Challenges in Diagnosis and Treatment of Pancreatic Exocrine Insufficiency among Patients with Pancreatic Ductal Adenocarcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Malnutrition and Pancreatic Cancer
3. Diagnosis of Pancreatic Exocrine Insufficiency (PEI) in PDAC
4. Prevalence of PEI in Pancreatic Cancer
5. Practical Considerations of PEI Management
6. Appropriate Use of PERT for Pancreatic Cancer
Reference | Study Population | Resectable/Unresectable | Study Location | Findings |
---|---|---|---|---|
[101] | Retrospective study of 129 patients with metastatic pancreatic cancer | Both | New Zealand |
|
[102] | Retrospective study of 183 patients with PDAC and pNETs | Both | UK |
|
[100] | 262 patients diagnosed with pancreatic cancer | Both | USA |
|
[109] | 32,461 individuals identified with pancreatic cancer from US insurance claims | Both | USA |
|
[106] | 1350 individuals with malignant pancreatic, peri-ampullary lesions or malignant biliary obstruction | Both | UK |
|
[103] | Survey of 208 hepato-pancreato-biliary surgeons | N/A | USA |
|
[110] | 95 patients who underwent pancreaticoduodenectomy for suspected/confirmed pancreatic or periampullary (pre)malignancy | Resectable | The Netherlands |
|
7. Impact of PERT on Patient Outcomes
Reference | Study Population | Resectable/Unresectable | Intervention | Findings |
---|---|---|---|---|
[122] | Prospective study of 12 patients with biopsy-proven pancreatic ductal adenocarcinoma | Unresectable | Pancreatic Tablets |
|
[112] | Randomized controlled trial of 21 patients with unresectable pancreatic cancer with suspected biliary obstruction | Unresectable | Panzytrat 25,000 (coated) |
|
[113] | Randomized controlled trial of 67 patients with unresectable pancreatic cancer (34% pancreatic head tumours) | Unresectable | Norzyme (coated) |
|
[102] | Retrospective study of 183 patients with PDAC and pNETs | Both | Nutritional intervention (including PERT) |
|
[118] | Retrospective analysis of 469 patients undergoing pancreaticoduodenectomy for PDAC, cholangiocarcinoma, ampullary carcinoma, or duodenal carcinoma | Resectable | PERT |
|
[119] | Prospective observational study of 46 patients with pancreatic cancer on PERT and 45 historical controls | Unresectable | Pancrelipase |
|
[114] | Randomized controlled trial of 18 patients with advanced pancreatic cancer | Unresectable | Creon 25,000 (coated) |
|
[115] | Randomized controlled trial of 88 patients with unresectable pancreatic cancer receiving chemotherapy | Unresectable | Pancrelipase |
|
[123] | Retrospective analysis of 160 patients with unresectable pancreatic cancer | Unresectable | Creon 25,000 (coated) |
|
[124] | Prospective study of 29 patients with metastatic pancreatic adenocarcinoma, excluding those with ECOG ≤ 3 or PPS < 60% | Unresectable | Creon 25,000 (coated) |
|
[120] | Retrospective observational cohort study of 807 patients with pancreatic adenocarcinoma on PERT matched to non-PERT treated controls | Both | PERT |
|
8. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Lan, X.; Robin, G.; Kasnik, J.; Wong, G.; Abdel-Rahman, O. Challenges in Diagnosis and Treatment of Pancreatic Exocrine Insufficiency among Patients with Pancreatic Ductal Adenocarcinoma. Cancers 2023, 15, 1331. https://doi.org/10.3390/cancers15041331
Lan X, Robin G, Kasnik J, Wong G, Abdel-Rahman O. Challenges in Diagnosis and Treatment of Pancreatic Exocrine Insufficiency among Patients with Pancreatic Ductal Adenocarcinoma. Cancers. 2023; 15(4):1331. https://doi.org/10.3390/cancers15041331
Chicago/Turabian StyleLan, Xiaoyang, Gabrielle Robin, Jessica Kasnik, Grace Wong, and Omar Abdel-Rahman. 2023. "Challenges in Diagnosis and Treatment of Pancreatic Exocrine Insufficiency among Patients with Pancreatic Ductal Adenocarcinoma" Cancers 15, no. 4: 1331. https://doi.org/10.3390/cancers15041331