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Pancreatic Neoplasms: HELP
Articles by Michael Tachezy
Based on 17 articles published since 2010
(Why 17 articles?)
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Between 2010 and 2020, Michael Tachezy wrote the following 17 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Pancreatic cancer and liver metastases: state of the art. 2016

Bellon, Eugen / Gebauer, Florian / Tachezy, Michael / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20249, Hamburg, Germany. · Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20249, Hamburg, Germany. M.bockhorn@uke.de. ·Updates Surg · Pubmed #27832445.

ABSTRACT: Pancreatic cancer is still one of the most aggressive oncological diseases with a 5-year mortality rate below 10%. Surgery remains the only curative treatment; however, most patients present with late-stage disease deemed unresectable, either due to extensive local vascular involvement or the presence of distant metastasis. In the detection of hepatic metastases, the current standard is palliative chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) or nab-paclitaxel with gemcitabine. Once hepatic metastases are diagnosed, the guidelines do not recommend resection of the primary tumor. Recent findings suggest that some patients with non-resectable diseases initially have survival rates as good as those with initially resectable disease when they are able to undergo surgical resection. Synchronous resection of both the primary tumour as well as the liver metastases may be beneficial and improves the outcome.

2 Clinical Trial Sequential neoadjuvant chemoradiotherapy (CRT) followed by curative surgery vs. primary surgery alone for resectable, non-metastasized pancreatic adenocarcinoma: NEOPA- a randomized multicenter phase III study (NCT01900327, DRKS00003893, ISRCTN82191749). 2014

Tachezy, Michael / Gebauer, Florian / Petersen, Cordula / Arnold, Dirk / Trepel, Martin / Wegscheider, Karl / Schafhausen, Phillipe / Bockhorn, Maximilian / Izbicki, Jakob Robert / Yekebas, Emre. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg Eppendorf, Martinistr, 52, Hamburg 20246, Germany. izbicki@uke.de. ·BMC Cancer · Pubmed #24906700.

ABSTRACT: BACKGROUND: Median OS after surgery in curative intent for non-metastasized pancreas cancer ranges under study conditions from 17.9 months to 23.6 months. Tumor recurrence occurs locally, at distant sites (liver, peritoneum, lungs), or both. Observational and autopsy series report local recurrence rates of up to 87% even after potentially "curative" R0 resection. To achieve better local control, neoadjuvant CRT has been suggested for preoperative tumour downsizing, to elevate the likelihood of curative, margin-negative R0 resection and to increase the OS rate. However, controlled, randomized trials addressing the impact of neoadjuvant CRT survival do not exist. METHODS/DESIGN: The underlying hypothesis of this randomized, two-armed, open-label, multicenter, phase III trial is that neoadjuvant CRT increases the three-year overall survival by 12% compared to patients undergoing upfront surgery for resectable pancreatic cancer. A rigorous, standardized technique of histopathologically handling Whipple specimens will be applied at all participating centers. Overall, 410 patients (n=205 in each study arm) will be enrolled in the trial, taking into regard an expected drop out rate of 7% and allocated either to receive neoadjuvant CRT prior to surgery or to undergo surgery alone. Circumferential resection margin status, i.e. R0 and R1 rates, respectively, surgical resectability rate, local and distant disease-free and global survival, and first site of tumor recurrence constitute further essential endpoints of the trial. DISCUSSION: For the first time, the NEOPA study investigates the impact of neoadjuvant CRT on survival of resectable pancreas head cancer in a prospectively randomized manner. The results of the study have the potential to change substantially the treatment regimen of pancreas cancer. TRIAL REGISTRATION: Clinical Trial gov: NCT01900327, DRKS00003893, ISRCTN82191749.

3 Article Improved Risk Stratification by Circulating Tumor Cell Counts in Pancreatic Cancer. 2018

Effenberger, Katharina E / Schroeder, Cornelia / Hanssen, Annkathrin / Wolter, Stefan / Eulenburg, Christine / Tachezy, Michael / Gebauer, Florian / Izbicki, Jacob R / Pantel, Klaus / Bockhorn, Maximilian. ·Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. pantel@uke.de. ·Clin Cancer Res · Pubmed #29559560.

