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Minimally invasive radical pancreatectomy for left-sided pancreatic cancer:Current status and future perspectives

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World Journal of Gastroenterology 2014年第9期20卷 2343-2351页

作者： chang moo kang Sung Hwan Lee Woo Jung Lee Department of Surgery Yonsei University College of Medicine Seoul 120-752 South Korea Pancreaticobiliary Cancer Clinic Institute of Gastroenterology Severance Hospital Seoul 120-752 South Korea

Minimally invasive distal pancreatectomy with splenectomy has been regarded as a safe and effective treatment for benign and borderline malignant pancreatic ***,its application for left-sided pancreatic cancer is still being *** clinical evidence for radical antegrade modular pancreatosplenectomy(RAMPS)-based minimally invasive approaches for leftsided pancreatic cancer was *** indications and surgical concepts for minimally invasive RAMPS were *** the limited clinical evidence for minimally invasive distal pancreatectomy in left-sided pancreatic cancer,the currently available clinical evidence supports the use of laparoscopic distal pancreatectomy under oncologic principles in wellselected left sided pancreatic cancers.A pancreasconfined tumor with an intact fascia layer between the pancreas and left adrenal gland/kidney positioned more than 1 or 2 cm away from the celiac axis is thought to constitute a good condition for the use of margin-negative minimally invasive *** use of minimally invasive(laparoscopic or robotic)anterior RAMPS is feasible and safe for margin-negative resection in wellselected left-sided pancreatic *** oncologic feasibility of the procedure remains to be determined;however,the currently available interim results indicate that even oncologic outcomes will not be inferior to those of open radical distal pancreatosplenectomy.

关键词： Pancreatic cancer Laparoscopic pancreatectomy Robotic pancreatectomy

Minimally invasive vs open pancreatectomy for nonfunctioning pancreatic neuroendocrine tumors

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World Journal of Gastrointestinal Oncology 2020年第10期12卷 1133-1145页

作者： Juwan Kim Ho Kyoung Hwang Woo Jung Lee chang moo kang Department of Surgery Yonsei University College of MedicineSeoul 03722South Korea

BACKGROUND The mainstay of treating nonfunctioning-pancreatic neuroendocrine tumors(NFPNETs)is surgical ***,minimally invasive approaches to pancreatic resection for treating NF-PNETs are not widely accepted,and the longterm oncological outcomes of such approaches remain *** To determine the short-and long-term outcomes of minimally invasive pancreatic resection conducted in patients with *** Prospective databases from Severance Hospital were searched for 110 patients who underwent curative resection for NF-PNETs between January 2003 and August *** The proportion of minimally invasive surgery(MIS)procedures performed for NF-PNET increased to more than 75%after *** was no significant difference in post-operative complications(P=0.654),including pancreatic fistula(P=0.890)and delayed gastric emptying(P=0.652),between MIS and open *** statistically significant difference was found in disease-free survival between the open approach group and the MIS group(median follow-up period,28.1 mo;P=0.428).In addition,the surgical approach(MIS vs open)was not found to be an independent prognostic factor in treating NF-PNET patients[Exp(β)=1.062;P=0.929].CONCLUSION Regardless of the type of surgery,a minimally invasive approach can be safe and feasible for select NF-PNET patients.

关键词： Nonfunctioning-pancreas neuroendocrine tumor Pancreatic neuroendocrine tumor Minimally invasive surgery Oncologic outcome Laparoscopic pancreaticoduodenectomy Laparoscopic distal pancreatectomy

Preoperative defining system for pancreatic head cancer considering surgical resection

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World Journal of Gastroenterology 2016年第26期22卷 6076-6082页

作者： Seok Jeong Yang Ho Kyoung Hwang chang moo kang Woo Jung Lee Department of Surgery Ulsan University Hospital University of Ulsan College of Medicine Department of Hepatobiliary and Pancreatic Surgery Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic Yonsei Cancer Center Institute of Gastroenterology Yonsei Severance Hospital

