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Cancers
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Advances in Surgical and Multimodal Treatments of Hepatopancreatobiliary Cancers
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Advances in Surgical and Multimodal Treatments of Hepatopancreatobiliary Cancers

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

Deadline for manuscript submissions: 31 January 2027 | Viewed by 1905

Special Issue Editors

Dr. Andrea Belli

E-Mail Website
Guest Editor
Istituto Nazionale Tumori IRCCS—Fondazione G Pascale, Via Mariano Semmola, 52, 80131 Napoli, NA, Italy
Interests: minimally invasive surgery; robotic surgery; liver resection; pancreatic resection
Special Issues, Collections and Topics in MDPI journals
Dr. Matteo Serenari

E-Mail Website
Guest Editor
IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Giuseppe Massarenti, 9, 40138 Bologna, BO, Italy
Interests: minimally invasive surgery; robotic surgery; liver resection; pancreatic resection
Prof. Dr. Benedetto Ielpo

E-Mail Website
Guest Editor
Hospital del Mar, Pg. Marítim de la Barceloneta, 25-29, Ciutat Vella, 08003 Barcelona, Spain
Interests: minimally invasive surgery; robotic surgery; liver resection; pancreatic resection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hepatopancreatobiliary (HPB) cancer surgery has witnessed significant advancements in recent years, driven by innovations in surgical techniques, imaging technologies, and multidisciplinary approaches to patient care. HPB cancers, which encompass liver, pancreas, gallbladder, and bile duct malignancies, remain among the most challenging and complex to treat due to their anatomical location, aggressive nature, and late-stage diagnosis. However, less invasive surgical approaches (laparoscopic and robotic), together with multimodal therapeutic strategies, are improving patient outcomes and survival rates.

This Special Issue aims to highlight the latest progress in HPB cancer surgery, from minimally invasive and endoscopic procedures to advances in robotic surgery, preoperative planning, and postoperative care. It also aims to explore the role of personalized treatment strategies, including neoadjuvant therapies and precision medicine, in optimizing surgical results. Contributions from leading experts in the field, focused on the evolving role of modern surgical techniques, imaging modalities, and the integration of new technologies in the management of HPB cancers, are welcome. This Special Issue aims to provide a comprehensive overview of recent advances in the treatment of HPB cancers and to be a useful tool for clinicians and researchers striving to improve patient care and outcomes in this demanding field.

Dr. Andrea Belli
Dr. Matteo Serenari
Prof. Dr. Benedetto Ielpo
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 250 words) can be sent to the Editorial Office for assessment.

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 metastases
  • hepatocellular carcinoma
  • cholangiocarcinoma
  • neuroendocrine tumours
  • intraductal papillary mucinous neoplasms (IPMN)
  • pancreatic cystic tumours
  • robotic surgery
  • laparoscopic surgery
  • 3D reconstruction
  • liver hypertrophy

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Published Papers (2 papers)

