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Pancreatic adenocarcinoma is one of the most lethal types of gastrointestinal cancer despite the latest medical advances. Its incidence has continuously increased in recent years in developed countries. The location of the pancreas can result in the initial symptoms of neoplasia being overlooked, which can lead to a delayed diagnosis and a subsequent reduction in the spectrum of available therapeutic options. The role of modifiable risk factors in pancreatic cancer has been extensively studied in recent years, with smoking and alcohol consumption identified as key contributors. However, the few screening programs that have been developed focus exclusively on genetic factors, without considering the potential impact of modifiable factors on disease occurrence. Thus, fully understanding and detecting the risk factors for pancreatic cancer represents an important step in the prevention and early diagnosis of this type of neoplasia. This review reports the available evidence on different risk factors and identifies the areas that could benefit the most from additional studies. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the fifth most common cancer, with an increasing incidence in recent years. The prognosis is unfavorable, representing the third most frequent cause of cancer-related death worldwide. This is because it generally develops in patients with pre-existing liver pathology, thus limiting therapeutic options. The role of ablative therapies is well-established in nodules smaller than 3 cm, but for nodules from 3 to 5 cm, the best therapeutic management is not well defined. Recent studies reported that combining minimally invasive procedures like transarterial chemoembolization (TACE) with microwave ablation (MWA) or radiofrequency ablation is superior to each alone. However, there is no consensus regarding the timing and the order in which each procedure should be performed. We report a case of an 86 years old male with HCV-related compensated hepatic cirrhosis and multiple cardiac comorbidities diagnosed with a 47/50 mm HCC. Pre-surgical evaluation of the associated pathologies determined that the risk for the surgical approach outweighs the benefits, so the committee decided to treat it in a less invasive manner. We performed MWA and TACE in a single session with technical success according to the modified Response Evaluation Criteria in Solid Tumors (m-RECIST). This case illustrates the first case of simultaneous MWA and TACE performed in our center. This new approach of hepatocellular carcinoma appears to be a good alternative to more invasive methods, with good results even in older people that are unfit for surgery. [ABSTRACT FROM AUTHOR]

Introduction. Obesity, lack of physical activity and diet have been inconsistently associated with pancreatic cancer. Aim. To evaluate the prevalence of overweight, body weight change trends, diet and physical activity level in pancreatic cancer patients diagnosed between 01.2018-02.2023. Methods. Prospective observational study that included patients diagnosed with pancreatic adenocarcinoma who were interviewed about dietary habits and weight changes, and physical activity over time. Results. A total of 186 patients with pancreatic adenocarcinoma were included. Regarding weight changes, it was observed that 56% of patients were under or normal weight at diagnosis, while a BMI below 25 was observed at one year and 5 years before only in 19.35%, respectively 12.9%. Excluding the data 5 years before diagnosis, the overweight and obesity prevalence between 20-29 years old was 43.54% respectively 11%, at 30-39 years old 43.54% respectively 25.8%, at 40-49 years old 22% respectively 45,6%, and at 50-59 years old 34% respectively 52.3%. Over 50 % of patients led a sedentary life. Regarding diet more than 75% of patients consumed red meat, dairy products, bread and bakery products, fruits and vegetables regularly more than 5 times a week. The consumption of fish and nut products was generally much less frequent, maximum 2 times a week in over 80% of cases. Less than half of the patients (47%) confirmed alcohol consumption, mostly occasionally, only 17% reported drinking more than 5 times a week. The favorite alcoholic drink was liquor, followed by wine, generally homemade. Conclusions. Most of the patients in the study were obese throughout their lives, but there was a weight loss starting 5 years before diagnosis, more severe in the last year. This can be explained by the advanced degree of the disease at diagnosis associated with a possible paraneoplastic hyperanabolic syndrome, the majority not complaining of loss of appetite or early satiety in the last year. Diet studies have suggested a protective effect against pancreatic cancer of the Mediterranean diet and regular consumption of nuts, even if in small quantities. This can also be confirmed by the patients included in this study whose diet does not respect these principles. Alcohol consumption does not seem to increase the risk of pancreatic neoplasm. This has also been observed in numerous studies with inconsistent results, and can also be determined by a declarative reduced consumption, due to the stigma associated with high consumption. [ABSTRACT FROM AUTHOR]

CANCER OF THE EXOCRINE PANCREAS IS A HIGHLY LETHAL MALIGNANCY. SURGICAL RESECTION IS THE ONLY POTENTIALLY CURATIVE TREATMENT. UNFORTUNATELY, BECAUSE OF THE LATE PRESENTATION, ONLY 15 TO 20 PERCENT OF PATIENTS ARE CANDIDATES FOR PANCREATECTOMY. THE AIM OF OUR STUDY WAS TO REVIEW THE RISK FACTORS, CLINICAL PRESENTATION, DIAGNOSTIC TOOLS AND THERAPEUTIC APPROACH OF PATIENTS WITH PANCREATIC CANCER, ADMITTED TO OUR CLINIC BETWEEN JANUARY 1ST AND DECEMBER 31ST OF 2016. WE ENROLLED TWO HUNDRED AND SIXTY EIGHT CONSECUTIVE PATIENTS. WE FOUND THAT MOST PATIENTS PRESENTED AT LEAST ONE RISK FACTOR FOR PANCREATIC NEOPLASIA, ESPECIALLY CIGARETTE SMOKING AND ALCOHOL DRINKING. MANY PATIENTS WERE DIAGNOSED IN ADVANCED STAGES OF THE DISEASE, WHEN THE TUMOR WAS LOCALLY INVASIVE OR HAD DISTANT METASTASES. THE MOST FREQUENT HISTOLOGICAL TYPE WAS ADENOCARCINOMA, FOLLOWED BY NEUROENDOCRINE TUMORS (13.36%). PATIENTS BENEFITED FROM SURGICAL, ONCOLOGICAL, AND/OR ENDOSCOPIC TREATMENT. THE MEDIAN SURVIVAL TIME WAS 8.83 MONTHS FOR ADENOCARCINOMA AND 66.34 MONTHS FOR NEUROENDOCRINE TUMORS. WE NOTED A LONGER MEDIAN SURVIVAL TIME FOR ADENOCACINOMA THAN THE EUROPEAN AVERAGE OF 4.6 MONTHS, PROBABLY DUE TO THE FACT THAN PATIENTS WERE DIAGNOSED AND TREATED BY A MULTIDISCIPLINARY TEAM, IN A TERTIARY CARE FACILITY. HOWEVER WE NEED TO DO A BETTER JOB IN IDENTIFYING HIGH RISK INDIVIDUALS AND THEN OFFERING THEM A PERSONALISED SCREENING PROGRAM, IN ORDER TO DIAGNOSE MORE PATIENTS IN POTENTIALLY CURATIVE STAGES. [ABSTRACT FROM AUTHOR]