AIM: To provide appropriate treatment, it is crucial to share the clinical status of pancreas head cancer among multidisciplinary treatment ***: A retrospective analysis of the medical records of 113 patients who underwent surgery for pancreas head cancer from January 2008 to December 2012 was performed. We developed preoperative defining system of pancreatic head cancer by describing “resectability - tumor location - vascular relationship - adjacent organ involvement - preoperative CA19-9 (initial bilirubin level) - vascular anomaly”. The oncologic correlations with this reporting system were ***: Among 113 patients, there were 75 patients (66.4%) with resectable, 34 patients (30.1%) with borderline resectable, and 4 patients (3.5%) with locally advanced pancreatic cancer. Mean disease-free survival was 24.8 mo (95%CI: 19.6-30.1) with a 5-year disease-free survival rate of 13.5%. Pretreatment tumor size ≥ 2.4 cm [Exp(B) = 3.608, 95%CI: 1.512-8.609, P = 0.044] and radiologic vascular invasion [Exp(B) = 5.553, 95%CI: 2.269-14.589, P = 0.002] were independent predictive factors for neoadjuvant treatment. Borderline resectability [Exp(B) = 0.222, P = 0.008], pancreatic head cancer involving the pancreatic neck [Exp(B) = 9.461, P = 0.001] and arterial invasion [Exp(B) = 6.208, P = 0.010], and adjusted CA19-9 ≥ 50 [Exp(B) = 1.972 P = 0.019] were identified as prognostic clinical factors to predict tumor ***: The suggested preoperative defining system can help with designing treatment plans and also predict oncologic outcomes.

关键词： Preoperative defining system Pancreas head cancer Borderline resectable Adjusted CA19-9 Neoadjuvant therapy

Negative oncologic impact of poor postoperative pain control in left-sided pancreatic cancer

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World Journal of Gastroenterology 2017年第4期23卷 676-686页

作者： Eun-Ki Min Jae Uk Chong Ho Kyoung Hwang Sang Joon Pae chang moo kang Woo Jung Lee Yonsei University College of Medicine Seoul 03722 Department of Hepatobiliary and Pancreatic Surgery Yonsei University College of Medicine Pancreaticobiliary Cancer Clinic Yonsei Cancer CenterSeverance Hospital National Health Insurance Corporation Ilsan Hospital

AIMTo investigate the association between postoperative pain control and oncologic outcomes in resected pancreatic ductal adenocarcinoma (PDAC).METHODSFrom January 2009 to December 2014, 221 patients were diagnosed with PDAC and underwent resection with curative intent. Retrospective review of the patients was performed based on electronic medical records system. One patient without records of numerical rating scale (NRS) pain intensity scores was excluded and eight patients who underwent total pancreatectomy were also excluded. NRS scores during 7 postoperative days following resection of PDAC were reviewed along with clinicopathologic characteristics. Patients were stratified into a good pain control group and a poor pain control group according to the difference in average pain intensity between the early (POD 1, 2, 3) and late (POD 5, 7) postoperative periods. Cox-proportional hazards multivariate analysis was performed to determine association between postoperative pain control and oncologic *** total of 212 patients were dichotomized into good pain control group (n = 162) and poor pain control group (n = 66). Median follow-up period was 17 mo. A negative impact of poor postoperative pain control on overall survival (OS) was observed in the group of patients receiving distal pancreatectomy (DP group; 42.0 mo vs 5.0 mo, P = 0.001). Poor postoperative pain control was also associated with poor disease-free survival (DFS) in the DP group (18.0 mo vs 8.0 mo, P = 0.001). Patients undergoing pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy (PD group) did not show associations between postoperative pain control and oncologic outcomes. Poor patients’ perceived pain control was revealed as an independent risk factor of both DFS (HR = 4.157; 95%CI: 1.938-8.915; P < 0.001) and OS (HR = 4.741; 95%CI: 2.214-10.153; P < 0.001) in resected left-sided pancreatic *** postoperative pain relief durin

