Evidence map›Paper›PMID 28229252›Full record

ReviewDigestive diseases and sciences2017

Pain in Patients with Pancreatic Cancer: Prevalence, Mechanisms, Management and Future Developments.

Andreas I Koulouris, Paul Banim, Andrew R Hart

Abstract readReview
PubMed Publisher
In one paragraph

Review in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 2 pooled it
10.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 121 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Early analgesic response to interventional pain procedures in hospitalized patients with cancer-related pain: clinical predictors and exploratory survival analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  5. Cancer pain.Nature reviews. Disease primers · 2026
    Review
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  11. Pain at the end of life in patients with cancer: a population-based study on prevalence, relief, and the role of pain assessment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

Andreas I KoulourisNorwich Medical School, University of East Anglia, Bob Champion Research Center, Norwich Research Park, Norfolk, NR4 7TJ, UK. a.koulouris@uea.ac.uk.
Paul BanimNorwich Medical School, University of East Anglia, Bob Champion Research Center, Norwich Research Park, Norfolk, NR4 7TJ, UK.
Andrew R HartNorwich Medical School, University of East Anglia, Bob Champion Research Center, Norwich Research Park, Norfolk, NR4 7TJ, UK.
Norfolk and Norwich University Hospital · GBNorwich Research Park · GBUniversity of East Anglia · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pain affects approximately 80% of patients with pancreatic cancer, with half requiring strong opioid analgesia, namely: morphine-based drugs on step three of the WHO analgesic ladder (as opposed to the weak opioids: codeine and tramadol). The presence of pain is associated with reduced survival. This article reviews the literature regarding pain: prevalence, mechanisms, pharmacological, and endoscopic treatments and identifies areas for research to develop individualized patient pain management pathways. The online literature review was conducted through: PubMed, Clinical Key, Uptodate, and NICE Evidence. There are two principal mechanisms for pain: pancreatic duct obstruction and pancreatic neuropathy which, respectively, activate mechanical and chemical nociceptors. In pancreatic neuropathy, several histological, molecular, and immunological changes occur which correlate with pain including: transient receptor potential cation channel activation and mast cell infiltration. Current pain management is empirical rather etiology-based and is informed by the WHO analgesic ladder for first-line therapies, and then endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in patients with resistant pain. For EUS-CPN, there is only one clinical trial reporting a benefit, which has limited generalizability. Case series report pancreatic duct stenting gives effective analgesia, but there are no clinical trials. Progress in understanding the mechanisms for pain and when this occurs in the natural history, together with assessing new therapies both pharmacological and endoscopic, will enable individualized care and may improve patients' quality of life and survival.

Indexed as

Disease ManagementAbdominal PainAnalgesicsClinical Trials as TopicForecastingHumansPain ManagementPancreatic NeoplasmsAnalgesicsAnalgesiaEndoscopic ultrasound-guided celiac plexus neurolysisPainPancreatic cancerPancreatic duct stentingPharmacotherapy

Identifiers

PMID28229252
OpenAlexW2590014060

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.