ABSTRACT:

4 Article Detection of mutant KRAS and TP53 DNA in circulating exosomes from healthy individuals and patients with pancreatic cancer. 2017

Yang, Sujuan / Che, Sara P Y / Kurywchak, Paul / Tavormina, Jena L / Gansmo, Liv B / Correa de Sampaio, Pedro / Tachezy, Michael / Bockhorn, Maximilian / Gebauer, Florian / Haltom, Amanda R / Melo, Sonia A / LeBleu, Valerie S / Kalluri, Raghu. ·a Department of Cancer Biology , Metastasis Research Center, University of Texas MD Anderson Cancer Center , Houston , TX , USA. · b Department of General , Visceral and Thoracic Surgery, University Medical Center of Hamburg-Eppendorf , Hamburg , Germany. · c Instituto de Investigação e Inovação em Saúde, Universidade do Porto , Porto , Portugal (I3S). · d Institute of Pathology and Molecular Immunology of the University of Porto (IPATIMUP) , Porto , Portugal. ·Cancer Biol Ther · Pubmed #28121262.

ABSTRACT: Pancreatic cancer presents with a dismal mortality rate and is in urgent need of methods for early detection with potential for timely intervention. All living cells, including cancer cells, generate exosomes. We previously discovered double stranded genomic DNA in exosomes derived from the circulation of pancreatic cancer patients, which enabled the detection of prevalent mutations associated with the disease. Here, we report a proof-of-concept study that demonstrates the potential clinical utility of circulating exosomal DNA for identification of KRAS

5 Article Synchronous resections of hepatic oligometastatic pancreatic cancer: Disputing a principle in a time of safe pancreatic operations in a retrospective multicenter analysis. 2016

Tachezy, Michael / Gebauer, Florian / Janot, Monika / Uhl, Waldemar / Zerbi, Alessandro / Montorsi, Marco / Perinel, Julie / Adham, Mustapha / Dervenis, Christos / Agalianos, Christos / Malleo, Giuseppe / Maggino, Laura / Stein, Alexander / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany. · Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany. Electronic address: fgebauer@uke.de. · Department of General and Visceral Surgery, St. Josef-Hospital Bochum, Hospital of the Ruhr-University, Bochum, Germany. · Department of General Surgery, University of Milan, Instituto Clinico Humanitas IRCCS, Milan, Italy. · Department of Hepato-Biliary and Pancreatic Surgery, Edouard Herriot Hospital, HCL, Lyon Faculty of Medicine - UCBL1, Lyon, France. · Department of Surgery, Agia Olga Hospital, Athens, Greece. · Department of Surgery, Unit of Surgery B, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of Oncology, Hematology, BMT with section Pneumology, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany. ·Surgery · Pubmed #27048934.

ABSTRACT: BACKGROUND: The prognosis of patients with liver metastasis is generally considered dismal, and combined resections of the primary tumor and metastasectomies are not recommended. In highly selected patients, however, resections are performed. The evidence for this indication is limited. The aim of the current study was to assess the operative and oncologic outcomes of patients with combined pancreatic and liver resections of synchronous liver metastases. METHODS: In a retrospective analysis of 6 European pancreas centers, we identified 69 patients with pancreatic ductal adenocarcinoma and synchronous liver metastasis who underwent simultaneous pancreas and liver metastasis resections. Patients receiving exploration without tumor resection served as the control group. RESULTS: Overall survival (OS) appeared to be prolonged in the group of resected patients (median 14 vs 8 months, P < .001). Subgroup analysis revealed that the survival benefit of the resected patients was driven by pancreatic ductal adenocarcinomas localized in the pancreatic head (median OS 13.6 vs 7 months, P < .001). Body/tail pancreatic ductal adenocarcinomas showed no benefit of resection (median OS 14 vs 15 months, P = .312). In the multivariate analysis, tumor resection was the only independent prognosticator for OS (hazard ratio 2.044, 95% confidence interval 1.342-3.114). CONCLUSION: The data of this retrospective and selective patient cohort suggested a clear survival benefit for patients undergoing synchronous pancreas and liver resections for pancreatic ductal adenocarcinoma, but due to the limitations of this retrospective study and very strong potential for selection bias, a strong conclusion for resection cannot be drawn. Prospective trials must validate these data and investigate the use of combined operative and systemic treatments in case of resectable metastatic pancreatic cancer. Is it time for a multicenter, prospective trial?

