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Special Issue "Current Surgical Management of Pancreatic Cancer"

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

Deadline for manuscript submissions: 31 January 2024 | Viewed by 8832

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Special Issue Editors

Dr. Kosei Takagi

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Guest Editor

Department of Gastroenterological Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
Interests: hepatopancreatobiliary surgery; organ transplantation; pancreatic surgery; liver transplantation; liver surgery
Special Issues, Collections and Topics in MDPI journals

Dr. Ryuuichi Yoshida

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Guest Editor

Department of Gastroenterological Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
Interests: liver transplantation; hepatectomy; pancreaticoduodenectomy; pancreatic surgery; pancreatic cancer

Dr. Yuzo Umeda

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Guest Editor

Department of Gastroenterological Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
Interests: hepatobiliary surgery; organ transplantation; pancreatic surgery; liver transplantation; liver surgery; hepatectomy

Special Issue Information

Dear Colleagues,

We invite your participation in the current Special Issue of JCM on “Current Surgical Management of Pancreatic Cancer”. Pancreatic cancer has a poor prognosis following its diagnosis. Altough the progress of treatment for pancreatic cancer is remarkable, surgery is the only treatment with the potential for curing it. Since neoadjuvant and adjuvant therapies used for pancreatic cancer have been recently developed, the role of surgery for pancreatic cancer has changed. Furthermore, minimally invasive surgery, including laparoscopic and robotic surgeries, is becoming mainstream even in hepato-pancreatico-biliary surgery. Minimally invasive surgery for pancreatic cancer might be safe and feasible; however, further research is required. In the current Special Issue, we aim to discuss the current surgical management of pancreatic cancer, focusing on open and minimally invasive surgery, neoadjuvant and adjuvant therapies, and the outcomes. The translational research conducted on this topic is also invited for submission. In addition, multimedia manuscripts are welcomed.

We anticipate receiving your submissions to this Special Issue.

Dr. Kosei Takagi
Dr. Ryuuichi Yoshida
Dr. Yuzo Umeda
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
pancreatectomy
minimally invasive surgery
neoadjuvant therapy
adjuvant therapy
conversion surgery
outcomes

Published Papers (4 papers)

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Open AccessEditorial

Role of Surgery for Pancreatic Ductal Adenocarcinoma in the Era of Multidisciplinary Treatment

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J. Clin. Med. 2023, 12(2), 465; https://doi.org/10.3390/jcm12020465 - 06 Jan 2023

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Abstract

The incidence and mortality rates of pancreatic ductal adenocarcinoma (PDAC) have increased in recent years worldwide [...] Full article

(This article belongs to the Special Issue Current Surgical Management of Pancreatic Cancer)

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Open AccessArticle

Does Surgical Resection Significantly Prolong the Long-Term Survival of Patients with Oligometastatic Pancreatic Ductal Adenocarcinoma? A Cross-Sectional Study Based on 18 Registries

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J. Clin. Med. 2023, 12(2), 513; https://doi.org/10.3390/jcm12020513 - 08 Jan 2023

Cited by 1 | Viewed by 930

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) is a type of lethal gastrointestinal malignancy. It is mainly discovered at, and diagnosed with, an advanced stage of metastasis. As the only potentially curative treatment for PDAC, surgical resection has an uncertain impact on the survival of these patients. As such, we aimed to investigate if patients with metastatic PDAC (mPDAC) benefit from surgery. Methods: Patients with pancreatic cancer in 18 registries of the Surveillance, Epidemiology, and End Results database between 2000 and 2018 were reviewed retrospectively. According to the American Joint Committee on Cancer (AJCC), the eighth edition staging system was utilized. Propensity score matching was applied to strengthen the comparability of the study. The impact of surgery on survival was evaluated by restricted mean survival time (RMST) and Kaplan–Meier analysis. Results: A total of 210 well-matched mPDAC patients were included in the study. The 1 year, 3 year, and 5 year overall survival (OS) of patients undergoing surgery was 34.3%, 15.2%, and 11.0%, respectively. The 1 year, 3 year, and 5 year cancer-specific survival (CSS) of these patients was 36.1%, 19.7%, and 14.2%, respectively. RMST analysis revealed that mPDAC patients with surgery had better OS and CSS than those without (OS: 9.49 months vs. 6.45 months, p < 0.01; CSS: 9.76 months vs. 6.54 months, p < 0.01). Nevertheless, subgroup analysis demonstrated that such statistical significance especially existed in oligometastatic PDAC patients, which refers to those metastases that were limited in number and concentrated to a single organ in this study. Additionally, surgery was identified as a significant predictor for the long-term prognosis of patients (OS: [HR, hazard ratio] = 0.48, 95% CI: 0.36–0.65, p < 0.001; CSS: HR = 0.45, 95% CI: 0.33–0.63, p < 0.001). Lastly, a nomogram was established to predict whether an individual was suitable for surgical treatment in this study. Conclusions: Surgical resection significantly prolonged the long-term prognosis of oligometastatic PDAC patients. Such insights might broaden the management of patients with mPDAC to a large extent. However, a prospective clinical trial should be conducted before a recommendation of surgery in these patients. Full article

