Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition

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

Deadline for manuscript submissions: 30 November 2024 | Viewed by 3782

Special Issue Editors


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Guest Editor
1. 10th Clinical Department—General Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
2. Department of General Surgery, “Colţea” Clinical Hospital, Bucharest, Romania
Interests: oncologic surgery; hepato-pancreato-biliary surgery; abdominal wall surgery
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. 10th Clinical Department—General Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
2. Department of General Surgery, "Bagdasar-Arseni" Emergency Clinical Hospital, Bucharest, Romania
Interests: oncologic surgery; trauma surgery; hepato-pancreato-biliary surgery; abdominal wall surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cancer is the leading cause of death worldwide, accounting for more than 10 million deaths each year and an even higher number of patients that are diagnosed with this disease undergoing various procedures. This is the consequence of the increased number of risk factors that have become present in our lives in recent decades, such as tobacco, obesity and various unhealthy food diets, alcohol, viral infections, exposure to certain chemicals or radiations, etc.

Our goal as medical practitioners or scientists is to obtain the best outcome for patients, from prophylactic procedures to a correct diagnosis, a specific multimodal treatment and rigorous follow-up. All these have significantly improved in recent years because of a better understanding of the genetic and molecular mechanisms of cancer development, the emergence of new technologies in cancer detection or surgical techniques, and breakthroughs in oncological therapies.

The aim of this Special Issue is to highlight new insights into advances of cancer multimodal approaches. Therefore, we encourage authors to submit their systematic reviews, meta-analyses, clinical outcome studies or new surgical techniques and oncological therapies regarding this subject.

Prof. Dr. Daniel Alin Cristian
Prof. Dr. Valentin Titus Grigorean
Guest Editors

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Keywords

  • cancer
  • mechanism
  • surgery
  • multimodal
  • advances

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Related Special Issue

Published Papers (4 papers)

