A study comparing hepatocellular carcinoma (HCC) patients in South Africa and Sweden found stark differences in survival and access to curative treatment, underscoring the need for region-specific guidelines. South African HCC patients were younger (median age 50 vs. 71) and predominantly had hepatitis B-related HCC (60% vs. 3.6%) compared to their Swedish counterparts. Only 9.2% […]

Non-receipt of guideline-concordant treatment in pancreatic cancer is linked to worse outcomes and distinct patient patterns. 32.4% of patients in a study cohort did not receive guideline-concordant treatment. Key factors include socioeconomic status, access to care, and patient vulnerability at first contact. Addressing these factors may improve treatment access and outcomes. Areas with higher deprivation […]

Surgeons need to know that bile leaks and Klebsiella pneumoniae infections are major predictors of severe postpancreatectomy hemorrhage in patients with postoperative pancreatic fistulas. Postpancreatectomy hemorrhage occurred in 7.8% of patients, with grade b/c complications in 5.2%. The pancreaticojejunal anastomosis was the most frequent bleeding source (15.6%), followed by branches of the superior mesenteric artery […]

A new three-tier nodal classification improves survival predictions for intrahepatic cholangiocarcinoma patients post-surgery. Median overall survival drops significantly: 55.3 months (n0) to 19.0 months (n2) (p < 0.001). Node-positive patients (n1, n2) face worse outcomes (HR 2.01 and HR 2.59, respectively) compared to node-negative (n0). Use this refined staging to guide treatment decisions, especially for […]

Neuroendocrine liver metastases are seeing better surgical outcomes as practices shift over the last two decades. In the later cohort (2009-2023), major hepatectomy dropped to 32.9%, compared to 60.0% (p < 0.001) in the earlier cohort (1998-2008). The 10-year overall survival improved significantly from 44.2% to 67.4% (p < 0.001). Surgeons should consider parenchyma-sparing approaches […]

Postoperative acute pancreatitis affects recovery after pancreatoduodenectomy—understanding its definitions can optimize patient management. Incidence of postoperative acute pancreatitis: 11.9% (ISGPS), 41.2% (Atlanta-adapted), and 17.6% (Connor’s definition). The Atlanta-adapted framework showed the best ability to predict severe complications (AUC 0.68). A new graded Atlanta-Helsinki classification correlates with complication rates: 12.3% (none), up to 56.3% (both criteria). […]

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 […]