Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Molecular and Clinical Oncology
Join Editorial Board Propose a Special Issue
Print ISSN: 2049-9450 Online ISSN: 2049-9469
Journal Cover
November-2023 Volume 19 Issue 5

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
November-2023 Volume 19 Issue 5

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article

Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery

  • Authors:
    • Keishi Kawasaki
    • Hideyuki Yoshitomi
    • Katsunori Furukawa
    • Tsukasa Takayashiki
    • Satoshi Kuboki
    • Shigetsugu Takano
    • Shingo Kagawa
    • Masayuki Ohtsuka
  • View Affiliations / Copyright

    Affiliations: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Chiba 260‑0856, Japan
  • Article Number: 92
    |
    Published online on: September 29, 2023
       https://doi.org/10.3892/mco.2023.2688
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

Mucinous cystic neoplasm (MCN) is a premalignant cystic tumor of the pancreas. Resection of MCN in the distal pancreas is a standard treatment; however, at present, there is no consensus on the necessity or extent of lymph node dissection, and minimally invasive pancreatectomy is commonly the preferred surgical technique. Thus, the present study aimed to assess the efficacy of minimally invasive surgery and the extent of lymph node metastasis as factors in determining an appropriate surgical treatment for MCN. The present study retrospectively analyzed 21 consecutive patients who underwent distal pancreatectomy (DP) for MCN under general anesthesia at Chiba University Hospital (Chiba, Japan) between April 2011 and July 2019. All 21 patients were female. DP with a splenectomy was performed in all the patients. A total of 14 patients underwent laparoscopic DP (LDP). No lymph node metastasis was found in any of the patients. The minimally invasive surgery group had lower operative blood loss and a shorter hospital stay than the open surgery group. There was no significant difference in the number of dissected lymph nodes between the open surgery group and the minimally invasive surgery group. Preoperative findings of malignancy in MCN included solid components on enhanced CT and endoscopic ultrasonography, high carbohydrate antigen 19‑9 values and large tumor size. In conclusion, DP with spleen preservation, which is minimally invasive, may be preferentially considered as a surgical technique for MCN without malignant findings because lymph node metastases are rare in MCN and were not observed in the present study.
View Figures
View References

1 

Tanaka M, Fernández-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, Kimura W, Levy P, Pitman MB, Schmidt CM, et al: International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 12:183–197. 2012.PubMed/NCBI View Article : Google Scholar

2 

Thompson LD, Becker RC, Przygodzki RM, Adair CF and Heffess CS: Mucinous cystic neoplasm (mucinous cystadenocarcinoma of low-grade malignant potential) of the pancreas: A clinicopathologic study of 130 cases. Am J Surg Pathol. 23:1–16. 1999.PubMed/NCBI View Article : Google Scholar

3 

Campbell F and Azadeh B: Cystic neoplasms of the exocrine pancreas. Histopathology. 52:539–551. 2008.PubMed/NCBI View Article : Google Scholar

4 

Crippa S, Salvia R, Warshaw AL, Domínguez I, Bassi C, Falconi M, Thayer SP, Zamboni G, Lauwers GY, Mino-Kenudson M, et al: Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients. Ann Surg. 247(571)2008.PubMed/NCBI View Article : Google Scholar

5 

Reddy RP, Smyrk TC, Zapiach M, Levy MJ, Pearson RK, Clain JE, Farnell MB, Sarr MG and Chari ST: Pancreatic mucinous cystic neoplasm defined by ovarian stroma: Demographics, clinical features, and prevalence of cancer. Clin Gastroenterol Hepatol. 2:1026–1031. 2004.PubMed/NCBI View Article : Google Scholar

6 

Tanaka M, Chari S, Adsay V, Fernandez-del Castillo C, Falconi M, Shimizu M, Yamaguchi K, Yamao K and Matsuno S: International Association of Pancreatology. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology. 6:17–32. 2006.PubMed/NCBI View Article : Google Scholar

7 

Visser B, Muthusamy V, Yeh B, Coakley F and Way L: Diagnostic evaluation of cystic pancreatic lesions. HPB (Oxford). 10:63–69. 2008.PubMed/NCBI View Article : Google Scholar

8 

Zamboni G, Scarpa A, Bogina G, Iacono C, Bassi C, Talamini G, Sessa F, Capella C, Solcia E, Rickaert F, et al: Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors. Am J Surg Pathol. 23:410–422. 1999.PubMed/NCBI View Article : Google Scholar

9 

Nathan H, Cameron JL, Goodwin CR, Seth AK, Edil BH, Wolfgang CL, Pawlik TM, Schulick RD and Choti MA: Risk factors for pancreatic leak after distal pancreatectomy. Ann Surg. 250:277–281. 2009.PubMed/NCBI View Article : Google Scholar

