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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

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World Journal of Gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Digestive endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy department of Gastroenterology and endoscopy Catholic UniversityRoma 00168Italy department of Gastroenterology University of Michigan HealthAnn ArborMI 48107United States department of endoscopy University of VeronaVerona 37121VenetoItaly Gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

Pancreatic cancer:Future challenges and new perspectives for an early diagnosis

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World Journal of Clinical oncology 2025年第2期16卷 1-8页

作者： Silvia Cocca Giuseppina Pontillo Marinella Lupo Raffaele Lieto Margherita Marocchi Maria Marsico Emanuela Dell'Aquila Santi Mangiafico Giuseppe Grande Rita Conigliaro Helga Bertani Gastroenterology and endoscopy Unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy Gastroenterology and endoscopy Unit Presidio Ospedaliero San Giuseppe Moscati(AversaCE)–ASL CasertaCaserta 81100Italy department of Clinical Medicine and Surgery University of Naples Federico IINaples 80131CampaniaItaly department of Medical oncology 1 IRCCS Regina Elena National Cancer InstituteRome 0144Italy Gastroenterology and endoscopy Unit Azienda Ospedaliero Universitaria Policlinico“G Rodolico–San Marco”Catania 95123SiciliaItaly

This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier ***,pancreatic cancer still has a poor prognosis,mainly due to late diagnosis in an advanced *** main precancerous routes have been identified as pathways to pancreatic adenocarcinoma:The first encompasses a large group of mucinous cystic lesions:intraductal papillary mucinous neoplasm and mucinous cystic neoplasm,and the second is pancreatic intraepithelial *** the last decade the focus of research has been to identify high-risk patients,using advanced imaging techniques(magnetic resonance cholangiopancreatography or endoscopic ultrasonography)which could be helpful in finding“indirect signs”of early stage pancreatic ***,the survival rate still remains poor,and alternative screening methods are under *** retrograde cholangiopancreatography followed by serial pancreatic juice aspiration cytology could be a promising tool for identifying precursor lesions such as intraductal papillary mucinous neoplasm,but confirming data are still needed to validate its *** a combination of cross-sectional imaging,endoscopic techniques(old and new ones)and genetic and biological biomarkers also in pancreatic juice)could be the best solution to reach an early *** could help to predict and follow the progression of early pancreatic ***,further studies are needed to validate their diagnostic reliability and to establish diagnostic algorithms to improve prognosis and survival in patients with pancreatic cancer.

关键词： Pancreatic cancer Endoscopic ultrasonography Endoscopic retrograde cholangiopancreatography Magnetic resonance cholangiopancreatography Serial pancreatic-juice aspiration cytologic examination

Current and future perspectives in the management and treatment of colorectal cancer

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World Journal of Clinical oncology 2025年第2期16卷 9-17页

作者： Sigfredo E Romero-Zoghbi Evita Krumina Fernando López-Campos Felipe Couñago department of Radiation oncology GenesisCare Talavera de la ReinaToledo 45600Spain department of Radiation oncology GenesisCare GuadalajaraGuadalajara 19004Spain department of Radiation oncology Hospital Universitario Ramón Y CajalMadrid 28034Spain department of Radiation oncology GenesisCare-Hospital Universitario Vithas Madrid La MilagrosaMadrid 28010Spain

In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical *** article provided a comprehensive and in-depth view of the management and treatment of colorectal cancer(CRC),one of the leading causes of cancer-related morbidity and mortality *** article analyzed the therapeutic modalities and their sequencing,focusing on total neoadjuvant therapy for locally advanced rectal *** highlighted the role of immunotherapy in tumors with high microsatellite instability or deficient mismatch repair,addressing recent advances that have improved prognosis and therapeutic response in localized and metastatic *** in surgical techniques,advanced radiotherapy,and systemic agents targeting specific mutational profiles are also discussed,reflecting on how they revolutionized clinical *** tumor DNA has emerged as a promising tool for detecting minimal residual disease,prognosis,and therapeutic monitoring,solidifying its role in precision *** review emphasized the importance of technological and therapeutic advancements in improving clinical outcomes and personalizing CRC treatment.