6 Article Resection margin clearance in pancreatic cancer after implementation of the Leeds Pathology Protocol (LEEPP): clinically relevant or just academic? 2015

Gebauer, Florian / Tachezy, Michael / Vashist, Yogesh K / Marx, Andreas H / Yekebas, Emre / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, University of Hamburg, Martinistrasse 52, 20246, Hamburg, Germany, fgebauer@uke.de. ·World J Surg · Pubmed #25270344.

ABSTRACT: BACKGROUND AND OBJECTIVES: The aim of this study was to assess the overall survival (OS) after R0/R1 resections in patients with pancreatic ductal adenocarcinoma (PDAC) of the pancreatic head after implementation of a standardized histopathologic protocol (Leeds Pathology Protocol, LEEPP). METHODS: One hundred and twenty-five patients underwent surgical resection because of PDAC of the pancreatic head. Patients were histopathologically examined according to a standardized protocol. Their oncologic outcome and clinicopathologic data were compared with those of a patient group before implementation of the LEEPP (n = 116). RESULTS: The R1 rate increased significantly from 13 to 52 %. There was no significant difference in OS between R0 and R1 resections. The median OS in patients with a tumor clearance of less than 2 mm from the resection margin was 15.1 months (12.1-18.1 months) versus 22.2 months (7.8-36.7 months) (P = 0.046). Multivariate analysis revealed a margin clearance or 2 mm and more as an independent prognosticator for OS. CONCLUSIONS: With applying the LEEPP, there was still no significant correlation between the R-status and OS in patients with PDAC. However, since a margin clearance of 2 mm or more is a predictive factor for OS, the R1 definition might have to be adapted in PDAC.

7 Article Carcinoembryonic antigen-related cell adhesion molecules (CEACAM) 1, 5 and 6 as biomarkers in pancreatic cancer. 2014

Gebauer, Florian / Wicklein, Daniel / Horst, Jennifer / Sundermann, Philipp / Maar, Hanna / Streichert, Thomas / Tachezy, Michael / Izbicki, Jakob R / Bockhorn, Maximilian / Schumacher, Udo. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany; Institute of Anatomy and Experimental Morphology and University Cancer Center Hamburg (UCCH), University Medical-Center Hamburg-Eppendorf, Hamburg, Germany. · Institute of Anatomy and Experimental Morphology and University Cancer Center Hamburg (UCCH), University Medical-Center Hamburg-Eppendorf, Hamburg, Germany. · Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany. · Institute of Clinical Chemistry, University Medical-Center Hamburg-Eppendorf, Hamburg, Germany. ·PLoS One · Pubmed #25409014.

ABSTRACT: BACKGROUND: Aim of this study was to assess the biological function in tumor progression and metastatic process carcinoembryonic antigen-related cell adhesion molecules (CEACAM) 1, 5 and 6 in pancreatic adenocarcinoma (PDAC). EXPERIMENTAL DESIGN: CEACAM knock down cells were established and assessed in vitro and in a subcutaneous and intraperitoneal mouse xenograft model. Tissue and serum expression of patients with PDAC were assessed by immunohistochemistry (IHC) and by enzyme linked immunosorbent assays. RESULTS: Presence of lymph node metastasis was correlated with CEACAM 5 and 6 expression (determined by IHC) and tumor recurrence exclusively with CEACAM 6. Patients with CEACAM 5 and 6 expression showed a significantly shortened OS in Kaplan-Meier survival analyses. Elevated CEACAM6 serum values showed a correlation with distant metastasis and. Survival analysis revealed a prolonged OS for patients with low serum CEACAM 1 values. In vitro proliferation and migration capacity was increased in CEACAM knock down PDAC cells, however, mice inoculated with CEACAM knock down cells showed a prolonged overall-survival (OS). The number of spontaneous pulmonary metastasis was increased in the CEACAM knock down group. CONCLUSION: The effects mediated by CEACAM expression in PDAC are complex, though overexpression is correlated with loco-regional aggressive tumor growth. However, loss of CEACAM can be considered as a part of epithelial-mesenchymal transition and is therefore of rather importance in the process of distant metastasis.

