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Cancers
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Advances in Abdominal Surgical Oncology and Intraperitoneal Therapies
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Advances in Abdominal Surgical Oncology and Intraperitoneal Therapies

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 7454

Special Issue Editors

Dr. Juan Jose Segura-Sampedro

E-Mail Website
Guest Editor
General and Digestive Surgery Service, Hospital Universitario La Paz, IdiPAZ, CIBERehd, 28046 Madrid, Spain
Interests: peritoneal carcinomatosis; HIPEC; EPIC; PIPAC; intraperitoneal chemotherapy; hyperthermia; peritoneal metastases; cytoreductive surgery; Sugarbaker’s procedure
Special Issues, Collections and Topics in MDPI journals
Dr. Constantino Fondevila

E-Mail Website
Guest Editor
1. General and Digestive Surgery Service, Hospital Universitario La Paz, IdiPAZ, CIBERehd, 28046 Madrid, Spain
2. School of Medicine, Universidad Autónoma de Madrid, 28049 Madrid, Spain
Interests: damage; inflammation; organ failure and transplantation; surgical oncology; innovation and technology in surgery; value-based healthcare

Special Issue Information

Dear Colleagues,

In recent decades, abdominal oncologic surgery has undergone remarkable advancements, reshaping the landscape of cancer management in this vital anatomical region.

The advent of minimally invasive techniques, such as laparoscopy and robotics, has heralded a new era in the treatment of abdominal cancer. These approaches not only mitigate surgical trauma but also abbreviate recovery periods, fostering improved postoperative quality of life for patients.

Moreover, the integration of cutting-edge technologies such as fluorescence, artificial intelligence, and augmented vision has propelled the field forward, enhancing the precision and efficacy of abdominal oncologic procedures. These innovations facilitate superior tumor visualization, refined surgical planning, and heightened accuracy during execution, thereby revolutionizing the practice of surgical oncology.

Furthermore, the once dire prognosis associated with peritoneal carcinomatosis has been transformed, as contemporary strategies now offer avenues for prevention and curative treatment. Despite promising advances in intraperitoneal chemotherapy, the absence of standardized treatments underscores the imperative for additional evidence to refine protocols and optimize patient selection.

In this Special Issue, we delve into the forefront of abdominal oncologic surgery, exploring the latest developments, challenges, and opportunities shaping the future of cancer care in this critical domain. Original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Current and new cytostatic agents;
  • Indications and new trends in PIPAC;
  • Diagnosis and selection of patients for oncologic surgery;
  • Cytoreductive surgery and HIPEC;
  • Liver transplantation for cancer;
  • Liver metastasis;
  • Pancreatic cancer;
  • Colorectal cancer;
  • Ovarian cancer;
  • Robotic surgery in abdominal cancer;
  • Role of liquid biopsy in abdominal surgery;
  • Cryoablation’s utility in inducing immune activation and immunotherapy response;
  • Evaluation of the diagnostic and therapeutic roles of new immune checkpoints in abdominal cancer;
  • Development of 3D organoids in abdominal surgery.

We look forward to receiving your contributions.

Dr. Juan Jose Segura-Sampedro
Dr. Constantino Fondevila
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

  • abdominal oncologic surgery
  • minimally invasive techniques
  • laparoscopy
  • robotics
  • fluorescence
  • artificial intelligence
  • augmented vision
  • peritoneal carcinomatosis
  • intraperitoneal chemotherapy
  • liquid biopsy

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Related Special Issue

Published Papers (5 papers)

