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Hepatobiliary and Pancreatic Cancers: Novel Strategies of Diagnosis and Treatments

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (25 July 2022) | Viewed by 11562

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Special Issue Editors

Dr. Sara Ramella

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Guest Editor

Radiation Oncology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
Interests: integration of radiotherapy; chemotherapy drugs and biological drugs into the treatment of neoplasms of the esophagus, liver, biliary tract, pancreas and rectum

Dr. Alessandro Coppola

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Guest Editor

Department of General Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
Interests: pancreatic cancer; pancreatic surgery; hepatobiliary cancers; liver surgery; liver transplant; surgical oncology
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Dr. Vincenzo La Vaccara

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PhD. Department of General Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
Interests: pancreatic cancer; pancreatic cyst; pancreatic surgery; surgical oncology; colorectal surgery early detection

Dr. Michele Fiore

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Guest Editor

Special Issue Information

Dear Colleagues,

Hepatobiliary and pancreatic cancers represent two of the deadliest malignances. The aggressive behavior of the diseases and the often-advanced stages at the moments of diagnosis are the main causes for the high mortality rate of these patients. However, in recent years, several advances have been made in the management of this family of diseases. The improvement of surgical techniques, more targeted chemo- and radiotherapy, and radiological and endoscopic techniques are at the core of the research in the hepatobiliary and pancreatic field.

Multidisciplinary approaches represent one of the most powerful weapons against this group of diseases. In fact, the adoption of this type of approach makes it possible to adopt increasingly advanced and complex strategies that allow obtaining increasingly encouraging results.

You are kindly invited to share your knowledge, perspectives, and recent advances in the management of hepatobiliary and pancreatic malignancies in this Special Issue of the Journal of Clinical Medicine.

Prof. Sara Ramella
Dr. Alessandro Coppola
Dr. Vincenzo La Vaccara
Dr. Michele Fiore
Guest Editors

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. Journal of Clinical Medicine 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 2600 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 cancer
Liver cancer
Biliary tract cancer
Liver surgery
Pancreatic surgery
Transplant surgery
Metastases
HPB oncology
Radiotherapy
Immunotherapy
Chemotherapy
Interventional radiology
Interventional endoscopy
Early detection
Mininvasive surgery

Published Papers (6 papers)

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Editorial

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4 pages, 201 KiB

Open AccessEditorial

Special Issue “Hepatobiliary and Pancreatic Cancers: Novel Strategies for of Diagnosis and Treatments”

by Alessandro Coppola, Michele Fiore, Vincenzo La Vaccara, Tommaso Farolfi, Damiano Caputo and Sara Ramella

J. Clin. Med. 2022, 11(13), 3849; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133849 - 02 Jul 2022

Cited by 1 | Viewed by 965

Abstract

In recent years, hepato-pancreato-biliary (HPB) cancers have been increasing their incidence [...] Full article

(This article belongs to the Special Issue Hepatobiliary and Pancreatic Cancers: Novel Strategies of Diagnosis and Treatments)

Research

Jump to: Editorial

12 pages, 1722 KiB

Open AccessArticle

Diagnostic Performance of AFP, AFP-L3, or PIVKA-II for Hepatitis C Virus-Associated Hepatocellular Carcinoma: A Multicenter Analysis

by Siyu Liu, Liyang Sun, Lanqing Yao, Hong Zhu, Yongkang Diao, Mingda Wang, Hao Xing, Wan Yee Lau, Mingcheng Guan, Timothy M. Pawlik, Feng Shen, Min Xu, Xiangmin Tong and Tian Yang

