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Role of neoadjuvant therapy for nonmetastatic pancreatic cancer:Current evidence and future perspectives

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World Journal of Gastrointestinal Oncology 2023年第6期15卷 911-924页

作者： gianluca cassese Ho-Seong Han Yoo-Seok Yoon Jun Suh Lee Boram Lee Antonio Cubisino Fabrizio Panaro Roberto Ivan Troisi Department of Clinical Medicine and Surgery Division of Minimally Invasive HPB Surgery and Transplantation ServiceFederico II University HospitalNaples 80131Italy Department of Surgery Seoul National University College of MedicineSeongnam 13620Gyeonggi-doSouth Korea Department of HPB Surgery and Transplantation Beaujon HospitalClichy 92110France Department of Digestive Surgery and Liver Transplantation CHU MontpellierMontpellier 34100France

Pancreatic adenocarcinoma(PDAC)is one of the most common and lethal human cancers worldwide.Surgery followed by adjuvant chemotherapy offers the best chance of a long-term survival for patients with PDAC,although only approximately 20%of the patients have resectable tumors when diagnosed.Neoadjuvant chemotherapy(NACT)is recommended for borderline resectable pancreatic cancer.Several studies have investigated the role of NACT in treating resectable tumors based on the recent advances in PDAC biology,as NACT provides the potential benefit of selecting patients with favorable tumor biology and controls potential micro-metastases in high-risk patients with resectable PDAC.In such challenging cases,new potential tools,such as ct-DNA and molecular targeted therapy,are emerging as novel therapeutic options that may improve old paradigms.This review aims to summarize the current evidence regarding the role of NACT in treating non-metastatic pancreatic cancer while focusing on future perspectives in light of recent evidence.

关键词： Pancreatic cancer Pancreatic duct adenocarcinoma Neoadjuvant chemotherapy Borderline resectable Locally advanced pancreatic cancer

Minimally invasive surgery for HCC

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Hepatoma Research 2022年第1期8卷 278-283页

作者： gianluca cassese Ho-Seong Han Department of Surgery College of MedicineSeoul National University Bundang HospitalSeongnam-siGyeonggi-do 13620South Korea Department of Clinical Medicine and Surgery Minimally invasive and robotic HPB Surgery UnitFederico II UniversityNaples 80131Italy

After an initial phase of skepticism and technical difficulties,minimally invasive liver surgery(MILS)has become a widespread practice in most high-volume hepatobiliary centers.Since the first laparoscopic liver resection(LLR)was carried out in France in 1991 for a benign lesion,the indications have substantially changed,including malignant diseases such as hepatocellular carcinoma(HCC)[1].Thanks to the improvements in both technical aspects and perioperative management,the extent of resection has also expanded during the last years,including patients with more advanced disease[2].With this redefinition of the boundaries of MILS,liver surgeons must be aware of the specific issues concerning HCC treatment,as well as the current evidence and strategies to overcome old limits.

关键词： surgery diseases overcome

Immunotherapy for hepatocellular carcinoma:A promising therapeutic option for advanced disease

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World Journal of Hepatology 2022年第10期14卷 1862-1874页

作者： gianluca cassese Ho-Seong Han Boram Lee Hae Won Lee Jai Young Cho Fabrizio Panaro Roberto Ivan Troisi Department of Clinical Medicine and Surgery Division of Minimally Invasive and Robotic HPB SurgeryFederico II UniversityNaples 80131Italy Department of Surgery Seoul National University Bundang HospitalSeongnam 13620South Korea Department of Surgery Division of HBP Surgery and TransplantationMontpellier University Hospital-School of MedicineMontpellier 34000France

Hepatocellular carcinoma(HCC)is the third leading cause of cancer-related deaths worldwide,and its incidence continues to increase.Despite improvements in both medical and surgical therapies,HCC remains associated with poor outcomes due to its high rates of recurrence and mortality.Approximately 50% of patients require systemic therapies that traditionally consist of tyrosine kinase inhibitors.Recently,however,immune checkpoint inhibitors have revolutionized HCC management,providing new therapeutic options.Despite these major advances,the different factors involved in poor clinical responses and molecular pathways leading to resistance following use of these therapies remain unclear.Alternative strategies,such as adoptive T cell transfer,vaccination,and virotherapy,are currently under evaluation.Combinations of immunotherapies with other systemic or local treatments are also being investigated and may be the most promising opportunities for HCC treatment.The aim of this review is to provide updated information on currently available immunotherapies for HCC as well as future perspectives.

