Extrahepatic bile duct resection shows lower complications but worse survival compared to pancreaticoduodenectomy in early-stage cholangiocarcinoma. Major complications: 5.9% for bile duct resection vs 45.3% for pancreaticoduodenectomy (p < .01) Length of stay: 11 days for bile duct resection vs 25 days for pancreaticoduodenectomy (p < .01) 5-year overall survival: 38.9% with bile duct resection […]

Anatomic and biologic criteria improve recurrence predictions post-surgery for perihilar cholangiocarcinoma, enhancing patient selection. Anatomic borderline resectability alone failed to predict recurrence; adding CA19-9 biomarker separated patients into three distinct risk levels for recurrence-free survival. Two-year recurrence-free survival rates were 55.7%, 37.8%, and 25.3% for low-, intermediate-, and high-risk groups respectively. This approach shifts decision-making […]

Cholangiocarcinomas show significant biological diversity, influencing treatment and patient selection. High rates of actionable mutations in intrahepatic cholangiocarcinoma, such as FGFR2 fusions and IDH1/2 mutations, offer new therapeutic targets. Understanding the molecular subtypes can enhance surgical approaches and refine prognostic assessments. Tailoring surgical strategies based on molecular profiles can improve outcomes in cholangiocarcinoma patients. Review […]

Incorporating palliative care can significantly impact procedural decisions for patients with hepatopancreatobiliary cancers. Among 2,848 patients, 48.2% underwent inpatient procedures; 40.7% received palliative care. Early palliative care involvement correlated with a 29% lower chance of undergoing nonpalliative procedures (odds ratio 0.71). Greater integration of palliative care may enhance decision-making aligned with patient quality of life […]

Splenectomy shows variable success across indications in hematologic cancers. Overall 30-day complication rate was 49%, with 22% being severe. Success rate was 91.7% for bridge-to-transplant, but only 38.5% for transfusion independence in lymphoid patients. Surgeons should evaluate the indication for splenectomy carefully, as outcomes differ significantly based on underlying conditions. Myeloid patients had a higher […]

Tumor features after surgery for intrahepatic cholangiocarcinoma can inform recurrence risk and patient outcomes. Of 1,328 patients, 57.5% experienced recurrence: 381 had intrahepatic-only, 171 extrahepatic-only, and 165 combined recurrences. Having three or more metastatic lymph nodes increased the odds of combined recurrence by 3.47 times compared to intrahepatic-only (adjusted odds ratio). Patients with combined recurrence […]

Neoadjuvant therapy may significantly enhance post-recurrence survival in patients with intrahepatic cholangiocarcinoma. Patients receiving neoadjuvant therapy had a median post-recurrence survival of 31.9 months compared to 16.4 months for those who did not (p = 0.006). Neoadjuvant therapy was an independent predictor of survival (hazard ratio, 0.506; p = 0.008). Consider integrating neoadjuvant therapy in […]

Younger patients with intrahepatic cholangiocarcinoma (IHC) show significantly better outcomes when unresectable compared to older patients, which may influence surgical decision-making. The median overall survival for the entire cohort was 23 months, with younger patients having longer overall survival when unresectable (p = 0.008). In the surgical group, older patients had better recurrence-free survival (27 […]