10 

Del Chiaro M, Verbeke C, Salvia R, Klöppel G, Werner J, McKay C, Friess H, Manfredi R, Van Cutsem E, Löhr M, et al: European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis. 45:703–711. 2013.PubMed/NCBI View Article : Google Scholar

11 

Park JW, Jang JY, Kang MJ, Kwon W, Chang YR and Kim SW: Mucinous cystic neoplasm of the pancreas: Is surgical resection recommended for all surgically fit patients? Pancreatology. 14:131–136. 2014.PubMed/NCBI View Article : Google Scholar

12 

Le Baleur Y, Couvelard A, Vullierme MP, Sauvanet A, Hammel P, Rebours V, Maire F, Hentic O, Aubert A, Ruszniewski P and Lévy P: Mucinous cystic neoplasms of the pancreas: definition of preoperative imaging criteria for high-risk lesions. Pancreatology. 11:495–499. 2011.PubMed/NCBI View Article : Google Scholar

13 

Crippa S, Fernández-Del Castillo C, Salvia R, Finkelstein D, Bassi C, Domínguez I, Muzikansky A, Thayer SP, Falconi M, Mino-Kenudson M, et al: Mucin-producing neoplasms of the pancreas: An analysis of distinguishing clinical and epidemiologic characteristics. Clin Gastroenterol Hepatol. 8:213–219. e214. 2010.PubMed/NCBI View Article : Google Scholar

14 

Fernández-del Castillo C: Mucinous cystic neoplasms. J Gastrointest Surg. 12:411–413. 2008.PubMed/NCBI View Article : Google Scholar

15 

Sarr MG, Carpenter HA, Prabhakar LP, Orchard TF, Hughes S, van Heerden JA and DiMagno EP: Clinical and pathologic correlation of 84 mucinous cystic neoplasms of the pancreas: Can one reliably differentiate benign from malignant (or premalignant) neoplasms? Ann Surg. 231(205)2000.PubMed/NCBI View Article : Google Scholar

16 

Wilentz RE, Albores-Saavedra J, Zahurak M, Talamini MA, Yeo CJ, Cameron JL and Hruban RH: Pathologic examination accurately predicts prognosis in mucinous cystic neoplasms of the pancreas. Am J Surg Pathol. 23:1320–1327. 1999.PubMed/NCBI View Article : Google Scholar

17 

Bosman FT, Carneiro F, Hruban RH and Theise ND: WHO classification of tumours of the digestive system. World Health Organization, 2010.

18 

Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, Allen P, Andersson R, Asbun HJ, Besselink MG, et al: The 2016 update of the international study group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery. 161:584–591. 2017.PubMed/NCBI View Article : Google Scholar

19 

Hart WR: Mucinous tumors of the ovary: A review. Int J Gynecol Pathol. 24:4–25. 2005.PubMed/NCBI

20 

Heinzelmann-Schwarz VA, Gardiner-Garden M, Henshall SM, Scurry JP, Scolyer RA, Smith AN, Bali A, Vanden Bergh P, Baron-Hay S, Scott C, et al: A distinct molecular profile associated with mucinous epithelial ovarian cancer. Br J Cancer. 94:904–913. 2006.PubMed/NCBI View Article : Google Scholar

21 

Hess V, A'Hern R, Nasiri N, King DM, Blake PR, Barton DP, Shepherd JH, Ind T, Bridges J, Harrington K, et al: Mucinous epithelial ovarian cancer: A separate entity requiring specific treatment. J Clin Oncol. 22:1040–1044. 2004.PubMed/NCBI View Article : Google Scholar

22 

Morice P, Joulie F, Camatte S, Atallah D, Rouzier R, Pautier P, Pomel C, Lhommé C, Duvillard P and Castaigne D: Lymph node involvement in epithelial ovarian cancer: Analysis of 276 pelvic and paraaortic lymphadenectomies and surgical implications. J Am Coll Surg. 197:198–205. 2003.PubMed/NCBI View Article : Google Scholar

23 

Rodríguez IM and Prat J: Mucinous tumors of the ovary: A clinicopathologic analysis of 75 borderline tumors (of intestinal type) and carcinomas. Am J Surg Pathol. 26:139–152. 2002.PubMed/NCBI View Article : Google Scholar

24 

Kimura W, Yano M, Sugawara S, Okazaki S, Sato T, Moriya T, Watanabe T, Fujimoto H, Tezuka K, Takeshita A and Hirai I: Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein: techniques and its significance. J Hepatobiliary Pancreat Sci. 17:813–823. 2010.PubMed/NCBI View Article : Google Scholar

25 

Sahani DV, Kadavigere R, Saokar A, Fernandez-del Castillo C, Brugge WR and Hahn PF: Cystic pancreatic lesions: A simple imaging-based classification system for guiding management. Radiographics. 25:1471–1484. 2005.PubMed/NCBI View Article : Google Scholar