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Research

16 pages, 879 KB  
Article
SCODA: A Low-Cost Prehabilitation Strategy to Improve Outcomes After Cytoreductive Surgery in a Low-Resource Setting
by Amine Souadka, Lina Alami, Zakaria Elmouatassim, Oumayma Lahnaoui, Yassine El Bouazizi, Sabrillah Echiguer, Oussama Ssouni, Ayman El Fassi, Abdelilah Ghannam, Zakaria Houssain Belkhadir and Brahim El Ahmadi
Cancers 2025, 17(22), 3687; https://doi.org/10.3390/cancers17223687 - 18 Nov 2025
Viewed by 382
Abstract
Background: Cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) remains the standard of care for peritoneal surface malignancies but carries significant postoperative risks. In low- and middle-income countries (LMICs), the challenge is magnified by limited access to high-cost enhanced recovery [...] Read more.
Background: Cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) remains the standard of care for peritoneal surface malignancies but carries significant postoperative risks. In low- and middle-income countries (LMICs), the challenge is magnified by limited access to high-cost enhanced recovery programs. The SCODA (Surgical Complication Optimization through Diet and Activity) program was developed as a low-cost prehabilitation intervention to improve outcomes in resource-constrained settings. Methods: This retrospective cohort study included 169 patients undergoing CRS ± HIPEC at a single academic center in Morocco between 2015 and 2023. Patients treated before SCODA implementation (pre-SCODA group, n = 83) were compared to those enrolled in the SCODA program (SCODA group, n = 86). SCODA included oral iron supplementation, a protein-rich food-based diet, and progressive walking sessions over 90 days. Perioperative outcomes, including pulmonary complications, major morbidity (Clavien–Dindo ≥ 3b), transfusions, ICU stay >3 days, and 90-day mortality, were analyzed using univariate and multivariate logistic regression models. Results: The SCODA group had significantly fewer pulmonary complications (2% vs. 13%, p = 0.008), reduced major morbidity (9% vs. 21%, p = 0.031), fewer transfusions (8% vs. 20%, p = 0.024), and shorter ICU stays (median 1.5 vs. 5 days, p < 0.001). Ninety-day mortality was also lower in the SCODA group (5.8% vs. 12.4%, p = 0.046). SCODA participation remained an independent protective factor in multivariate analyses for all endpoints except major complications. Conclusions: The SCODA program is a feasible and effective prehabilitation strategy for improving surgical outcomes after CRS/HIPEC in LMICs. Its low-cost, food-based, and activity-centered design may support broader implementation in resource-limited environments and inform future perioperative care policies in oncology. Full article
(This article belongs to the Special Issue Advances in Abdominal Surgical Oncology and Intraperitoneal Therapies)
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9 pages, 397 KB  
Article
Challenges of Nontherapeutic Laparotomy in Patients with Peritoneal Surface Malignancies Selected for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
by Elena Gil-Gómez, Alida González-Gil, Vicente Olivares-Ripoll, Álvaro Cerezuela-Fernández de Palencia, Francisco López-Hernández, Álvaro Martínez-Espí, Jerónimo Martínez-García, Francisco Barceló, Alberto Rafael Guijarro-Campillo and Pedro Antonio Cascales-Campos
Cancers 2025, 17(9), 1445; https://doi.org/10.3390/cancers17091445 - 25 Apr 2025
Viewed by 811
Abstract
Background: This study aimed to analyze the morbidity, mortality, and survival outcomes in patients with peritoneal surface malignancies who were initially considered candidates for cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) but were found to have unresectable disease, resulting in nontherapeutic exploratory [...] Read more.
Background: This study aimed to analyze the morbidity, mortality, and survival outcomes in patients with peritoneal surface malignancies who were initially considered candidates for cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) but were found to have unresectable disease, resulting in nontherapeutic exploratory laparotomy. Patients and Methods: We evaluated data from our referral center for the treatment of peritoneal surface malignancies between January 2008 and December 2022. Adverse events following nontherapeutic laparotomy were classified using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results: Among a cohort of 486 patients with peritoneal surface malignancies initially considered candidates for CRS + HIPEC, 46 cases (9.4%) were aborted due to the disease being deemed unresectable during exploratory laparotomy. The primary reasons for unresectability included