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Advances in the Diagnosis and Treatment of Pancreatic Cancer
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Advances in the Diagnosis and Treatment of Pancreatic Cancer

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: 10 June 2024 | Viewed by 5715

Special Issue Editors

Dr. Thinzar M. Lwin

E-Mail Website
Guest Editor
Division of Surgical Oncology, City of Hope Medical Center, Duarte, CA 91010, USA
Interests: fluorescence-guided surgery; tumor-specific fluorescence; minimally invasive surgery; pancreatic cancer; surgical oncology; peritoneal carcinomatosis; cytoreduction; heated intraperitoneal chemotherapy (HIPEC)
Dr. Gagandeep Singh

E-Mail Website
Guest Editor
Division of Surgical Oncology, City of Hope Medical Center, Duarte, CA 91010, USA
Interests: pancreatic cancer; robotic and laparoscopic surgery; gallbladder and bile duct cancer; liver cancer and metastases; neuroendocrine tumors (NETs); ablations—microwave ablations and nanoknife ablations
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The prognosis for patients with pancreatic cancer is dismal, and surgery is the only chance for a cure. Modern systemic chemotherapy regimens have shifted the definition of resectability in pancreatic cancer. Patients with borderline resectable (BR) and locally advanced (LA) pancreatic cancers were previously not considered surgical candidates, but current combination regimens in the neoadjuvant setting have demonstrated significant clinical responses such that these patients are increasingly undergoing operative resection. Even patients with limited metastatic disease who demonstrate excellent tumor biology may now be considered for locoregional therapies, including pancreatectomy. Advances in surgical techniques and peri-operative care, including increasingly complex resections and reconstructions, minimally invasive approaches, and adjunct therapies such as irreversible electroporation, ablative radiation therapy, metastatectomy, heated intraperitoneal chemotherapy, and others, have broadened the treatment spectrum for this aggressive disease. The role of locoregional treatments for a disease with aggressive systemic biology is understandably limited. With continued improvement in systemic therapies, the breadth and depth of what is possible will continue to expand. Careful patient selection will be critical, and advanced diagnostic and imaging modalities will be needed to help to identify patients with pancreatic cancer who derive maximal benefit from these aggressive approaches.

The goal of this Special Issue is to provide information on novel and innovative approaches to the diagnosis and treatment of pancreatic cancer and better defining of patient selection for advanced therapies.

Dr. Thinzar M. Lwin
Dr. Gagandeep Singh
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

  • borderline resectable pancreatic cancer
  • locally advanced pancreatic cancer
  • peritoneal carcinomatosis
  • neoadjuvant therapy
  • locally advanced pancreatic cancer

Published Papers (3 papers)

