Submit to Cancers Review for Cancers Propose a Special Issue

Journal Browser

► Journal Browser

Recent Highly Advanced Surgery for Pancreatic Cancer

Special Issue Editors
Special Issue Information
Keywords
Published Papers

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (10 February 2022) | Viewed by 16068

Share This Special Issue

Special Issue Editor

Prof. Dr. Tsutomu F.Tsutomu Fujii

E-Mail Website
Guest Editor

Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Interests: pancreatic cancer; pancreatic surgery; multidisciplinary treatment; minimally invasive pancreatic surgery

Special Issue Information

We would like to invite you to submit either original research or review articles for this Special Issue on “Recent Highly Advanced Surgery for Pancreatic Cancer”.

In pancreatic cancer, which is an incurable disease, improved results have begun to be reported due to the advancement of multidisciplinary treatment, including state-of-the-art chemotherapy regimens and improvements in perioperative procedures and management. Recently, there are increasing cases in which resection is possible in pancreatic cancer which was unresectable at the time of initial diagnosis. There is still no clear evidence on the validity and usefulness of this option; however, good prognosis has been reported in locally advanced pancreatic cancer patients little by little. Nevertheless, surgery for UR-LA pancreatic cancer requires advanced techniques such as portal vein and arterial resection.

This Special Issue will focus on the recent advances in surgical methods for advanced pancreatic cancer, including combined vascular resection/reconstruction, gastrointestinal reconstruction, laparoscopic/robotic procedure, resection of metastatic or recurrent lesions, and so on.

Prof. Tsutomu Fujii
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

pancreatic surgery
multidisciplinary treatment
extended pancreatectomy
combined portal vein resection
combined arterial resection
locally advanced pancreatic cancer

Published Papers (7 papers)

Download All Papers

Research

Jump to: Review

15 pages, 2162 KiB

Open AccessArticle

Intraperitoneal Paclitaxel Treatment for Patients with Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination Provides a Survival Benefit

by Tomohisa Yamamoto, Sohei Satoi, So Yamaki, Daisuke Hashimoto, Mitsuaki Ishida, Tsukasa Ikeura, Satoshi Hirooka, Yuki Matsui, Shogen Boku, Shinji Nakayama, Koh Nakamaru, Nobuhiro Shibata, Utae Katsushima and Mitsugu Sekimoto

Cancers 2022, 14(5), 1354; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14051354 - 07 Mar 2022

Cited by 6 | Viewed by 2266

Abstract

Background: Intraperitoneal chemotherapy using paclitaxel (i.p.-PTX) is expected to be a new therapeutic strategy for patients with pancreatic ductal adenocarcinoma (PDAC) and peritoneal dissemination. We evaluated the survival benefit of i.p.-PTX compared with standard systemic chemotherapy. Methods: Clinical data of 101 consecutive PDAC patients with peritoneal dissemination between 2007 and 2018 were analyzed. All patients were determined to have no other sites of distant organ metastasis to the lung, bone, or liver on contrast-enhanced CT imaging. Patients underwent staging laparoscopy or open laparotomy to confirm pathological evidence of peritoneal dissemination, and to exclude occult liver metastasis. Survival curves were estimated using the Kaplan–Meier method, and differences were compared using the log-rank test. Results: Forty-three patients were treated with i.p.-PTX (i.p.-PTX group) and forty-nine patients received standard systemic chemotherapy (Ctrl group). Nine patients did not receive any treatment (BSC group). The median survival time (MST) in the i.p.-PTX group was significantly longer than that in the Ctrl group (17.9 months vs. 10.2 months, p = 0.006). Negative peritoneal washing cytology was observed in 24 out of 43 patients in the i.p.-PTX group. The i.p.-PTX group tended to have a higher proportion of clinical responses than the Ctrl group (30% vs. 18%, p = 0.183). Conversion surgery was performed in 10 patients in the i.p.-PTX group and 2 patients in the Ctrl group after confirming disappearance of peritoneal dissemination with staging laparoscopy or open laparotomy (p = 0.005). The MST in patients who underwent surgical resection was significantly longer than that in patients who did not (27.4 months vs. 11.3 months; p < 0.0001). Conclusion: i.p.-PTX therapy provided improved survival in PDAC patients with peritoneal dissemination, and conversion surgery enhanced it in patients with favorable responses to chemotherapy. i.p.-PTX might become one of the treatment options to PDAC patients with peritoneal dissemination. Full article