extensive disease spread, observed in 28 patients, with massive small intestine involvement detected in 13 of these cases. The median duration of surgery was 90 min (range: 60–180 min). Postoperative complications occurred in 10 patients (22%), with a mortality rate of 4.3% (2 patients). Survival was significantly lower in patients who did not receive adjuvant systemic chemotherapy with palliative intent (4 months vs. 15 months, p < 0.01). Conclusions: Exploratory laparotomy in patients with peritoneal surface malignancies considered for CRS with HIPEC carries a substantial risk of complications. Improved preoperative staging using advanced technologies such as radiomics and laparoscopy is expected to reduce the number of patients undergoing nontherapeutic laparotomy. Full article
(This article belongs to the Special Issue Advances in Abdominal Surgical Oncology and Intraperitoneal Therapies)
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11 pages, 1543 KB  
Article
Breaking Myths: Comparable Outcomes in Lymph Node Analysis Across Surgical Methods
by Salvatore Pezzino, Tonia Luca, Mariacarla Castorina, Giulia Fuccio Sanzà, Gaetano Magro, Stefano Puleo, Ornella Coco and Sergio Castorina
Cancers 2025, 17(8), 1312; https://doi.org/10.3390/cancers17081312 - 14 Apr 2025
Viewed by 732
Abstract
Background/Objectives: Colorectal cancer is the third most common cancer worldwide, making lymph node recovery critical for treatment decisions and prognosis. The relationship between body mass index (BMI) and the number of lymph nodes retrieved during laparoscopic and open surgeries remains controversial. This study [...] Read more.
Background/Objectives: Colorectal cancer is the third most common cancer worldwide, making lymph node recovery critical for treatment decisions and prognosis. The relationship between body mass index (BMI) and the number of lymph nodes retrieved during laparoscopic and open surgeries remains controversial. This study aimed to evaluate whether surgical approach and BMI influence lymph node retrieval in colon cancer surgeries. Methods: A retrospective analysis was conducted on 560 patients who underwent colon cancer surgery at a single institution between 2018 and 2023. The average number of lymph nodes retrieved during laparoscopic and open procedures was compared. Distribution analysis using violin plots was performed to assess the pattern of lymph node yield between surgical approaches. Additionally, the impact of BMI on lymph node recovery was assessed. All surgeries were performed by a standardized surgical team using consistent fat clearance techniques. Results: The mean number of lymph nodes retrieved was 15.89 ± 0.84 for laparoscopic surgeries and 15.98 ± 0.50 for open surgeries, with no statistically significant difference (p = 0.9166). The violin plot analysis confirmed overlapping distributions between the two surgical approaches, with no significant difference (p = 0.6270). BMI also showed no significant effect on the number of lymph nodes removed during surgery. The consistency in outcomes was attributed to standardized surgical practices across all cases. Conclusions: Laparoscopic and open surgical approaches yield comparable lymph node recovery in colon cancer surgeries, both in terms of mean values and overall distribution patterns, regardless of patient BMI. These findings emphasize the importance of standardized surgical techniques in ensuring reliable outcomes and suggest that both approaches are equally effective in meeting oncological standards for lymph node retrieval. Full article
(This article belongs to the Special Issue Advances in Abdominal Surgical Oncology and Intraperitoneal Therapies)
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11 pages, 520 KB  
Article
Usefulness of Serum Biomarkers in Predicting Anastomotic Leakage After Gastrectomy
by Diego Ramos, Enrique Gallego-Colón, Javier Mínguez, Ignacio Bodega, Pablo Priego and Francisca García-Moreno
Cancers 2025, 17(1), 125; https://doi.org/10.3390/cancers17010125 - 3 Jan 2025
Cited by 2 | Viewed by 1622
Abstract
Background/Objectives: Anastomotic leakage (AL) is one of the most concerning complications following gastrectomy. The aim of this study was to assess and compare the predictive accuracy of C-reactive protein (CRP), procalcitonin (PCT), the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), fibrinogen, and the [...] Read more.
