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Cancers
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Clinical Surgery for Hepato-Pancreato-Biliary (HPB) Cancer
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Clinical Surgery for Hepato-Pancreato-Biliary (HPB) Cancer

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

Deadline for manuscript submissions: 15 December 2024 | Viewed by 3620

Special Issue Editors

Dr. Gennaro Nappo

E-Mail Website
Guest Editor
1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
2. Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
Interests: pancreatic cancer; pancreatic cysts; pancreatic diseases; pancreatic surgery; distal cholangiocarcinoma; ampullary cancer; periampullary diseases
Special Issues, Collections and Topics in MDPI journals
Dr. Michele Pagnanelli

E-Mail Website
Guest Editor
Pancreatic Surgery Department, Humanitas Research Hospital (IRCCS), 20089 Milan, Italy
Interests: pancreatic cancer; pancreatic cysts; pancreatic diseases; pancreatic surgery; distal cholangiocarcinoma; ampullary cancer; periampullary diseases

Special Issue Information

Dear Colleagues,

Hepato-biliary and pancreatic (HPB) malignancies still represent one of the most complex challenges for surgeons, both from a technical and oncological point of view. HPB malignancies range from liver ones (intrahepatic cholangiocarcinoma, Klatskin tumor, hepatocellular carcinoma, metastases from other solid neoplasms) to pancreas (pancreatic ductal adenocarcinoma, metastases from other solid malignancies, neuroendocrine neoplasms, degenerated cysts), bile duct (distal cholangiocarcinoma, Todani’s cysts) and Vater papilla (ampullary cancer) ones. Each of these malignancies require a complex multidisciplinary approach, involving gastroenterologists, endoscopists, oncologists, radiologists, pathologists and surgeons. From a surgical point of view, the treatment of these malignancies often requires a large complex procedure, exposing the patients to a high risk in terms of morbidity and mortality. However, despite their complexity, currently, many procedures can be performed via a minimally invasive approach. Despite many efforts over the last few decades, the majority of these malignancies continue to have a bad prognosis.

The aim of this Special Issue is to collect different experiences regarding the multidisciplinary management of the most frequent and important HPB diseases.    

Dr. Gennaro Nappo
Dr. Michele Pagnanelli
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 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. Cancers 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 2900 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 malignancies
  • HPB malignancies
  • pancreatic ductal adenocarcinoma
  • liver cholangiocarcinoma
  • HPB surgery
  • liver resection
  • pancreatic resection

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Published Papers (4 papers)

