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Cancers
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Surgical Oncology for Hepato-Pancreato-Biliary Cancer
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Surgical Oncology for Hepato-Pancreato-Biliary Cancer

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

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1881

Special Issue Editor

Dr. Zaed Z. R. Hamady

E-Mail Website
Guest Editor
1. Human Development & Health, University of Southampton, Southampton SO16 6YD, UK
2. University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
Interests: surgical oncology; early detection of cancer; pancreatic cancer surgery outcome; colorectal liver metastases

Special Issue Information

Dear Colleagues,

In recent years, pancreatic and liver cancer have ranked fifth in terms of cancer prevalence; however, the mortality of this disease is almost of a similar level to its incidence. There have also been many advances in surgical techniques related to the curative treatment of heato-biliar and pancreatic (HPB) cancers. Robotic surgery is just an example of the most recent advances that are likely to present a global shift in HPB cancer surgery in the coming years. Yet, we need a deeper understanding of these advances, and in particular, their effect on both short- and long-term outcomes.

Furthering our understanding of the surgical anatomy of the liver and pancreas, combined with progress in surgical techniques and the accumulation of surgical experience, things have improved dramatically. It is now feasible to use more challenging liver and pancreatic resections with the use of traditional and cutting-edge techniques in the context of multidisciplinary team management.

The objective of this Special Issue is to provide an update in the field of the surgical oncology of primary and metastatic hepatobiliary, as well as pancreatic tumors, and on their future challenges. This issue aims to review outcomes from traditionally used surgical interventions, as well as novel surgical techniques that are emerging in modern clinical practice. We strongly encourage authors to submit high-quality research articles focusing on emerging surgical strategies and innovative multidisciplinary treatment protocols for the management of HPB tumors. Original articles, as well as review articles, communication, and commentary are welcome for submission.

Dr. Zaed Z. R. Hamady
Guest Editor

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
  • liver cancer
  • liver metastases
  • surgical oncology
  • multidisciplinary approach

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Published Papers (3 papers)