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Research

19 pages, 6743 KB  
Article
Endoscopic Ultrasound-Guided Versus Percutaneous Transhepatic Biliary Drainage After Failed Endoscopic Retrograde Cholangiopancreatography in Malignant Biliary Obstruction: A Single-Center Retrospective Cohort
by Wojciech Ciesielski, Łukasz Durko, Ludomir Stefańczyk, Adam Dobek, Anna Bulicz, Amelia Wojnicka, Zuzanna Sosnowska, Agata Grochowska, Janusz Strzelczyk, Piotr Hogendorf, Adam Durczyński and Tomasz Klimczak
Cancers 2026, 18(5), 783; https://doi.org/10.3390/cancers18050783 - 28 Feb 2026
Viewed by 1008
Abstract
Background: After a failed endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary obstruction (MBO), second-line drainage is performed with endoscopic ultrasound-guided biliary drainage (EUS-BD) or percutaneous transhepatic biliary drainage (PTBD). We compared their effectiveness, safety, and short-term survival. Methods: We conducted a single-center retrospective [...] Read more.
Background: After a failed endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary obstruction (MBO), second-line drainage is performed with endoscopic ultrasound-guided biliary drainage (EUS-BD) or percutaneous transhepatic biliary drainage (PTBD). We compared their effectiveness, safety, and short-term survival. Methods: We conducted a single-center retrospective cohort of 101 adults with MBO after they had experienced a failed ERCP (EUS-BD n = 37; PTBD n = 64). Allocation was non-randomized and driven by operational availability. Baseline laboratory tests (complete blood count, platelets, and C-reactive protein) and derived indices (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR], systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], neutrophil-to-platelet score [NPS], and lymphocyte-to-CRP ratio [LCR]) were compared. Outcomes that were a technical success include: an early biochemical response (bilirubin reduction), complications (Clavien–Dindo), length of stay (LOS), and overall survival (OS). Between-group comparisons used the two-sided Mann–Whitney U test (continuous) and Fisher’s exact (binary) test. Survival was assessed by the Kaplan–Meier estimator using log-rank testing. To address later adoption of EUS-BD, we also estimated a restricted mean survival time of 180 days (RMST_0–180) with 95% confidence intervals (CIs). Results: Baseline inflammatory markers and composite indices were similar; baseline total bilirubin was higher in PTBD. The technical success was 100% in both groups. Early biochemical response was 86.5% after EUS-BD vs. 78.1% after PTBD (p = 0.43). Any complication occurred in 29.7% vs. 12.5% (p = 0.04); major complications (Clavien–Dindo ≥ III) occurred in 10.8% vs. 0% (p = 0.02), respectively; and the LOS did not differ (p = 0.21). OS favored EUS-BD (median 143 vs. 54 days and log-rank p = 0.012). RMST_0–180 was 111.1 days for EUS-BD vs. 71.4 days for PTBD (difference + 39.6 days; 95% CI 11.3–65.9). Conclusions: After a failed ERCP for MBO, EUS-BD and PTBD achieved universal technical success and similar early biochemical responses, but EUS-BD was associated with higher complication rates and a significantly longer six-month survival. These findings support the individualized selection balancing procedural risk with the anticipated survival benefit and highlight the need for prospective comparative studies. Full article
(This article belongs to the Special Issue Advances in Surgical and Multimodal Treatments of Hepatopancreatobiliary Cancers)
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15 pages, 546 KB  
Article
Does Minimally Invasive Approach Change Criteria of Allocation to Treatment Strategy in Synchronous Colorectal Metastases? An Italian National Registry-Based Analysis
by Giorgio Traina, Alessandro Ferrero, Felice Giuliante, Andrea Ruzzenente, Giorgio Ercolani, Umberto Cillo, Vincenzo Mazzaferro, Giuseppe Maria Ettorre, Andrea Belli, Elio Jovine, Rebecca Marino, Pierpaolo Sileri and Francesca Ratti
Cancers 2026, 18(3), 479; https://doi.org/10.3390/cancers18030479 - 31 Jan 2026
Viewed by 481
Abstract
Background/Objectives: Heterogeneity in clinical scenarios of colorectal liver metastases (CRLM) leads to the possible application of different surgical strategies. Specifically, the possibility of performing combined colorectal and liver resections for synchronous CRLM has been proposed in specific settings but its feasibility, safety [...] Read more.
Background/Objectives: Heterogeneity in clinical scenarios of colorectal liver metastases (CRLM) leads to the possible application of different surgical strategies. Specifically, the possibility of performing combined colorectal and liver resections for synchronous CRLM has been proposed in specific settings but its feasibility, safety and impact in minimally invasive settings remain underexplored. This study examines a multicenter Italian experience, comparing perioperative outcomes of combined (CR) versus non-combined (NCR) minimally invasive liver resections (MILR) for CRLM. Methods: Patients from the prospective multicenter registry of the Italian Group of Minimally Invasive Liver Surgery (I Go MILS) who underwent MILR for CRLM between 2016 and 2024 were included. Perioperative outcomes were compared between CR and NCR using Nearest Neighbor Matching. Results: In total, 2286 patients were analyzed, including 1879 NCR and 407 CR. CR was associated with less challenging resections (technical difficulty Kawaguchi grade III: 7.13% vs. 14.53%, p < 0.001), longer operative time (385 vs. 270 min, p < 0.001) and higher major complication rate (11.55% vs. 5.11%, p < 0.001) compared to NCR. The conversion rate was similar between the two groups (9.09% vs. 7.91%, p = 0.479). Technical complexity, operative time, conversion, low-volume hospital, and CR was an independent predictor of major complications after matching. Conclusions: CR is associated with a higher risk of postoperative complications, despite being selected for minor liver resections, confirming the impact of associated colorectal surgery in determining the postoperative risk and hence highlighting the concept that accurate preoperative patient selection is a key step in guiding treatment allocation for CRLM. Therefore, MILR does not yet justify broadening indications for combined resection beyond carefully selected patients. Full article
(This article belongs to the Special Issue Advances in Surgical and Multimodal Treatments of Hepatopancreatobiliary Cancers)
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