8 Article ABO blood group IgM isoagglutinins interact with tumor-associated O-glycan structures in pancreatic cancer. 2014

Hofmann, Bianca T / Stehr, Anne / Dohrmann, Thorsten / Güngör, Cenap / Herich, Lena / Hiller, Jens / Harder, Sönke / Ewald, Florian / Gebauer, Florian / Tachezy, Michael / Precht, Clarissa / Izbicki, Jakob R / Bockhorn, Maximilian / Wagener, Christoph / Wolters-Eisfeld, Gerrit. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Insitute of Medical Statistics, Informatics and Epidemiology (IMSIE) University Hospital of Cologne, Cologne, Germany. · Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ge.wolters@uke.de. ·Clin Cancer Res · Pubmed #25320359.

ABSTRACT: PURPOSE: The ABO gene locus is associated with the risk of developing pancreatic ductal adenocarcinoma (PDAC) resulting in an increased incidence in individuals with non-O blood groups. Up to 90% of PDAC specimens display alterations in mucin type O-GalNAc glycosylation. Because aberrant O-GalNAc glycans (Tn and T antigen) are structurally related to blood group A and B glycans, we investigated the role of IgM isoagglutinins in PDAC. EXPERIMENTAL DESIGN: Binding studies of IgM isoagglutinins toward blood group A, B, Tn antigen, and T antigen glycoconjugates from patients with PDAC and healthy individuals were conducted. Isoagglutinin titers and total IgM were compared between patients with PDAC and control group. An anti-A antibody was used for immunoprecipitation of aberrant O-glycosylated tumor proteins and subsequent mass spectromic analysis. RESULTS: We found that IgM isoagglutinins bind blood group antigens, Tn and T glycoconjugates as well as tumor-derived glycoproteins. Blood group A isoagglutinins exhibited a strong binding toward blood group B antigen and T antigen, whereas blood group B showed binding to blood group A antigen and Tn antigen. Furthermore, we confirmed a decreased frequency in individuals with blood group O and observed a significant decrease of IgM isoagglutinin titers in PDAC sera compared with control sera, whereas total IgM levels were unaltered. We identified new PDAC-derived O-GalNAc glycoproteins by mass spectrometry using a blood group A-specific antibody. CONCLUSION: Our data elucidated a novel interaction of blood group IgM isoagglutinins and PDAC O-GalNAc glycoproteins that may contribute to the pathogenesis and progression of pancreatic cancer.

9 Article Serum EpCAM expression in pancreatic cancer. 2014

Gebauer, Florian / Struck, Lea / Tachezy, Michael / Vashist, Yogesh / Wicklein, Daniel / Schumacher, Udo / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany University Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany fgebauer@uke.uni-hamburg.de. · Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany University Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ·Anticancer Res · Pubmed #25202052.

