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Medicina
Special Issues
Development of Gastrointestinal Cancer Surgery
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Development of Gastrointestinal Cancer Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 20 May 2024 | Viewed by 4812

Special Issue Editors

Dr. Justas Žilinskas

E-Mail Website
Guest Editor
Department of Surgery, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
Interests: general, emergency and trauma surgery; digestive surgery; laparoscopic surgery; surgical oncology; advanced surgical technologies; basic science; colorectal surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Tadas Latkauskas

E-Mail Website
Guest Editor
Department of Surgery, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
Interests: colorectal surgery, digestive surgery; laparoscopic surgery; surgical oncology
Dr. Saulius Švagždys

E-Mail Website
Guest Editor
Department of Surgery, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
Interests: colorectal surgery; digestive surgery; laparoscopic surgery; surgical oncology

Special Issue Information

Dear Colleagues,

According to GLOBOCAN, five major gastrointestinal cancers (esophagus, stomach, pancreas, liver, and colorectum) acount for 5 million new cases and almost 3.5 million cancer-related deaths worldwide. Despite remarkable advances in diagnostics, screening, combined systemic and surgical treatment, and new personalized medicine approaches, some of these cancers still have poor prognoses. Usually, due to cancers frequently being diagnosed at an advanced stage, treatment options are limited and cure is not possible.

The Special Issue of Medicina aims to discuss novel treatment strategies and share the most recent findings of developing and implementing new energy devices and technologies to improve gastrointestinal surgery cancer results.

Therefore, this Special Issue of Medicina will cover some of the topics presenting cutting-edge research related to the development of gastrointestinal cancer, from the implementation of ex vivo patient and liquid biopsies and biomarkers nowadays to the benefit of indocyanine-green-, fluorescence-, and 3D-model-guided surgery. We also invite you to share data about the novel interventional, minimally invasive, and surgical management methods of gastrointestinal cancer surgery.

We are soliciting original articles, clinical trials, systematic reviews, and meta-analyses.

Research areas may include (but are not limited to) the following: 

  • Conventional, laparoscopic, and robotic surgery;
  • Minimal invasive surgery;
  • Surgical technique and energy devices;
  • Esophageal, gastric, and duodenal cancers;
  • Biliary and pancreatic cancers;
  • Hepatocellular carcinoma;
  • Colorectal cancers.

Dr. Justas Žilinskas
Prof. Dr. Tadas Latkauskas
Dr. Saulius Švagždys
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. Medicina is an international peer-reviewed open access monthly 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 1800 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

  • conventional vs laparoscopic surgery
  • robotic surgery
  • minimally invasive approach
  • gastrointestinal cancer surgery
  • energy devices
  • ex vivo and liquid biopsy
  • ICG
  • 3D

Published Papers (4 papers)