(This article belongs to the Special Issue Current Surgical Management of Pancreatic Cancer)

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Open AccessArticle

Surgical Strategies to Dissect around the Superior Mesenteric Artery in Robotic Pancreatoduodenectomy

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J. Clin. Med. 2022, 11(23), 7112; https://doi.org/10.3390/jcm11237112 - 30 Nov 2022

Cited by 5 | Viewed by 1321

Abstract

The concept of the superior mesenteric artery (SMA)-first approach has been widely accepted in pancreatoduodenectomy. However, few studies have reported surgical approaches to the SMA in robotic pancreatoduodenectomy (RPD). Herein, we present our surgical strategies to dissect around the SMA in RPD. Among the various approaches, our standard protocol for RPD included the right approach to the SMA, which can result in complete tumor resection in most cases. In patients with malignant diseases requiring lymphadenectomy around the SMA, we developed a novel approach by combining the left and right approaches in RPD. Using this approach, circumferential dissection around the SMA can be achieved through both the left and right sides. This approach can also be helpful in patients with obesity or intra-abdominal adhesions. The present study summarizes the advantages and disadvantages of both the approaches during RPD. To perform RPD safely, surgeons should understand the different surgical approaches and select the best approach or a combination of different approaches, depending on demographic, anatomical, and oncological factors. Full article

(This article belongs to the Special Issue Current Surgical Management of Pancreatic Cancer)

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Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer

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J. Clin. Med. 2022, 11(22), 6792; https://doi.org/10.3390/jcm11226792 - 16 Nov 2022

Cited by 2 | Viewed by 5050

Abstract

Survival remains poor even after resection of pancreatic cancer and the postoperative recurrence rate is extremely high. Thus, neoadjuvant treatment may improve outcomes for resectable pancreatic cancer (RPC). This study evaluated the efficacy of neoadjuvant therapy for radiologically judged RPC. A prospectively maintained institutional database was reviewed to identify patients who underwent potentially curative resection of radiologically judged RPC. Patient characteristics and intermediate-term outcomes were compared between groups that received neoadjuvant treatment or upfront surgery (UFS). We identified 353 eligible patients, including 55 patients who received neoadjuvant chemoradiotherapy (CRT group), 53 patients who received neoadjuvant gemcitabine plus nab-paclitaxel (GnP group), and 245 patients who underwent UFS (UFS group). The cumulative rates of pancreatic cancer recurrence at 2 years after pancreatic surgery were 49.5% in the UFS, 48.1% in the CRT group, and 52.7% in the GnP group. The recurrence rate tended to be improved after neoadjuvant treatment, although the difference was not significant at this follow-up point. While the clinical TNM classifications were noticeably different from the final pathological findings, the clinical and pathological TNM classifications were more similar in the groups that underwent neoadjuvant treatment. Neoadjuvant treatment can help identify good surgical candidates and avoid unnecessary laparotomy. Our results also suggest that neoadjuvant therapy might help improve the preoperative diagnostic accuracy for patients with RPC. Full article

(This article belongs to the Special Issue Current Surgical Management of Pancreatic Cancer)

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