J. Clin. Med. 2022, 11(17), 5075; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11175075 - 29 Aug 2022

Cited by 10 | Viewed by 2211

Abstract

Background and Aim: Alpha-fetoprotein (AFP), a lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), is a protein that is induced by vitamin K deficiency or antagonist-II (PIVKA-II) that has been clinically used as a serum biomarker for early detection and diagnosis of hepatocellular carcinoma (HCC). Diagnostic performance of each serum biomarker alone, or their combinations for the detection of hepatitis C virus (HCV)-associated HCC were compared. Methods: Serum AFP, AFP-L3, and PIVKA-II levels were evaluated in patients with HCV-associated HCC, and those with chronic HCV infection without HCC (HCV-controls). The areas under the curve (AUC), sensitivity, and specificity were compared to identify the diagnostic performance of each serum HCC biomarker alone or in combination. Results: Overall, 172 HCV controls and 105 patients with HCV-associated HCC were enrolled. The AFP, AFP-L3, and PIVKA-II levels were significantly increased among patients with HCV-associated HCC when compared with HCV patients without HCC (p < 0.001). When these biomarkers were analyzed individually, PIVKA-II revealed the best predictive performance (AUC: PIVKA-II 0.90 vs. AFP 0.80 vs. AFP-L3 0.69, p < 0.001). In evaluating the combinations of any two biomarkers, the best predictive performance was found in PIVKA-II + AFP (0.93 vs. AFP + AFP-L3 0.78, p = 0.001; and PIVKA-II + AFP-L3 0.89, p < 0.001), which had no difference compared to the predictive performance of the combination of all three serum biomarkers (AFP + AFP-L3 + PIVKA-II 0.93, p = 0.277). Similar results were identified in the subgroups of patients with HCV-induced cirrhosis, and among patients with early-stage HCC defined by BCLC and TNM staging. Conclusions: The addition of the PIVKA-II test to routine AFP test maybe provide a more suitable biomarker approach to detect HCV-induced HCC in patients with HCV infection undergoing HCC surveillance. Full article

(This article belongs to the Special Issue Hepatobiliary and Pancreatic Cancers: Novel Strategies of Diagnosis and Treatments)

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8 pages, 256 KiB

Open AccessArticle

Two-Phase MDCT Protocol for the Screening of Small Hepatocellular Carcinoma

by Anita Paisant, Jérôme Boursier, Djamel Dabli, Jérôme Lebigot, Frédéric Oberti, Sophie Michalak, Valérie Vilgrain and Christophe Aubé

J. Clin. Med. 2022, 11(15), 4282; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154282 - 22 Jul 2022

Cited by 2 | Viewed by 1079

Abstract

Screening programmes for cirrhotic patients are based on ultrasound (US) examinations at 6-month intervals, but a US sensitivity of 47% has recently been reported. The aim of this study was to evaluate a two-phase MDCT protocol in terms of hepatic nodule detection within a hepatocellular carcinoma (HCC) screening situation and to evaluate a reduction in irradiation dose for the 6-monthly checks compared to the classic four-phase protocol. In total, 373 patients with 498 nodules that were suspected to be HCC and ranged from 10 to 30 mm in size were prospectively included. All patients underwent four-phase MDCT with an unenhanced phase, arterial phase (AP), portal phase (PP) and delayed phase (DP). The cumulative irradiation from the repeated 6-monthly MDCT protocol was calculated. Of the 498 nodules, only 4 (0.008%) were only seen in the PP and not in the AP or AP. Of the 319 HCC nodules, 270 (84.6%) had AP hyperenhancement, while 115 had washout in the PP and 224 had washout in the DP. Overall, 222 of the 224 (99.1%) HCC nodules with typical features were seen in the AP and DP. The dose reduction was estimated at 55.4% when using the two-phase protocol (AP and DP). The cumulative irradiation of the two-phase protocol, which was performed every 6 months over 5 years, was 96.5 mSv. MDCT with the two-phase protocol could offer an alternative to ultrasound screening with an interesting risk–benefit trade-off. Full article

(This article belongs to the Special Issue Hepatobiliary and Pancreatic Cancers: Novel Strategies of Diagnosis and Treatments)

10 pages, 2149 KiB

Open AccessArticle

Finding the Appropriate Therapeutic Strategy in Patients with Neuroendocrine Tumors of the Pancreas: Guideline Recommendations Meet the Clinical Reality

by Sebastian Krug, Marko Damm, Jakob Garbe, Senta König, Rosa Lynn Schmitz, Patrick Michl, Jörg Schrader and Anja Rinke

J. Clin. Med. 2021, 10(14), 3023; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10143023 - 07 Jul 2021

Cited by 9 | Viewed by 2560

Abstract

The systemic treatment of patients with pancreatic neuroendocrine tumors is based on placebo-controlled trials and long-established chemotherapy approaches. In addition, peptide receptor radionuclide therapy (PRRT) was approved as a parallel approach for pancreatic neuroendocrine tumors (NET), in addition to small bowel NET, after the NETTER-1 trial. The current ESMO and NCCN guidelines attempted to describe treatment algorithms for pancreatic NET based on the current data. In our survey, we recorded therapy decisions for the first- until the third-line of therapy in German-speaking countries (Germany, Austria, and Switzerland) using fictional case reports and discussed these in the context of the current ESMO guidelines. Compared with the recommendations of the guidelines, PRRT was used more frequently and earlier. In patients with NET G1/G2 Ki-67 < 10%, the therapy algorithm consisting of somatostatin analogs (SSA)-PRRT-targeted therapy is a relevant approach. In clinical situations where chemotherapy is primarily used (remission pressure, Ki-67 > 10%), second-line PRRT was found acceptance and was often considered prior to targeted therapies. Despite the lack of prospective controlled trials, our study demonstrated the pivotal impact of PRRT. Therefore, further studies should compare PRRT with chemotherapy in pancreatic NETs in different clinical settings in first- and second-line approaches. Full article

