Analyzing 72,376 patients with colorectal liver metastases (CRLM) from the National Cancer Database, researchers found that liver-only CRLM patients undergoing perioperative chemotherapy had a superior median overall survival (OS) of 44.7 months. Resection of both primary and metastatic sites also correlated with better OS (38.9 months) compared to metastatic site alone (30.2 months) or primary […]
Category: HPB & Spleen
Predicting Portal Vein System Thrombosis: A Nomogram Using Preoperative Portal Vein Velocity after Splenectomy with Esophagogastric Devascularization
In cirrhotic patients with portal hypertension undergoing splenectomy with esophagogastric devascularization (SED), portal vein system thrombosis (PVST) is a serious concern. This study involving 562 patients revealed that low preoperative portal vein velocity (PVV) was the strongest independent risk factor for PVST. Patients with PVV ≤ 16.5 cm/s had a significantly higher incidence of PVST. […]
Combined Hepatic Resection and Ablation Ensure Safety and Long-Term Survival in Extensive Colorectal Liver Metastases
Examining 161 patients with colorectal liver metastases (CRLM), researchers investigated the safety and efficacy of simultaneous hepatic resection (HR) and ablation. With 77.6% having bilobar disease and 57.1% having ≥5 tumors, the combined procedure demonstrated acceptable safety and durable long-term survival (median 38.2 months, 5-year OS 33.2%). Simultaneous colon resection increased complications. Importantly, patients with […]
Adjuvant Chemotherapy’s Limited Benefit in Node-Negative Pancreatic Cancer
In a Danish cohort study emulating a randomized controlled trial, researchers assessed adjuvant chemotherapy’s impact on node-negative (PN0) and node-positive (PN+) pancreatic cancer survival after surgery. Among PN0 patients, adjuvant therapy showed no significant 2-year survival difference (-2.2%). For PN+ individuals, a 9.9% improvement in 2-year survival was noted. Median overall survival was 24.9 months […]
Optimizing Surgical Approach in Synchronous Colorectal Liver Metastases
Analyzing data from 976 patients with synchronous colorectal liver metastases, researchers compared simultaneous and staged resections. Simultaneous resection, beneficial for low to moderate tumor burden and node-negative right-sided primary tumors, showed increased complications in high tumor burden cases. Staged resection demonstrated better outcomes for patients with node-positive left-sided primaries and higher tumor burden scores. Tailoring […]
Margin Clearance and Survival in Ampullary Adenocarcinoma After Pancreaticoduodenectomy
Examining 128 patients undergoing pancreaticoduodenectomy for ampullary adenocarcinoma, Danish researchers found that a margin clearance of ≥1 mm was independently associated with significantly improved survival compared to
ERCP Shows High Effectiveness in Managing Malignant Biliary Obstruction: Real-world Analysis of 596 Cases
In a real-world study at Oslo University Hospital, ERCP was assessed as the initial management for malignant biliary obstruction (MBO). Of 596 patients, the primary outcome was achieved in 62%, with an 80% overall technical success rate. Distal extrahepatic MBO had an 85% success rate. Reinterventions were performed in 27%, and complications occurred in 15%, […]
Hepatectomy with Bile Duct Resection Hinders Adjuvant Chemotherapy in Biliary Tract Cancer Patients
In a retrospective analysis of 168 biliary tract carcinoma patients post-surgery, 83.9% received adjuvant chemotherapy, while 16.1% did not. Notably, hepatectomy with extrahepatic bile duct resection (BDR) significantly hindered chemotherapy administration compared to other surgeries. Refractory bile leak, primarily post hepatectomy with BDR, was a common reason for non-administration. Multivariate analysis identified hepatectomy with BDR […]
Augmented Reality Improves Outcomes in Laparoscopic Segmentectomy for Hepatocellular Carcinoma
In a retrospective analysis of 98 hepatocellular carcinoma patients undergoing laparoscopic segmentectomy, augmented reality navigation (ARN) combined with fluorescence imaging (FI) significantly reduced intraoperative blood loss and remnant liver ischemia compared to non-ARN-FI cases. The ARN-FI group exhibited higher 1-year and 3-year disease-free survival rates, indicating improved oncological prognosis. The study concludes that ARN-FI enhances […]
Multidisciplinary Clinics Improve Pancreatic Cancer Treatment and Equity
Examining 4141 pancreatic cancer patients, this study in a high-volume hospital system found that Multidisciplinary Clinics (MDCs) significantly boost comprehensive treatment rates, such as neoadjuvant chemotherapy, surgery, palliative care, and clinical trial participation. MDC management effectively eliminates socioeconomic disparities in treatment access, particularly benefiting disadvantaged patients. The study underscores the crucial role of multidisciplinary team-based […]