatic cancer had a deleterious germline mutation, 31 (3.5%) of which affected known familial pancreatic cancer susceptibility genes: BRCA2 (12 patients), ATM (10 patients), BRCA1 (3 patients), PALB2 (2 patients), MLH1 (2 patients), CDKN2A (1 patient), and TP53 (1 patient). Patients with these germline mutations were younger than those without (mean ± SD, 60.8 ± 10.6 v 65.1 ± 10.5 years; P = .03). Deleterious germline mutations were also found in BUB1B (1) and BUB3 (1). Only three of these 33 patients had reported a family history of pancreatic cancer, and most did not have a cancer family history to suggest an inherited cancer syndrome. Five (1.7%) of 288 patients with other periampullary neoplasms also had a deleterious germline mutation. Conclusion Germline mutations in pancreatic cancer susceptibility genes are commonly identified in patients with pancreatic cancer without a significant family history of cancer. These deleterious pancreatic cancer susceptibility gene mutations, some of which are therapeutically targetable, will be missed if current family history guidelines are the main criteria used to determine the appropriateness of gene testing.

13 Article Efficacy and safety of neoadjuvant FOLFIRINOX for borderline resectable pancreatic adenocarcinoma: improved efficacy compared with gemcitabine-based regimen. 2017

Yoo, Changhoon / Kang, Jihoon / Kim, Kyu-Pyo / Lee, Jae-Lyun / Ryoo, Baek-Yeol / Chang, Heung-Moon / Lee, Sang Soo / Park, Do Hyun / Song, Tae Jun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Park, Jin-Hong / Hwang, Dae Wook / Song, Ki Byung / Lee, Jae Hoon / Kim, Song Cheol. ·Departments of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ·Oncotarget · Pubmed #28564637.

ABSTRACT: Borderline resectable pancreatic cancer (BRPC) is a potentially resectable disease but is associated with poorer survival compared to primary resectable disease. There has been no prospective trial that compare the efficacy of FOLFIRNOX and gemcitabine-based regimen for BRPC. Between February 2013 and December 2014, 18 patients with BRPC receiving FOLFIRINOX were reviewed retrospectively. For comparative analysis, data for all BRPC patients (n=18) in our previous phase 2 study of neoadjuvant fixed-dose rate-gemcitabine plus capecitabine were pooled. Patients received a median 6 cycles (range, 3-13) of FOLFIRINOX. Surgical resection was performed in 12 patients (67%) and R0 resection in 9 patients. Median progression-free survival (PFS) and overall survival (OS) were 16.8 (95% confidence interval [CI], 9.4-24.2) and 21.2 (95% CI, 14.2-28.2) months, respectively. Patients who underwent surgical resection showed significantly better PFS (p=0.01) and OS (p=0.003) than those unresected. In the exploratory analysis, patients receiving FOLFIRINOX showed significantly longer PFS compared to those receiving fixed-dose rate-gemcitabine plus capecitabine (median 16.8 months [95% CI, 9.4-24.2] vs. 6.5 months [1.6-11.3]; p = 0.04). There was a trend toward improved OS in patients who received FOLFIRINOX (median 21.2 months [95% CI, 14.2-28.2]) compared to those who received fixed-dose rate-gemcitabine plus capecitabine (13.6 months [11.8-15.4]; p=0.12). FOLFIRINOX was feasible and effective as neoadjuvant chemotherapy for patients with BRPC and may have improved efficacy compared to a gemcitabine-based regimen.

14 Article Long-term outcomes after endoscopic ultrasound-guided ablation of pancreatic cysts. 2017

Choi, Jun-Ho / Seo, Dong Wan / Song, Tae Jun / Park, Do Hyun / Lee, Sang Soo / Lee, Sung Koo / Kim, Myung-Hwan. ·Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Korea. · Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ·Endoscopy · Pubmed #28511236.