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Research

13 pages, 611 KiB  
Article
Impact of MASLD on Portal Vein Thrombosis Following Hepatectomy for Liver Cancer
by Yoshito Wada, Koji Okuda, Shin Sasaki, Shigeo Shimose, Takamichi Nishida, Hisaaki Shimokobe, Yuichi Nagao, Takayuki Torigoe, Koji Hayashi, Hidetoshi Akashi, Satoshi Taniwaki and Tetsuo Imamura
Cancers 2024, 16(22), 3844; https://doi.org/10.3390/cancers16223844 - 15 Nov 2024
Viewed by 309
Abstract
Background: Due to the increasing global prevalence of non-alcoholic fatty liver disease (NAFLD), which is closely linked to metabolic disorders, there has been a rise in the number of patients with NAFLD undergoing hepatectomy. The metabolic disorders, as well as NAFLD, increase [...] Read more.
Background: Due to the increasing global prevalence of non-alcoholic fatty liver disease (NAFLD), which is closely linked to metabolic disorders, there has been a rise in the number of patients with NAFLD undergoing hepatectomy. The metabolic disorders, as well as NAFLD, increase venous thrombotic risk. NAFLD was recently updated to a new concept of hepatic steatosis: metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to investigate the impact of MASLD on post-hepatectomy portal vein thrombosis (PH-PVT). Methods: A total of 106 patients who underwent hepatectomy for liver cancer were included. Steatotic liver disease (SLD) was diagnosed using a CT L/S ratio of <1.1. SLD was classified as follows: MASLD, SLD associated with metabolic factors without alcohol consumption; MetALD, SLD with metabolic factors and moderate alcohol consumption; Other SLD, alcohol or other specific etiology of SLD; and No SLD, no hepatic steatosis. Results: PH-PVT was detected in 12/106 patients (11.3%); MASLD, 7/20 (35%); MetALD, 1/5 (20%); Other SLD, 1/13 (8%); and No SLD, 3/68 (4.4%). Multivariate analysis showed that the MASLD group (including MASLD and MetALD) (odds ratio [OR], 9.27) and left lateral sectionectomy (OR, 6.22) were significant independent risk factors for PH-PVT. Additionally, the incidence of PH-PVT was significantly higher in patients with MASLD than in those without SLD, along with metabolic factors, excluding alcohol consumption. Conclusions: MASLD and MetALD were identified as independent and significant risk factors for PH-PVT. Consideration was given to the idea that hepatic steatosis and metabolic dysfunction play synergistic roles in PH-PVT development. Full article
(This article belongs to the Special Issue Clinical Surgery for Hepato-Pancreato-Biliary (HPB) Cancer)
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14 pages, 505 KiB  
Article
Intraoperative Allogeneic Blood Transfusion Has No Impact on Postoperative Short-Term Outcomes After Pancreatoduodenectomy for Periampullary Malignancies: A Propensity Score Matching Analysis and Mediation Analysis
by Kristjan Ukegjini, René Warschkow, Henrik Petrowsky, Philip C. Müller, José Oberholzer, Ignazio Tarantino, Jan Philipp Jonas, Bruno M. Schmied and Thomas Steffen
Cancers 2024, 16(20), 3531; https://doi.org/10.3390/cancers16203531 - 18 Oct 2024
Viewed by 699
Abstract
Background/Objectives: The aim of this study was to investigate the association between intraoperative blood transfusion (BT) and the short-term outcomes of pancreatoduodenectomy (PD) for patients with periampullary malignancies. Methods: In a retrospective two-center cohort analysis, we utilized a logistic and mixed-effects [...] Read more.
Background/Objectives: The aim of this study was to investigate the association between intraoperative blood transfusion (BT) and the short-term outcomes of pancreatoduodenectomy (PD) for patients with periampullary malignancies. Methods: In a retrospective two-center cohort analysis, we utilized a logistic and mixed-effects ordinal regression, nonparametric partial correlation, and mediation analysis, complemented by propensity score matching (PSM) and weighting. Results: A total of 491 patients were included. Of these, 18 (3.7%) received an intraoperative BT. An intraoperative BT was associated with blood loss (odds ratio (OR) per 100 mL = 1.42; 95% CI 1.27 to 1.62; p < 0.001) and relatively high ASA classes (OR = 3.75; 95% CI 1.05 to 17.74; p = 0.041). Intraoperative blood loss (r = 0.27; p < 0.001) but not intraoperative BT (r = 0.015; p = 0.698) was associated with postoperative complications. Intraoperative BT was associated with postoperative complications according to the unadjusted regression (OR = 1.95; 95% CI 1.38–2.42, p < 0.001) but not the multivariable ordinal regression. In the mediation analysis for relative risk (RR), intraoperative BT was beneficial (RR = 0.51; 95% CI: 0.01–0.78), and blood loss (RR = 2.49; 95% CI: 1.75–177.34) contributed to the occurrence of major postoperative complications. After PSM, analyses revealed that an intraoperative BT did not have a significant impact on the rates of postoperative major complications (OR = 1.048; p = 0.919), clinically relevant postoperative pancreatic fistula (OR = 0.573; p = 0.439) or postoperative 90-day mortality (OR = 0.714; p = 0.439). Conclusions: When adjusting for intraoperative blood loss, intraoperative BT is not associated with postoperative complications. Full article
(This article belongs to the Special Issue Clinical Surgery for Hepato-Pancreato-Biliary (HPB) Cancer)