Background/Objectives: Anastomotic leakage (AL) is one of the most concerning complications following gastrectomy. The aim of this study was to assess and compare the predictive accuracy of C-reactive protein (CRP), procalcitonin (PCT), the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), fibrinogen, and the mean platelet volume (MPV) in the early diagnosis of post-gastrectomy AL. Methods: A prospective bicentric observational study was conducted including all patients undergoing elective gastrectomy between August 2018 and December 2022. The performance of the selected biomarkers in predicting the existence of AL within the first 7 postoperative days (PODs) was assessed. Results: A total of 107 patients were included for analysis. The incidence of AL was 20.56%, and the median day of diagnosis was on POD5 (interquartile range 4–6). CRP, PCT, the NLR, the PLR, and fibrinogen showed significant associations with the presence of AL (from POD2 for CRP and fibrinogen and from POD3 for PCT, NLR, and PLR). CRP demonstrated a superior predictive accuracy on POD4, with a threshold value of 181.4 mg/L (NPV 99%; AUC 0.87, p < 0.001); PCT demonstrated a superior predictive accuracy on POD7, with a threshold value of 0.13 μg/L (NPV 98%; AUC 0.84, p < 0.001); the NLR showed a superior predictive accuracy on POD6, with a threshold ratio of 6.77 (NPV 95%; AUC 0.86, p < 0.001); the PLR achieved a superior predictive accuracy on POD7, with a ratio of 234 (NPV 98%; AUC 0.71; p = 0.002); and fibrinogen demonstrated a superior predictive accuracy on POD5, with a threshold of 7.344 g/L (NPV 98%; AUC 0.74; p = 0.003). In the comparison of predictive accuracy, CPR, PCT, and the NLR were found to be superior to all other biomarkers. Conclusions: CRP, PCT, and the NLR are biomarkers with a sufficient predictive ability to clinically discard the presence of AL within the first postoperative week. Full article
(This article belongs to the Special Issue Advances in Abdominal Surgical Oncology and Intraperitoneal Therapies)
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24 pages, 10892 KB  
Article
Pancreatectomy with En Bloc Superior Mesenteric Vein and All Its Tributaries Resection without PV/SMV Reconstruction for “Low” Locally Advanced Pancreatic Head Cancer
by Viacheslav Egorov, Pavel Kim, Soslan Dzigasov, Eugeny Kondratiev, Alexander Sorokin, Alexey Kolygin, Mikhail Vyborniy, Grigoriy Bolshakov, Pavel Popov, Anna Demchenkova and Tatiana Dakhtler
Cancers 2024, 16(12), 2234; https://doi.org/10.3390/cancers16122234 - 15 Jun 2024
Cited by 2 | Viewed by 2982
Abstract
The “vein definition” for locally advanced pancreatic ductal adenocarcinoma (LA PDAC) assumes portal-to-superior mesenteric vein (PV/SMV) unreconstructability due to tumor involvement or occlusion. Radical pancreatectomies with SMV resection without PV/SMV reconstruction are scarcely discussed in the literature. Retrospective analysis of 19 radical pancreatectomies [...] Read more.
The “vein definition” for locally advanced pancreatic ductal adenocarcinoma (LA PDAC) assumes portal-to-superior mesenteric vein (PV/SMV) unreconstructability due to tumor involvement or occlusion. Radical pancreatectomies with SMV resection without PV/SMV reconstruction are scarcely discussed in the literature. Retrospective analysis of 19 radical pancreatectomies for “low” LA PDAC with SMV and all its tributaries resection without PV/SMV reconstruction has shown zero mortality; overall morbidity—56%; Dindo–Clavien—3–10.5%; R0—rate—82%; mean operative procedure time—355 ± 154 min; mean blood loss—330 ± 170 mL; delayed gastric emptying—25%; and clinically relevant postoperative pancreatic fistula—8%. In three cases, surgery was associated with superior mesenteric (n2) and common hepatic artery (n1) resection. Surgery was completed without vein reconstruction (n13) and with inferior mesenteric-to-splenic anastomosis (n6). There were no cases of liver, gastric, or intestinal ischemia. A specific complication of the SMV resection without reconstruction was 2–3 days-long intestinal edema (48%). Median overall survival was 25 months, and median progression-free survival was 18 months. All the relapses, except two, were distant. The possibility of successful SMV resection without PV/SMV reconstruction can be predicted before surgery by CT-based reconstructions. The mandatory anatomical conditions for the procedure were as follows: (1) preserved SMV-SV confluence; (2) occluded SMV for any reason (tumor or thrombus); (3) well-developed inferior mesenteric vein collaterals with dilated intestinal veins; (4) no right-sided vein collaterals; and (5) no varices in the upper abdomen. Conclusion: “Low” LA PDACs involving SMV with all its tributaries can be radically and safely resected in highly and specifically selected cases without PV/SMV reconstruction with an acceptable survival rate. Full article
(This article belongs to the Special Issue Advances in Abdominal Surgical Oncology and Intraperitoneal Therapies)
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