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New Insights into Personalized Surgical Oncology
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New Insights into Personalized Surgical Oncology

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: 20 April 2025 | Viewed by 7734

Special Issue Editor

Dr. Maximos Frountzas

E-Mail Website
Guest Editor
First Propaedeutic Department of Surgery, Hippocration General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: Gastrointestinal cancer; gastric cancer surgery; esophageal cancer surgery; pancreatic cancer surgery; oncology; nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In a significant number of cancer treatment cases, surgery remains the cornerstone for achieving long-term survival. At the same time, the concept of personalized medicine has evolved over the last decade, thereby increasing the chances of improving long-term outcomes.

In this Special Issue, entitled "New Insights into Personalized Surgical Oncology", we invite clinical researchers and scientists to contribute relevant clinical and basic research on cancer. Research on surgical techniques, improvements in clinical practice, the application of cutting-edge technologies, and personalized perioperative management also fall within the scope of this Special Issue. Original articles and review papers (systematic and narrative approaches) are also welcome. Papers that meet the criteria of the peer review process will be accepted for publication. We hope that this Special Issue will enrich our understanding of surgical oncology and further improve the quality of surgical care for cancer patients.

Dr. Maximos Frountzas
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 short 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. Journal of Personalized Medicine is an international peer-reviewed open access monthly 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 2600 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

  • surgical oncology
  • intention to treat surgery
  • chemoradiotherapy
  • interventional treatment
  • minimally invasive techniques
  • palliative surgery
  • neo-adjuvant treatments

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Published Papers (5 papers)