关键词： Pancreatic cancer Pancreatectomy Survival Postoperative pain Recurrence

A nomogram to preoperatively predict 1-year disease-specific survival in resected pancreatic cancer following neoadjuvant chemoradiation therapy

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Chinese Journal of Cancer Research 2020年第1期32卷 105-114页

作者： Ho Kyoung Hwang Keita Wada Ha Yan Kim Yuichi Nagakawa Yosuke Hijikata Yota Kawasaki Yoshiharu Nakamura Lip Seng Lee Dong Sup Yoon Woo Jung Lee chang moo kang Division of HBP Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722Korea Pancreatobiliary Cancer Clinic Yonsei Cancer CenterSeverance HospitalSeoul 03722Korea Department of Surgery Teikyo University School of MedicineTokyo 173-8605Japan Biostatistician Biostatistics Collaboration UnitDepartment of Biomedical Systems InformaticsYonsei University College of MedicineSeoul 03722Korea Department of Gastrointestinal and Pediatric Surgery Tokyo Medical UniversityTokyo 160-8402Japan Department of Digestive Surgery Breastand Thyroid SurgeryGraduate School of Medical SciencesKagoshima UniversityKagoshima 890-0065Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical SchoolTokyo 890-0065Japan Department of General Surgery Changi General HospitalSingapore 529889Singapore

Objective: This study aimed to develop a nomogram to predict the 1-year survival of patients with pancreatic cancer who underwent pancreatectomy following neoadjuvant treatment with preoperatively detectable clinical parameters. Extended pancreatectomy is necessary to achieve complete tumor removal in borderline resectable and locally advanced pancreatic cancer. However, it increases postoperative morbidity and mortality rates, and should be balanced with potential benefit of long-term ***: The medical records of patients who underwent pancreatectomy following neoadjuvant treatment from January 2005 to December 2016 at Severance Hospital were retrospectively reviewed. Medical records were collected from five international institutions from Japan and Singapore for external ***: A total of 113 patients were enrolled. The nomogram for predicting 1-year disease-specific survival was created based on 5 clinically detectable preoperative parameters as follows: age(year), symptom(no/yes), tumor size at initial diagnostic stage(cm), preoperative serum carbohydrate antigen(CA) 19-9 level after neoadjuvant treatment(<34/≥34 U/m L), and planned surgery [pancreaticoduodenectomy(PD)(pylorus-preserving PD)/distal pancreatectomy(DP)/total pancreatectomy]. Model performance was assessed for discrimination and *** calibration plot showed good agreement between actual and predicted survival probabilities;the the Greenwood-Nam-D’Agostino(GND) goodness-of-fit test showed that the model was well calibrated(χ~2=8.24,P=0.5099). A total of 84 patients were used for external validation. When correlating actual disease-specific survival and calculated 1-year disease-specific survival, there were significance differences according to the calculated probability of 1-year survival among the three groups(P=0.044).Conclusions: The developed nomogram had quite acceptable accuracy and clinical feasibility in the decision-making process for the management of p

关键词： Pancreatic cancer neoadjuvant treatment pancreatectomy survival nomogram

Two distinct stem cell-like subtypes of hepatocellular carcinoma with clinical significance and their therapeutic potentials

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Cancer Communications 2022年第2期42卷 179-183页

作者： Sung Hwan Lee Yun Seong Jeong Sunyoung Lee Bo Hwa Sohn Ho Kyoung Hwang Gi Hong Choi chang moo kang Jin Sub Choi Woo Jung Lee Jae-Ho Cheong Hee Jin Jang Ahmed Kaseb Lewis Roberts Sun Young Yim Yun Shin Chun Ju-Seog Lee Department of Systems Biology the University of Texas MD Anderson Cancer CenterHoustonTX 77030USA Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722Republic of Korea Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryCHA Bundang Medical CenterCHA UniversitySeongnam 13496Republic of Korea Department of GI Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTX 77030USA Department of Surgery Yonsei University Health SystemYonsei University College of MedicineSeoul 03722Republic of Korea Division of Thoracic Surgery Michael E.DeBakey Department of SurgeryBaylor College of MedicineHoustonTX 77030USA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55902USA Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of MedicineSeoul 02841Republic of Korea Department of Surgery The University of Texas MD Anderson Cancer CenterHoustonTX 77030USA

