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Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and...
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Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (31 May 2025) | Viewed by 10277

Special Issue Editors

Prof. Dr. Daniel Alin Cristian

E-Mail Website
Guest Editor
1. 10th Clinical Department—General Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
2. Department of General Surgery, “Colţea” Clinical Hospital, Bucharest, Romania
Interests: oncologic surgery; hepato-pancreato-biliary surgery; abdominal wall surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Valentin Titus Grigorean

E-Mail Website
Guest Editor
1. 10th Clinical Department—General Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
2. Department of General Surgery, "Bagdasar-Arseni" Emergency Clinical Hospital, Bucharest, Romania
Interests: oncologic surgery; trauma surgery; hepato-pancreato-biliary surgery; abdominal wall surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cancer is the leading cause of death worldwide, accounting for more than 10 million deaths each year and an even higher number of patients that are diagnosed with this disease undergoing various procedures. This is the consequence of the increased number of risk factors that have become present in our lives in recent decades, such as tobacco, obesity and various unhealthy food diets, alcohol, viral infections, exposure to certain chemicals or radiations, etc.

Our goal as medical practitioners or scientists is to obtain the best outcome for patients, from prophylactic procedures to a correct diagnosis, a specific multimodal treatment and rigorous follow-up. All these have significantly improved in recent years because of a better understanding of the genetic and molecular mechanisms of cancer development, the emergence of new technologies in cancer detection or surgical techniques, and breakthroughs in oncological therapies.

The aim of this Special Issue is to highlight new insights into advances of cancer multimodal approaches. Therefore, we encourage authors to submit their systematic reviews, meta-analyses, clinical outcome studies or new surgical techniques and oncological therapies regarding this subject.

Prof. Dr. Daniel Alin Cristian
Prof. Dr. Valentin Titus Grigorean
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 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. Medicina 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 2200 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

  • cancer
  • mechanism
  • surgery
  • multimodal
  • advances

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Related Special Issue

Published Papers (6 papers)