关键词： Hepatocellular Carcinoma Immunotherapy Hepatocellular Carcinoma management Hepatocellular Carcinoma therapy Molecular targeted therapy

Portal vein embolization failure:Current strategies and future perspectives to improve liver hypertrophy before major oncological liver resection

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World Journal of Gastrointestinal Oncology 2022年第11期14卷 2088-2096页

作者： gianluca cassese Ho-Seong Han Boram Lee Jai Young Cho Hae Won Lee Boris Guiu Fabrizio Panaro Roberto Ivan Troisi Clinical Medicine and Surgery Federico II UniversityNaples 80131Italy Department of Surgery Seoul National University College of MedicineSeongnam 13620South Korea Department of Surgery Seoul National University Bundang HospitalSeongnam 13620South Korea Department of Medical Imaging and Interventional Radiology St-Eloi University HospitalMontpellier 34295France Digestive Surgery and Transplantation CHU de MontpellierMontpellier 34295France

Portal vein embolization(PVE)is currently considered the standard of care to improve the volume of an inadequate future remnant liver(FRL)and decrease the risk of post-hepatectomy liver failure(PHLF).PHLF remains a significant limitation in performing major liver surgery and is the main cause of mortality after resection.The degree of hypertrophy obtained after PVE is variable and depends on multiple factors.Up to 20%of patients fail to undergo the planned surgery because of either an inadequate FRL growth or tumor progression after the PVE procedure(usually 6-8 wk are needed before surgery).The management of PVE failure is still debated,with a lack of consensus regarding the best clinical strategy.Different additional techniques have been proposed,such as sequential transarterial chemoembolization followed by PVE,segment 4 PVE,intra-portal administration of stem cells,dietary supplementation,and hepatic vein embolization.The aim of this review is to summarize the up-to-date strategies to overcome such difficult situations and discuss future perspectives on improving FRL hypertrophy.

关键词： Portal vein embolization Portal vein embolization failure Rescue associating liver partition and portal vein ligation Hepatic vein embolization Liver venous deprivation Segment 4 portal vein embolization

Comment on:simultaneous versus delayed resection for initially resectable synchronous colorectal cancer liver metastases

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Hepatobiliary Surgery and Nutrition 2021年第1期10卷 131-133页

作者： gianluca cassese Zineb Cherkaoui Francis Navarro Patrick Pessaux Division of HBP Surgery and Transplantation Department of SurgerySt.Eloi HospitalMontpellier University Hospital-School of MedicineMontpellierFrance Digestive and Endocrine Surgery Department Nouvel Hôpital CivilStrasbourgFrance Institute of Image Guided Surgery(IHU Strasbourg) StrasbourgFrance INSERM UnitéInserm U1110 Institut de Recherche sur les Maladies Vrales et HépatiquesStrasbourgFrance

We read with great interest the recently published article of Boudjema and collaborators(1).The authors evaluated the safety and efficacy of delayed resection(DR)versus simultaneous resection(SR)for patients with initially resectable synchronous colorectal cancer liver metastases(CRC-SLM).The aforementioned study(METASYNC)was the first randomized controlled trial comparing two resection strategies for CRC-SLM.In the literature,large retrospective studies didn’t seem to favor one type of treatment,particularly when comparisons are based on a propensity match score(2).

关键词： resection colorectal metastases

The role of minimally invasive surgery in the treatment of HCC

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Hepatoma Research 2022年第1期8卷 301-312页

作者： gianluca cassese Ho-Seong Han Boram Lee Hae Won Lee Jai Young Cho Roberto Ivan Troisi Department of HPB Surgery Seoul National University Bundang HospitalSeongnam-si 13620South Korea Department of Clinical Medicine and Surgery Minimally invasive and robotic HPB Surgery UnitFederico II UniversityNaples 80131Italy

Liver surgery is the first-line treatment for hepatocellular carcinoma(HCC).Minimally invasive liver resection(MILS)has become an attractive option thanks to reduced intraoperative blood losses,shortened length of hospital stay,and similar oncological outcomes when compared to open liver resection.Nonetheless,the safety of MILS is still debated in challenging situations,such as in cirrhotic patients,difficult tumor locations,multiple or large tumors,and repeat resection.The aim of this review is to discuss current indications of laparoscopic liver resection for HCC treatment in the light of its outcomes,focusing on technical aspects of minimally invasive anatomic liver resection and state of the art of MILS in challenging situations.

关键词： Laparoscopic liver resection hepatocellular carcinoma minimally invasive liver surgery anatomic liver resection