Dear Editor Hepatocellular carcinoma(HCC)is among the most com-mon cancers worldwide,causing about 600,000 deaths annully[1].In HCC,stem cell-like characteristics,which drive early recurrence and therapy resistance,are major contributors to poor prognosis[2].In this current study,we integrated and analyzed gene expression data from human fetal liver cells and primary HCC tumors(n=1231)*** two clinically and biologically distinct hepatic stem cell(HS)subtypes,potential biomarkers associated with these subtypes,and a potential new therapeutic inter-vention for these subtypes.

关键词： therapeutic subtypes prognosis

International consensus statement on robotic pancreatic surgery

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Hepatobiliary Surgery and Nutrition 2019年第4期8卷 345-360页

作者： Rong Liu Go Wakabayashi Chinnusamy Palanivelu Allan Tsung Kehu Yang Brian KPGoh Charing Ching-Ning Chong chang moo kang Chenghong Peng Eli Kakiashvili Ho-Seong Han Hong-Jin Kim Jin He Jae Hoon Lee Kyoichi Takaori Marco Vito Marino Shen-Nien Wang Tiankang Guo Thilo Hackert Ting-Shuo Huang Yiengpruksawan Anusak Yuman Fong Yuichi Nagakawa Yi-Ming Shyr Yao-Ming Wu Yupei Zhao Department of Hepatopancreatobiliary Surgical Oncology Chinese People’s Liberation Army(PLA)General HospitalBeijing 100853China Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases Ageo Central General HospitalAgeoJapan Division of Gastrointestinal Surgery and Minimal Access Surgery GEM Hospital and Research CentreCoimbatoreIndia Division of Surgical Oncology Gastrointestinal Disease Specific Research GroupThe Ohio State University Wexner Medical Center Department of SurgeryColumbusOHUSA Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore Department of Surgery Division of Hepatobiliary and Pancreatic SurgeryPrince of Wales Hospitalthe Chinese University of Hong KongHong KongChina Division of HBP Surgery Yonsei University College of MedicinePancreatobiliary Cancer CenterYonsei Cancer CenterSeverance HospitalSeoulKorea Pancreatic Disease Centre Ruijin HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200025China Department of General Surgery Galilee Medical CenterNahariyaIsrael Department of Surgery Seoul National University College of MedicineSeoul National University Bundang HospitalSeoulKorea Department of Surgery Yeungnam University HospitalDaeguKorea Department of Surgery The Johns Hopkins HospitalBaltimoreMDUSA Division of Hepatobiliary&Pancreas Surgery Department of SurgeryAsan Medical CenterSeoulKorea Department of Surgery Kyoto University HospitalShogoinSakyo-KuKyotoJapan Department of General Surgery Azienda OspedalieraOspedali Riuniti Villa Sofia-CervelloPalermoItaly Division of General and Digestive Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Department of General Surgery Gansu Provincial HospitalLanzhou 730030China Department of General Visceral and Transplantation SurgeryHeidelberg University HospitalHeidelbergGermany Division of General Surge

The robotic surgical system has been applied to various types of pancreatic surgery. However, controversies exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. This study aimed to evaluate the current status of robotic pancreatic surgery and put forth experts' consensus and recommendations to promote its development. Based on the WHO Handbook for Guideline Development, a Consensus Steering Group* and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 19 topics were analyzed. The first 16 recommendations were generated by GRADE using an evidence-based method (EBM) and focused on the safety, feasibility, indication, techniques, certification of the robotic surgeon, and cost-effectiveness of robotic pancreatic surgery. The remaining three recommendations were based on literature review and expert panel opinion due to insufficient EBM results. Since the current amount of;evidence was low/meager as evaluated by the GRADE method, further randomized controlled trials (RCTs) are needed in the future to validate these recommendations.

