Improving Outcomes of Pancreatic Cancer Surgery

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Surgical Oncology".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 2298

Special Issue Editors


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Guest Editor
1. AP-HP, Department of Digestive and Oncologic Surgery, Ambroise Paré Hospital, Boulogne-Billancourt 92104, France
2. Versailles St-Quentin-en-Yvelines/Paris Saclay University, UFR des Sciences de la Santé Simone Veil, Montigny-le-Bretonneux 78180, France
Interests: pancreatic surgery; liver surgery; surgical oncology; pancreatic cancer; laparoscopy; robotic

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Guest Editor
Department of Surgery, Austin Health,The University of Melbourne, Melbourne 3084, Australia
Interests: pancreatic surgery; liver surgery; surgical oncology; pancreatic cancer; laparoscopy; robotic; liver transplantation

Special Issue Information

Dear Colleagues,

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers and is set to become one of the leading causes of cancer-related deaths in the next few years. Despite the advancements in surgical technique and peri-operative care in recent decades, overall survival rate for PDAC remains almost unchanged, even with the most recent chemotherapeutic regimens, mainly focused on cytotoxic drugs with or without the use of radiotherapy. From a public health point of view, surgeons can decrease the costs related to the operative procedure itself by creating a better definition of the patients who benefit from it the most and providing minimally invasive surgery when suitable.

On the other hand, the advent of early diagnosis with the potential use of liquid biopsy and the use of immunotherapy are still in their infancies, and a lot must be done in this field. The use of immunotherapy as an adjuvant treatment for surgery is still evolving, with some encouraging results emerging. Minimally invasive techniques (laparoscopic and robotic) have become the standard of practice for most distal body and tail lesions; however, in randomized trials, the routine use of such techniques in cephalic resections has not shown its superiority to the open approach. More recently, metastatic disease, once considered to be an absolute contraindication for surgery, has begun to be treated, with promising results.

This Special Issue aims to offer an update on the cutting-edge treatment of PDAC and contribute to the current medical literature on this topic. Herein, we are pleased to invite you to join us in this Special Issue of Current Oncology by submitting either your basic, translational or clinical studies.

We look forward to receiving your contributions.  

Dr. Renato M. Lupinacci
Prof. Dr. Marcos Perini
Guest Editors

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Keywords

  • pancreatic ductal adenocarcinoma
  • prognosis
  • survival
  • chemotherapy
  • recurrence
  • surgery
  • pancreas cancer
  • pancreatectomy
  • pancreatic resections
  • robotic

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Published Papers (1 paper)

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Research

11 pages, 1149 KiB  
Article
Intraoperative Positive Pancreatic Parenchymal Resection Margin: Is It a True Indication of Completion Total Pancreatectomy after Partial Pancreatectomy for Pancreatic Ductal Adenocarcinoma?
by Ji-Hye Jung, So-Jeong Yoon, Ok-Joo Lee, Sang-Hyun Shin, Jin-Seok Heo and In-Woong Han
Curr. Oncol. 2022, 29(8), 5295-5305; https://doi.org/10.3390/curroncol29080420 - 27 Jul 2022
Cited by 2 | Viewed by 1779
Abstract
Background: Total pancreatectomy (TP) can be performed in cases with positive resection margin after partial pancreatectomy for pancreatic cancer. However, despite complete removal of the residual pancreatic parenchyme, it is questionable whether an actual R0 resection and favorable survival can be achieved. This [...] Read more.
Background: Total pancreatectomy (TP) can be performed in cases with positive resection margin after partial pancreatectomy for pancreatic cancer. However, despite complete removal of the residual pancreatic parenchyme, it is questionable whether an actual R0 resection and favorable survival can be achieved. This study aimed to identify the R0 resection rate and postoperative outcomes, including survival, following completion TP (cTP) performed due to intraoperative positive margin. Methods: From 1995 to 2015, 1096 patients with pancreatic ductal adenocarcinoma underwent elective pancreatectomy at the Samsung Medical Center. Among these, 25 patients underwent cTP, which was converted during partial pancreatectomy because of a positive resection margin. To compare survival after R0 resection between the cTP R0 and pancreaticoduodenectomy (PD) R0 cases, propensity score matching was conducted to balance the baseline characteristics. Results: The R0 rate of cTP performed due to intraoperative positive margin was 84% (21/25). The overall 5-year survival rate (5YSR) in the 25 cTP cases was 8%. There was no difference in the 5YSR between the cTP R0 and cTP R1 groups (9.5% versus 0.0%, p = 0.963). However, the 5YSR of the cTP R0 group was significantly lower than that of the PD R0 group (9.5% versus 20.0%, p = 0.022). There was no distinct difference in postoperative complications between the cTP R0 versus cTP R1 and cTP R0 versus PD R0 groups. Conclusions: In cases with intraoperative positive pancreatic parenchymal resection margin, survival after cTP was not favorable. Careful patient selection is needed to perform cTP in such cases. Full article
(This article belongs to the Special Issue Improving Outcomes of Pancreatic Cancer Surgery)
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