A study involving 346 patients with hepatocellular carcinoma and microvascular invasion demonstrated that adjuvant transcatheter arterial chemoembolization (TACE) combined with lenvatinib significantly improves overall survival and recurrence-free survival compared to no adjuvant therapy. Group one, which received both treatments, showed superior outcomes (overall survival HR 0.321, recurrence-free survival HR 0.319), whereas groups receiving either treatment […]
Author: STITCHES Newsletter
Central line placement errors in pediatric cancer patients eliminated
A multi-faceted quality improvement initiative effectively eliminated incorrect central line placements and near-miss events in pediatric cancer patients. By redefining responsibilities, adding staff, and modifying processes, the team achieved zero errors over 1,018 consecutive days. This comprehensive approach demonstrates significant improvements in surgical safety and patient care, highlighting the critical importance of systematic changes in […]
Machine learning enhances predictions for biliary tract cancer survival.
A novel “biliary tract cancer survival calculator” was developed, utilizing machine learning to provide personalized survival estimates for patients with biliary tract cancers, incorporating data from 62,877 cases. Key factors negatively impacting survival included metastatic disease, age at diagnosis, and lack of surgical treatment. The model demonstrated significant accuracy during internal validation, with a c-index […]
New algorithm effectively identifies gastric cancer cases in Japan
A validated claims-based algorithm successfully identifies incident gastric cancer cases and determines progression phases in Japan. It demonstrated a positive predictive value of up to 95.9% and sensitivity rates reaching 98.9% in validation cohorts. This advancement enables better analysis of real-world gastric cancer scenarios, facilitating improved decision-making in treatment options. By addressing issues associated with […]
Bariatric surgery significantly reduces cancer risk in obese patients
A systematic review and meta-analysis of 21 studies revealed that metabolic and bariatric surgeries (MBS) substantially lower cancer risk in obese patients compared to non-surgical treatments. Specifically, MBS showed protective effects against colorectal (mean effect size -.28), uterine (mean effect size -.42), breast (mean effect size -.37), and esophageal cancers (mean effect size -.23). Overall, […]
Initial assessments of resectability influence outcomes for colorectal cancer patients
In a study of 1,250 patients with liver-only metastatic colorectal cancer (mCRC), less than half of those initially deemed unresectable achieved successful surgical resection after systemic therapy. Factors such as younger age and better performance status correlated with the likelihood of conversion to resectability. Overall survival rates post-resection significantly exceeded those of non-resected patients across […]
ICG imaging effectively predicts benign adrenal tumors intraoperatively
Near-infrared indocyanine green (ICG) imaging demonstrates promise in distinguishing between benign and malignant adrenal tumors during robotic surgeries. In a cohort of 197 patients, the method achieved an 87% sensitivity and a positive predictive value of 95.2% for identifying benign tumors. While specificity and negative predictive value were lower, results indicate that ICG can significantly […]
Transanal and robotic surgeries yield better outcomes for rectal cancer
A Bayesian network meta-analysis of 27 randomized controlled trials involving 8,696 patients indicates that transanal robotic resection (ta-rr) and robotic resection (r-rr) demonstrate superior histopathological outcomes compared to laparoscopic resection (l-rr) for rectal cancer. Specifically, ta-rr was associated with significantly lower odds of non-complete mesorectal excision (odds ratio, 0.60). These findings contribute to ongoing debates […]
Percutaneous cholecystostomy enhances surgical outcomes in elderly patients.
In a study involving octogenarians with acute cholecystitis, percutaneous cholecystostomy (PC) improved preoperative conditions, including systemic inflammation and blood coagulation abnormalities, compared to upfront surgery (US). Patients undergoing PC had worse initial health status but exhibited higher elective surgery rates post-treatment. Remarkably, despite the complexity of cases, surgical quality indicators such as conversion rates and […]
ICD-10 codes fail to accurately capture postoperative complications
A study of 11,827 surgical cases revealed that ICD-10 codes identified only 20.8% of postoperative complications (PCs) compared to 1047 PCs identified through manual curation. Patients with PCs faced significantly increased resource utilization, including a 6.6 times higher readmission rate and considerable economic costs, amounting to €25.5 million annually just from additional admission days. These […]