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Locoregional Treatment Options in Surgical Oncology

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (20 March 2023) | Viewed by 8094

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Special Issue Editors

Prof. Dr. Nikolaos Vassos

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Guest Editor

MD, PhD, FEBS (SurgOnc), MHBA, Medical Faculty Mannheim, Mannheim University Medical Center, University of Heidelberg, 68167 Mannheim, Germany
Interests: surgical oncology; sarcoma; gastrointestinal stromal tumors; desmoid; melanoma; gastrointestinal cancer; digestive surgery
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Aristotelis Perrakis

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Guest Editor

Department of General, Abdominal, Vascular and Transplant Surgery, University Hospital Magdeburg, Magdeburg, Germany
Interests: liver metastasis; liver cancer; colorectal cancer; pancreatic cancer
Special Issues, Collections and Topics in MDPI journals

Dr. Ioannis Konstantinidis

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Guest Editor

Departments of Surgery, Texas Tech University, Surgery 2000B Transmountain Road, El Paso, TX 79911, USA
Interests: surgical oncology; HPB surgery; robotic surgery; HIPEC

Special Issue Information

Dear Colleagues,

In a large subset of patients with advanced and oligometastatic cancer disease, multimodality treatment with surgery and/or locoregional approaches may provide long-term disease control and prolong survival.

Over the last few decades, improved surgical and interventional techniques have unlocked new potential for the locoregional treatment of various tumor entities (gastrointestinal cancer, primary and metastatic liver disease, peritoneal carcinomatosis, gastroenteropancreatic neuroendocrine tumors, breast cancer, sarcoma).

While surgical resection remains the cornerstone of therapy, different locoregional approaches (ablative and embolization techniques, stereotactic body radiotherapy (SBRT), local or intraoperative radiotherapy (IORT), hyperthermic isolated limb perfusion (ILP), hyperthermia, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)) represent promising treatment options and an integral component of the interdisciplinary management of these patients.

Further investigation of various locoregional therapies or even combinations thereof in the ambit of personalized patient selection will provide evidence that could modify the existing therapeutic protocols and improve both quality of life and survival outcomes of oncological patients.

In this Special Issue, we would like to invite original clinical and basic research, meta-analyses, and state-of-the-art reviews related to locoregional treatment options in surgical oncology.

We will be grateful to receive your submissions.

Prof. Dr. Nikolaos Vassos
Prof. Dr. Aristotelis Perrakis
Dr. Ioannis Konstantinidis
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 short 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. Journal of Clinical Medicine 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 2600 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

locoregional treatment
surgical oncology
advanced disease
metastatic disease
ablation
embolization
radiation
hyperthermia
isolated limb perfusion
HIPEC

Published Papers (3 papers)

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Research

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15 pages, 1345 KiB

Open AccessArticle

Surgical Approaches and Oncological Outcomes in the Management of Duodenal Gastrointestinal Stromal Tumors (GIST)

by Nikolaos Vassos, Aristotelis Perrakis, Werner Hohenberger and Roland S. Croner

J. Clin. Med. 2021, 10(19), 4459; https://doi.org/10.3390/jcm10194459 - 28 Sep 2021

Cited by 6 | Viewed by 1802

Abstract

Background: Duodenal gastrointestinal stromal tumors (GIST) are a rare subset of GIST. Their surgical management in this anatomically complex region consists of varied approaches, and the administration of imatinib mesylate (IM) has not been clarified. Methods: We retrospectively reviewed patients with duodenal GIST treated during a 10-year-period. We analysed the clinicopathological characteristics and survival factors and evaluated the perioperative and long-term outcomes based on the extent of resection ((ocal-resection (LR) versus pancreaticoduodenectomy (PD)) and the IM-administration. The median follow-up period was 60 months (range, 12–140). Results: A total of thirteen patients (M:F = 7:6) with median age of 64 years (range, 42–77) underwent resection of duodenal GIST. Median tumor size was 5.2 cm (range, 1.5–13.3). Eight patients (61.5%) underwent LR and five patients (38.5%) PD. R0-resection was achieved in 92.5%. Neoadjuvant IM-therapy was administered in five patients leading to tumor downsizing and in 40% to less-extended resection. The PD group consisted of larger tumors with higher mitotic count, mostly located in D2 (p = 0.031). The PD group had longer operative time (p = 0.026), longer hospital stay (p = 0.016), and higher rate of postoperative complications (p = 0.128). The actuarial 1-, 3-, and 5-year overall survival were 92.5%, 84%, and 73.5%, respectively, whereas the disease-free survival rates at 1, 3, and 5 years were 91.5%, 83%, and 72%, respectively. A tendency towards increased risk of disease recurrence was demonstrated for patients with tumor >5 cm and high-risk potential. There was not statistic survival benefit for one or the other surgical approach. Conclusion: The type of resection depends on duodenal site of origin and tumor size. LR can be the treatment of choice for duodenal GIST whenever technically feasible. Recurrence of duodenal GIST is dependent on tumor biology rather than surgical approach. Administration of IM in neaodjuvant setting should be considered in cases with high-risk GIST scheduled for PD since it might facilitate less-extended resection. Full article

