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Two Cases of Unresectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgical Resection

Gunn HUH ; Jung Won CHUN ; Min Su YOU ; Woo Hyun PAIK ; Sang Hyub LEE ; Yong Tae KIM ; Ji Kon RYU

Journal of Digestive Cancer Report.2019;7(2):61-64. doi:10.0000/jdcr.2019.7.2.61

We report two cases of patients with unresectable pancreatic cancer treated with neoadjuvant chemotherapy and surgical resection. In the first case, main mass was located at the neck of the pancreas, encasing superior mesenteric artery and peritoneal seeding was suspected. In the second case, main mass was located at the body of pancreas and superior mesenteric artery was encased. Both patients received FOLFIRINOX chemotherapy regimen, consisting of 5-FU, folinic acid, irinotecan and oxaliplatin. In both cases, tumor size decreased and vascular involvement regressed in response to chemotherapy. After subsequent chemoradiation therapy, both patients underwent surgical resection with negative resection margin. The pathological stages were ypT1cN0 and ypT1aN0, respectively. Both patients received postoperative adjuvant chemotherapy with 6 cycles of 5-FU/folinic acid and remained without evidence of disease for more than 6 months after the surgery.

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Salvage Endoscopic Resection for Residual Lesion after Definitive Chemoradiotherapy in Esophageal Cancer

Seong Jung KIM ; Ran HONG ; Jun LEE

Journal of Digestive Cancer Report.2019;7(2):57-60. doi:10.0000/jdcr.2019.7.2.57

Definitive chemoradiotherapy (CRT) with its significant efficacy and safety in esophageal cancer is reserved for patients with unresectable tumor or those who decline surgery. However, the incidence of locoregional failure or recurrence after definitive CRT remains high. Although esophagectomy is the standard treatment for locoregional failure or recurrence, this approach is associated with high mortality and morbidity. A 56-year-old man diagnosed with esophageal squamous cell carcinoma who refused to undergo surgery received definitive CRT. An endoscopy for response assessment performed after 2 months revealed a residual lesion, which was completely resected by salvage endoscopic submucosal dissection. To the best of our knowledge, endoscopic resection in locoregional failure or recurrence after definitive CRT is very rarely reported, and there are no guidelines or consensus to date. Here, we report a case of successful salvage endoscopic resection of residual lesion after definitive CRT.

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Cholelithiasis as a Risk Factor for Gallbladder Cancer

Dong Jun OH ; Dong Kee JANG ; Jun Kyu LEE

Journal of Digestive Cancer Report.2019;7(2):51-56. doi:10.0000/jdcr.2019.7.2.51

Although the incidence of gallbladder cancer is relatively low, Korea is one of the countries with the highest incidences of gallbladder cancer in the world. Gallbladder cancer is also often diagnosed in an advanced state, and has poor prognosis. A gallstone is one of the major risk factors for gallbladder cancer and a majority of epidemiological studies support correlation between cholelithiasis and gallbladder cancer. Clear mechanism, however, regarding how gallstones cause gallbladder cancer is not known. In this article, results of studies about the relationship between gallstone and gallbladder cancer were thoroughly reviewed. Also, it was discussed whether prophylactic cholecystectomy is necessary to prevent gallbladder cancer in asymptomatic gallstone patients without other risk factors such as a gallbladder polyp or porcelain gallbladder.

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Management of T1 Rectal NEN

Ji Hyun KIM ; Seung Joo NAM

Journal of Digestive Cancer Report.2019;7(2):45-50. doi:10.0000/jdcr.2019.7.2.45

Incidence of rectal neuroendocrine neoplasms (NEN) has increased tremendously over the decades due to disease awareness and widespread use of screening colonoscopy. Although NEN has been recognized as malignant disease, most rectal NENs are initially found as small mass confined to the submucosa, which can be removed completely through various endoscopic treatments with good prognosis. In this review, we summarize the treatment options focusing on localized T1 rectal NEN by comparing representative international guidelines and discuss current controversies on the management. We also discuss various resection techniques focusing on endoscopic resection.

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Gastric Polyp: Is It Serious?

Kyuwon LEE ; Tae Ho KIM

Journal of Digestive Cancer Report.2019;7(2):40-44. doi:10.0000/jdcr.2019.7.2.40

Gastric polyps are morphological diagnoses that collectively refer to various types of lesions, and are commonly found by accident in gastroscopy. Gastric polyps in the broad sense are commonly referred to as abnormal structures protruding toward the gastric lumen, but are generally used only in lesions of the gastric mucosa. The incidence of gastric polyps ranged from 1 to 30% and varied by reporter, and differs by region. Fundic gland polyps were the most common in the West, while hyperplastic polyps were the most common in Korea. Gastric polyps are usually discovered by accident, but because some kinds of polyps have the potential to transform of malignant tumors, histological diagnosis is essential. There should be adequate treatment and management according to the histological results.

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Detection of Gastrointestinal Cancer using Linked Color Imaging and Blue Light Imaging

In Kyung YOO ; Joo Young CHO ; Hiroyuki OSAWA

Journal of Digestive Cancer Report.2019;7(2):31-39. doi:10.0000/jdcr.2019.7.2.31

The early detection of early gastric cancer (EGC) is important. However, the sensitivity of conventional white light imaging (WLI) in detecting EGC had been reported to range only from 77% to 84%. Although the resolution of endoscopes has been remarkably developed, precancerous lesions such as adenomas and microscopic early cancers are difficult to diagnose with general endoscopy. Linked Color Imaging (LCI) magnifies the differences in color for easy detection. Therefore, it produces a bright image from a distance and is performed for screening endoscopy. The 410 nm wavelength of BLI (Blue Light Imaging) helps to detect cancer by showing microstructure and microvessels in the mucosal superficial layer. This review will focus on the utility of Image enhanced endoscopy (IEE) techniques in diagnosis of gastrointestinal cancer.

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An Unusual Cause of Acute Pancreatitis

Jung Wan CHOE

Journal of Digestive Cancer Report.2021;9(2):75-77. doi:10.52927/jdcr.2021.9.2.75

no abstract available.

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Immune Checkpoint Inhibitors in Advanced Colorectal Cancer

Jaekyung CHEON

Journal of Digestive Cancer Report.2021;9(2):71-74. doi:10.52927/jdcr.2021.9.2.71

no abstract available.

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Multiple Rectal Neuroendocrine Tumor

So Jung HAN ; Jun Yong KIM ; Jae Jun PARK

Journal of Digestive Cancer Report.2021;9(2):68-70. doi:10.52927/jdcr.2021.9.2.68

no abstract available

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Premalignant Lesions of the Small Intestine

Su Hwan KIM ; Ji Won KIM

Journal of Digestive Cancer Report.2021;9(2):60-67. doi:10.52927/jdcr.2021.9.2.60

Tumors of the small intestine are rare and generally asymptomatic or with nonspecific symptoms. The small intestine is difficult to approach using conventional endoscopy, and early diagnosis of the small intestinal tumors is difficult. Therefore, many of the small intestinal tumors are diagnosed at an advanced stage, which makes the prognosis poor. Premalignant lesions of the small intestine or known risk factors of small bowel cancer are sporadic adenoma, adenoma associated with familial adenomatous polyposis, hamartomatous polyp associated with PeutzJeghers syndrome, Crohn’s disease, and celiac disease. Therefore, it is necessary to recognize that the small bowel cancer can occur in these patients with premalignant lesions or risk factors of small bowel cancer. To reduce the possibility of small bowel cancer or to detect at an earlier stage, attention should be paid to screening and surveillance of these patients with premalignant lesions or risk factors of the small bowel cancer.

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