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Research

19 pages, 3920 KiB  
Article
Assessing the Therapeutic Impacts of HAMLET and FOLFOX on BRAF-Mutated Colorectal Cancer: A Study of Cancer Cell Survival and Mitochondrial Dynamics In Vitro and Ex Vivo
by Justas Žilinskas, Darius Stukas, Aldona Jasukaitienė, Inga Žievytė, Zbigniev Balion, Jurgita Šapauskienė, Rasa Banienė, Henrikas Paužas, Paulius Lizdenis, Vaidotas Čėsna, Žilvinas Dambrauskas, Antanas Gulbinas and Algimantas Tamelis
Medicina 2024, 60(1), 142; https://doi.org/10.3390/medicina60010142 - 12 Jan 2024
Viewed by 1171
Abstract
Background and Objectives: Colorectal cancer (CRC) is a major global health challenge. The BRAF V600E mutation, found in 8–12% of CRC patients, exacerbates this by conferring poor prognosis and resistance to therapy. Our study focuses on the efficacy of the HAMLET complex, [...] Read more.
Background and Objectives: Colorectal cancer (CRC) is a major global health challenge. The BRAF V600E mutation, found in 8–12% of CRC patients, exacerbates this by conferring poor prognosis and resistance to therapy. Our study focuses on the efficacy of the HAMLET complex, a molecular substance derived from human breast milk, on CRC cell lines and ex vivo biopsies harboring this mutation, given its previously observed selective toxicity to cancer cells. Materials and Methods: we explored the effects of combining HAMLET with the FOLFOX chemotherapy regimen on CRC cell lines and ex vivo models. Key assessments included cell viability, apoptosis/necrosis induction, and mitochondrial function, aiming to understand the mutation-specific resistance or other cellular response mechanisms. Results: HAMLET and FOLFOX alone decreased viability in CRC explants, irrespective of the BRAF mutation status. Notably, their combination yielded a marked decrease in viability, particularly in the BRAF wild-type samples, suggesting a synergistic effect. While HAMLET showed a modest inhibitory effect on mitochondrial respiration across both mutant and wild-type samples, the response varied depending on the mutation status. Significant differences emerged in the responses of the HT-29 and WiDr cell lines to HAMLET, with WiDr cells showing greater resistance, pointing to factors beyond genetic mutations influencing drug responses. A slight synergy between HAMLET and FOLFOX was observed in WiDr cells, independent of the BRAF mutation. The bioenergetic analysis highlighted differences in mitochondrial respiration between HT-29 and WiDr cells, suggesting that bioenergetic profiles could be key in determining cellular responses to HAMLET. Conclusions: We highlight the potential of HAMLET and FOLFOX as a combined therapeutic approach in BRAF wild-type CRC, significantly reducing cancer cell viability. The varied responses in CRC cell lines, especially regarding bioenergetic and mitochondrial factors, emphasize the need for a comprehensive approach considering both genetic and metabolic aspects in CRC treatment strategies. Full article
(This article belongs to the Special Issue Development of Gastrointestinal Cancer Surgery)
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14 pages, 1450 KiB  
Article
Prognostic Value of Tumor Volume, Tumor Volume Reduction Rate and Magnetic Resonance Tumor Regression Grade in Rectal Cancer
by Ingrida Pikūnienė, Vestina Strakšytė, Algidas Basevičius, Justas Žilinskas, Rita Ambrazienė, Rasa Jančiauskienė and Žilvinas Saladžinskas
Medicina 2023, 59(12), 2194; https://doi.org/10.3390/medicina59122194 - 18 Dec 2023
Viewed by 894
Abstract
Background and Objectives: Rectal cancer poses significant treatment challenges, especially in advanced stages. Radiologic assessment, particularly with MRI, is critical for surgeons and oncologists to understand tumor dynamics and tailor treatment strategies to improve patient outcomes. The purpose of this study was [...] Read more.
Background and Objectives: Rectal cancer poses significant treatment challenges, especially in advanced stages. Radiologic assessment, particularly with MRI, is critical for surgeons and oncologists to understand tumor dynamics and tailor treatment strategies to improve patient outcomes. The purpose of this study was to correlate MRI-based tumor volumetric and tumor regression grade analysis in patients with advanced rectal cancer, assessing the impact of preoperative chemotherapy (CT) alone or chemoradiotherapy (CRT) on surgical technique choices. Materials and Methods: Between 2015 and 2022, a prospective study was enrolled, including a cohort of 89 patients diagnosed with rectal cancer at stage II or III. The participants were divided into two distinct therapy groups, ensuring an equal distribution with a ratio of 1:1. The initial group was treated with the contemporary preoperative chemotherapy protocol FOLFOX4. In contrast, the alternative group received conventional preoperative chemoradiotherapy. Before surgery, each patient underwent a rectal MRI scan at 1.5 T, including T2-weighted and diffusion-weighted imaging (DWI) sequences. Results: The CT group showed a 36.52% tumor volume reduction rate (TVRR), and the CRT group showed 54.87%, with varying magnetic resonance and pathological tumor regression grades (mrTRG and pTRG). Analysis revealed a significant interaction between mrTRG and tumor volumetrics (volume and VRR) in both groups, especially CRT, underscoring the complexity of tumor response. Both treatment groups had similar initial tumor volumes, with CRT displaying a higher TVRR, particularly in higher pathological TRG (3/4) cases. This interaction and the strong correlation between mrTRG and pTRG suggest mrTRG’s role as a non-invasive predictor for treatment response, highlighting the need for personalized treatment plans. Conclusions: Rectal tumor volume, volume reduction rate, and mrTRG are not just abstract measures; they are concrete indicators that have a direct and practical impact on surgical decision-making, planning, and prognosis, ultimately influencing the quality of care and life expectancy of patients with rectal cancer. Full article