(This article belongs to the Special Issue Locoregional Treatment Options in Surgical Oncology)

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Review

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23 pages, 3901 KiB

Open AccessReview

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

by Chiara Floridi, Michaela Cellina, Giovanni Irmici, Alessandra Bruno, Nicolo’ Rossini, Alessandra Borgheresi, Andrea Agostini, Federico Bruno, Francesco Arrigoni, Antonio Arrichiello, Roberto Candelari, Antonio Barile, Gianpaolo Carrafiello and Andrea Giovagnoni

J. Clin. Med. 2022, 11(14), 4028; https://doi.org/10.3390/jcm11144028 - 12 Jul 2022

Cited by 3 | Viewed by 2478

Abstract

Interventional oncology (IO) procedures have become extremely popular in interventional radiology (IR) and play an essential role in the diagnosis, treatment, and supportive care of oncologic patients through new and safe procedures. IR procedures can be divided into two main groups: vascular and non-vascular. Vascular approaches are mainly based on embolization and concomitant injection of chemotherapeutics directly into the tumor-feeding vessels. Percutaneous approaches are a type of non-vascular procedures and include percutaneous image-guided biopsies and different ablation techniques with radiofrequency, microwaves, cryoablation, and focused ultrasound. The use of these techniques requires precise imaging pretreatment planning and guidance that can be provided through different imaging techniques: ultrasound, computed tomography, cone-beam computed tomography, and magnetic resonance. These imaging modalities can be used alone or in combination, thanks to fusion imaging, to further improve the confidence of the operators and the efficacy and safety of the procedures. This article aims is to provide an overview of the available IO procedures based on clinical imaging guidance to develop a targeted and optimal approach to cancer patients. Full article

(This article belongs to the Special Issue Locoregional Treatment Options in Surgical Oncology)

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18 pages, 3505 KiB

Open AccessReview

Complications Risk Assessment and Imaging Findings of Thermal Ablation Treatment in Liver Cancers: What the Radiologist Should Expect

by Vincenza Granata, Roberta Fusco, Federica De Muzio, Carmen Cutolo, Sergio Venanzio Setola, Igino Simonetti, Federica Dell’Aversana, Francesca Grassi, Federico Bruno, Andrea Belli, Renato Patrone, Vincenzo Pilone, Antonella Petrillo and Francesco Izzo

J. Clin. Med. 2022, 11(10), 2766; https://doi.org/10.3390/jcm11102766 - 13 May 2022

Cited by 8 | Viewed by 2389

Abstract

One of the major fields of application of ablation treatment is liver tumors. With respect to HCC, ablation treatments are considered as upfront treatments in patients with early-stage disease, while in colorectal liver metastases (CLM), they can be employed as an upfront treatment or in association with surgical resection. The main prognostic feature of ablation is the tumor size, since the goal of the treatment is the necrosis of all viable tumor tissue with an adequate tumor-free margin. Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most employed ablation techniques. Ablation therapies in HCC and liver metastases have presented a challenge to radiologists, who need to assess response to determine complication-related treatment. Complications, defined as any unexpected variation from a procedural course, and adverse events, defined as any actual or potential injury related to the treatment, could occur either during the procedure or afterwards. To date, RFA and MWA have shown no statistically significant differences in mortality rates or major or minor complications. To reduce the rate of major complications, patient selection and risk assessment are essential. To determine the right cost-benefit ratio for the ablation method to be used, it is necessary to identify patients at high risk of infections, coagulation disorders and previous abdominal surgery interventions. Based on risk assessment, during the procedure as part of surveillance, the radiologists should pay attention to several complications, such as vascular, biliary, mechanical and infectious. Multiphase CT is an imaging tool chosen in emergency settings. The radiologist should report technical success, treatment efficacy, and complications. The complications should be assessed according to well-defined classification systems, and these complications should be categorized consistently according to severity and time of occurrence. Full article

(This article belongs to the Special Issue Locoregional Treatment Options in Surgical Oncology)

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