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Cancers
Special Issues
Endoscopic Management of Pancreatic Neoplasms
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Endoscopic Management of Pancreatic Neoplasms

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (1 August 2024) | Viewed by 6464

Special Issue Editors

Dr. Nam Quoc Nguyen

E-Mail Website
Guest Editor
1. Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia
2. School Medicine, The University of Adelaide, Adelaide, SA 5005, Australia
Interests: pancreatic cancer; endoscopic ultrasound; personalized medicine; fine needle aspiration; organoids; radiation therapy; fiducial guided therapy; intra-tumoural radioactive implantation; cholangioscopy; pancreatoscopy
Special Issues, Collections and Topics in MDPI journals
Dr. Takuji Iwashita

E-Mail Website
Guest Editor
First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan
Interests: pancreatic cancer; pancreatic neoplasm; endoscopic retrograde cholangiopancreatography; endoscopic ultrasound; fine needle aspiration/biopsy; local treatment; biliary stent; biliary drainage; contrast-enhanced

Special Issue Information

Dear Colleagues,

The prevalence and incidence of pancreatic cancer are increasing, with it on track to soon become the second most frequent cause of cancer death in the world. Unfortunately, only 15% to 20% of pancreatic cancers at diagnosis are suitable for surgery and potential cure. Thus, the management of over 80% of patients with pancreatic cancer relies on chemo-radiotherapy, endoscopic treatment, and palliative care.

In the management of pancreatic cancer, the role of endoscopes is expanding from diagnosis to treatment. For example, endoscopic biliary stenting is still a major topic of discussion in malignant biliary obstruction during pancreatic cancer, since recurrent biliary obstruction or stent-related adverse events could create obstacles in the clinical course. Here, several new approaches for the management of biliary obstruction (e.g., new stents or EUS-guided biliary drainage) are presented.

This Special Issue aims to present up-to-date and recent advances that have been made in the field of endoscopy for pancreatic cancer or neoplasms.  More specifically, this Special Issue will cover the following topics:

  • Endoscopic ultrasound (EUS) and related techniques in the diagnosis of pancreatic cancer;
  • The role of EUS-guided tissue acquisition in the characterization of tumour behaviour and guiding therapy, including biomarker and genomic analyses, as well as creating organoids and xenografts for drug testing;
  • EUS-guided radiation therapy, including intra-tumoural radioactive implantation;
  • Endoscopic alleviation of biliary and duodenal obstruction due to pancreatic cancer;
  • Endoscopic therapy for pancreatic cystic neoplasms;
  • The role of EUS-guided techniques to further characterize pancreatic cystic neoplasms;
  • Endoscopic therapy for pancreatic neuroendocrine tumours;
  • Future endoscopic treatment of pancreatic cancer.

In this Special Issue, we aims to collect evidence of the efficacy and safety of endoscopic procedures, such as cutting-edge approaches, large-scale comparisons, and review articles of specific topics in the management of pancreatic cancer.

We believe that the content of this Special Issue will not only consolidate our current knowledge in the field but will also stimulate further innovation and research in endoscopic techniques to deliver targeted therapy. In combination with the advances in systemic chemotherapy, such improvements in endoscopic therapies for pancreatic cancer will result in better outcomes.

Dr. Nam Quoc Nguyen
Dr. Takuji Iwashita
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 cancer
  • pancreatic neoplasm
  • endoscopic retrograde cholangiopancreatography
  • endoscopic ultrasound
  • fine needle aspiration/biopsy
  • local treatment
  • biliary stent
  • biliary drainage
  • contrast-enhanced

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Published Papers (3 papers)