ABSTRACT:

15 Article Metal versus plastic stents for drainage of malignant biliary obstruction before primary surgical resection. 2016

Song, Tae Jun / Lee, Jae Hoon / Lee, Sang Soo / Jang, Ji Woong / Kim, Jung Wook / Ok, Tae Jin / Oh, Dong Wook / Park, Do Hyun / Seo, Dong Wan / Lee, Sung Koo / Kim, Myung-Hwan / Kim, Song Cheol / Kim, Chul Nam / Yun, Sung Cheol. ·Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Department of Internal Medicine, Eulgi University College of Medicine, Daejeon, Korea. · Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. · Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea. · Department of Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ·Gastrointest Endosc · Pubmed #27109456.

ABSTRACT: BACKGROUND AND AIMS: Preoperative biliary drainage (PBD) with stent placement has been commonly used for patients with malignant biliary obstruction. In PBD, the placement of fully covered self-expandable metal stents (FCSEMSs) may provide better patency duration and a lower incidence of cholangitis compared with plastic stents. We aimed to evaluate which type of stent showed better outcomes in PBD. METHODS: In this multicenter, prospective randomized trial, we compared PBD with FCSEMSs versus plastic stents in 86 patients with malignant biliary obstruction between January 2012 and December 2014. Patients with obstructive jaundice were randomly assigned to undergo PBD either with plastic stents or FCSEMS placement. RESULTS: Baseline characteristics were not significantly different between the 2 groups. Endoscopic stent placement was technically successful in all patients. Procedure-related adverse events were not significantly different between the 2 groups (plastic vs FCSEMS group; 16.3% vs 16.3%, P = 1.0). Reintervention was required in 16.3% of the plastic stent group and 14.0% of the FCSEMS group (P = .763). The interval to surgery after PBD (plastic vs FCSEMS group; 14.2 ± 8.3 vs 12.3 ± 6.9 days, P = .426) was not significantly different between groups. Surgery-related adverse events occurred in 43.6% of the plastic stent group and 40.0% of the FCSEMS group (P = .755). CONCLUSIONS: In patients with resectable malignant biliary obstruction, the outcomes of PBD with plastic stents and FCSEMSs were similar. Considering the cost-effectiveness, PBD with plastic stents may be preferable to FCSEMS placement. (Clinical trial registration number: NCT01789502.).

16 Article Endoscopic ultrasound-guided ablation of branch-duct intraductal papillary mucinous neoplasms: Feasibility and safety tests using porcine gallbladders. 2016

Park, Jin-Seok / Seo, Dong-Wan / Song, Tae Jun / Park, Do Hyun / Lee, Sang Soo / Lee, Sung Koo / Kim, Myung-Hwan. ·Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea. · Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. ·Dig Endosc · Pubmed #26856542.

ABSTRACT: BACKGROUND AND AIM: Radiofrequency ablation (RFA) and ethanol ablation are accepted methods of tissue destruction for treating cystic tumors. The aim of the present study was to evaluate the feasibility, efficacy, and safety of endoscopic ultrasound (EUS)-guided ablation using normal porcine gallbladders as a substitute model for branch-duct intraductal papillary mucinous neoplasms (BD-IPMN). METHODS: Six adult mini pigs were included in this prospective study. EUS-guided RFA with or without ethanol ablation of the gallbladder was carried out using a prototype 18-gauge endoscopic RFA electrode, and RFA and ethanol ablation were done in a single session. Outcomes were assessed in terms of macroscopic and microscopic evaluations of the treated gallbladders. RESULTS: The prototype RFA electrode was used for ablation of the mucosa, aspiration of the internal contents of the gallbladder, and ethanol injection. RFA plus ethanol lavage resulted in a greater mean percentage of denuded gallbladder mucosa (97.5%) than RFA alone (55.8%). Effects of ablation extending to the cystic duct and partially denuded cystic duct mucosae were detected in five of the six pigs. There were no major procedure-related adverse events. CONCLUSIONS: EUS-guided ablation of the gallbladder mucosa was feasible and effective in the porcine model. Additional studies will be required to fully assess the risk of procedure-related damage to the main pancreatic duct before using this technique in a clinical setting.

