Neoadjuvant chemotherapy followed by surgery significantly improves outcomes for potentially resectable intrahepatic cholangiocarcinoma compared to upfront surgery. Median overall survival is 52.9 months with neoadjuvant therapy versus 37.0 months with upfront surgery. Recurrence is delayed (34.6 months vs. 24.4 months) and fewer patients are at risk of death (46.4% vs. 75.3%). Five-year survival rates are […]
Category: HPB & Spleen
Tailored Prognostication with Deep Learning After HCC Resection
Using deep-learning models with CT imaging can significantly improve prognostication for patients after hepatocellular carcinoma surgery. Postoperative recurrence rates within 2 and 5 years are 52.6% vs. 18.5% and 78.9% vs. 46.7% in high-risk vs. low-risk groups (p < 0.001). 5-year mortality rates are 45.1% vs. 9.2% and 10-year rates are 87.1% vs. 43.2% (p […]
New Endpoint May Streamline Trials for Colon and Liver Surgery
A composite endpoint approach can help assess outcomes in simultaneous resections for colon cancer with synchronous liver metastases, improving clinical trial efficiency. In a study of 1,591 patients, 24.3% had a positive composite postoperative endpoint (CELCSS), indicating potential complications. CELCSS includes key issues like colon anastomotic leak (15.4%) and postoperative bleeding (6.5%), predicting prolonged hospital […]
Improved Survival in Gallbladder Cancer Post-Surgery
Textbook outcomes in liver surgery link directly to better survival in gallbladder cancer patients. 61.9% of patients achieved textbook outcomes (TOLS) after curative-intent resection. The 5-year overall survival rate was 45.4% in the TOLS group compared to 21.9% for non-TOLS (p < 0.001). Surgeons should prioritize achieving TOLS to improve long-term patient outcomes. Key risk […]
Biliary Stenting with Radioactive Seeds Enhances Survival in Cholangiocarcinoma
Combining biliary stenting with intraluminal 125 I seed brachytherapy significantly improves outcomes for advanced cholangiocarcinoma patients. Patients receiving the combination treatment had a longer overall survival and better stent patency (p < 0.001) compared to those with stenting alone. Complication rates were comparable between both groups, indicating safety (p > 0.85). Integrating this technique could […]
Predict PHLF in HCC: New Nomogram Revolutionizes Surgery
A new nomogram predicts post-hepatectomy liver failure (PHLF) for hepatocellular carcinoma, improving patient outcomes. Analyzed 654 patients, identifying 55 PHLF cases linked to seven key predictors: liver cirrhosis, total bilirubin, prothrombin time, albumin-bilirubin, fibrosis-4 index, ascites, and intraoperative blood loss. Nomogram achieved an AUC of 0.880 for training and 0.879 for validation, indicating strong predictive […]
Serosal Invasion Drastically Impacts Survival in Cholangiocarcinoma
Tumor serosal invasion (si) significantly worsens outcomes in perihilar cholangiocarcinoma (pcca). 37.7% of 725 patients had si, linked to 34.1% postoperative peritoneal dissemination versus 12.8% in non-si. Overall recurrence rates were 81.0% for si vs. 58.6% for non-si (p<0.001). Five-year survival was only 25.2% in si patients compared to 53.5% in non-si (p<0.001). Surgeons should […]
Efficacy of Percutaneous Papillary Balloon Dilation for CBD Stones
Percutaneous papillary balloon dilation is a safe, effective option for treating common bile duct stones when endoscopy or surgery isn’t viable. Successful stone clearance rates were notable, supporting its efficacy. Complication rates remained low, indicating a favorable safety profile. Surgeons should consider this technique for patients unable to undergo standard procedures, enhancing treatment options. Systematic […]
New Prediction Models for Pancreatic Cancer in Diabetes
New-onset diabetes significantly raises pancreatic cancer risk, an insight that could transform early detection strategies. New-onset diabetes triples pancreatic cancer risk, compared to the general population. Recent prediction models achieve AUCs up to 0.91, but face challenges with validation. Optimizing screening could improve early detection, particularly if localized stage cases are prioritized. Current detection rates […]
Laparoscopic hepatectomy excels for high-risk HCC patients
Laparoscopic hepatectomy achieves better outcomes for hepatocellular carcinoma patients with high-risk features, which matters for surgical selection and strategy. Textbook outcome rate after laparoscopic surgery was 75.8% compared to 67.7% for open surgery (p=0.041). Overall survival at 5 years was similar: laparoscopic 55.6% vs. open 55.5% (p=0.334). Recurrence-free survival also showed no significant difference: laparoscopic […]