In the vast universe of medicine, there are some stars that shine brightly, and their light pierces the darkness and guides humanity in its battle against disease. In 1989, under the leadership of Professor Wang Benmao, Changhai Hospital established a pancreatic and spleen surgery professional group in China, which took the surgical treatment of pancreatic malignant tumors, the "king of cancer", as the clinical characteristics and main direction, and participated in and witnessed the start and development of pancreatic surgery in China.
In 1994, Jin Gang graduated with honors from the Second Military Medical University with a six-year major in clinical medicine, and started his career in the Department of General Surgery of Changhai Hospital. Under the guidance of the older generation of experts, such as Prof. Wang Benmao, Prof. Zhong Jianping, Prof. Tang Yan and Prof. Hu Xiangui, his clinical skills and level have grown rapidly. Subsequently, during his three-year doctoral studies at the School of Life Sciences of Fudan University, he developed a rigorous and meticulous scientific research style. In 2003, he was awarded the Sasakawa Scholarship of the Ministry of Health of the People's Republic of China and sent to the Faculty of Medicine of Kyorin University in Japan to study international advanced hepatobiliary and pancreatic surgery techniques.
In 2013, Professor Jin Gang became the head of the Department of Hepatobiliary, Pancreatic and Spleen Surgery at Changhai Hospital. Under his leadership, the department has been approved by the Ministry of Education of the People's Republic of China as the "Early Diagnosis and Comprehensive Treatment of Pancreatic Cancer" Innovation Team, the Shanghai "Top Priority" Clinical Center, and has in-depth cooperation with Johns Hopkins University Hospital in United States, Royal Cancer Centre in Glasgow United Kingdom, Shanghai Academy of Biological Sciences of the Chinese Academy of Sciences and other units, becoming a bright "star" leading the field of precision medicine and standardized surgical treatment of pancreatic cancer in mainland China.
Four Steps to Innovation
A new chapter in the treatment of pancreatic cancer
"Director Jin, save him!"
A young man surnamed Xia, accompanied by his mother, came all the way from Jiangxi to Changhai Hospital. He was less than 30 years old, but his diagnosis read: pancreatic head cancer liver metastasis - a desperate diagnosis. After careful evaluation, he enrolled Xiaoxia in the clinical trial and led a multidisciplinary team to adopt chemotherapy combined with immunotherapy for treatment. In half a year, Xiao Xia's liver metastases were effectively controlled, and then Professor Jin Gang operated on him.
In the past 4 years, Xiao Xia has not only shared her experience on social media to encourage other patients, but also often "appeared to speak" outside the clinic during follow-up visits to comfort and educate those patients who have sympathy for the same disease.
"Actually, he made us a little embarrassed...... "Professor Jin Gang said with a smile, "but his story always tells me that we must live up to the expectations of patients." ”
The 5-year survival rate for patients with pancreatic cancer is less than 10%. The high mortality rate is mainly due to the delay in diagnosis caused by the insidious early symptoms and the missed opportunity for radical surgery. As a surgeon, Professor Jin Gang has taken a holistic approach to the fight against pancreatic cancer from a new perspective – a holistic strategy that he sums up as a "four-step process for pancreatic cancer treatment".
Step 1 Early screening
"To subversively and fundamentally improve the treatment effect of pancreatic cancer, we must start from the source." Professor Jin Gang is well aware that early detection is the key to improving the medium- and long-term survival rate of pancreatic cancer patients. In the second half of 2020, he led the team to officially launch Asia's first "AI-based Pancreatic Cancer Early Screening and High-Risk Group Follow-up Program" (ESPRIT-AI) in Yangpu District, Shanghai, and built the "Shanghai Cohort" for early screening of pancreatic cancer. Through the statistical analysis of large-sample clinical data and questionnaires, a high-risk risk assessment model for pancreatic cancer was constructed. During the pandemic, with the support of the Yangpu District Center for Disease Control and Prevention and 12 community hospitals, the project team successfully screened 50,000 residents over the age of 55 and screened out 60 cases of pancreatic cancer, one-third of which were early-stage cases. In 2024, Yangpu District included early screening of pancreatic cancer in the "Practical Project" and "Ten Measures for Health and Health to Benefit the People". "The project not only improves the early detection rate of pancreatic cancer, but also provides a more accurate health management plan for high-risk groups." Professor Jin Gang said.
Step 2 Multidisciplinary collaboration
"Treatment of pancreatic cancer should not be limited to surgery alone, but should be done collaboratively by a multidisciplinary team (MDT)." According to Professor Jin Gang, the MDT diagnosis and treatment team of pancreatic malignant tumors in Changhai Hospital covers multiple disciplines such as gastroenterology, imaging, pathology, radiotherapy, nuclear medicine and intervention, bringing together top domestic experts including Academician Li Zhaoshen, Professor Jin Zhendong and Professor Du Yiqi, etc., and has achieved remarkable results in the treatment of locally advanced pancreatic cancer (i.e., advanced unresectable pancreatic cancer). Median survival was 28 months after MDT evaluation, needle biopsy, neoadjuvant therapy, and conversion therapy, followed by radical surgery. This data is not only leading in China, but also on par with internationally renowned cancer centers such as MD Anderson Cancer Center in United States and Heidelberg Cancer Research Center in Germany.
