Management of Pancreatic Cancer: Prediction and Prognostic Factors

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 7858

Special Issue Editors


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Guest Editor
Department of General Surgery, University Campus-Biomedico di Roma, Via Alvaro del Portillo 200, 00128 Rome, Italy
Interests: pancreatic ductal adenocarcinoma; pancreatic cancer; surgery; colon cancer

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Guest Editor
Associate Professor of Surgery, Head of the Laparoscopic and Mini-Invasive Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Università Campus Bio-Medico di Roma, Rome, Italy
Interests: pancreatic cancer; pancreatic surgery; hepatobiliary disease; liver surgery; mini invasive surgery, surgical oncology
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Special Issue Information

Dear Colleagues,

Pancreatic cancer is a leading cause of cancer-related deaths with an incidence that is forecast to increase in the near future. Regrettably, despite recent advances in its diagnostic and therapeutic management, prognosis remains poor. The aggressive behavior of the disease, the lack of cheap and user-friendly tools for early detection, and the high rates of postoperative morbidity and mortality together with the high radio-chemo resistances of the tumor are the leading factors responsible for the dismal prognosis. Over the last decade, a large number of different biomarkers have been identified; many have proved their efficacy, alone or in combination with Ca 19.9, in detecting PDAC; unfortunately, almost all of them failed to become reproducible in routine practice since they result from complex, expensive, and laborious technology. Nevertheless, in the field of cancer treatment, even the more recent strategies such as immunotherapy have failed due to the pancreatic cancer microenvironment.

You are kindly invited to share your knowledge, purposes, and recent advances in the management of pancreatic cancer in this Special Issue of Cancers.

Prof. Dr. Roberto Coppola
Prof. Dr. Damiano Caputo
Guest Editors

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Keywords

  • pancreatic cancer
  • biomarkers
  • prognostic factors
  • predictive
  • radiotherapy
  • immunotherapy
  • chemotherapy
  • interventional radiology
  • endoscopy
  • early detection

Published Papers (4 papers)