(This article belongs to the Special Issue Development of Gastrointestinal Cancer Surgery)
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10 pages, 574 KiB  
Article
Effect of Microsatellite Status and Pan-Immune-Inflammation Score on Pathological Response in Patients with Clinical Stage III Stomach Cancer Treated with Perioperative Chemotherapy
by Ahmet Gulmez, Hatice Coskun, Tolga Koseci, Serdar Ata, Berna Bozkurt and Timucin Cil
Medicina 2023, 59(9), 1625; https://doi.org/10.3390/medicina59091625 - 08 Sep 2023
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Abstract
Background and Objective: This study evaluated the relationship between microsatellite status (MSI) and pan-immune-inflammation score (PIV) in tumor response to neoadjuvant chemotherapy (NAC) in patients with clinical stage III gastric cancer (cStage III GC). Materials and Methods: Microsatellite instability (MSI) status [...] Read more.
Background and Objective: This study evaluated the relationship between microsatellite status (MSI) and pan-immune-inflammation score (PIV) in tumor response to neoadjuvant chemotherapy (NAC) in patients with clinical stage III gastric cancer (cStage III GC). Materials and Methods: Microsatellite instability (MSI) status was evaluated based on pathology preparations. Pan-immune-inflammation score (PIV) was obtained from pre-treatment blood tests. The relationship of both parameters with pathological complete response (pCR) was evaluated. Results: A total of 104 patients were included in this study. All the patients were stage III GC patients receiving perioperative treatment. There were 13 patients in total who achieved a pCR response. While CNS was detected in 11 of the patients who achieved a pCR, the MSI status of the other two patients was unknown. No pCR was observed in any patient with MSI-H. According to the cut-off value for PIV, 25 (24%) patients were in the PIV-low (≤53.9) group, while 79 (76%) were in the PIV-high (>53.9) group. Based on univariate analysis, a higher PIV was associated with worse outcomes for pathological response, disease recurrence, and survival (p < 0.05). Conclusions: In patients with clinically stage III GC, the presence of MSI-H may predict no benefit from perioperative treatment. Conversely, a pre-treatment PIV score using specific cut-off values may provide a positive prediction of pathological response and survival. Full article
(This article belongs to the Special Issue Development of Gastrointestinal Cancer Surgery)
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11 pages, 1734 KiB  
Article
The Prognostic Utility of the Metastatic Lymph Node Ratio and the Number of Regional Lymph Nodes Removed from Patients with Small Bowel Adenocarcinomas
by Dincer Aydin, Umut Kefeli, Melike Ozcelik, Gokmen Umut Erdem, Mehmet Ali Sendur, Mahmut Emre Yildirim, Basak Bala Oven, Ahmet Bilici and Mahmut Gumus
Medicina 2023, 59(8), 1472; https://doi.org/10.3390/medicina59081472 - 16 Aug 2023
Viewed by 846
Abstract
Background and Objectives: Small bowel adenocarcinomas (SBAs) are rare tumors of the gastrointestinal system. Lymph node metastasis in patients with curatively resected SBAs is associated with poor prognosis. In this study, we determined the prognostic utility of the number of removed lymph [...] Read more.
Background and Objectives: Small bowel adenocarcinomas (SBAs) are rare tumors of the gastrointestinal system. Lymph node metastasis in patients with curatively resected SBAs is associated with poor prognosis. In this study, we determined the prognostic utility of the number of removed lymph nodes and the metastatic lymph node ratio (the N ratio). Materials and Methods: The data of 97 patients who underwent curative SBA resection in nine hospitals of Turkey were retrospectively evaluated. Univariate and multivariate analyses of potentially prognostic factors including the N ratio and the numbers of regional lymph nodes removed were evaluated. Results: Univariate analysis showed that perineural and vascular invasion, metastatic lymph nodes, advanced TNM stage, and a high N ratio were significant predictors of poor survival. Multivariate analysis revealed that the N ratio was a significant independent predictor of disease-specific survival (DSS). The group with the lowest N ratio exhibited the longest disease-free survival (DFS) and DSS; these decreased significantly as the N ratio increased (both, p < 0.001). There was no significant difference in either DFS or DSS between groups with low and high numbers of dissected lymph nodes (i.e., <13 and ≥13) (both, p = 0.075). Conclusions: We found that the N ratio was independently prognostic of DSS in patients with radically resected SBAs. The N ratio is a convenient and accurate measure of the severity of lymph node metastasis. Full article
(This article belongs to the Special Issue Development of Gastrointestinal Cancer Surgery)
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