(This article belongs to the Special Issue Recent Highly Advanced Surgery for Pancreatic Cancer)

► Show Figures

Figure 1

11 pages, 2289 KiB

Open AccessArticle

The “K-Sign”—A Novel CT Finding Suggestive before the Appearance of Pancreatic Cancer

by Yuko Kobashi, Masateru Uchiyama and Junichi Matsui

Cancers 2021, 13(16), 4222; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13164222 - 22 Aug 2021

Cited by 5 | Viewed by 2116

Abstract

Pancreatic invasive ductal adenocarcinoma (PDAC) has a poor prognosis, and the detection of PDAC during the early stage is thought to improve prognosis. In this study, we retrospectively investigated pancreatic morphological abnormalities that lead to the early diagnosis of PDAC with computed tomography (CT) imaging. In total, 41 out of 308 patients diagnosed with pancreatic cancer between 2011 and 2017 in our institution were enrolled. As a control group for the group with pancreatic cancer, 4277 patients without pancreato-biliary diseases were enrolled. We retrospectively reviewed and analyzed the clinical data including patient characteristics, the clinical course and preoperative CT imaging with pancreatic morphological features. Out of 41 patients, 24 patients (58.5%) showed local K-shaped constriction of the pancreatic parenchyma “K-sign” on preoperative CT images. Eight patients (19.5%) showed localized fatty change. Out of 4277 control patients, seven patients (0.16%) showed K-sign. “K-sign” may be used for the early diagnosis of PDAC by CT imaging. Full article

(This article belongs to the Special Issue Recent Highly Advanced Surgery for Pancreatic Cancer)

► Show Figures

Figure 1

11 pages, 1176 KiB

Open AccessArticle

Skeletal Muscle Loss and Octogenarian Status Are Associated with S-1 Adjuvant Therapy Discontinuation and Poor Prognosis after Pancreatectomy

by Mariko Tsukagoshi, Norifumi Harimoto, Kenichiro Araki, Norio Kubo, Akira Watanabe, Takamichi Igarashi, Norihiro Ishii, Takahiro Yamanaka, Kei Hagiwara, Kouki Hoshino, Ryo Muranushi, Toshiki Yajima and Ken Shirabe

Cancers 2021, 13(16), 4105; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13164105 - 15 Aug 2021

Cited by 4 | Viewed by 1628

Abstract

The efficacy and prognosis of adjuvant chemotherapy for resected pancreatic cancer remain unclear. We investigated the utility and risk factors of S-1 adjuvant chemotherapy in patients with pancreatic cancer undergoing pancreatectomy. This study comprised 80 patients, including 58 patients who received S-1 adjuvant chemotherapy. Skeletal muscle loss was defined using cutoff values of skeletal muscle mass index. In total, 16 (20%) octogenarian patients underwent pancreatectomy. Skeletal muscle loss was present in 56 (70%) patients. The entire course of S-1 adjuvant chemotherapy for 6 months was completed in 33 patients (41%). S-1 adjuvant chemotherapy <6 months was an independent prognostic indicator of poor overall survival. Patients who completed S-1 adjuvant chemotherapy exhibited significantly longer overall and relapse-free survival rates than those did not complete the chemotherapy (p < 0.0001 and p = 0.0003, respectively). Being an octogenarian and skeletal muscle loss were independent variables associated with the discontinuation of S-1 adjuvant chemotherapy. Finally, the S-1 adjuvant chemotherapy rates were 6.3% (1/16) and 28.6% (16/56) in octogenarian patients and those with skeletal muscle loss, respectively. S-1 adjuvant chemotherapy completion was associated with improved prognosis in patients with pancreatic cancer. Skeletal muscle loss and octogenarian status predicted the failure of S-1 adjuvant chemotherapy completion. Full article

