A new consensus framework for hepatocellular carcinoma (HCC) could transform surgical decision-making and patient outcomes. The BEACON-HCC system integrates clinical features like tumor burden and vascular invasion for more precise treatment options. In a pilot with 29 cases, expert decisions matched BEACON-HCC recommendations 96.6% of the time, compared to 72.4% for current standards. This framework […]

Liver stiffness measurement using Fibroscan® is an effective tool for risk stratification in primary sclerosing cholangitis (PSC). Baseline liver stiffness shows strong correlation with transplant-free survival: 5-year survival rates were 93.9% (<10 kPa), 78.1% (10-15 kPa), and 46.0% (>15 kPa). Progressors (increasing stiffness) had worse outcomes: an adjusted hazard ratio of 3.12 for death or […]

NCI-designated cancer centers lead to better surgical options and survival rates for patients with pancreatic ductal adenocarcinoma (PDAC). Patients at NCI centers had 2.37 times higher odds of surgical resection compared to non-designated centers. One-year mortality was halved (hazard ratio 0.50) for those receiving care at NCI centers. Access to NCI centers is crucial for […]

Biliary tract cancers are now seeing transformative therapies that enhance patient outcomes. Chemo-immunotherapy is the new first-line standard of care. Targeted therapies, especially for intrahepatic cholangiocarcinoma with FGFR2 fusions, show high response rates with drugs like pemigatinib and futibatinib. IDH1-mutant cholangiocarcinoma can be treated effectively with ivosidenib. Surgeons should prioritize biomarker testing to personalize treatment […]

Primary liver cancer cases are increasing rapidly, demanding enhanced screening and surgical readiness. Incidence and deaths have surged 59.4% and 55.8% from 2000 to 2023, respectively. Hepatitis B and C remain key causes, but rates have rebounded since 2020 despite prior declines. Surgeons must prioritize patient selection and intervention strategies, especially for patients with metabolic […]

A meta-analysis finds that neoadjuvant chemoradiotherapy and chemotherapy have comparable outcomes for pancreatic ductal adenocarcinoma. Surgical resection rates were nearly identical: 68.9% for chemoradiotherapy versus 71.5% for chemotherapy. R0 resection rates were also similar: 70.7% for chemoradiotherapy and 64.2% for chemotherapy. Both treatment modalities produced similar one-year survival rates (71.3% versus 72.4%) and overall survival […]

A new study shows urine cell-free DNA can aid in diagnosing intraductal papillary mucinous neoplasms (IPMN), which may improve patient management. Urine cfDNA detected GNAS mutations in 32% and KRAS mutations in 58% of IPMN cases, compared to just 10% and 19% in plasma, respectively. Main pancreatic duct diameter ≥10 mm and urine mutations significantly […]

Robotic liver surgery proves effective for complex resections of benign liver tumors like focal nodular hyperplasia. A 24-year-old woman underwent robotic partial hepatectomy for a growing 7 cm FNH with critical hilar involvement. The procedure lasted 3 hours with minimal blood loss (100 cc) and no complications. She was discharged on postoperative day 3, and […]

Surgeons need to balance level 1 evidence and experiential insight in mitigating pancreatic fistulas after pancreatoduodenectomy. Analysis of 37 randomized controlled trials reveals low patient inclusion rates (39.6%) and significant discord in findings for 6 of 7 mitigation techniques. Meta-analyses provided more consistent conclusions than individual trials, yet rates of clinically relevant fistulas differed notably […]