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11 pages, 986 KiB  
Article
Kras Gene Analysis Using Liquid-Based Cytology Specimens Predicts Therapeutic Responses and Prognosis in Patients with Pancreatic Cancer
by Masahiro Itonaga, Reiko Ashida, Shin-Ichi Murata, Yasunobu Yamashita, Keiichi Hatamaru, Takashi Tamura, Yuki Kawaji, Yuudai Kayama, Tomoya Emori, Manabu Kawai, Hiroki Yamaue, Ibu Matsuzaki, Hirokazu Nagai, Yuichi Kinoshita, Ke Wan, Toshio Shimokawa and Masayuki Kitano
Cancers 2022, 14(3), 551; https://doi.org/10.3390/cancers14030551 - 22 Jan 2022
Cited by 6 | Viewed by 1859
Abstract
Background: Although several molecular analyses have shown that the Kras gene status is related to long-term survival of patients with pancreatic ductal adenocarcinoma (PDAC), the results remain controversial. Here, we examined the Kras gene status in a cohort of unresectable PDAC patients who [...] Read more.
Background: Although several molecular analyses have shown that the Kras gene status is related to long-term survival of patients with pancreatic ductal adenocarcinoma (PDAC), the results remain controversial. Here, we examined the Kras gene status in a cohort of unresectable PDAC patients who underwent first-line therapy with gemcitabine and nab-paclitaxel (GA) and assessed differences in chemotherapy responses and survival. Methods: Patients with a histological diagnosis of PDAC (based on EUS-guided fine-needle aspiration) from 2017 to 2019 were enrolled. Tumor genomic DNA was extracted from residual liquid-based cytology specimens and Kras mutations were assessed using the quenching probe method. The relationships between the Kras status and progression-free survival (PFS) and overall survival (OS) were assessed. Results: Of the 110 patients analyzed, 15 had wild-type Kras. Those with the wild-type gene showed significantly longer PFS and OS than those with mutant Kras (6.9/5.3 months (p = 0.044) vs. 19.9/11.8 months (p = 0.037), respectively). Multivariate analyses identified wild-type Kras as a significant independent factor associated with longer PFS and OS (HR = 0.53 (p = 0.045) and HR = 0.35 (p = 0.007), respectively). Conclusions: The analysis of the Kras gene status could be used to predict therapeutic responses to GA and prognosis in unresectable PDAC patients. Full article
(This article belongs to the Special Issue Management of Pancreatic Cancer: Prediction and Prognostic Factors)
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13 pages, 2761 KiB  
Article
Detection of Pancreatic Ductal Adenocarcinoma by Ex Vivo Magnetic Levitation of Plasma Protein-Coated Nanoparticles
by Luca Digiacomo, Erica Quagliarini, Vincenzo La Vaccara, Alessandro Coppola, Roberto Coppola, Damiano Caputo, Heinz Amenitsch, Barbara Sartori, Giulio Caracciolo and Daniela Pozzi
Cancers 2021, 13(20), 5155; https://doi.org/10.3390/cancers13205155 - 14 Oct 2021
Cited by 10 | Viewed by 1912
Abstract
Pancreatic Ductal Adeno Carcinoma (PDAC) is one of the most lethal malignancies worldwide, and the development of sensitive and specific technologies for its early diagnosis is vital to reduce morbidity and mortality rates. In this proof-of-concept study, we demonstrate the diagnostic ability of [...] Read more.
Pancreatic Ductal Adeno Carcinoma (PDAC) is one of the most lethal malignancies worldwide, and the development of sensitive and specific technologies for its early diagnosis is vital to reduce morbidity and mortality rates. In this proof-of-concept study, we demonstrate the diagnostic ability of magnetic levitation (MagLev) to detect PDAC by using levitation of graphene oxide (GO) nanoparticles (NPs) decorated by a biomolecular corona of human plasma proteins collected from PDAC and non-oncological patients (NOP). Levitation profiles of corona-coated GO NPs injected in a MagLev device filled with a paramagnetic solution of dysprosium(III) nitrate hydrate in water enables to distinguish PDAC patients from NOP with 80% specificity, 100% sensitivity, and global classification accuracy of 90%. Our findings indicate that Maglev could be a robust and instrumental tool for the early detection of PDAC and other cancers. Full article
(This article belongs to the Special Issue Management of Pancreatic Cancer: Prediction and Prognostic Factors)
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13 pages, 1777 KiB  
Article
The Role of Pathological Method and Clearance Definition for the Evaluation of Margin Status after Pancreatoduodenectomy for Periampullary Cancer. Results of a Multicenter Prospective Randomized Trial
by Gennaro Nappo, Domenico Borzomati, Alessandro Zerbi, Paola Spaggiari, Ugo Boggi, Daniela Campani, Sławomir Mrowiec, Łukasz Liszka, Alessandro Coppola, Michela Amato, Tommasangelo Petitti, Fabio Vistoli, Marco Montorsi, Giuseppe Perrone, Roberto Coppola and Damiano Caputo
Cancers 2021, 13(9), 2097; https://doi.org/10.3390/cancers13092097 - 26 Apr 2021
Cited by 6 | Viewed by 1658
Abstract
Background: There is extreme heterogeneity in the available literature on the determination of R1 resection rate after pancreatoduodenectomy (PD); consequently, its prognostic role is still debated. The aims of this multicenter randomized study were to evaluate the effect of sampling and clearance definition [...] Read more.
Background: There is extreme heterogeneity in the available literature on the determination of R1 resection rate after pancreatoduodenectomy (PD); consequently, its prognostic role is still debated. The aims of this multicenter randomized study were to evaluate the effect of sampling and clearance definition in determining R1 rate after PD for periampullary cancer and to assess the prognostic role of R1 resection. Methods: PD specimens were randomized to Leeds Pathology Protocol (LEEPP) (group A) or the conventional method adopted before the study (group B). R1 rate was determined by adopting 0- and 1-mm clearance; the association between R1, local recurrence (LR) and overall survival (OS) was also evaluated. Results. One-hundred-sixty-eight PD specimens were included. With 0 mm clearance, R1 rate was 26.2% and 20.2% for groups A and B, respectively; with 1 mm, R1 rate was 60.7% and 57.1%, respectively (p > 0.05). Only in group A was R1 found to be a significant prognostic factor: at 0 mm, median OS was 36 and 20 months for R0 and R1, respectively, while at 1 mm, median OS was not reached and 30 months. At multivariate analysis, R1 resection was found to be a significant prognostic factor independent of clearance definition only in the case of the adoption of LEEPP. Conclusions. The 1 mm clearance is the most effective factor in determining the R1 rate after PD. However, the pathological method is crucial to accurately evaluate its prognostic role: only R1 resections obtained with the adoption of LEEPP seem to significantly affect prognosis. Full article
(This article belongs to the Special Issue Management of Pancreatic Cancer: Prediction and Prognostic Factors)
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14 pages, 1684 KiB  
Systematic Review
Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
by Andrea Grego, Alberto Friziero, Simone Serafini, Amanda Belluzzi, Lucia Moletta, Luca Maria Saadeh and Cosimo Sperti
Cancers 2021, 13(22), 5803; https://doi.org/10.3390/cancers13225803 - 19 Nov 2021
Cited by 11 | Viewed by 1860
Abstract
Background: The impact of postoperative pancreatic fistula (POPF) on survival after resection for pancreatic ductal adenocarcinoma (PDAC) remains unclear. Methods: The MEDLINE, Scopus, Embase, Web of Science, and Cochrane Library databases were searched for studies reporting on survival in patients with and without [...] Read more.
Background: The impact of postoperative pancreatic fistula (POPF) on survival after resection for pancreatic ductal adenocarcinoma (PDAC) remains unclear. Methods: The MEDLINE, Scopus, Embase, Web of Science, and Cochrane Library databases were searched for studies reporting on survival in patients with and without POPF. A meta-analysis was performed to investigate the impact of POPF on disease-free survival (DFS) and overall survival (OS). Results: Sixteen retrospective cohort studies concerning a total of 5019 patients with an overall clinically relevant POPF (CR-POPF) rate of 12.63% (n = 634 patients) were considered. Five of eleven studies including DFS data reported higher recurrence rates in patients with POPF, and one study showed a higher recurrence rate in the peritoneal cavity. Six of sixteen studies reported worse OS rates in patients with POPF. Sufficient data for a meta-analysis were available in 11 studies for DFS, and in 16 studies for OS. The meta-analysis identified a shorter DFS in patients with CR-POPF (HR 1.59, p = 0.0025), and a worse OS in patients with POPF, CR-POPF (HR 1.15, p = 0.0043), grade-C POPF (HR 2.21, p = 0.0007), or CR-POPF after neoadjuvant therapy. Conclusions: CR-POPF after resection for PDAC is significantly associated with worse overall and disease-free survival. Full article
(This article belongs to the Special Issue Management of Pancreatic Cancer: Prediction and Prognostic Factors)
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