(This article belongs to the Special Issue Recent Highly Advanced Surgery for Pancreatic Cancer)

► Show Figures

Figure 1

13 pages, 3248 KiB

Open AccessArticle

Hyperspectral Imaging (HSI)—A New Tool to Estimate the Perfusion of Upper Abdominal Organs during Pancreatoduodenectomy

by Yusef Moulla, Dorina Christin Buchloh, Hannes Köhler, Sebastian Rademacher, Timm Denecke, Hans-Jonas Meyer, Matthias Mehdorn, Undine Gabriele Lange, Robert Sucher, Daniel Seehofer, Boris Jansen-Winkeln and Ines Gockel

Cancers 2021, 13(11), 2846; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13112846 - 07 Jun 2021

Cited by 12 | Viewed by 2482

Abstract

Hyperspectral imaging (HSI) in abdominal surgery is a new non-invasive tool for the assessment of the perfusion and oxygenation of various tissues and organs. Its benefit in pancreatic surgery is still unknown. The aim of this study was to evaluate the key impact of using HSI during pancreatoduodenectomy (PD). In total, 20 consecutive patients were included. HSI was recorded during surgery as part of a pilot study approved by the local Ethics Committee. Data were collected prospectively with the TIVITA^® Tissue System. Intraoperative HS images were recorded before and after gastroduodenal artery (GDA) clamping. We detected four patients with celiac artery stenosis (CAS) caused by a median arcuate ligament (MAL). In two of these patients, a reduction in liver oxygenation (StO₂) was discovered 15 and 30 min after GDA clamping. The MAL was divided in these patients. HSI showed an improvement of liver StO₂ after MAL division (from 61% to 73%) in one of these two patients. There was no obvious decrease in liver StO₂ in the other two patients with CAS. HSI, as a non-invasive procedure, could be helpful in evaluating liver and gastric perfusion during PD, which might assist surgeons in choosing the best surgical approach and in improving patients’ outcomes. Full article

(This article belongs to the Special Issue Recent Highly Advanced Surgery for Pancreatic Cancer)

► Show Figures

Graphical abstract

14 pages, 1014 KiB

Open AccessArticle

Perioperative Predictors of Early Recurrence for Resectable and Borderline-Resectable Pancreatic Cancer

by Masafumi Imamura, Minoru Nagayama, Daisuke Kyuno, Shigenori Ota, Takeshi Murakami, Akina Kimura, Hiroshi Yamaguchi, Toru Kato, Yasutoshi Kimura and Ichiro Takemasa

Cancers 2021, 13(10), 2285; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13102285 - 11 May 2021

Cited by 17 | Viewed by 2163

Abstract

We aimed to identify the perioperative predictors of the early recurrence (ER) of resectable and borderline-resectable pancreatic ductal adenocarcinomas (PDACs). After surgery for a PDAC, most patients develop a recurrence. Predictive factors may therefore guide therapeutic decision-making. Patients (n = 234) who underwent a pancreatectomy for a PDAC between 2006 and 2019 were included. The postrecurrence survival (PRS) was estimated using Kaplan–Meier curves. Predictive factors for an ER were assessed using logistic regression analyses; 93 patients (39.7%) were recurrence-free at the last follow-up. Patients with an ER (n = 85, 36.3%), defined as a recurrence within the first 12 months after surgery, had 1- and 2-year PRS rates of 38.7% and 9.5%, respectively, compared with 66.9% and 37.2% for those with a late recurrence (n = 56, 23.9%; both p < 0.001). The most common site of an ER was the liver (55.3%) with a significantly shorter median overall survival time than that with either a local or a lung recurrence (14.5 months; p < 0.001). Preoperative and postoperative risk factors for an ER included a tumor size >3.0 cm (odds ratio (OR): 3.11, 95% confidence interval (CI): 1.35–7.14) and preoperative carbohydrate antigen 19-9 (CA19-9) levels >52 U/mL (OR: 3.25, 95% CI: 1.67–6.30) and a pathological tumor size >3.0 cm (OR: 2.00, 95% CI: 1.03–3.90) and postoperative carbohydrate antigen 19-9 levels >37 U/mL (OR: 2.11, 95% CI: 1.02–4.36), respectively. Preoperatively (>52 U/mL) and postoperatively (>37 U/mL) elevated CA19-9 and a tumor size >3.0 cm were independent predictors for an ER after a pancreatectomy for a PDAC. Full article