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Research

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15 pages, 4189 KiB  
Article
Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
by Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang and Kwang-Ryul Baek
Medicina 2024, 60(12), 1966; https://doi.org/10.3390/medicina60121966 - 29 Nov 2024
Viewed by 1395
Abstract
Background and Objectives: This study aimed to determine the minimal effective dose of indocyanine green (ICG) required for accurately assessing colonic perfusion during laparoscopic colorectal surgery using a laser-assisted laparoscopic near-infrared (NIR) camera system. Materials and Methods: In 15 patients with [...] Read more.
Background and Objectives: This study aimed to determine the minimal effective dose of indocyanine green (ICG) required for accurately assessing colonic perfusion during laparoscopic colorectal surgery using a laser-assisted laparoscopic near-infrared (NIR) camera system. Materials and Methods: In 15 patients with colorectal cancer undergoing right hemicolectomy, the left branch of the middle colic artery was preserved, and ICG angiography was performed in the transverse colon. To determine the optimal ICG dose, experimental doses of 0.01, 0.02, 0.03, 0.04, and 0.05 mg of ICG per patient’s body weight (kg) were administered intravenously in each group. Additionally, a conventional dose of 0.2 mg/kg was administered in the same patients more than 30 min after the initial dose. For quantitative analysis, the fluorescent expression region was extracted, and fluorescence intensity was analyzed using automatic image processing. Analysis accessibility, T1/2MAX, perfusion time ratio, slope, artificial intelligence (AI)-based perfusion pattern analysis, and washout time were measured in 150 detailed regions of interest in each image. Results: Group 1 (0.01 mg/kg) showed significantly lower accessibility rates for quantitative analysis (48.0%) compared with Groups 2–5 (84.7–100%). The mean slope value in Group 1 was 3.7, which fell below the acceptable threshold (>4) and was significantly lower than that of the other groups (p < 0.001). An acceptable AI-based perfusion pattern was 14.2% in Group 1, significantly lower than in Groups 2–5 (66.4–100%). Washout time was significantly faster with minimal doses compared with conventional doses (39.0 ± 15.8 s vs. 117.5 ± 4.9 s, respectively, p < 0.001). Conclusions: This study supports the use of minimal ICG doses, ranging from 0.02 to 0.05 mg/kg, to optimize repetitive ICG angiography using a laser-assisted laparoscopic NIR camera. Full article
(This article belongs to the Special Issue Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition)
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13 pages, 1155 KiB  
Article
Prognostic Impact and Clinical Features of Spread through Air Spaces in Operated Lung Cancer: Real-World Analysis
by Sedat Yildirim, Ozkan Alan, Zeynep Yuksel Yasar, Tugba Kaya, Goncagul Akdag, Oguzcan Kinikoglu, Gonca Gul Gecmen, Alper Yasar, Deniz Isik, Heves Surmeli, Tugba Basoglu, Ozlem Nuray Sever, Mahmut Emre Yildirim, Hatice Odabas and Nedim Turan
Medicina 2024, 60(8), 1374; https://doi.org/10.3390/medicina60081374 - 22 Aug 2024
Cited by 2 | Viewed by 1665
Abstract
Background and Objectives: Lung cancer is the leading cause of cancer-related deaths. Spread through air spaces (STAS) is an adverse prognostic factor that has become increasingly known in recent years. This study aims to investigate the impact of STAS presence on overall [...] Read more.
Background and Objectives: Lung cancer is the leading cause of cancer-related deaths. Spread through air spaces (STAS) is an adverse prognostic factor that has become increasingly known in recent years. This study aims to investigate the impact of STAS presence on overall survival (OS) and disease-free survival (DFS) in patients with surgically resected stage IA-IIIA lung cancer and to identify clinicopathological features associated with STAS. Materials and Methods: This research involved 311 lung cancer surgery patients. The relationship between the presence of STAS in the patients’ surgical pathology and OS and DFS values was examined. Clinicopathological features associated with the presence of STAS were determined. Results: There were 103 (33%) STAS-positive patients. Adenocarcinoma histological subtype, perineural invasion (PNI), and lymphovascular invasion (LVI) were significantly correlated with being STAS positive. STAS significantly predicted DFS and OS. One-year and five-year DFS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (65% vs. 88%, 29% vs. 62%, respectively, p ≤ 0.001). Similarly, one-year and five-year OS rates were significantly lower in the STAS-positive group compared to the STAS-negative group (92% vs. 94%, 54% vs. 88%, respectively, p ≤ 0.001). In multivariate analysis, STAS was found to be an independent prognostic factor for both DFS and OS (HR: 3.2 (95%CI: 2.1–4.8) and 3.1 (95%CI: 1.7–5.5), p < 0.001 and <0.001, respectively). Conclusions: In our study, STAS was found to be an independent prognostic biomarker in operated stage IA-IIIA lung cancer patients. It may be a beneficial pathological biomarker in predicting the survival of patients and managing their treatments. Full article
(This article belongs to the Special Issue Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition)
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23 pages, 3534 KiB  
Article
Emergency and Elective Colorectal Cancer—Relationship between Clinical Factors, Tumor Topography and Surgical Strategies: A Cohort Study
by Ionuţ Simion Coman, Raluca Cristina Vital, Violeta Elena Coman, Cosmin Burleanu, Mircea Liţescu, Costin George Florea, Daniel Alin Cristian, Gabriel-Petre Gorecki, Petru Adrian Radu, Iancu Emil Pleşea, Anwar Erchid and Valentin Titus Grigorean
Medicina 2024, 60(6), 898; https://doi.org/10.3390/medicina60060898 - 29 May 2024
Cited by 1 | Viewed by 1961
Abstract
Background and Objectives: The purpose of the study was to analyze the relationships among several clinical factors and also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that [...] Read more.
Background and Objectives: The purpose of the study was to analyze the relationships among several clinical factors and also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that included patients admitted to our emergency surgical department and diagnosed with colorectal cancer. The study group inclusion criteria were: patients admitted during 2020–2022; patients diagnosed with colorectal cancer (including the ileocecal valve); patients who benefited from a surgical procedure, either emergency or elective. Results: In our study group, consisting of 153 patients, we accounted for 56.9% male patients and 43.1% female patients. The most common clinical manifestations were pain (73.2% of the study group), followed by abdominal distension (69.3% of the study group) and absence of intestinal transit (38.6% of the study group). A total of 69 patients had emergency surgery (45.1%), while 84 patients (54.9%) benefited from elective surgery. The most frequent topography of the tumor was the sigmoid colon, with 19.60% of the patients, followed by the colorectal junction, with 15.68% of the patients, and superior rectum and inferior rectum, with 11.11% of the patients in each subcategory. The most frequent type of procedure was right hemicolectomy (21.6% of the study group), followed by rectosigmoid resection (20.9% of the study group). The surgical procedure was finished by performing an anastomosis in 49% of the patients, and an ostomy in 43.1% of the patients, while for 7.8% of the patients, a tumoral biopsy was performed. Conclusions: Colorectal cancer remains one of the most frequent cancers in the world, with a heavy burden that involves high mortality, alterations in the quality of life of patients and their families, and also the financial costs of the medical systems. Full article
(This article belongs to the Special Issue Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition)
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12 pages, 1531 KiB  
Article
Clinicopathologic Analysis and Prognostic Factors for Survival in Patients with Operable Ampullary Carcinoma: A Multi-Institutional Retrospective Experience
by Nebi Serkan Demirci, Eyyup Cavdar, Nuriye Yildirim Ozdemir, Sinemis Yuksel, Yakup Iriagac, Gokmen Umut Erdem, Hatice Odabas, Ilhan Hacibekiroglu, Mustafa Karaagac, Mahmut Ucar, Banu Ozturk and Yakup Bozkaya
Medicina 2024, 60(5), 818; https://doi.org/10.3390/medicina60050818 - 16 May 2024
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Abstract
Background and Objectives: In ampullary cancer, 5-year survival rates are 30–50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and [...] Read more.
Background and Objectives: In ampullary cancer, 5-year survival rates are 30–50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and Methods: We included 197 patients who underwent pancreaticoduodenectomy to treat ampullary carcinomas between December 2003 and May 2019. Demographics, clinical features, treatments, and outcomes/survival were analyzed. Results: The median disease-free survival (mDFS) and median overall survival (mOS) were 40.9 vs. 63.4 months, respectively. The mDFS was significantly lower in patients with lymphovascular invasion (p < 0.001) and lymph node involvement (p = 0.027). Potential predictors of decreased OS on univariate analysis included age ≥ 50 years (p = 0.045), poor performance status (p = 0.048), weight loss (p = 0.045), T3–T4 tumors (p = 0.018), surgical margin positivity (p = 0.01), lymph node involvement (p = 0.001), lymphovascular invasion (p < 0.001), perineural invasion (p = 0.007), and poor histological grade (p = 0.042). For the multivariate analysis, only nodal status (hazard ratio [HR]1.98; 95% confidence interval [CI], 1.08–3.65; p = 0.027) and surgical margin status (HR 2.61; 95% CI, 1.09–6.24; p = 0.03) were associated with OS. Conclusions: Nodal status and a positive surgical margin were independent predictors of a poor mOS for patients with ampullary carcinomas. Additional studies are required to explore the role of adjuvant therapy in patients with ampullary carcinomas. Full article
(This article belongs to the Special Issue Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition)
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Review

