Gadoxetate disodium-enhanced MRI can predict post-hepatectomy liver failure. Low signal intensity of the remnant liver compared to the spleen post-contrast is associated with higher odds of liver failure. Functional liver remnant determined by this imaging can accurately predict post-hepatectomy liver failure, with a specific cut-off value and high sensitivity and specificity. This predictive tool may […]
Category: HPB & Spleen
Monitoring Hepatocellular Carcinoma Burden with Methylated ctDNA Quantification
Quantifying methylated circulating tumor DNA effectively monitors HCC burden without the need for biopsy. Tumor methylation scores rapidly decline postoperatively in surgical HCC patients. Preoperative tms moderately correlates with tumor burden on pathology. Δtms is better associated with tumor progression than Δalpha-fetoprotein, and a composite score improves tumor progression detection. These findings show that ctdna […]
Effective Infection of Pancreatic Tumors with Oncolytic Virus Expressing CD19 Antigen Triggers Enhanced Tumor Regression with CD19-CAR T Cells
Intravenous administration of an oncolytic virus (cf33) engineered to express a nonsignaling CD19 antigen (CD19t) effectively infected and expressed CD19t in pancreatic tumors, triggering cell killing and increased immunogenic response by CD19-CAR T cells. Combination therapy of virus+CAR T cells led to significant tumor regression in pancreatic cancer models. Journal Article by Chen C, Park […]
Key Role of Molecular Profiling in Intrahepatic Cholangiocarcinoma Treatment
Analysis of 125 patients with molecular profiling for intrahepatic cholangiocarcinoma revealed actionable molecular alterations in 45%, leading to targeted therapies in 21 patients. Patients with such alterations had significantly improved overall survival, with mean survival of 34.1 vs 23.6 months in those with actionable alterations. This highlights the importance of molecular profiling in guiding personalized […]
Left-sided liver resection leads to lower mortality and better survival in perihilar cholangiocarcinoma
Left-sided liver resection for perihilar cholangiocarcinoma is associated with lower 90-day mortality and superior overall survival compared to right-sided resection. In a study of 1701 patients, 90-day mortality rates were 9% for left-sided and 18% for right-sided resection, with median overall survival of 30 months for left and 23 months for right. Left-sided resection was […]
High Accuracy Classification of Pancreatic Neoplasms Based on DNA Methylation Signatures.
DNA methylation profiling accurately classifies nonductal primary pancreatic neoplasms, with a random forest model achieving 96.9% accuracy and near perfect precision in identifying nonpancreatic neoplasms. Methylation signatures offer a valuable diagnostic tool with minimal misdiagnosis risk, even in preoperative settings. Journal Article by Verschuur AVD, Hackeng WM (…) Brosens LAA et 13 al. in Clin […]
Perioperative FOLFIRINOX Outperforms Adjuvant Gemcitabine in Resectable Pancreatic Cancer
Patients with resectable pancreatic cancer were randomized to receive either adjuvant gemcitabine or perioperative FOLFIRINOX. Perioperative FOLFIRINOX led to almost doubled median progression-free survival compared to adjuvant gemcitabine in patients who underwent surgical resection. Despite premature trial termination due to poor accrual, perioperative FOLFIRINOX showed feasibility and potential effectiveness in selected patient cohorts. Safety issues […]
“Biological R2 Definition” Predicts Early Recurrence in Pancreatic Cancer
One in ten patients with pancreatic ductal adenocarcinoma experiences very early recurrence after surgery (classified as biological R2), necessitating routine imaging within 12 weeks. Body-tail site lesion was the only preoperative predictor, with higher pt, g3 differentiation, and high lymph node ratio as pathological predictors. Neoadjuvant patients had different predictors, emphasizing the need for tailored […]
Textbook Outcome in Pancreatoduodenectomy for Nonfunctioning Pancreatic Neuroendocrine Tumors
Textbook outcome (TO) was achieved in one-third of patients after pancreatoduodenectomy (PD) for nonfunctioning pancreatic neuroendocrine tumors (NF-PANNETs). Tumor size, minimally invasive approach, and surgical volume were predictors of TO. TO was not associated with improved long-term survival, with similar rates seen in patients with and without TO. The TO rate was higher in patients […]
Identification of Difficulty Scores for Robotic Hepatectomy Using Tampa Difficulty Score System
Researchers developed and validated a novel Difficulty Score System for robotic hepatectomy based on 274 patients. Factors such as neoadjuvant chemotherapy, tumor characteristics, extent of resection, and additional procedures were associated with operative time and blood loss, resulting in difficulty scores ranging from 1 to 49. The patients were grouped into different levels of difficulty, […]