关键词： Colorectal cancer Metastatic colorectal cancer Total neoadjuvant therapy Chemoradiotherapy Colon surgery Rectal surgery Chemotherapy Immunotherapy

Breakthrough therapy for peritoneal carcinomatosis of gastric cancer:Intraperitoneal chemotherapy with taxanes

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World Journal of Gastrointestinal oncology 2015年第11期7卷 285-291页

作者： Hironori Yamaguchi Joji Kitayama Hironori Ishigami Shinsuke Kazama Hiroaki Nozawa Kazushige Kawai Keisuke Hata Tomomichi Kiyomatsu Toshiaki Tanaka Junichiro Tanaka Takeshi Nishikawa Kensuke Otani Koji Yasuda Soichiro Ishihara Eiji Sunami Toshiaki Watanabe department of surgical oncology the University of Tokyo

The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains ***,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperative period has shown promising ***,we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical *** administered taxanes remain in the IP space at an extremely high concentration for 48-72 *** drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects,making it ideal for IP *** are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy(SPIC).In SPIC,patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery(CRS) until disease ***,a taxane dissolved in 500-1000 m L of saline at ordinary temperature is administered through an IP access port on an outpatient *** to phase Ⅰ?studies,the recommended doses(RD) are as follows: IP DOC,45-60 mg/m2; IP PTX [without intravenous(IV) PTX],80 mg/m2; and IP PTX(with IV PTX),20 mg/*** Ⅱ studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%.A phase Ⅲ study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in *** prognosis of patients who underwent CRS was better than that of those who did not; however,this was partly due to selection *** several phase Ⅱ studies have shown promising results,a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer.

关键词： Taxane Paclitaxel Docetaxel Carcinoma Gastric canc

Precision surgical approach with lymph-node dissection in early gastric cancer

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World Journal of Gastroenterology 2019年第14期25卷 1640-1652页

作者： Shinichi Kinami Naohiko Nakamura Yasuto Tomita Takashi Miyata Hideto Fujita Nobuhiko Ueda Takeo Kosaka department of surgical oncology Kanazawa Medical University

The gravest prognostic factor in early gastric cancer is lymph-node metastasis,with an incidence of about 10% overall. About two-thirds of early gastric cancer patients can be diagnosed as node-negative prior to treatment based on clinicpathological data. Thus, the tumor can be resected by endoscopic submucosal dissection. In the remaining third, surgical resection is necessary because of the possibility of nodal metastasis. Nevertheless, almost all patients can be cured by gastrectomy with D1+ lymph-node dissection. Laparoscopic or robotic gastrectomy has become widespread in East Asia because perioperative and oncological safety are similar to open surgery. However, after D1+ gastrectomy,functional symptoms may still result. Physicians must strive to minimize postgastrectomy symptoms and optimize long-term quality of life after this *** on the location and size of the primary lesion, preservation of the pylorus or cardia should be considered. In addition, the extent of lymph-node dissection can be individualized, and significant gastric-volume preservation can be achieved if sentinel node biopsy is used to distinguish node-negative *** the surgical treatment for early gastric cancer may be less radical than in the past, the operative method itself seems to be still in transition.

关键词： Stomach neoplasms surgery Gastrectomy methods Recovery of function Sentinel lymph node surgery Gastric cancer

Minimally invasive surgical approach to pancreatic malignancies

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World Journal of Gastrointestinal oncology 2015年第12期7卷 411-421页

作者： Lapo Bencini Mario Annecchiarico Marco Farsi Ilenia Bartolini Vita Mirasolo Francesco Guerra Andrea Coratti department of oncology Division of Surgical Oncology and Robotics Careggi University Hospital

Pancreatic surgery for malignancy is recognized as challenging for the surgeons and risky for the patientsdue to consistent perioperative morbidity and mortality. Furthermore, the oncological long-term results are largely disappointing, even for those patients who experience an uneventfully hospital stay. Nevertheless, surgery still remains the cornerstone of a multidisciplinary treatment for pancreatic cancer. In order to maximize the benefits of surgery, the advent of both laparoscopy and robotics has led many surgeons to treat pancreatic cancers with these new methodologies. The reduction of postoperative complications, length of hospital stay and pain, together with a shorter interval between surgery and the beginning of adjuvant chemotherapy, represent the potential advantages over conventional surgery. Lastly, a better cosmetic result, although not crucial in any cancerous patient, could also play a role by improving overall well-being and patient self-perception. The laparoscopic approach to pancreatic surgery is, however, difficult in inexperienced hands and requires a dedicated training in both advanced laparoscopy and pancreatic surgery. The recent large diffusion of the da Vinci® robotic platform seems to facilitate many of the technical maneuvers, such as anastomotic biliary and pancreatic reconstructions, accurate lymphadenectomy, and vascular sutures. The two main pancreatic operations, distal pancreatectomy and pancreaticoduodenectomy, are approachable by a minimally invasive path, but more limited interventions such as enucleation are also feasible. Nevertheless, a word of caution should be taken into account when considering the increasing costs of these newest technologies because the main concerns regarding these are the maintenance of all oncological standards and the lack of long-term follow-up. The purpose of this review is to examine the evidence for the use of minimally invasive surgery in pancreatic cancer(and less aggressive tumors), w

关键词： Pancreatic cancer Pancreatic adenocarcinoma Neuroe

Pancreatic adenosquamous carcinoma and intraductal papillary mucinous neoplasm in a CDKN2A germline mutation carrier

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World Journal of Gastrointestinal oncology 2017年第9期9卷 390-396页