ABSTRACT: BACKGROUND: Aim of the study was to assess the diagnostic and prognostic impact of serum EpCAM levels in patients with pancreatic adenocarcinoma (PDAC). MATERIALS AND METHODS: For quantitative measurement of preoperative serum EpCAM levels, a sandwich enzyme immunoassay kit was used (ELISA). Sixty-six patients with PDAC were included in the study and for comparison 43 patients with chronic pancreatitis and 104 healthy blood donors without any clinical evidence of cancer were analyzed as well. RESULTS: Serum EpCAM levels differed significantly between the groups. The average value for patients with PDAC was 0.240±0.833 ng/ml, in patients with CP 0.192±0.590 ng/ml and 0.626±1.164 ng/ml in normal blood donor sera. With a cut-off level of 0.422 ng/ml EpCAM, the calculated sensitivity of detecting PDAC was 66.7% with corresponding specificity of 77.5%. A correlation with clinico-pathological data (pT, pN, M, R-status, grading, UICC stage) was not found and in addition there was no difference in overall survival between patients with high- and low-preoperative serum EpCAM levels. CONCLUSION: EpCAM can be detected in the serum in patients with PDAC though the sensitivity for detecting PDAC is low and a correlation with clinical parameters was not found.

10 Article ALCAM (CD166) expression and serum levels in pancreatic cancer. 2012

Tachezy, Michael / Zander, Hilke / Marx, Andreas H / Stahl, Phillip R / Gebauer, Florian / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. mtachezy@uke.uni-hamburg.de ·PLoS One · Pubmed #22745698.

ABSTRACT: BACKGROUND: This study was conducted to evaluate the expression of the activated leukocyte cell adhesion molecule (ALCAM) in pancreatic cancer (PAC) and to determine whether or not the ectodomain shedding of ALCAM (s-ALCAM) could serve as a biomarker in the peripheral blood of PAC patients. MATERIAL AND METHODS: Tissue specimens and blood sera of patients with PAC (n = 264 and n = 116, respectively) and the sera of 115 patients with chronic pancreatitis (CP) were analyzed via ALCAM immunohistochemistry and s-ALCAM ELISA tests. Results were correlated with clinical, histopathological, and patient survival data (Chi-square test, Kaplan-Meier analysis, log-rank test, respectively). RESULTS: ALCAM was expressed in the majority of PAC lesions. Immunohistochemistry and serum ELISA tests revealed no association between ALCAM expression in primary tumors or s-ALCAM and clinical or histopathological data. Neither ALCAM nor s-ALCAM showed a significant impact regarding overall survival (p = 0.261 and p = 0.660, respectively). S-ALCAM serum levels were significantly elevated compared to the sera of CP patients (p<0.001). The sensitivity of s-ALCAM in detecting PAC was 58.6% at a specificity of 73.9% (AUC = 0.69). CONCLUSIONS: ALCAM is expressed in the majority of PAC lesions, but statistical analysis revealed no association with clinical or pathological data. Although significantly elevated in patients with PAC, the sensitivity and specificity of the s-ALCAM serum quantification test was low. Therefore, its potential as a novel diagnostic marker for PAC remains elusive and further investigations are required.

11 Article Disseminated tumor cells in pancreatic cancer-an independent prognosticator of disease progression and survival. 2012

Effenberger, Katharina E / Schroeder, Cornelia / Eulenburg, Christine / Reeh, Matthias / Tachezy, Michael / Riethdorf, Sabine / Vashist, Yogesh K / Izbicki, Jakob R / Pantel, Klaus / Bockhorn, Maximilian. ·Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Germany. k.effenberger@uke.de ·Int J Cancer · Pubmed #21932421.

ABSTRACT: Pancreatic cancer is one of the most devastating cancers with a 6-month median survival and a 5-year survival rate of 3-5%. Still important aspects of its aggressive biology remain elusive and advanced therapeutic regimens have not been substantially successful. We investigated the prognostic role of disseminated tumor cells (DTC) in bone marrow, a reservoir for early DTC potentially contributing to metastatic progression, of pancreatic cancer patients. After exclusion of patients with different postsurgery diagnosis or missing DTC status (n = 40) a total of 175 patients remained for final analyses. One-hundred and nineteen patients were male and 96 female with a median age of 67 years, 96 patients underwent complete resection. Bone marrow aspirates taken at primary surgery were analyzed for DTC by an immunocytochemical cytokeratin assay and correlated to survival data. Overall 13.7% of patient samples (24/175) harbored DTC in their bone marrow. Histopathological parameters did not correlate significantly. Univariate survival analysis revealed a borderline significant correlation between DTC and decreased progression-free survival (p = 0.069), and was significant for overall survival (p = 0.036). Regarding patients with resected tumors, the respective p-values were 0.058 for progression-free and 0.016 for overall survival. Importantly, the prognostic influence was independent from other risk factors as shown by multivariate analyses for progression-free (p = 0.030, HR: 2.057; CI (95%): 1.073-3.943) and overall survival (p = 0.006, HR: 2.283; CI (95%): 1.260-4.135). The presence of DTC in bone marrow is a strong and independent prognostic factor of survival in patients with pancreatic cancer. Thus, bone-targeting may be a new future therapeutic option for DTC-positive patients.