17 Article Outcomes of ERCP in Billroth II gastrectomy patients. 2016

Park, Tae Young / Kang, Jong Sik / Song, Tae Jun / Lee, Sang Soo / Lee, Hyuk / Choi, Jung Sik / Kim, Hong Jun / Jang, Ji Woong. ·Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea. · Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. · Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea. · Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea. · Department of Internal Medicine, Eulgi University College of Medicine, Daejeon, Korea. ·Gastrointest Endosc · Pubmed #26546981.

ABSTRACT: BACKGROUND AND AIMS: ERCP is a difficult procedure to perform in Billroth II gastrectomy patients because of altered anatomy. We investigated the outcomes and risk factors for adverse events with ERCP using a cap-fitted forward-viewing endoscope with endoscopic papillary balloon dilation (EPBD) in Billroth II gastrectomy patients. METHODS: The records for Billroth II gastrectomy patients who underwent ERCP using a cap-fitted forward-viewing endoscope with EPBD at 5 institutions between August 2008 and April 2014 were retrospectively reviewed. The outcomes and risk factors for adverse events resulting from this treatment were analyzed. RESULTS: In total, 165 patients were identified. ERCP was technically successful in 144 patients (87.3%) and clinically successful in 141 patients (85.5%). Adverse events occurred in 38 patients (23.0%): perforation in 3 cases (1.8%), pancreatitis in 13 cases (7.9%), and asymptomatic hyperamylasemia in 22 patients (13.3%). In univariate analysis, ≥2 ERCP sessions, periampullary diverticulum, and common bile duct (CBD) stone size ≥ 12 mm were found to be associated with ERCP-related adverse events. In multivariate analysis, ≥2 ERCP sessions (odds ratio [OR], 4.762; 95% confidence interval [CI], 1.472-15.402; P = .009) and a CBD stone size ≥ 12 mm (OR, 3.213; 95% CI, 1.140-9.057; P = .027) were significant. CONCLUSIONS: ERCP using a cap-fitted forward-viewing endoscope with EPBD is feasible in Billroth II gastrectomy patients. In patients with ≥2 ERCP sessions or a CBD stone size ≥ 12 mm, special attention should be paid to the possible occurrence of significant adverse events.

18 Article Initial experience of EUS-guided radiofrequency ablation of unresectable pancreatic cancer. 2016

Song, Tae Jun / Seo, Dong Wan / Lakhtakia, Sundeep / Reddy, Nageshwar / Oh, Dong Wook / Park, Do Hyun / Lee, Sang Soo / Lee, Sung Koo / Kim, Myung-Hwan. ·Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Gastroenterology and Therapeutic Endoscopy, Asian Institute of Gastroenterology, Hyderabad, India. ·Gastrointest Endosc · Pubmed #26344883.

ABSTRACT: BACKGROUND AND AIMS: Radiofrequency ablation (RFA) has been used as a valuable treatment modality for various unresectable malignancies. EUS-guided radiofrequency ablation (EUS-RFA) of the porcine pancreas was reported to be feasible and safe in our previous study, suggesting that EUS-RFA may be applicable as an adjunct and effective alternative treatment method for unresectable pancreatic cancer. This study aimed to assess the technical feasibility and safety of EUS-RFA for unresectable pancreatic cancer. METHODS: An 18-gauge endoscopic RFA electrode and a radiofrequency generator were used for the procedure. The length of the exposed tip of the RFA electrode was 10 mm. After insertion of the RFA electrode into the mass, the radiofrequency generator was activated to deliver 20 to 50 W ablation power for 10 seconds. Depending on tumor size, the procedure was repeated to sufficiently cover the tumor. RESULTS: EUS-RFA was performed successfully in all 6 patients (median age 62 years, range 43-73 years). Pancreatic cancer was located in the head (n = 4) or body (n = 2) of the pancreas. The median diameter of masses was 3.8 cm (range 3cm-9cm). Four patients had stage 3 disease, and 2 patients had stage 4 disease. After the procedure, 2 patients experienced mild abdominal pain, but there were no other adverse events such as pancreatitis or bleeding. CONCLUSIONS: EUS-RFA could be a technically feasible and safe option for patients with unresectable pancreatic cancer.

