Improving Surgical Care for Patients with Hepatobiliary and Pancreatic Cancers

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 20 May 2025 | Viewed by 4155

Special Issue Editors


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Guest Editor
Westmead Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, NSW 2565, Australia
Interests: pancreatic cancer; cholangiocarcinoma; biomarkers; colorectal liver metastases; hepatocellular carcinoma

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Guest Editor
1. Cancer Surgery and Metabolism Research Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
2. Upper GI Surgical Unit, Royal North Shore Hospital and North Shore Private Hospital, St Leonards, NSW 2065, Australia
3. Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW 2052, Australia
Interests: cancer; colorectal cancer; research facilitation; surgery; upper gastrointestinal cancer

Special Issue Information

Dear Colleagues, 

Cancers of the hepatic, pancreatic and biliary (HPB) system are associated with poor prognosis, with the majority of cases presenting at an advanced stage, rendering them unsuitable for potentially curative surgical resection. For the proportion of patients who have localized disease amenable to resection, surgery is normally a major under-taking, carrying a moderate risk of short- and medium-term morbidity. This is especially problematic, given that many patients who undergo this major surgery experience the problem of early disease recurrence. There is there-fore a great need for enhancement of patient selection for these procedures, development of alternative treatment strategies for patients at high risk of early disease recurrence, and also a review of peri- and intra-operative strategies to enhance recovery from major HPB surgery. This special edition will address the discovery of prognostic biomarkers in HPB cancer, biomarker-driven treatment strategies for HPB cancer, and the relationship between short-term and oncological outcomes after major HPB surgery. 

Dr. Christopher B. Nahm
Dr. Kai M. Brown
Guest Editors

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Keywords

  • hepatobiliary
  • pancreatic
  • surgery
  • biomarkers
  • prognosis
  • treatment strategy

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Published Papers (2 papers)

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Review

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27 pages, 730 KiB  
Review
Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review
by Nadya Rykina-Tameeva, Jaswinder S. Samra, Sumit Sahni and Anubhav Mittal
Cancers 2023, 15(24), 5865; https://doi.org/10.3390/cancers15245865 - 15 Dec 2023
Cited by 2 | Viewed by 1845
Abstract
Clinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence of surgical technique, the [...] Read more.
Clinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence of surgical technique, the solution to preventing CR-POPF may lie instead in non-surgical, mainly pharmacological interventions. Five databases were searched, identifying eight pharmacological preventative strategies, including neoadjuvant therapy, somatostatin and its analogues, antibiotics, analgesia, corticosteroids, protease inhibitors, miscellaneous interventions with few reports, and combination strategies. Two further non-surgical interventions studied were nutrition and fluids. New potential interventions were also identified from related surgical and experimental contexts. Given the varied efficacy reported for these interventions, numerous opportunities for clarifying this heterogeneity remain. By reducing CR-POPF, patients may avoid morbid sequelae, experience shorter hospital stays, and ensure timely delivery of adjuvant therapy, overall aiding survival where prognosis, particularly in pancreatic cancer patients, is poor. Full article
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24 pages, 603 KiB  
Systematic Review
Systematic Review of Preoperative Prognostic Biomarkers in Perihilar Cholangiocarcinoma
by Rishaan Pawaskar, Kevin Zhang Huang, Helen Pham, Adnan Nagrial, Mark Wong, Siobhan O’Neill, Henry Pleass, Lawrence Yuen, Vincent W. T. Lam, Arthur Richardson, Tony Pang and Christopher B. Nahm
Cancers 2024, 16(4), 698; https://doi.org/10.3390/cancers16040698 - 7 Feb 2024
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Abstract
Perihilar cholangiocarcinoma (pCCA) is an uncommon malignancy with generally poor prognosis. Surgery is the primary curative treatment; however, the perioperative mortality and morbidity rates are high, with a low 5-year survival rate. Use of preoperative prognostic biomarkers to predict survival outcomes after surgery [...] Read more.
Perihilar cholangiocarcinoma (pCCA) is an uncommon malignancy with generally poor prognosis. Surgery is the primary curative treatment; however, the perioperative mortality and morbidity rates are high, with a low 5-year survival rate. Use of preoperative prognostic biomarkers to predict survival outcomes after surgery for pCCA are not well-established currently. This systematic review aimed to identify and summarise preoperative biomarkers associated with survival in pCCA, thereby potentially improving treatment decision-making. The Embase, Medline, and Cochrane databases were searched, and a systematic review was performed using the PRISMA guidelines. English-language studies examining the association between serum and/or tissue-derived biomarkers in pCCA and overall and/or disease-free survival were included. Our systematic review identified 64 biomarkers across 48 relevant studies. Raised serum CA19-9, bilirubin, CEA, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and tumour MMP9, and low serum albumin were most associated with poorer survival; however, the cutoff values used widely varied. Several promising molecular markers with prognostic significance were also identified, including tumour HMGA2, MUC5AC/6, IDH1, PIWIL2, and DNA index. In conclusion, several biomarkers have been identified in serum and tumour specimens that prognosticate overall and disease-free survival after pCCA resection. These, however, require external validation in large cohort studies and/or in preoperatively obtained specimens, especially tissue biopsy, to recommend their use. Full article
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