(This article belongs to the Special Issue Recent Highly Advanced Surgery for Pancreatic Cancer)

► Show Figures

Figure 1

Review

Jump to: Research

25 pages, 366 KiB

Open AccessReview

Vascular Resection in Pancreatectomy—Is It Safe and Useful for Patients with Advanced Pancreatic Cancer?

by Beata Jabłońska, Robert Król and Sławomir Mrowiec

Cancers 2022, 14(5), 1193; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14051193 - 25 Feb 2022

Cited by 7 | Viewed by 1927

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease with poor prognosis and increased incidence. Surgical resection R0 remains the most important treatment to prolong survival in PDAC patients. In borderline and locally advanced cancer, vascular resection and reconstruction during pancreatectomy enables achieving R0 resection. This study is a comprehensive review of the literature regarding the role of venous and arterial resection with vascular reconstruction in the treatment of pancreatic cancer. The literature review is focused on the use of venous and arterial resection with immediate vascular reconstruction in pancreaticoduodenectomy. Different types of venous and arterial resections are widely described. Different methods of vascular reconstructions, from primary vessel closure, through end-to-end vascular anastomosis, to interposition grafts with use autologous veins (internal jugular vein, saphenous vein, superficial femoral vein, external or internal iliac veins, inferior mesenteric vein, and left renal vein or gonadal vein), autologous substitute grafts constructed from various parts of parietal peritoneum including falciform ligament, cryopreserved and synthetic allografts. The most attention was given to the most common venous reconstructions, such as end-to-end anastomosis and interposition graft with the use of an autologous vein. Moreover, we presented mortality and morbidity rates as well as vascular patency and survival following pancreatectomy combined with vascular resection reported in cited articles. Full article

(This article belongs to the Special Issue Recent Highly Advanced Surgery for Pancreatic Cancer)

13 pages, 1359 KiB

Open AccessReview

Sinistral Portal Hypertension after Pancreaticoduodenectomy with Splenic Vein Resection: Pathogenesis and Its Prevention

by Yoshihiro Ono, Yosuke Inoue, Tomotaka Kato, Kiyoshi Matsueda, Atsushi Oba, Takafumi Sato, Hiromichi Ito, Akio Saiura and Yu Takahashi

Cancers 2021, 13(21), 5334; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers13215334 - 24 Oct 2021

Cited by 11 | Viewed by 2523

Abstract

To achieve curative resection for pancreatic cancer during pancreaticoduodenectomy (PD), extensive portal vein (PV) resection, including porto-mesenterico-splenic confluence (PMSC), may sometimes be necessary if the tumor is close to the portal venous system. Recently, this extended resection has been widely accepted in high-volume centers for pancreatic resection due to its favorable outcomes compared with non-operative treatment. However, in patients with long-term survival, sinistral portal hypertension (SPH) occurs as a late-onset postoperative complication. These patients present gastrointestinal varices due to congested venous flow from the spleen, which may cause critical variceal bleeding. Since the prognosis of patients with pancreatic cancer has improved, owing to the development of chemotherapy and surgical techniques, SPH is no longer a negligible matter in the field of pancreatic cancer surgery. This review clarifies the pathogenesis and frequency of SPH after PD through PMSC resection and discusses its prediction and prevention. Full article

(This article belongs to the Special Issue Recent Highly Advanced Surgery for Pancreatic Cancer)

► Show Figures