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15 pages, 270 KiB  
Article
Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?
by Sara Acciuffi, Mohammed Abu Hilal, Clarissa Ferrari, Sara Al-Madhi, Marc-Anthony Chouillard, Nouredin Messaoudi, Roland S. Croner and Andrew A. Gumbs
Cancers 2024, 16(5), 1051; https://doi.org/10.3390/cancers16051051 - 5 Mar 2024
Cited by 1 | Viewed by 926
Abstract
Background: Minimally invasive surgery is increasingly preferred for left-sided pancreatic resections. The SIMPLR study aims to compare open, laparoscopic, and robotic approaches using propensity score matching analysis. Methods: This study included 258 patients with tumors of the left side of the pancreas who [...] Read more.
Background: Minimally invasive surgery is increasingly preferred for left-sided pancreatic resections. The SIMPLR study aims to compare open, laparoscopic, and robotic approaches using propensity score matching analysis. Methods: This study included 258 patients with tumors of the left side of the pancreas who underwent surgery between 2016 and 2020 at three high-volume centers. The patients were divided into three groups based on their surgical approach and matched in a 1:1 ratio. Results: The open group had significantly higher estimated blood loss (620 mL vs. 320 mL, p < 0.001), longer operative time (273 vs. 216 min, p = 0.003), and longer hospital stays (16.9 vs. 6.81 days, p < 0.001) compared to the laparoscopic group. There was no difference in lymph node yield or resection status. When comparing open and robotic groups, the robotic procedures yielded a higher number of lymph nodes (24.9 vs. 15.2, p = 0.011) without being significantly longer. The laparoscopic group had a shorter operative time (210 vs. 340 min, p < 0.001), shorter ICU stays (0.63 vs. 1.64 days, p < 0.001), and shorter hospital stays (6.61 vs. 11.8 days, p < 0.001) when compared to the robotic group. There was no difference in morbidity or mortality between the three techniques. Conclusion: The laparoscopic approach exhibits short-term benefits. The three techniques are equivalent in terms of oncological safety, morbidity, and mortality. Full article
(This article belongs to the Special Issue Clinical Surgery for Hepato-Pancreato-Biliary (HPB) Cancer)
12 pages, 1396 KiB  
Article
Survival Comparison of Different Operation Types for Middle Bile Duct Cancer: Bile Duct Resection versus Pancreaticoduodenectomy Considering Complications and Adjuvant Treatment Effects
by Soo Yeun Lim, Hani Jassim Alramadhan, HyeJeong Jeong, Hochang Chae, Hyeong Seok Kim, So Jeong Yoon, Sang Hyun Shin, In Woong Han, Jin Seok Heo and Hongbeom Kim
Cancers 2024, 16(2), 297; https://doi.org/10.3390/cancers16020297 - 10 Jan 2024
Viewed by 1236
Abstract
Background: Margin status is one of the most significant prognostic factors after curative surgery for middle bile duct (MBD) cancer. Bile duct resection (BDR) is commonly converted to pancreaticoduodenectomy (PD) to achieve R0 resection. Additionally, adjuvant treatment is actively performed after surgery to [...] Read more.
Background: Margin status is one of the most significant prognostic factors after curative surgery for middle bile duct (MBD) cancer. Bile duct resection (BDR) is commonly converted to pancreaticoduodenectomy (PD) to achieve R0 resection. Additionally, adjuvant treatment is actively performed after surgery to improve survival. However, the wider the range of surgery, the higher the chance of complications; this, in turn, makes adjuvant treatment impossible. Nevertheless, no definitive surgical strategy considers the possible complication rates and subsequent adjuvant treatment. We aimed to investigate the appropriate surgical type considering the margin status, complications, and adjuvant treatment in MBD cancer. Materials and Methods: From 2008 to 2017, 520 patients diagnosed with MBD cancer at the Samsung Medical Center were analyzed retrospectively according to the operation type, margin status, complications, and adjuvant treatment. The R1 group was defined as having a carcinoma margin. Results: The 5-year survival rate for patients who underwent R0 and R1 resection was 54.4% and 33.3%, respectively (p = 0.131). Prognostic factors affecting the overall survival were the age, preoperative CA19-9 level, T stage, and N stage, but not the operation type, margin status, complications, or adjuvant treatment. The complication rates were 11.5% and 29.8% in the BDR and PD groups, respectively (p < 0.001). We observed no significant difference in the adjuvant treatment ratio according to complications (p = 0.675). Patients with PD who underwent R0 resection and could not undergo chemotherapy because of complications reported better survival rates than those with BDR who underwent R1 resection after adjuvant treatment (p = 0.003). Conclusion: The survival outcome of patients with R1 margins who underwent BDR did not match those with R0 margins after PD, even after adjuvant treatment. Due to improvements in surgical techniques and the ability to resolve complications, surgical complications exert a marginal effect on survival. Therefore, surgeons should secure R0 margins to achieve the best survival outcomes. Full article
(This article belongs to the Special Issue Clinical Surgery for Hepato-Pancreato-Biliary (HPB) Cancer)
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