12 Article Multivisceral resections in pancreatic cancer: identification of risk factors. 2011

Burdelski, Christoph M / Reeh, Matthias / Bogoevski, Dean / Gebauer, Florian / Tachezy, Michael / Vashist, Yogesh K / Cataldegirmen, Guellue / Yekebas, Emre / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral, and Thoracic Surgery, University Medical Center, Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany. c.burdelski@uke.de ·World J Surg · Pubmed #21938586.

ABSTRACT: BACKGROUND: There is an assumption that multivisceral resections (MVRs) in patients with a pancreatic malignancy are associated with higher morbidity. The oncologic benefit, however, remains controversial. METHODS: The aim was to identify risk factors for complications in cases of MVR in patients with pancreatic cancer. Of 1099 patients who underwent major pancreatic resection at our institution between January 1992 and October 2008, a total of 55 were treated with an MVR involving resection of one or more additional organs. This group was compared with 154 patients who had palliative bypass surgery and 303 patients who underwent standard pancreatic head resection. RESULTS: Multivisceral resection patients had an overall higher incidence of major surgical complications (p < 0.001). In-hospital mortality was comparable in all groups. Median survival after MVR was inferior to that after standard resection but was significantly better than that after palliative bypass. Univariate logistic regression analysis identified concomitant colon, kidney, and liver resections and any intraoperative transfusion as predictors of complications; in the multivariate analysis, only kidney resections and any intraoperative transfusion were confirmed predictors. In contrast, T status, kidney resection, resection of four or more organs, any postoperative transfusion, and intensive care unit stay of >2 days were identified as predictors of survival in the univariate Cox regression analysis; in the multivariate analysis, only the T status was confirmed. Median survival after MVR was 16 months, after palliative bypass 6 months, and after standard resection 18 months (p < 0.001). CONCLUSIONS: Multivisceral resections are technically feasible procedures with increased survival when compared to palliative bypass procedures. The incidence of postoperative complications was increased with kidney resection and when intraoperative transfusion was required.

13 Article ALCAM (CD166) expression as novel prognostic biomarker for pancreatic neuroendocrine tumor patients. 2011

Tachezy, Michael / Zander, Hilke / Marx, Andreas H / Gebauer, Florian / Rawnaq, Tamina / Kaifi, Jussuf T / Sauter, Guido / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral, and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ·J Surg Res · Pubmed #21816425.

ABSTRACT: BACKGROUND: Activated leukocyte cell adhesion molecule (ALCAM, CD166) is a cell membrane protein that is aberrantly expressed in different tumors, including pancreatic neuroendocrine tumors (PNET). The aim of this study was to determine the expression of ALCAM in PNET to learn more about the prevalence and clinical significance of ALCAM expression in PNET. METHODS: Primary tumors (n = 38) and corresponding lymph node (n = 5) and liver metastases (n = 9) of patients with PNET, treated at the University Medical Center Hamburg-Eppendorf between 1993 and 2006, were analyzed via ALCAM immunohistochemistry in a tissue microarray format. The results were correlated with clinical and histopathologic data, including the WHO classification of PNET. RESULTS: The majority of primary (74%) and secondary (50%) lesions of PNET showed strong ALCAM expression. Immunohistochemistry of primary tumors revealed an association between high ALCAM expression and the hormone production status of the tumor (P = 0.037), and an inverse correlation with metastasis status (P = 0.041) and tumor size (cut off level 2 cm, P = 0.013). Elevated ALCAM expression was a significant positive prognostic factor for recurrence-free (P = 0.002) and disease-specific survival (P = 0.009) in Kaplan-Meier survival analysis (log rank test). CONCLUSIONS: ALCAM is abundantly expressed in PNET and decreased expression is significantly associated with poor prognosis. ALCAM may be a potential marker for risk prediction in patients diagnosed with PNET. Further studies with larger patient collectives are required to validate the results of this study and investigate the functional role of ALCAM in PNET.