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16 pages, 1178 KiB  
Article
Venous Resection During Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma—A Multicentre Propensity Score Matching Analysis of the Recurrence After Whipple’s (RAW) Study
by Ruben Bellotti, Somaiah Aroori, Benno Cardini, Florian Ponholzer, Thomas B. Russell, Peter L. Labib, Stefan Schneeberger, Fabio Ausania, Elizabeth Pando, Keith J. Roberts, Ambareen Kausar, Vasileios K. Mavroeidis, Gabriele Marangoni, Sarah C. Thomasset, Adam E. Frampton, Pavlos Lykoudis, Nassir Alhaboob, Hassaan Bari, Andrew M. Smith, Duncan Spalding, Parthi Srinivasan, Brian R. Davidson, Ricky H. Bhogal, Daniel Croagh, Ismael Dominguez, Rohan Thakkar, Dhanny Gomez, Michael A. Silva, Pierfrancesco Lapolla, Andrea Mingoli, Alberto Porcu, Nehal S. Shah, Zaed Z. R. Hamady, Bilal Al-Sarrieh, Alejandro Serrablo, RAW Study Collaborators and Manuel Maglioneadd Show full author list remove Hide full author list
Cancers 2025, 17(7), 1223; https://doi.org/10.3390/cancers17071223 - 4 Apr 2025
Viewed by 383
Abstract
Background: Pancreatoduodenectomy with venous resection (PDVR) may be performed to achieve tumour clearance in patients with a pancreatic ductal adenocarcinoma (PDAC) with venous involvement. This study aimed to evaluate the impact of PDVR on PDAC outcomes. Methods: In total, 435 PDAC [...] Read more.
Background: Pancreatoduodenectomy with venous resection (PDVR) may be performed to achieve tumour clearance in patients with a pancreatic ductal adenocarcinoma (PDAC) with venous involvement. This study aimed to evaluate the impact of PDVR on PDAC outcomes. Methods: In total, 435 PDAC patients with either R0 status (n = 322) or R1 status within the superior mesenteric vein groove (n = 113) were extracted from the Recurrence After Whipple’s (RAW) study dataset. PDVR patients were matched in a 1:2 ratio with standard PD patients. Comparisons were then made between the two groups (surgical radicality and survival). Results: A total of 81 PDVRs were matched with 162 PDs. Neoadjuvant chemotherapy (5.7% vs. 13.6%, p = 0.032) and R1 resection rates (17.9% vs. 42%, p < 0.001) were higher in the PDVR group. Risk factors for R1 resection included venous resection (p < 0.001 for sleeve and p = 0.034 for segmental resection), pT3 (p = 0.007), and pN1 stage (p = 0.045). PDVR patients had lower median overall survival (OS, 21 vs. 30 months (m), p = 0.023) and disease-free survival (DFS, 17 m vs. 24 m, p = 0.043). Among PDVR patients, R status did not impact on OS (R0: 23 m, R1: 21 m, p = 0.928) or DFS (R0: 18 m, R1: 17 m, p = 0.558). Irrespective of R status, systemic recurrence was higher in the PDVR group (p = 0.034). Conclusions: Independent of R status, the PDVR group had lower overall survival and higher systemic recurrence rates. Full article
(This article belongs to the Special Issue Surgical Oncology for Hepato-Pancreato-Biliary Cancer)
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13 pages, 1465 KiB  
Article
Correlation of GNAS Mutational Status with Oncologic Outcomes in Patients with Resected Intraductal Papillary Mucinous Neoplasms
by Julia Evans, Kylee Shivok, Hui Hsuan Chen, Eliyahu Gorgov, Wilbur B. Bowne, Aditi Jain, Harish Lavu, Charles J. Yeo and Avinoam Nevler
Cancers 2025, 17(4), 705; https://doi.org/10.3390/cancers17040705 - 19 Feb 2025
Viewed by 647
Abstract
Background: Intraductal papillary mucinous neoplasms (IPMNs) are pre-malignant pancreatic lesions that may progress to invasive pancreatic ductal adenocarcinoma (PDAC). IPMN-associated invasive carcinoma (iIPMN) has been associated with more favorable survival outcomes compared to non-iIPMN-derived PDAC. Here, we aim to investigate the genetic landscape [...] Read more.
Background: Intraductal papillary mucinous neoplasms (IPMNs) are pre-malignant pancreatic lesions that may progress to invasive pancreatic ductal adenocarcinoma (PDAC). IPMN-associated invasive carcinoma (iIPMN) has been associated with more favorable survival outcomes compared to non-iIPMN-derived PDAC. Here, we aim to investigate the genetic landscape of IPMNs to assess their relevance to oncologic outcomes. Methods: This retrospective study used a large single-institution prospectively maintained database. Patients who underwent curative-intent pancreatic resection between 2016 and 2022 with histologically confirmed diagnosis of IPMN were included. Demographic, pathologic, molecular, and oncologic outcome data were recorded. Kaplan–Meier survival analyses were performed. PDAC data from public genetic databases were used for mutational correlation analysis. p-value ≤ 0.05 was considered as significant. Results: A total of thirty-nine patients with resected IPMN with complete clinical and sequencing data were identified and included in the final cohort. The male-to-female distribution was 21:18, and the mean age was 70.1 ± 9.1 years. GNAS mutations occurred in 23.1% of patients, and 89.7% of patients had iIPMN. In iIPMN patients, GNAS mutation was strongly associated with improved disease-free survival: all GNAS-mutant patients survived to follow-up with significantly fewer recurrences than in GNAS wild-type (WT) patients (p = 0.013). Mutated GNAS closely co-occurred with wild-type KRAS (p < 0.001), and further analysis of large genomic PDAC datasets validated this finding (OR 3.47, p < 0.0001). Conclusions: Our study suggests prognostic value of mutational status in malignant resected IPMNs. WT GNAS, mutant P53, and mutant KRAS each correlate with recurrence and decreased survival. Further studies are required to validate these preliminary observations. Full article
(This article belongs to the Special Issue Surgical Oncology for Hepato-Pancreato-Biliary Cancer)
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11 pages, 904 KiB  
Systematic Review
Prognostic Significance of Sarcopenia in Patients Undergoing Surgery for Perihilar Cholangiocarcinoma: A Systematic Review and Meta-Analysis
by Anastasia Efstathiou, Pablo Suarez Benitez, Shahin Hajibandeh, Shahab Hajibandeh and Thomas Satyadas
Cancers 2025, 17(5), 837; https://doi.org/10.3390/cancers17050837 - 28 Feb 2025
Viewed by 485
Abstract
Aim: The aim of this study was to determine the impact of sarcopenia on outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma. Methods: A systematic review and meta-analysis following PRISMA standards were conducted, searching for studies comparing patients with and without sarcopenia [...] Read more.
Aim: The aim of this study was to determine the impact of sarcopenia on outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma. Methods: A systematic review and meta-analysis following PRISMA standards were conducted, searching for studies comparing patients with and without sarcopenia undergoing surgery for perihilar cholangiocarcinoma. The outcomes included postoperative mortality, Clavien–Dindo ≥ 3 complications, intraoperative blood loss, need for blood transfusion, length of hospital stay, and overall survival (OS) (time-to-event). The odds ratio (OR), mean difference (MD), and adjusted hazard ratio (HR) were calculated as summary measures using random effect modelling. Risk of bias was assessed with the Quality in Prognosis Studies tool. Results: Five studies featuring 1304 patients were included. There was no significant difference in postoperative mortality (OR 1.85, 95% CI 0.75–4.57, p = 0.18), Clavien–Dindo ≥ 3 complications (OR 1.44, 95% CI 0.92–2.25, p = 0.11), length of hospital stay (MD 2.13 days, 95% CI −0.89–5.15, p = 0.17) or OS (adjusted HR 1.48, 95% CI, 0.97–2.28, p = 0.07) between the patients with and without sarcopenia. Sarcopenia increased intraoperative blood loss (MD 388.00 mL, 95% CI, 114.99–683.01, p = 0.006) and the need for blood transfusion (OR 2.27, 95% CI, 1.66, 3.10, p < 0.00001). Conclusions: Sarcopenia may increase the risk of bleeding during the resection of perihilar cholangiocarcinoma (low certainty); however, this may not translate into a higher risk of postoperative morbidity or mortality (moderate certainty). Our findings regarding the OS may be subject to type 2 error; hence, the effect of sarcopenia on long-term outcomes after the resection of perihilar cholangiocarcinoma remains unknown and requires further research. Full article
(This article belongs to the Special Issue Surgical Oncology for Hepato-Pancreato-Biliary Cancer)
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