19 Article 1-Pamitoyl-2-Linoleoyl-3-Acetyl-rac-Glycerol May Reduce Incidence of Gemcitabine-Induced Neutropenia: A Pilot Case-Controlled Study. 2015

Oh, Dongwook / Kim, Myung-Hwan / Song, Tae Jun / Cho, Charles J / Nam, Kwangwoo / Cho, Min Keun / Chun, Joo Hyun / Jung, Kyoungwon / Kim, Kyu-Pyo / Kim, Jae Wha. ·Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Division of Oncology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. · Biomedical Translational Research Center, Korea Research Institute of Bioscience and Biotechnology, Deajeon, Korea. ·World J Oncol · Pubmed #28983339.

ABSTRACT: BACKGROUND: Chemotherapy-induced neutropenia (CIN) may compromise planned chemotherapy, resulting in severe infection, dose reduction or delayed treatment. Orally administered 1-pamitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) is a synthetic monoacetyldiglyceride, a product found in the antlers of sika deer. The aim of this study was to evaluate the effectiveness of PLAG for the prevention of CIN. METHODS: A total of 48 patients with unresectable pancreatic cancer received gemcitabine-based palliative chemotherapy. Among those patients, 16 patients received PLAG (500 mg) twice daily from the start of chemotherapy to the completion. RESULTS: The PLAG group showed a significantly lower incidence of neutropenia (absolute neutrophil count < 1,500 cells/mm CONCLUSIONS: PLAG was shown to be clinically effective and safe in reducing the incidence of CIN in pancreatic cancer patients receiving gemcitabine-based chemotherapy.

20 Article Initial human experience of endoscopic ultrasound-guided photodynamic therapy with a novel photosensitizer and a flexible laser-light catheter. 2015

Choi, Jun-Ho / Oh, Dongwook / Lee, Jae Hoon / Park, Jin-Hong / Kim, Kyu-Pyo / Lee, Seung Soo / Lee, Young-Joo / Lim, Young-Suk / Song, Tae Jun / Lee, Sang Soo / Seo, Dong-Wan / Lee, Sung Koo / Kim, Myung-Hwan / Park, Do Hyun. ·Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea. · Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Hepato-biliary and Pancreatic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. · Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. ·Endoscopy · Pubmed #26070006.

ABSTRACT: BACKGROUND AND STUDY AIMS: New methods for the endoscopic selective ablation of locally advanced pancreaticobiliary malignancies as a minimally invasive approach are needed. Our aim was to examine the feasibility and safety of endoscopic ultrasonography (EUS)-guided photodynamic therapy (PDT) for local tumor control in patients with locally advanced pancreaticobiliary malignancies. PATIENTS AND METHODS: A chlorin e6 derivative and a flexible laser-light catheter were used to perform EUS-guided PDT in four patients with locally advanced pancreaticobiliary malignancies. RESULTS: EUS-guided PDT was technically feasible in all four patients with locally advanced pancreaticobiliary malignancies (two in the caudate lobe of the liver, one in the far distal bile duct, and one in the tail of the pancreas). No treatment-related complications occurred. The median volume of necrosis produced by PDT was 4.0 cm(3) (range 0.7 - 11.3). Disease remained stable in all four patients during a median follow-up of 5 months (range 3 - 7). CONCLUSION: These preliminary data suggest that EUS-guided PDT with a second-generation photosensitizer and a flexible laser probe is feasible and safe.