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Research

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13 pages, 814 KiB  
Article
Efficacy and Safety of Chemotherapy in Elderly Patients with Unresectable Pancreatic Cancer
by Byung Soo Kwan, Ok Jae Lee, Hyun Jin Kim, Kwang Min Kim, Sang Goon Shim, Dae Hyeon Cho, Sung Min Kong, Jun Young Kim and Jun Ho Ji
J. Clin. Med. 2023, 12(9), 3334; https://doi.org/10.3390/jcm12093334 - 08 May 2023
Cited by 1 | Viewed by 1566
Abstract
Background/Aims: The incidence of pancreatic cancer (PC) is gradually increasing among elderly individuals, but there are insufficient clinical data on elderly individuals. To determine the efficacy and safety of chemotherapy, we compared the. the outcomes of elderly patients with unresectable PC. Methods: We [...] Read more.
Background/Aims: The incidence of pancreatic cancer (PC) is gradually increasing among elderly individuals, but there are insufficient clinical data on elderly individuals. To determine the efficacy and safety of chemotherapy, we compared the. the outcomes of elderly patients with unresectable PC. Methods: We enrolled patients aged 75 years or older diagnosed with PC from 1 January 2010 to 30 November 2021. Propensity score matching (PSM) was used to reduce the heterogeneity of the study population. For efficacy evaluation, the median overall survival (OS) was estimated for the chemotherapy and nonchemotherapy groups. Chemotherapy tolerability evaluations were also investigated. Results: The study included 115 patients, 47 of whom received chemotherapy and 68 who did not. After PSM, compared with the nonchemotherapy group, the chemotherapy group had more myocardial infarctions (14.6 vs. 0.0%, p < 0.001) and chronic obstructive pulmonary disease (4.4 vs. 0.0%, p = 0.043). The primary endpoint, median OS, was significantly different in the with vs. without chemotherapy groups (203 vs. 106 days, p = 0.013). In the chemotherapy group, 10 patients (21.3%) discontinued treatment due to adverse events. However, there were no reports of death due to severe adverse events. Conclusions: This study demonstrated that chemotherapy improved median OS among elderly patients. These data could support the use of chemotherapy for elderly patients with unresectable PC. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Pancreatic Cancer)
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15 pages, 2292 KiB  
Article
Protein Induced by Vitamin K Absence II: A Potential Biomarker to Differentiate Pancreatic Ductal Adenocarcinoma from Pancreatic Benign Lesions and Predict Vascular Invasion
by Yang Yang, Guangbing Li, Yu Zhang, Yunfeng Cui and Jun Liu
J. Clin. Med. 2023, 12(8), 2769; https://doi.org/10.3390/jcm12082769 - 07 Apr 2023
Cited by 2 | Viewed by 1199
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant gastrointestinal tumor with a poor prognosis. Serum biomarker carbohydrate antigen 19-9 (CA19-9) was the only well-established biomarker for PDAC with inadequate efficacy. This present study aimed to determine the ability of PIVKA-II to discriminate [...] Read more.
Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant gastrointestinal tumor with a poor prognosis. Serum biomarker carbohydrate antigen 19-9 (CA19-9) was the only well-established biomarker for PDAC with inadequate efficacy. This present study aimed to determine the ability of PIVKA-II to discriminate PDAC from pancreatic benign lesions and predict vascular invasion preoperatively. Methods: Patients who underwent pancreatic surgery from 2017 to 2020 were enrolled. We examined the differential diagnostic ability of protein induced by vitamin K absence II (PIVKA-II), CA19-9, and their combination and 138 with PDAC evaluated the predictive value of PIVKA-II for vascular invasion in PDAC. Methods: A total of 138 patients with PDAC and 90 patients with pancreatic benign lesions who underwent pancreatic surgery from 2017 to 2020 were enrolled. The clinicopathological characteristics were recorded. Results: There was a significant difference in levels of serum PIVKA-II between PDAC patients and patients with pancreatic benign lesions (p < 0.001). When the cut-off value was set to 28.9 mAU/mL according to the ROCs, the AUC, sensitivity, and specificity of PIVKA-II were 0.787, 68.1%, and 83.3%, respectively. The combined PIVKA-II and carbohydrate antigen 19-9 (CA19-9) enhanced the diagnostic accuracy, and the AUC, sensitivity, and specificity were 0.945, 87.7%, and 94.4%, respectively. PIVKA-II > 36.4 mAU/mL were independent predictive factors of vascular invasion in PDAC (p < 0.001). Conclusion: PIVKA-II was a potential diagnostic biomarker to differentiate PDAC from pancreatic benign lesions. PIVKA-II was complementary to CA19-9, and the combination enhanced the differential diagnostic performance. PIVKA-II > 36.4 mAU/mL was an independent predictive factor of vascular invasion in PDAC. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Pancreatic Cancer)
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Review

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18 pages, 657 KiB  
Review
Modifiable Pancreatic Ductal Adenocarcinoma (PDAC) Risk Factors
by Natalia Michalak and Ewa Małecka-Wojciesko
J. Clin. Med. 2023, 12(13), 4318; https://doi.org/10.3390/jcm12134318 - 27 Jun 2023
Cited by 5 | Viewed by 2579
Abstract
This study aims to summarize the modifiable risk factors for pancreatic ductal adenocarcinoma (PDAC) that have been known for a long time, as well as information from the most recent reports. As a cancer with a late diagnosis and poor prognosis, accurate analysis [...] Read more.
This study aims to summarize the modifiable risk factors for pancreatic ductal adenocarcinoma (PDAC) that have been known for a long time, as well as information from the most recent reports. As a cancer with a late diagnosis and poor prognosis, accurate analysis of PDAC risk factors is warranted. The incidence of this cancer continues to rise, and the five-year survival rate is the lowest with respect to other tumors. The influence of cigarette smoking, alcohol consumption, and chronic pancreatitis in increasing the risk of pancreatic ductal adenocarcinoma is continually being confirmed. There are also newly emerging reports relating to the impact of lifestyle, including physical activity, the gut and oral microbiome, and hepatotropic viruses. A precise understanding of PDAC risk factors can help to identify groups of high-risk patients, and this may contribute to population awareness and education as well as earlier diagnoses with possible better treatment outcomes. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Pancreatic Cancer)
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