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Research

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13 pages, 2184 KiB  
Article
RNA-Seq Analysis in Non-Small Cell Lung Cancer: What Is the Best Sample from Clinical Practice?
by Lorenzo Nibid, Giovanna Sabarese, Luca Andreotti, Benedetta Canalis, Daniela Righi, Filippo Longo, Margherita Grazi, Pierfilippo Crucitti and Giuseppe Perrone
J. Pers. Med. 2024, 14(8), 851; https://doi.org/10.3390/jpm14080851 - 11 Aug 2024
Viewed by 1600
Abstract
RNA-based next-generation sequencing (RNA-seq) represents the gold standard for detecting gene fusion in non-small cell lung cancer (NSCLC). Despite this, RNA instability makes the management of tissue samples extremely complex, resulting in a significant number of test failures with missing data or the [...] Read more.
RNA-based next-generation sequencing (RNA-seq) represents the gold standard for detecting gene fusion in non-small cell lung cancer (NSCLC). Despite this, RNA instability makes the management of tissue samples extremely complex, resulting in a significant number of test failures with missing data or the need to switch to other techniques. In the present study, we analyzed pre-analytical variables in 140 tumor tissue samples from patients affected by NSCLC to detect features that increase the chances of successful RNA-seq. We found that the success rate of the analysis positively correlates with the RNA concentration and fragmentation index. Interestingly, small biopsies were more suitable samples than surgical specimens and cell blocks. Among surgical specimens, wedge resections demonstrated better results than lobectomy. Moreover, samples stored for less than 30 days (1 month) had a better chance of success than older samples. Defining the role of pre-analytical variables in RNA-seq allows the detection of more suitable samples for analysis and more effective planning of molecular-based diagnostic approaches in NSCLC. Full article
(This article belongs to the Special Issue New Insights into Personalized Surgical Oncology)
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21 pages, 7532 KiB  
Article
Outcomes of Radiotherapy in Oligoprogressive Breast Cancer
by Fabio Marazzi, Valeria Masiello, Armando Orlandi, Francesca Moschella, Silvia Chiesa, Alba Di Leone, Giovanna Garufi, Ciro Mazzarella, Alejandro M. Sanchez, Calogero Casa, Angela Bucaro, Flavia De Lauretis, Niccolo Borghesan, Luca Tagliaferri, Gianluca Franceschini, Emilio Bria, Riccardo Masetti, Alessandra Fabi, Cynthia Aristei, Giampaolo Tortora, Vincenzo Valentini and Maria A. Gambacortaadd Show full author list remove Hide full author list
J. Pers. Med. 2024, 14(8), 805; https://doi.org/10.3390/jpm14080805 - 29 Jul 2024
Cited by 1 | Viewed by 1151
Abstract
Introduction: Radiotherapy (RT) shows potential for improving local control in cases of oligoprogressive metastatic breast cancer (mBC). This retrospective analysis aims to evaluate the advantages of RT in such a clinical scenario. Methods: We conducted a retrospective analysis including patients with mBC who [...] Read more.
Introduction: Radiotherapy (RT) shows potential for improving local control in cases of oligoprogressive metastatic breast cancer (mBC). This retrospective analysis aims to evaluate the advantages of RT in such a clinical scenario. Methods: We conducted a retrospective analysis including patients with mBC who received radiation therapy (RT) for up to three sites of oligoprogression while continuing systemic therapy. The study took place between January 2014 and December 2021. Our endpoints were progression-free survival after radiotherapy (PFS-AR), the rate of discontinuation of systemic therapy (RDT) at three months post-RT, and overall survival (OS). We used Cox regression analysis to perform multivariate analysis for PFS-AR. Results: Fifty-nine patients met the inclusion criteria. The PFS-AR was 13 months (95% CI 8.5–18.8 months). At three months, the RDT was 3% (two patients). A significant difference in median PFS-AR was observed between patients in the first + second-line group and those in the subsequent line group (p = 0.03). In the multivariate analysis conducted for PFS-AR, the biologically effective dose (BED) with α/β = 4 > 100 Gy emerged as the sole significant variable (p = 0.0017). The median overall survival (OS) was 24.4 months (95% CI 17–24.4 months). Conclusions: This study is the first report on the outcomes of radiotherapy in a cohort of over 50 patients with oligoprogressive metastatic breast cancer (mBC). Our findings emphasize the significant relationship between PFS-AR, the number of ongoing lines of systemic therapy, and the BED of radiotherapy. Full article
(This article belongs to the Special Issue New Insights into Personalized Surgical Oncology)
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10 pages, 1150 KiB  
Article
Isolated Limb Perfusion and Immunotherapy in the Treatment of In-Transit Melanoma Metastases: Is It a Real Synergy?
by Marco Rastrelli, Francesco Russano, Francesco Cavallin, Paolo Del Fiore, Claudia Pacilli, Claudia Di Prata, Carlo Riccardo Rossi, Antonella Vecchiato, Luigi Dall’Olmo and Simone Mocellin
J. Pers. Med. 2024, 14(5), 442; https://doi.org/10.3390/jpm14050442 - 23 Apr 2024
Cited by 1 | Viewed by 1472
Abstract
Background: Isolated limb hyperthermic-antiblastic perfusion (ILP) was the most effective local treatment for advanced in-transit melanoma, but the advent of modern effective immunotherapy (IT), such as immune checkpoint inhibitors, has changed the treatment landscape. Methods: This study evaluated the role of the association [...] Read more.
Background: Isolated limb hyperthermic-antiblastic perfusion (ILP) was the most effective local treatment for advanced in-transit melanoma, but the advent of modern effective immunotherapy (IT), such as immune checkpoint inhibitors, has changed the treatment landscape. Methods: This study evaluated the role of the association between ILP and IT in the treatment of locally advanced unresectable melanoma, particularly in relation to modern systemic therapies. We analyzed 187 consecutive patients who were treated with ILP (melphalan or melphalan associated with TNF-alpha) for advanced melanoma at the Veneto Institute of Oncology of Padua (Italy) and the Padua University Hospital (Italy) between June 1989 and September 2021. Overall survival (OS), disease-specific survival (DSS), local disease-free survival (local DFS) and distant disease-free survival (distant DFS) were evaluated. Local toxicity was classified according to the Wieberdink scale and surgical complications according to the Clavien–Dindo classification. Response to locoregional therapy was evaluated during follow-up according to the RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumor). Results: A total of 99 patients were treated with ILP and 88 with IT + ILP. The overall response rate was 67% in both groups. At 36 months, OS was 43% in the ILP group and 61% in the ILP + IT group (p = 0.02); DSS was 43% in the ILP group and 64% in the ILP + IT group (p = 0.02); local DFS was the 37% in ILP group and 53% in the ILP + IT group (p = 0.04); and distant DFS was 33% in the ILP group and 35% in the ILP + IT group (p = 0.40). Adjusting for age and lymph node involvement, receiving ILP + IT was associated with improved OS (p = 0.01) and DSS (p = 0.007) but not local DFS (p = 0.13) and distant DFS (p = 0.21). Conclusions: Our findings confirm the synergy between ILP and IT. ILP remains a valuable loco-regional treatment option in the era of effective systemic treatments. Further studies are needed to establish the optimal combination of loco-regional and systemic treatments and address the best timing of this combination to obtain the highest local response rate. Full article
(This article belongs to the Special Issue New Insights into Personalized Surgical Oncology)
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11 pages, 1471 KiB  
Article
The Impact of Chemotherapy and Transforming Growth Factor-β1 in Liver Regeneration after Hepatectomy among Colorectal Cancer Patients
by Rokas Račkauskas, Raminta Lukšaitė-Lukštė, Rokas Stulpinas, Augustinas Baušys, Marius Paškonis, Mindaugas Kvietkauskas, Vitalijus Sokolovas, Arvydas Laurinavičius and Kęstutis Strupas
J. Pers. Med. 2024, 14(2), 144; https://doi.org/10.3390/jpm14020144 - 28 Jan 2024
Cited by 1 | Viewed by 1649
Abstract
An ongoing debate surrounds the impact of chemotherapy on post-hepatectomy liver regeneration in patients with colorectal cancer liver metastases (CRLM), with unclear regulatory mechanisms. This study sought to delve into liver regeneration post-resection in CRLM patients, specifically examining the roles of hepatocyte growth [...] Read more.
An ongoing debate surrounds the impact of chemotherapy on post-hepatectomy liver regeneration in patients with colorectal cancer liver metastases (CRLM), with unclear regulatory mechanisms. This study sought to delve into liver regeneration post-resection in CRLM patients, specifically examining the roles of hepatocyte growth factor (HGF) and transforming growth factor β1 (TGF-β1). In this longitudinal observational study, 17 patients undergoing major liver resection for CRLM and 17 with benign indications as controls were enrolled. Liver regeneration within 30 postoperative days was assessed via CT, considering clinicopathological characteristics, liver enzymes, liver stiffness by elastography, and the impact of HGF and TGF-β1 on liver regeneration. The results revealed that the control group exhibited significantly higher mean liver regeneration volume (200 ± 180 mL) within 30 days postoperatively compared to the CRLM group (72 ± 154 mL); p = 0.03. Baseline alkaline phosphatase (AP) and TGF-β1 blood levels were notably higher in the CRLM group. Immunohistochemical analysis indicated a higher proportion of CRLM patients with high TGF-β1 expression in liver tissues compared to the control group (p = 0.034). Correlation analysis showed that resected liver volume, baseline plasma HGF, AP, and albumin levels significantly correlated with liver regeneration volume. However, in multivariable analysis, only resected liver volume (β: 0.31; 95% CI: 0.14–0.47, p = 0.01) remained significant. In conclusion, this study highlights compromised liver regeneration in CRLM patients post-chemotherapy. Additionally, these patients exhibited lower serum TGF-β1 levels and reduced TGF-β1 expression in liver tissue, suggesting TGF-β1 involvement in mechanisms hindering liver regeneration capacity following major resection after chemotherapy. Full article
(This article belongs to the Special Issue New Insights into Personalized Surgical Oncology)
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Review