21 Article Predictors of malignancy in pure branch duct type intraductal papillary mucinous neoplasm of the pancreas: A nationwide multicenter study. 2015

Kim, Tae Hyeon / Song, Tae Jun / Hwang, Jin-Hyeok / Yoo, Kyo-Sang / Lee, Woo-Jin / Lee, Kwang-Hyuck / Dong, Seok-Ho / Park, Chang-Hwan / Park, Eun-Taek / Moon, Jong-Ho / Kim, Ho-Gak / Kim, Eun-Young / Cho, Kwang Bum / Kim, Hong-Ja / Lee, Seung-Ok / Cheon, Young Koog / Lee, Jeong Mi / Oh, Dong Wook / Kim, Myung-Hwan. ·Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea. · Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. · Department of Internal Medicine, Seoul National University College of Medicine, Bundang, Republic of Korea. · Department of Internal Medicine, Hanyang University College of Medicine, Guri, Republic of Korea. · Pancreatobiliary Cancer Clinic, Center for Liver Cancer, National Cancer Center, Goyang, Republic of Korea. · Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. · Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea. · Department of Internal Medicine, Chonnam University College of Medicine, Kwangju, Republic of Korea. · Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea. · Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon, Republic of Korea. · Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea. · Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea. · Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea. · Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea. · Digestive Disease Center, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea. · Department of Public Health, Wonkwang University Graduate School, Iksan, Republic of Korea. · Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. Electronic address: mhkim@amc.seoul.kr. ·Pancreatology · Pubmed #25998516.

ABSTRACT: BACKGROUND/OBJECTIVES: Prediction of malignancy in patients with BD-IPMNs is critical for the management. The aim of this study was to elucidate predictors of malignancy in patients with 'pure' BD-IPMNs who had a main pancreatic duct (MPD) diameter of ≤5 mm according to the most recent international consensus criteria and in whom MPD involvement was excluded on postoperative histology. METHODS: We identified 177 patients with 'pure' BD-IPMNs based on preoperative imaging and postoperative histology from 15 tertiary referral centers in Korea. BD-IPMNs with low-grade (n = 72) and moderate-grade (n = 66) dysplasia were grouped as benign and BD-IPMNs with high-grade dysplasia (n = 10) and invasive carcinoma (n = 29) were grouped as malignancy. RESULTS: On univariate analysis, particular symptoms (jaundice and clinical pancreatitis), CT findings (cyst size > 3 cm, the presence of enhancing mural nodules) and EUS features (the presence of mural nodules, the mural nodule size > 5 mm) were significant risk factors predicting malignant BD-IPMNs. Multivariate analysis revealed that the cyst size > 3 cm (odds ratio = 9.9), the presence of enhancing mural nodules on CT (odds ratio = 19.3) and the mural nodule size > 5 mm on EUS (odds ratio = 14.9) were the independent risk factors for the presence of malignancy in BD-IPMNs (p < 0.001). CONCLUSIONS: The cyst size > 3 cm, the presence of enhancing mural nodules on CT, the mural nodule size > 5 mm on EUS are three independent predictors of malignancy in patients with 'pure' BD-IPMNs.

22 Article Xanthogranulomatous pancreatitis presents as a solid tumor mass: a case report. 2011

Kim, Han-Seong / Joo, Mee / Chang, Sun Hee / Song, Hwa Young / Song, Tae Jun / Seo, Jung Wook / Kim, Chul-Nam. ·Department of Pathology, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang, Korea. hskim@paik.ac.kr ·J Korean Med Sci · Pubmed #21468270.

ABSTRACT: Xanthogranulomatous inflammation (XGI) is a rare, idiopathic process in which lipid-laden histiocytes are deposited at various locations in the body. Although XGI has been reported to occur in various organs such as the gallbladder, kidney, bone, stomach, colon, appendix, lymph nodes, urachus, and urinary bladder and in soft tissues, xanthogranulomatous pancreatitis (XGP) is extremely rare. Herein, we report a case of XGP occurring in a 70-yr-old woman, who presented with abdominal pain for several months. On physical examination, mild epigastric tenderness was noted. Abdomen CT scan revealed a low attenuated mass in uncinate process of pancreas, suggesting malignant lesion. Whipple's operation was performed and the final pathologic diagnosis was XGP. The patient's post-operative course was uneventful, and no recurrence was found within 7 months of the operation. When a pancreatic mass does not show clinico-radiological features typical of common pancreatic neoplasms, XGP should be considered for a differential diagnosis.