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Research

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14 pages, 2189 KiB  
Article
The Impact of Combined Chemotherapy and Intra-Tumoural Injection of Phosphorus-32 Microparticles on Vascularity in Locally Advanced Pancreatic Carcinoma
by Amanda Huoy Wen Lim, Joshua Zobel, Madison Bills, William Hsieh, Benjamin Crouch, Rohit Joshi, John-Edwin Thomson, EuLing Neo, Li Lian Kuan, Romina Safaeian, Edmund Tse, Christopher K. Rayner, Andrew Ruszkiewicz, Nimit Singhal, Dylan Bartholomeusz and Nam Quoc Nguyen
Cancers 2024, 16(19), 3412; https://doi.org/10.3390/cancers16193412 - 8 Oct 2024
Cited by 1 | Viewed by 1332
Abstract
Background: Poor intra-tumoural vascularity contributes to a lack of response to chemotherapy in pancreatic cancers. Preliminary data suggest that the addition of endoscopic ultrasound (EUS)-guided intra-tumoural injection of phosphorus-32 (32P) microparticles to standard chemotherapy is potentially beneficial in locally advanced pancreatic [...] Read more.
Background: Poor intra-tumoural vascularity contributes to a lack of response to chemotherapy in pancreatic cancers. Preliminary data suggest that the addition of endoscopic ultrasound (EUS)-guided intra-tumoural injection of phosphorus-32 (32P) microparticles to standard chemotherapy is potentially beneficial in locally advanced pancreatic cancer (LAPC). We aimed to assess changes in pancreatic tumour vascularity following 32P implantation, using contrast-enhanced EUS (CE-EUS). Methods: This was a prospective single-centre trial from January 2022 to 2024 of patients with unresectable, non-metastatic LAPC undergoing standard FOLFIRINOX chemotherapy and 32P implantation. We performed CE-EUS pre-implantation after two chemotherapy cycles and 4 and 12 weeks after implantation. Time–intensity curves were analysed for 90 s after IV contrast bolus to ascertain peak intensity and intensity gain. Results: A total of 20 patients underwent 32P implantation, with 15 completing 12-week follow-up. The technical success of 32P implantation was 100%. The median primary tumour size reduced from 32 mm (IQR 27.5–38.75) pre-implantation to 24 mm (IQR 16–26) 12 weeks post-implantation (p < 0.001). Five patients (25%) had tumour downstaging, and four underwent resections. The baseline (pre-implantation, post-chemotherapy) median intensity gain of contrast enhancement within the tumour was 32.15 (IQR 18.08–54.35). This increased to 46.85 (IQR 35.05–76.6; p = 0.007) and 66.3 (IQR 54.7–76.3; p = 0.001) at 4 weeks and 12 weeks post-implantation, respectively. Over a median follow-up of 11.2 months (IQR 7.8–12.8), 15/20 (75%) of patients remained alive, with 3/20 (15%) demonstrating local disease progression. Overall survival was not significantly different between patients with or without an increased intensity of 10 a.u. or more at 12 weeks post-implantation. Conclusion: This is the first clinical study to demonstrate treatment-induced increased vascularity within pancreatic primary tumours, which followed 32P implantation and FOLFIRINOX chemotherapy. Larger comparative trials are warranted. Full article
(This article belongs to the Special Issue Endoscopic Management of Pancreatic Neoplasms)
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Review

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20 pages, 1094 KiB  
Review
Role of Endoscopic Ultrasound-Guided Radiofrequency Ablation in Pancreatic Lesions: Where Are We Now and What Does the Future Hold?
by Radhika Chavan, Nirav Thosani and Shivangi Kothari
Cancers 2024, 16(21), 3662; https://doi.org/10.3390/cancers16213662 - 30 Oct 2024
Cited by 1 | Viewed by 2640
Abstract
Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has emerged as an effective and minimally invasive treatment for pancreatic lesions, particularly in patients at high surgical risk. Utilizing thermal energy, RFA induces the coagulative necrosis of the tissue and potentially triggers immunomodulation by releasing intracellular antigens. [...] Read more.
Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has emerged as an effective and minimally invasive treatment for pancreatic lesions, particularly in patients at high surgical risk. Utilizing thermal energy, RFA induces the coagulative necrosis of the tissue and potentially triggers immunomodulation by releasing intracellular antigens. Numerous studies have confirmed the technical feasibility, safety, and efficacy of EUS-RFA in pancreatic neuroendocrine tumors and premalignant cystic lesions, with an acceptable profile of adverse events. The technique’s potential immunomodulatory effects offer intriguing implications for the treatment of advanced pancreatic malignancies, encouraging further evaluation. This review paper aims to highlight the EUS-RFA principles, technology, and clinical applications in various pancreatic lesions and safety, and the future research directions. Full article
(This article belongs to the Special Issue Endoscopic Management of Pancreatic Neoplasms)
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18 pages, 311 KiB  
Review
Endoscopic Ultrasound-Guided Locoregional Treatments for Solid Pancreatic Neoplasms
by Luca Di Gialleonardo, Giulia Tripodi, Gianenrico Rizzatti, Maria Elena Ainora, Cristiano Spada, Alberto Larghi, Antonio Gasbarrini and Maria Assunta Zocco
Cancers 2023, 15(19), 4718; https://doi.org/10.3390/cancers15194718 - 25 Sep 2023
Cited by 3 | Viewed by 1812
Abstract
Solid pancreatic neoplasms are one of the most diagnosed gastrointestinal malignancies thanks to the current and progressive advances in radiologic methods. Endoscopic ultrasound-guided techniques have over time gained a prominent role in the differential diagnosis and characterization of these pancreatic lesions, including pancreatic [...] Read more.
Solid pancreatic neoplasms are one of the most diagnosed gastrointestinal malignancies thanks to the current and progressive advances in radiologic methods. Endoscopic ultrasound-guided techniques have over time gained a prominent role in the differential diagnosis and characterization of these pancreatic lesions, including pancreatic cancer, neuroendocrine tumors, and metastases. Recently, several endoscopic ultrasound-guided locoregional treatment techniques, which are divided into thermal ablative techniques and non-thermal injection techniques, have been developed and applied in different settings for the treatment of solid pancreatic neoplasms. The most common ablative techniques are radiofrequency, microwave, laser, photodynamic therapy and hybrid techniques such as hybrid cryothermal ablation. The most common injection techniques are ethanol injection, immunotherapy and brachytherapy. In this review, we update evidence about the efficacy and safety of endoscopic ultrasound-guided locoregional treatments for solid pancreatic neoplasms. Full article
(This article belongs to the Special Issue Endoscopic Management of Pancreatic Neoplasms)
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