Surgery for 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: closed (25 July 2023) | Viewed by 3357

Special Issue Editor

Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
Interests: pancreatoblastoma; pancreaticoduodenectomy; pancreas; pancreas adenocarcinoma; neoadjuvant therapy; hepatic artery; mesenteric veins

Special Issue Information

Dear Colleagues,

Pancreatic cancer is the most common highly malignant tumor of the pancreas. Surgical resection is the only possible cure for patients with pancreatic cancer. However, the initial resection rate is only 20% because the cancer has already metastasized or is in the locally advanced stage when it is detected. Although the resection rate and surgical safety of pancreatic cancer have been improved in recent years, the long-term survival of patients has not been significantly improved. It is unrealistic to improve the 5-year survival rate simply through surgery. The probability of recurrence and metastasis in pancreatic cancer patients after surgery is very high, even in the early stage. This provides a theoretical basis for the neoadjuvant therapy for this devastating disease. The proportion of patients with pancreatic cancer receiving neoadjuvant therapy is increasing each year. Traditional "surgery first" treatment strategy, which is appropriate for resectable pancreatic cancer, is now facing doubts and challenges, especially for locally advanced and borderline resectable pancreatic cancer. Additionally, with the development of surgical techniques and instruments, the minimally invasive surgical treatment of pancreatic cancer has achieved unprecedented development.

In this Special Issue, we will pay attention to a variety of surgical treatment strategies in pancreatic cancer, including preoperative and postoperative management (such as neoadjuvant chemoradiotherapy, the prevention of postoperative complications, nutritional supplement and other perioperative management), and methods to prevent postoperative recurrence and metastasis.

Dr. Feng Yang
Guest Editor

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Keywords

  • pancreatic cancer
  • pancreaticoduodenectomy
  • distal pancreatectomy
  • neoadjuvant therapy
  • pancreatic fistula
  • minimally invasive surgery

Published Papers (2 papers)

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9 pages, 1607 KiB  
Article
Long Term Outcomes of No-Touch Isolation Principles Applied in Pancreaticoduodenectomy for Treatment of Pancreatic Adenocarcinoma: A Multicenter Retrospective Study with Propensity Score Matching
by Yu Mou, Yi Song, Jinheng Liu, Haiyu Song, Xubao Liu, Jiang Li and Nengwen Ke
J. Clin. Med. 2023, 12(2), 632; https://doi.org/10.3390/jcm12020632 - 12 Jan 2023
Cited by 1 | Viewed by 1490
Abstract
Background: The recurrence and liver metastasis rates are still high in pancreatic head cancer with curative surgical resection. A no-touch isolation principle in pancreaticoduodenectomy (PD) may improve this situation, however, the exact advantages and efficacy of these principles have not been confirmed. [...] Read more.
Background: The recurrence and liver metastasis rates are still high in pancreatic head cancer with curative surgical resection. A no-touch isolation principle in pancreaticoduodenectomy (PD) may improve this situation, however, the exact advantages and efficacy of these principles have not been confirmed. Materials and methods: Among 370 patients who underwent PD, three centers were selected and classified into two groups: the no-touch PD group (n = 70) and the conventional PD group (n = 300). Propensity score matching was used to control for selection bias at a ratio of 1:1. The confounding variables were age, sex, body mass index, adjuvant chemotherapy, carbohydrate antigen 19-9, tumor size and tumor differentiation. Results: Patients in the no-touch PD group had better overall survival (OS) and disease-free survival (DFS) than those in the conventional PD group (OS: 17 vs. 13 months, p = 0.0035, DFS: 15 vs. 12 months, p = 0.087), with lower 1- and 2-year disease-related mortality rates (1-year: 32.9% vs. 47%, p = 0.032; 2-year: 42.5% vs. 82% p = 0.000) and recurrence and liver metastasis rates (1-year: 30.0% vs. 43.3%, p = 0.041; 2-year: 34.3% vs. 48.7%, p = 0.030). Compared with the matched conventional PD group, the no-touch PD group also had a better OS (17 vs. 12 months, p = 0.032). Conclusions: Our study showed the no-touch isolation principle may be a better choice to improve long-term survival for pancreatic cancer patients. Full article
(This article belongs to the Special Issue Surgery for Pancreatic Cancer)
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Case Report
Stage II Pancreatic Adenocarcinoma after Endovascular Repair of Abdominal Aortic Aneurysm: A Case Report and Literature Review
by Zihuan Zhang, Duo Li, Tianxiao Wang, Heyuan Niu, Wenquan Niu and Zhiying Yang
J. Clin. Med. 2023, 12(2), 443; https://doi.org/10.3390/jcm12020443 - 5 Jan 2023
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Abstract
Backgrounds: Concomitant abdominal aortic aneurysms (AAA) and gastrointestinal malignancies are uncommon. Endovascular repair (EVAR) is widely used to treat AAA. However, no consensus exists on the optimal strategy for treating AAA when associated with pancreatic adenocarcinoma. In addition, only few reports of pancreaticoduodenectomy [...] Read more.
Backgrounds: Concomitant abdominal aortic aneurysms (AAA) and gastrointestinal malignancies are uncommon. Endovascular repair (EVAR) is widely used to treat AAA. However, no consensus exists on the optimal strategy for treating AAA when associated with pancreatic adenocarcinoma. In addition, only few reports of pancreaticoduodenectomy (PD) after EVAR exist. Presentation of case: A pancreatic tumor was detected during follow-up after EVAR for AAA in an 83-year-old female patient. The diagnosis was high-grade intraepithelial neoplasia. Modified pylorus-preserving pancreaticoduodenectomy was safely performed. The patient recovered moderately and was discharged two weeks after surgery. The pathological diagnosis was middle-grade pancreatic ductal adenocarcinoma. The patient survived for 24 months with no recurrence or cardiovascular complications. Conclusions: Conducting periodic follow-ups after AAA surgery is helpful for the early discovery of gastrointestinal tumors. EVAR surgery is safe and feasible and thus recommended for AAA patients with pancreatic cancer, although it may increase the risk of cancer. The stage of malignancy and post-EVAR medical history can be valuable in evaluating the benefits of pancreatic surgery for such cases. Full article
(This article belongs to the Special Issue Surgery for Pancreatic Cancer)
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