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11 pages, 253 KiB  
Review
Controversies and Advances in the Personalized Surgical Treatment of Cervical Cancer
by Vasilios Pergialiotis, Ioannis Rodolakis, Alexandros Rodolakis and Nikolaos Thomakos
J. Pers. Med. 2024, 14(6), 606; https://doi.org/10.3390/jpm14060606 - 6 Jun 2024
Viewed by 1032
Abstract
Cervical cancer represents a global health issue as it is mostly encountered in women of reproductive age, while at the same time, survival outcomes seem to have remained constant during the last two decades. The need to implement fertility-sparing strategies as well as [...] Read more.
Cervical cancer represents a global health issue as it is mostly encountered in women of reproductive age, while at the same time, survival outcomes seem to have remained constant during the last two decades. The need to implement fertility-sparing strategies as well as to decrease the morbidity that accompanies radical treatment has been extensively studied. During the last decade, several randomized clinical trials have been released, resulting in significant advances in the surgical treatment of early-stage disease. At the same time, evidence about the surgical treatment of advanced-stage disease as well as recurrent disease has gradually appeared and seems to be promising, thus leading the point forward towards personalized medicine that will remove the surgical barriers that seem concrete in our era. Nevertheless, the discrepancies in perioperative morbidity and survival outcomes that were observed among published studies raise several questions. In the present article, we chose to review the gray fields in the surgical treatment of early-stage and advanced-stage cervical cancer. Studies that are based on strong evidence that support current clinical practice are compared to smaller cohorts that present novel data that may form the basis for future research, and issues that remain poorly explored are discussed in an effort to help establish a consensus for future research development. Full article
(This article belongs to the Special Issue New Insights into Personalized Surgical Oncology)
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