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50 pages, 1233 KiB  
Review
From Nature to Nanomedicine: Enhancing the Antitumor Efficacy of Rhein, Curcumin, and Resveratrol
by Ana-Maria Trofin, Dragoș Viorel Scripcariu, Silviu-Iulian Filipiuc, Anca-Narcisa Neagu, Leontina-Elena Filipiuc, Bogdan-Ionel Tamba, Madalina Maria Palaghia and Cristina Mariana Uritu
Medicina 2025, 61(6), 981; https://doi.org/10.3390/medicina61060981 - 26 May 2025
Viewed by 220
Abstract
Natural compounds have garnered increasing interest as potential antitumor agents due to their multifaceted biological activities and relatively low toxicity profiles. This review focuses on three well-studied natural molecules: rhein, curcumin, and resveratrol, analyzing and comparing their antitumor potential across a variety of [...] Read more.
Natural compounds have garnered increasing interest as potential antitumor agents due to their multifaceted biological activities and relatively low toxicity profiles. This review focuses on three well-studied natural molecules: rhein, curcumin, and resveratrol, analyzing and comparing their antitumor potential across a variety of cancer models. For each compound, we present an integrated perspective encompassing natural sources, physicochemical properties, pharmacological and pharmacokinetic characteristics, and the latest in vitro and in vivo evidence of anticancer activity. Special attention is given to the molecular mechanisms underlying their antitumor effects, including the modulation of cell cycle regulators, induction of apoptosis, inhibition of metastasis and angiogenesis, and regulation of key signaling pathways such as NF-κB, PI3K/Akt/mTOR, STAT3, and MAPKs. Although numerous studies highlighted their therapeutic promise, significant barriers remain—particularly related to poor solubility and limited bioavailability—which have hindered clinical translation, especially in the case of rhein. Advances in nanotechnology-based drug delivery systems offer promising solutions to these limitations, enabling improved targeting and enhanced efficacy. This review underscores the need for continued preclinical and clinical investigations to fully elucidate the therapeutic value of these compounds and support their integration into modern oncological treatment strategies. Full article
(This article belongs to the Special Issue Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition)
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Other