14 Article Prognostic impact of CXCR4 and CXCR7 expression in pancreatic adenocarcinoma. 2011

Gebauer, Florian / Tachezy, Michael / Effenberger, Katharina / von Loga, Katharina / Zander, Hilke / Marx, Alexander / Kaifi, Jussuf T / Sauter, Guido / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. fgebauer@uke.uni-hamburg.de ·J Surg Oncol · Pubmed #21520098.

ABSTRACT: BACKGROUND: Chemokines and their receptors are known to play important roles in the tumorigenesis of many malignancies. The aim of this study was to evaluate the prognostic impact of the expression of the chemokine receptors CXCR4 and CXCR7 in patients with pancreatic adenocarcinoma (PAC). METHODS: Expression of CXCR4 and CXCR7 in specimens from 249 patients with PAC was evaluated by immunohistochemistry on a tissue microarray and matched with clinicopathological parameters and overall survival. RESULTS: Expression of CXCR4 was detected in 215 patients (86.4%) and CXCR7 in 47 patients (18.9%). No association between CXCR4 and CXCR7 expression was evident, although all the CXCR7 positive tumors were also CXCR4 positive. pT1/2 tumors showed a higher frequency of CXCR7 expression than pT3/4 tumors (P = 0.018), while more dedifferentiated tumors had elevated CXCR7 expression (P = 0.036). Overall and disease-free survival revealed no association with either CXCR4 or CXCR7 expression. CONCLUSION: CXCR7 is associated with tumor grade and inversely associated with tumor size and may play a potential role in tumor progression and differentiation. In contrast to previously reported data our results revealed no significant association between CXCR4 expression and clinical or pathological data.

15 Article High surgical morbidity following distal pancreatectomy: still an unsolved problem. 2011

Reeh, Matthias / Nentwich, Michael F / Bogoevski, Dean / Koenig, Alexandra M / Gebauer, Florian / Tachezy, Michael / Izbicki, Jakob R / Bockhorn, Maximilian. ·Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. mreeh@uke.de ·World J Surg · Pubmed #21387132.

ABSTRACT: BACKGROUND: High surgical morbidity following distal pancreatectomy, especially pancreatic fistula, remains an unsolved problem. The aim of this study was to identify potential risk factors for surgical morbidity with a focus on the development of pancreatic fistula. METHODS: Clinicopathologic parameters were collected for 283 patients who underwent distal pancreatectomy between January 2000 and May 2010. Logistic regression analyses were performed to identify potential risk factors for surgical morbidity and pancreatic fistula. RESULTS: Spleen-preserving pancreatectomy was carried out in 12% of all cases and multivisceral resections were performed in 37.8%. For closure of the pancreatic remnant, three different techniques were used: hand-sewn suture in 44.5%, pancreaticojejunal anastomosis in 24%, and closure by stapler in 31.5%. Overall morbidity and mortality were 53 and 3.5%. Surgical morbidity was observed in 50.2% of all cases and pancreatic fistula in 24%. The stapling group had significantly higher surgical morbidity at 65.2% (p=0.001) and the most pancreatic fistulas, though this did not reach statistical significance (p=0.189). Univariate and multivariate logistic analyses indicated that closure by stapler [odds ratio (OR)=3.61; p<0.001] is a risk factor for surgical morbidity. CONCLUSION: Closure of the pancreatic remnant by using a stapling device was associated with an increased risk of surgical morbidity. With an increasing number of laparoscopic distal pancreatectomies being performed, further studies analyzing the use of stapling devices and newer closure techniques are needed.