26 

Brugge WR, Lewandrowski K, Lee-Lewandrowski E, Centeno BA, Szydlo T, Regan S, del Castillo CF and Warshaw AL: Diagnosis of pancreatic cystic neoplasms: A report of the cooperative pancreatic cyst study. Gastroenterology. 126:1330–1336. 2004.PubMed/NCBI View Article : Google Scholar

27 

Postlewait LM, Ethun CG, McInnis MR, Merchant N, Parikh A, Idrees K, Isom CA, Hawkins W, Fields RC, Strand M, et al: Association of preoperative risk factors with malignancy in pancreatic mucinous cystic neoplasms: A multicenter study. JAMA Surg. 152:19–25. 2017.PubMed/NCBI View Article : Google Scholar

28 

Eom B, Jang JY, Lee S, Han HS, Yoon YS and Kim SW: Clinical outcomes compared between laparoscopic and open distal pancreatectomy. Surg Endosc. 22:1334–1338. 2008.PubMed/NCBI View Article : Google Scholar

29 

Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, Sellers JB, Merchant NB, Scoggins CR, Martin RC 3rd, et al: A multicenter analysis of distal pancreatectomy for adenocarcinoma: Is laparoscopic resection appropriate? J Am Coll Surg. 210:779–785. 2010.PubMed/NCBI View Article : Google Scholar

30 

Venkat R, Edil BH, Schulick RD, Lidor AO, Makary MA and Wolfgang CL: Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: A systematic review and meta-analysis. Ann Surg. 255:1048–1059. 2012.PubMed/NCBI View Article : Google Scholar

31 

Daouadi M, Zureikat AH, Zenati MS, Choudry H, Tsung A, Bartlett DL, Hughes SJ, Lee KK, Moser AJ and Zeh HJ: Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique. Ann Surg. 257:128–132. 2013.PubMed/NCBI View Article : Google Scholar

32 

Postlewait LM, Ethun CG, McInnis MR, Merchant N, Parikh A, Idrees K, Isom CA, Hawkins W, Fields RC, Strand M, et al: The hand-assisted laparoscopic approach to resection of pancreatic mucinous cystic neoplasms: An underused technique? Am Surg. 84:56–62. 2018.PubMed/NCBI

33 

Shinchi H, Takao S, Noma H, Mataki Y, Iino S and Aikou T: Hand-assisted laparoscopic distal pancreatectomy with minilaparotomy for distal pancreatic cystadenoma. Surg Laparosc Endosc Percutan Tech. 11:139–143. 2001.PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Kawasaki K, Yoshitomi H, Furukawa K, Takayashiki T, Kuboki S, Takano S, Kagawa S and Ohtsuka M: Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery. Mol Clin Oncol 19: 92, 2023.
APA
Kawasaki, K., Yoshitomi, H., Furukawa, K., Takayashiki, T., Kuboki, S., Takano, S. ... Ohtsuka, M. (2023). Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery. Molecular and Clinical Oncology, 19, 92. https://doi.org/10.3892/mco.2023.2688
MLA
Kawasaki, K., Yoshitomi, H., Furukawa, K., Takayashiki, T., Kuboki, S., Takano, S., Kagawa, S., Ohtsuka, M."Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery". Molecular and Clinical Oncology 19.5 (2023): 92.
Chicago
Kawasaki, K., Yoshitomi, H., Furukawa, K., Takayashiki, T., Kuboki, S., Takano, S., Kagawa, S., Ohtsuka, M."Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery". Molecular and Clinical Oncology 19, no. 5 (2023): 92. https://doi.org/10.3892/mco.2023.2688
Copy and paste a formatted citation
x
Spandidos Publications style
Kawasaki K, Yoshitomi H, Furukawa K, Takayashiki T, Kuboki S, Takano S, Kagawa S and Ohtsuka M: Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery. Mol Clin Oncol 19: 92, 2023.
APA
Kawasaki, K., Yoshitomi, H., Furukawa, K., Takayashiki, T., Kuboki, S., Takano, S. ... Ohtsuka, M. (2023). Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery. Molecular and Clinical Oncology, 19, 92. https://doi.org/10.3892/mco.2023.2688
MLA
Kawasaki, K., Yoshitomi, H., Furukawa, K., Takayashiki, T., Kuboki, S., Takano, S., Kagawa, S., Ohtsuka, M."Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery". Molecular and Clinical Oncology 19.5 (2023): 92.
Chicago
Kawasaki, K., Yoshitomi, H., Furukawa, K., Takayashiki, T., Kuboki, S., Takano, S., Kagawa, S., Ohtsuka, M."Lymph node involvement is rare in mucinous cystic neoplasms of the pancreas: Role of minimally invasive surgery". Molecular and Clinical Oncology 19, no. 5 (2023): 92. https://doi.org/10.3892/mco.2023.2688
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team