作者： Fernando Martínez de Juan María Reolid Escribano Carmen Martínez Lapiedra Fernanda Maia de Alcantara María Caballero Soto Ana Calatrava Fons Isidro Machado Gastroenterology and Digestive endoscopy department Valencian Institute of Oncology Digestive Surgery department Valencian Institute of Oncology Pathology department Valencian Institute of Oncology

A 69-year-old woman from a kindred with familial atypical multiple mole melanoma and carrier of a germline mutation in CDKN2A, presented with abdominal pain caused by a solid-cystic pancreatic mass. The patient had an abdominal computed tomography three years before in which there was no evidence of pancreatic lesion. The endoscopic ultrasound guided fine needle aspiration showed adenocarcinoma with squamous component. After surgical resection the final diagnosis was adenosquamous pancreatic carcinoma(ASPC) arising in an intraductal papillar mucinous neoplasm(IPMN). Adenosquamous carcinomas are uncommon in the pancreas and have rarely been described in association with IPMNs. It has worse prognosis than the ordinary pancreatic ductal adenocarcinoma and some distinct features. We review the clinical, imaging, pathologic and molecular aspects of ASPC. Differential diagnosis with contamination, squamous metaplasia and pancreatic metastases from a distant squamous carcinoma is discussed. Besides, the case is an accelerated model of the adenoma(IPMN)-carcinoma sequence probably due to the CDKN2A ger-mline mutation. Somatic CDKN2A mutations are commonevents in the early steps of sporadic pancreatic cancer, but germline mutation carriers have a significantly higher risk of pancreatic carcinoma.

关键词： Intraductal papillary mucinous neoplasia Melanoma-pancreatic cancer syndrome Adenosquamous carcinoma Pancreatic carcinoma CDKN2A

Pancreaticoduodenectomy with combined superior mesenteric vein resection without reconstruction is possible:A case report and review of the literature

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World Journal of Clinical Cases 2018年第8期6卷 214-218页

作者： Lionel Jouffret Theophile Guilbaud Olivier Turrini Jean-Robert Delpero department of surgical oncology Institut PaoliC almettes

We report the case of a 56-year-old woman with pancreatic adenocarcinoma(PA) discovered during an episode of febrile jaundice. A computed tomography(CT) scan showed a mass in the head of the pancreas with circumferential infiltration of the superior mesenteric vein(SMV) and dilatation of the biliary and pancreatic ducts without metastases. The patient benefited from neoadjuvant chemotherapy(FOLFIRINOX) followed by radio-chemotherapy(45 Gy) and chemotherapy(LV5 FU2). The revaluation CT revealed SMV thrombosis without portal vein(PV) thrombosis. There was no contact of the tumor with the PV. Pancreatoduodenectomy with combined resection of the SMV was performed with no reconstruction of this venous axis after confirmation of adequate PV, splenic, and left gastric venous flow and the absence of bowel ischemia. The pathological diagnosis was p T4 N1 R0 PA. There were no bowel angina issues during the follow-up period. At 15 mo after surgery, the patient died of metastatic recurrence.

关键词： Pancreatic ducts Locally advanced No reconstruction Pancreatic adenocarcinoma Superior mesenteric vein

Laparoscopic approach to gastrointestinal malignancies: Toward the future with caution

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World Journal of Gastroenterology 2014年第7期20卷 1777-1789页

作者： Lapo Bencini Marco Bernini Marco Farsi Division of surgical oncology Department of OncologyCareggi University Hospital50134 FlorenceItaly

After the rapid acceptance of laparoscopy to manage multiple benign diseases arising from gastrointestinal districts,some surgeons started to treat malignancies by the same ***,if the limits of laparoscopy for benign diseases are mainly represented by technical issues,oncologic outcomes remain the foundation of any procedures to cure *** patients represent an important group with peculiar aspects including reduced survival expectancy,worsened quality of life due to surgery itself and adjuvant therapies,and challenging psychological *** these issues could,potentially,receive a better management with a laparoscopic surgical *** order to confirm such aspects,similarly to testing the newest weapons(surgical or pharmacologic)against cancer,long-term follow-up is always recommendable to assess the real benefits in terms of overall survival,cancer-free survival and quality of ***,it seems of crucial importance that surgeons will be correctly trained in specific oncologic principles of surgical oncology as well as in modern miniinvasive ***,laparoscopic treatment of gastrointestinal malignancies requires more caution and deep analysis of published evidences,as compared to those achieved for inflammatory bowel diseases,gastroesophageal reflux disease or diverticular *** review tries to examine the evidence available to date for the use of laparoscopy and robotics in malignancies arising from the gastrointestinal district.

关键词： Gastrointestinal cancer Laparoscopic oncology Laparoscopic surgery Robotic surgery surgical outcomes Oncologic outcomes