(This article belongs to the Special Issue Hepatobiliary and Pancreatic Cancers: Novel Strategies of Diagnosis and Treatments)

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13 pages, 1199 KiB

Open AccessArticle

Effect of Hepatocellular Carcinoma Surveillance Programmes on Overall Survival in a Mixed Cirrhotic UK Population: A Prospective, Longitudinal Cohort Study

by Mohammad Inamul Haq, Thomas M. Drake, Tee Lin Goh, Asma Ahmed, Ewan Forrest, Stephen Barclay, Ruth Gillespie, Mathew Priest, Jeff Evans, Janet Graham, Stuart Ballantyne, Donald C. McMillan, Peter C. Hayes, Thomas G. Bird and Adrian J. Stanley

J. Clin. Med. 2021, 10(13), 2770; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10132770 - 24 Jun 2021

Cited by 7 | Viewed by 2036

Abstract

Introduction: Surveillance for hepatocellular carcinoma (HCC) is recommended by national and international guidelines. However, there are no trial data on whether surveillance improves clinical outcomes in a UK cirrhosis population of mixed aetiology. Our aim was to determine the impact of, and adherence to, surveillance on overall survival. Methods: We prospectively collected data on consecutive patients diagnosed with HCC between January 2009 and December 2015 at two large UK centres. We assessed outcomes depending on whether they had been entered into an HCC surveillance programme, and if they had adhered to that. Results: Out of 985 patients diagnosed with HCC in this study, 40.0% had been enrolled in a surveillance programme. Of these, 76.6% were adherent with surveillance and 24.4% were not. Adherence to surveillance was significantly associated with improved overall survival, even when accounting for lead-time bias using different approaches (HR for 270 days lead-time adjustment 0.64, 0.53 to 0.76, p < 0.001). Conclusions: When adjusted for lead-time bias, HCC surveillance is associated with improved overall survival; however, the beneficial effect of surveillance on survival was lower than reported in studies that did not account fully for lead-time bias. Full article

(This article belongs to the Special Issue Hepatobiliary and Pancreatic Cancers: Novel Strategies of Diagnosis and Treatments)

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12 pages, 1878 KiB

Open AccessArticle

Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis

by Alessandro Coppola, Vincenzo La Vaccara, Tommaso Farolfi, Michele Fiore, Chiara Cascone, Sara Ramella, Silvia Spoto, Massimo Ciccozzi, Silvia Angeletti, Roberto Coppola and Damiano Caputo

J. Clin. Med. 2021, 10(10), 2180; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10102180 - 18 May 2021

Cited by 13 | Viewed by 1662

Abstract

Background: Bacterobilia is associated with postoperative morbidity after pancreaticoduodenectomy (PD), mostly due to infectious complications. The aim of this study was to investigate the prevalence of bacteria species isolated from intraoperative biliary cultures, and related complications after PD. Methods: An ANOVA test was used to assess the prevalence of isolated bacterial species and postoperative complications. The odds ratio was computed to evaluate the association between biliary cultures and each complication, Endoscopic Retrograde CholangioPancreatography (ERCP) and each complication, ERCP and biliary cultures, Delayed Gastric Emptying (DGE) and Postoperative Pancreatic Fistula (POPF). Results: Positive biliary cultures were found in 162/244 (66%) PDs. Different prevalences of polymicrobial biliary culture were detected in patients with postoperative complications. In SSIs, a significant prevalence of biliary culture positive for E. coli, Klebsiella pneumoniæ and Enterococcus fæcalis (p < 0.001) was detected. Prevalences of polymicrobial biliary cultures with Escherichia coli, Klebsiella pneumoniæ, Enterococcus fæcalis and Enterococcus fæcium were significantly associated with POPF (p < 0.001). Biliary culture positive for Escherichia coli, Enterococcus fæcalis and Enterococcus fæcium showed a higher prevalence of intra-abdominal collection and DGE (p < 0.001). Notably, Escherichia coli was significantly associated with DGE as a unique complication (OR = 2.94 (1.30–6.70); p < 0.01). Conclusions: Specific prevalences of polymicrobial bacterobilia are associated with major complications, while monomicrobial Escherichia coli bacterobilia is associated with DGE as a unique complication after PD. Full article

(This article belongs to the Special Issue Hepatobiliary and Pancreatic Cancers: Novel Strategies of Diagnosis and Treatments)

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