Professor Jin Gang said that the strategy of neoadjuvant therapy and downstaging, conversion therapy to shrink or even eliminate tumor lesions, and then carry out surgery can significantly improve the median survival of patients with high-risk resectable pancreatic cancer, junctional resectable pancreatic cancer and even advanced pancreatic cancer with metastasis, among which, the median survival of advanced patients with pancreatic cancer with liver metastasis even reached 32.6 months after conversion therapy, while the average in international clinical trials is only 12 months. Today, he said, the pancreatic malignancy MDT team handles dozens of patients from all over the country every week, providing translational therapy, neoadjuvant therapy and individualized intervention.
Step 3 Individualized treatment
"Individualized treatment is one of the core goals of precision medicine, and it is also the future trend of cancer treatment." In the field of precision medicine, Professor Jin Gang led the team to develop a tumor neoantigen peptide vaccine with independent intellectual property rights, tailored a personalized precision treatment plan for patients, and truly realized the precision treatment concept of "one patient, one policy".
At the same time, Professor Jin Gang's team has also built the world's largest pancreatic cancer organoid bank, which has completely changed the traditional drug screening method and achieved high-throughput and high-efficiency "individualized drug screening". Tumor organoids can mimic the orthotopic tissue structure and biological characteristics of tumors in vitro, helping researchers quickly evaluate the sensitivity and effectiveness of drugs to tumor cells, and screen out drugs that are effective for specific patients, thereby greatly improving the therapeutic effect of intermediate and advanced pancreatic cancer. The results were published in the journals Cell and Nature, and were supported by major projects in Shanghai in 2022, bringing new hope to patients.
Step 4 Technological innovation in surgery
"In terms of surgical techniques, through the efforts of generations of surgeons, we are gradually breaking the 'ceiling' of the past!" According to Professor Jin Gang, the team continues to explore and innovate, and has taken the lead in carrying out "extended pancreatic cancer resection combined with plexus and lymphatic dissection" and "arterial pre-path pancreatic cancer resection" in China. It not only improves the safety and effectiveness of surgery, but also enables the treatment of some cases that would otherwise be inoperable. Honors such as the "Golden Scissors" award, the "Golden Scalpel" award, and the "Famous Doctor of the Country" have also come one after another.
In addition, as the training center of the da Vinci robotic surgery system in the Asia-Pacific region, Changhai Hospital is the first in China to carry out minimally invasive surgery for hepatobiliary and pancreatic robots. "Robotic surgery is the way of the future, but it is just as 'tactical' as the revolution in the way surgery is performed, and tactics should be subordinated to the patient's overall treatment strategy." Professor Jin Gang said that robotic surgery is a very good choice in the treatment of low malignancy and early tumors, but in practical application, the patient's disease characteristics and economic affordability should be specifically considered. To cure the disease, but also to "save people".
Save lives with benevolence
Light up hope with benevolence
"Medical education and talent training are the key to promoting medical development and improving the quality of medical services."
More than 100 outpatients per week, more than 500 cases of pancreatic tumor surgery and more than 300 cases of pancreaticoduodenectomy are completed every year...... But to this day, Professor Jin Gang still remembers the first surgery he performed under the guidance of Professor Wang Benmao during his residency.
It was a simple hernia operation, and after discussion, Professor Wang Benmao decided to use the most classic McVay method of hernia repair. "Actually, I have already performed 20 or 30 appendiceal surgeries during my internship, so I am a little 'unimpressed'."
However, this simple operation, which originally only took 20 to 30 minutes, took two and a half hours - from designing the incision and incision, to separating the tissue layer by layer, finding the hernia sac and properly disposing of it, Professor Wang Benmao patiently taught and explained in detail every step. When encountering the adhesion of the omentum tissue caused by the hernia sac, Professor Wang Benmao also made Jin Gang tie a knot.
"I was very excited, and everything seemed to be going well with the surgery, but at 7 a.m. the next morning, the first thing Professor Wang Benmao said when he saw me was, 'I barely slept all night yesterday.'" It turned out that Professor Wang Benmao had been worried that the knot tied by Jin Gang would be loosened, and in the evening, he called the ward several times to ask about the patient's blood pressure and condition, and rushed to the hospital as soon as it was dawn - this rigorous academic spirit and serious and responsible attitude towards patients profoundly affected Professor Jin Gang's entire career.
Now, Professor Jin Gang, who grew up under the words and deeds of his predecessors, has already become a teacher who "looks up to the mountains" in the eyes of young doctors. As an "outstanding teacher" of the General Logistics Department of the People's Liberation Army and a winner of the "Silver Award for Cultivating Talents" in military academies, he not only pays attention to tempering benevolence but also pays attention to cultivating benevolence in the process of cultivating talent echelons.
Professor Jin Gang attaches great importance to the all-round systematic training of students and young doctors, including humanistic accomplishment, doctor-patient communication, scientific research ability, teamwork, etc., and will conduct multi-faceted training covering clinical, scientific research and teaching for each doctor. At the same time, he also asked young doctors to rotate between different groups of professors in surgery in order to "win over the strengths of others". Medicine is a discipline that needs to be inherited for a long time, and only through self-cultivation and teaching by word and deed can we truly cultivate doctors with both superb medical skills and noble medical ethics.
"We are not just dealing with disease, but with patients, so we must first be a good person." Professor Jin Gang emphasized that we should always be patient-centered, treat every patient with scientific methods and humanistic care, save lives with benevolence, and light up hope with benevolence