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Research

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13 pages, 1155 KiB  
Article
Prognostic Impact and Clinical Features of Spread through Air Spaces in Operated Lung Cancer: Real-World Analysis
by Sedat Yildirim, Ozkan Alan, Zeynep Yuksel Yasar, Tugba Kaya, Goncagul Akdag, Oguzcan Kinikoglu, Gonca Gul Gecmen, Alper Yasar, Deniz Isik, Heves Surmeli, Tugba Basoglu, Ozlem Nuray Sever, Mahmut Emre Yildirim, Hatice Odabas and Nedim Turan
Medicina 2024, 60(8), 1374; https://doi.org/10.3390/medicina60081374 - 22 Aug 2024
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Abstract
Background and Objectives: Lung cancer is the leading cause of cancer-related deaths. Spread through air spaces (STAS) is an adverse prognostic factor that has become increasingly known in recent years. This study aims to investigate the impact of STAS presence on overall [...] Read more.
Background and Objectives: Lung cancer is the leading cause of cancer-related deaths. Spread through air spaces (STAS) is an adverse prognostic factor that has become increasingly known in recent years. This study aims to investigate the impact of STAS presence on overall survival (OS) and disease-free survival (DFS) in patients with surgically resected stage IA-IIIA lung cancer and to identify clinicopathological features associated with STAS. Materials and Methods: This research involved 311 lung cancer surgery patients. The relationship between the presence of STAS in the patients’ surgical pathology and OS and DFS values was examined. Clinicopathological features associated with the presence of STAS were determined. Results: There were 103 (33%) STAS-positive patients. Adenocarcinoma histological subtype, perineural invasion (PNI), and lymphovascular invasion (LVI) were significantly correlated with being STAS positive. STAS significantly predicted DFS and OS. One-year and five-year DFS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (65% vs. 88%, 29% vs. 62%, respectively, p ≤ 0.001). Similarly, one-year and five-year OS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (92% vs. 94%, 54% vs. 88%, respectively, p ≤ 0.001). In multivariate analysis, STAS was found to be an independent prognostic factor for both DFS and OS (HR: 3.2 (95%CI: 2.1–4.8) and 3.1 (95%CI: 1.7–5.5), p < 0.001 and <0.001, respectively). Conclusions: In our study, STAS was found to be an independent prognostic biomarker in operated stage IA-IIIA lung cancer patients. It may be a beneficial pathological biomarker in predicting the survival of patients and managing their treatments. Full article
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23 pages, 3534 KiB  
Article
Emergency and Elective Colorectal Cancer—Relationship between Clinical Factors, Tumor Topography and Surgical Strategies: A Cohort Study
by Ionuţ Simion Coman, Raluca Cristina Vital, Violeta Elena Coman, Cosmin Burleanu, Mircea Liţescu, Costin George Florea, Daniel Alin Cristian, Gabriel-Petre Gorecki, Petru Adrian Radu, Iancu Emil Pleşea, Anwar Erchid and Valentin Titus Grigorean
Medicina 2024, 60(6), 898; https://doi.org/10.3390/medicina60060898 - 29 May 2024
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Abstract
Background and Objectives: The purpose of the study was to analyze the relationships among several clinical factors and also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that [...] Read more.
Background and Objectives: The purpose of the study was to analyze the relationships among several clinical factors and also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that included patients admitted to our emergency surgical department and diagnosed with colorectal cancer. The study group inclusion criteria were: patients admitted during 2020–2022; patients diagnosed with colorectal cancer (including the ileocecal valve); patients who benefited from a surgical procedure, either emergency or elective. Results: In our study group, consisting of 153 patients, we accounted for 56.9% male patients and 43.1% female patients. The most common clinical manifestations were pain (73.2% of the study group), followed by abdominal distension (69.3% of the study group) and absence of intestinal transit (38.6% of the study group). A total of 69 patients had emergency surgery (45.1%), while 84 patients (54.9%) benefited from elective surgery. The most frequent topography of the tumor was the sigmoid colon, with 19.60% of the patients, followed by the colorectal junction, with 15.68% of the patients, and superior rectum and inferior rectum, with 11.11% of the patients in each subcategory. The most frequent type of procedure was right hemicolectomy (21.6% of the study group), followed by rectosigmoid resection (20.9% of the study group). The surgical procedure was finished by performing an anastomosis in 49% of the patients, and an ostomy in 43.1% of the patients, while for 7.8% of the patients, a tumoral biopsy was performed. Conclusions: Colorectal cancer remains one of the most frequent cancers in the world, with a heavy burden that involves high mortality, alterations in the quality of life of patients and their families, and also the financial costs of the medical systems. Full article
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12 pages, 1531 KiB  
Article
Clinicopathologic Analysis and Prognostic Factors for Survival in Patients with Operable Ampullary Carcinoma: A Multi-Institutional Retrospective Experience
by Nebi Serkan Demirci, Eyyup Cavdar, Nuriye Yildirim Ozdemir, Sinemis Yuksel, Yakup Iriagac, Gokmen Umut Erdem, Hatice Odabas, Ilhan Hacibekiroglu, Mustafa Karaagac, Mahmut Ucar, Banu Ozturk and Yakup Bozkaya
Medicina 2024, 60(5), 818; https://doi.org/10.3390/medicina60050818 - 16 May 2024
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Abstract
Background and Objectives: In ampullary cancer, 5-year survival rates are 30–50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and [...] Read more.
Background and Objectives: In ampullary cancer, 5-year survival rates are 30–50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and Methods: We included 197 patients who underwent pancreaticoduodenectomy to treat ampullary carcinomas between December 2003 and May 2019. Demographics, clinical features, treatments, and outcomes/survival were analyzed. Results: The median disease-free survival (mDFS) and median overall survival (mOS) were 40.9 vs. 63.4 months, respectively. The mDFS was significantly lower in patients with lymphovascular invasion (p < 0.001) and lymph node involvement (p = 0.027). Potential predictors of decreased OS on univariate analysis included age ≥ 50 years (p = 0.045), poor performance status (p = 0.048), weight loss (p = 0.045), T3–T4 tumors (p = 0.018), surgical margin positivity (p = 0.01), lymph node involvement (p = 0.001), lymphovascular invasion (p < 0.001), perineural invasion (p = 0.007), and poor histological grade (p = 0.042). For the multivariate analysis, only nodal status (hazard ratio [HR]1.98; 95% confidence interval [CI], 1.08–3.65; p = 0.027) and surgical margin status (HR 2.61; 95% CI, 1.09–6.24; p = 0.03) were associated with OS. Conclusions: Nodal status and a positive surgical margin were independent predictors of a poor mOS for patients with ampullary carcinomas. Additional studies are required to explore the role of adjuvant therapy in patients with ampullary carcinomas. Full article
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12 pages, 2901 KiB  
Case Report
Reinitiating Chemotherapy beyond Progression after Maintenance Immunotherapy in Extensive-Stage Small-Cell Lung Cancer
by Roxana-Andreea Rahnea-Nita, Radu-Valeriu Toma, Valentin Titus Grigorean, Ionuţ Simion Coman, Violeta Elena Coman, Iancu Emil Pleşea, Anwar Erchid, Gabriel-Petre Gorecki and Gabriela Rahnea-Nita
Medicina 2024, 60(8), 1225; https://doi.org/10.3390/medicina60081225 - 28 Jul 2024
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Abstract
Introduction: Small-cell lung cancer (SCLC) is an aggressive form of cancer with a poor prognosis. The two-year survival rate is 8% of all cases. Case presentation: We present the case of a male patient who was 50 years old at the [...] Read more.
Introduction: Small-cell lung cancer (SCLC) is an aggressive form of cancer with a poor prognosis. The two-year survival rate is 8% of all cases. Case presentation: We present the case of a male patient who was 50 years old at the time of diagnosis in May 2022. He was diagnosed with extensive-stage small-cell lung cancer, treated with immunotherapy in combination with chemotherapy (Durvalumab in combination with Etoposide plus Carboplatin) as a first-line treatment, followed by maintenance immunotherapy. In December 2023, a PET-CT scan revealed progressive disease with multiple metastases. Chemotherapy was reinitiated with Etoposide plus Cisplatin in January 2024. After two cycles of chemotherapy, the patient developed post-chemotherapy anemia, for which treatment with Epoetinum alpha was initiated. Chemotherapy was continued for another five cycles, until May 2024, with the maintenance of hemoglobin at a level within 9.9 mg/dL–11 mg/dL. Upon assessment at the end of May 2024, the patient presented an ECOG = 2 performance status, with a moderate general state, moderate-intensity fatigue, no pain, no anxiety or depression and no dyspnea. Discussions, Literature Review and Conclusions: Reinitiating chemotherapy after the failure of maintenance immunotherapy may be an option in patients with SCLC. Epoetinum allows oncological treatment by preventing chemotherapy-induced anemia. Full article
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