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12 pages, 2901 KiB  
Case Report
Reinitiating Chemotherapy beyond Progression after Maintenance Immunotherapy in Extensive-Stage Small-Cell Lung Cancer
by Roxana-Andreea Rahnea-Nita, Radu-Valeriu Toma, Valentin Titus Grigorean, Ionuţ Simion Coman, Violeta Elena Coman, Iancu Emil Pleşea, Anwar Erchid, Gabriel-Petre Gorecki and Gabriela Rahnea-Nita
Medicina 2024, 60(8), 1225; https://doi.org/10.3390/medicina60081225 - 28 Jul 2024
Cited by 1 | Viewed by 2024
Abstract
Introduction: Small-cell lung cancer (SCLC) is an aggressive form of cancer with a poor prognosis. The two-year survival rate is 8% of all cases. Case presentation: We present the case of a male patient who was 50 years old at the [...] Read more.
Introduction: Small-cell lung cancer (SCLC) is an aggressive form of cancer with a poor prognosis. The two-year survival rate is 8% of all cases. Case presentation: We present the case of a male patient who was 50 years old at the time of diagnosis in May 2022. He was diagnosed with extensive-stage small-cell lung cancer, treated with immunotherapy in combination with chemotherapy (Durvalumab in combination with Etoposide plus Carboplatin) as a first-line treatment, followed by maintenance immunotherapy. In December 2023, a PET-CT scan revealed progressive disease with multiple metastases. Chemotherapy was reinitiated with Etoposide plus Cisplatin in January 2024. After two cycles of chemotherapy, the patient developed post-chemotherapy anemia, for which treatment with Epoetinum alpha was initiated. Chemotherapy was continued for another five cycles, until May 2024, with the maintenance of hemoglobin at a level within 9.9 mg/dL–11 mg/dL. Upon assessment at the end of May 2024, the patient presented an ECOG = 2 performance status, with a moderate general state, moderate-intensity fatigue, no pain, no anxiety or depression and no dyspnea. Discussions, Literature Review and Conclusions: Reinitiating chemotherapy after the failure of maintenance immunotherapy may be an option in patients with SCLC. Epoetinum allows oncological treatment by preventing chemotherapy-induced anemia. Full article
(This article belongs to the Special Issue Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition)
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