关键词： Robotic surgery consensus statement pancreatectomy pancreaticoduodenectomy pancreatic enucleation

Catalytic removal of phenol from gas streams by perovskite-type catalysts

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Journal of Environmental Sciences 2017年第6期29卷 131-139页

作者： Dai Ling Chen Kuan Lun Pan moo Been chang Graduate Institute of Environmental Engineering 'National'Central UniversityTaoyuan City 32001Chinese Taipei

Three perovskite-type catalysts prepared by citric acid method are applied to remove phenol from gas streams with the total flow rate of 300 mL/min, corresponding to a GHSV of 10,000/hr. LaMnO3 catalyst is first prepared and further partially substituted with Sr and Cu to prepare ***.2MnO3 and ***.203, and catalytic activities and fundamen- tal characteristics of these three catalysts are compared. The results show that phenol removal efficiency achieved with ***.203 reaches 100% with the operating temperature of 200℃ and the rate of mineralization at 300℃ is up to 100%, while the phenol removal efficiencies achieved with ***.2MnO3 and LaMnO3 are up to 100% with the operating temperature of 300℃ and 400℃, respectively. X-ray photoelectron spectroscopy （XPS） analysis shows that the addition of Sr and Cu increases the lattice oxygen of ***.203, and further increases mobility or availability of lattice oxygen. The results indicate that ***.203 has the best activity for phenol removal among three catalysts prepared and the catalytic activity of phenol oxidation is enhanced by the introduction of Sr and Cu into LaMnO3. Apparent activation energy of 48 kJ/mol is calculated by Mars-Van Krevelen Model for phenol oxidation with ***.203 as catalyst.

关键词： Volatile organic compounds (VOCs)PhenolPerovskite-type catalystCatalysisActivation energyMineralization rate

Mitochondria-targeting drug conjugates for cytotoxic, anti-oxidizing and sensing purposes:current strategies and future perspectives

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Acta Pharmaceutica Sinica B 2018年第6期8卷 862-880页

作者： Gantumur Battogtokh Yeon Su Choi Dong Seop kang Sang Jun Park Min Suk Shim kang moo Huh Yong-Yeon Cho Joo Young Lee Hye Suk Lee Han chang kang Department of Pharmacy Integrated Research Institute of Pharmaceutical Sciences and BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy College of Pharmacy The Catholic University of Korea Division of Bioengineering Incheon National University Department of Polymer Science and Engineering Chungnam National University

mitochondrial-targeting moieties to anticancer drugs, antioxidants and sensor molecules. Among them, the most widely applied mitochondrial targeting moiety is triphenylphosphonium(TPP), which is a delocalized cationic lipid that readily accumulates and penetrates through the mitochondrial membrane due to the highly negative mitochondrial membrane potential. Other moieties, including short peptides,dequalinium, guanidine, rhodamine, and F16, are also known to be promising mitochondrial targeting agents. Direct conjugation of mitochondrial targeting moieties to anticancer drugs, antioxidants and sensors results in increased cytotoxicity, anti-oxidizing activity and sensing activity, respectively,compared with their non-targeting counterparts, especially in drug-resistant cells. Although many mitochondria-targeted anticancer drug conjugates have been investigated in vitro and in vivo, further clinical studies are still needed. On the other hand, several mitochondria-targeting antioxidants have been analyzed in clinical phases I, II and III trials, and one conjugate has been approved for treating eye disease in Russia. There are numerous ongoing studies of mitochondria-targeted sensors.

关键词： Anticancer agents Antioxidants Direct conjugation Mitochondria-targeting Sensing agents