16 Article Bypass surgery versus intentionally incomplete resection in palliation of pancreatic cancer: is resection the lesser evil? 2011

Tachezy, Michael / Bockhorn, Maximilian / Gebauer, Florian / Vashist, Yogesh K / Kaifi, Jussuf Thomas / Izbicki, Jakob Robert. ·Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Germany, Martinistraße 52, 20246, Hamburg, Germany. m.tachezy@uke.uni-hamburg.de ·J Gastrointest Surg · Pubmed #21359594.

ABSTRACT: OBJECTIVE: As technical expertise increases, the indication for pancreatic resection for advanced pancreatic cancer has been expanded over the last years. Recently, several groups reported their series of unintentionally incomplete tumor resections and reported a potential survival benefit for patients after incomplete resection when compared with palliative bypass surgery. We investigated in a retrospective analysis whether even tumor resection that was intended to be incomplete might provide a better outcome than conventional palliative procedures. METHODS: Twenty-two patients with a locally non-resectable or disseminated adenocarcinoma of the pancreas underwent a palliative intentionally incomplete resection. Outcome after resection was compared with that of 46 patients matched for age, sex, and histopathological tumor type who underwent a palliative bypass operation. RESULTS: Overall surgical morbidity was significantly higher in the resection group (59%) compared with the bypass group (33%, p < 0.05), resulting in a higher relaparotomy rate and a significantly longer postoperative hospital stay (p < 0.001). Surgery-related mortality was significantly higher in the resection group (p < 0.05). Overall survival showed no statistically significant difference between the two groups. CONCLUSIONS: Because of the higher surgery-related morbidity and mortality and lack of survival benefit in cases of advanced adenocarcinoma of the pancreas, intentionally incomplete palliative resection is not advisable.

17 Article Angiogenesis index CD105 (endoglin)/CD31 (PECAM-1) as a predictive factor for invasion and proliferation in intraductal papillary mucinous neoplasm (IPMN) of the pancreas. 2010

Tachezy, Michael / Reichelt, Uta / Melenberg, Tanja / Gebauer, Florian / Izbicki, Jakob R / Kaifi, Jussuf T. ·Department of General-, Visceral-, and Thoracic-Surgery, University Medical Center Hamburg Eppendorf, Germany. mtachezy@uke.uni-hamburg.de ·Histol Histopathol · Pubmed #20712008.

ABSTRACT: BACKGROUND: Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is an increasingly diagnosed entity since its definition by the World Health Organization in 1996. It has a broad clinical spectrum ranging from benign to malignant tumors. Optimum treatment is controversial and a better understanding of the development of IPMN of the pancreas and identification of potential prognostic factors will help to address this. Angiogenesis plays an elementary role in the development of malignant tumors and may well also be important in the development of IPMN of the pancreas. Therefore we investigated endothelial cell marker CD31 (PECAM-1) and angiogenesis associated marker CD105 (endoglin) by immunohistochemistry. METHODS: Thirty-two cases of surgically resected IPMN were chosen retrospectively and clinical data were obtained. Specimens were stained for proliferation marker (Ki-67), CD31 and CD105 by immunohistochemistry. A CD105/CD31 Angiogenesis ratio (AR) was established to determine the proliferating fraction of endothelial cells. RESULTS: The AR is significantly elevated in invasive IPMN of the pancreas (Mann-Whitney-U Test, p<0.05) and is associated with the Ki-67-labelling-index, demonstrating synergy between tumor-growth and neovascularisation. Invasive IPMN of the pancreas is associated with significantly lower recurrence-free and overall survival. CONCLUSIONS: Neovascularisation plays an important role in the tumorigenesis of invasive IPMN of the pancreas, and therefore angiogenesis-associated molecules like CD105 and CD31 might be useful tools as prognostic markers. Furthermore, the results indicate a potential role for adjuvant anti-angiogenic therapies in selected patients with recurring and/or invasive IPMN of the pancreas.