Understanding non-tumor factors affecting surgery outcomes for colorectal liver metastases (CRLM) is crucial for reducing disparities. Only 20% of the 14,047 patients with synchronous CRLM received local treatment. Older age (OR 0.94) and female sex (OR 0.87) decreased the likelihood of receiving surgery, while higher socioeconomic status improved access (OR 1.35 for middle, OR 1.61 […]
Category: HPB & Spleen
Evolving Strategies for BCLC-B Hepatocellular Carcinoma
Localized hepatocellular carcinoma patients in the BCLC-B stage may be better treated with liver resection instead of standard therapy. New findings indicate selective liver resection can improve outcomes for specific BCLC-B patients. Emerging subclassifications within BCLC-B highlight the heterogeneity of this stage, necessitating tailored approaches. Surgeons should consider patient-specific factors to optimize treatment plans and […]
Merger of Two High-Volume Centers Lowers Pancreatic Surgery Risks
Combining two high-volume centers for pancreatoduodenectomies significantly improves patient outcomes. Post-merger in-hospital/30-day mortality dropped from 2.0% to 0.4%. Major morbidity rates decreased from 41% to 35%. This suggests that surgical volume and enhanced patient management can lead to better results. Robot-assisted surgeries rose from 16% to 36%, enhancing procedural precision. Journal Article by Rompen IF, […]
Sequential Strategy Improves Survival in High-Risk Liver Metastases
A sequential approach combining neoadjuvant and adjuvant chemotherapy with surgery markedly boosts survival for high-risk colorectal liver metastasis patients. Patients receiving neoadjuvant chemotherapy had a median progression-free survival of 1.1 years versus 0.6 years for surgery-first patients (p<0.001). Overall survival was better in the neoadjuvant group: 5.2 years compared to 4.3 years (p=0.044). Completing the […]
Improved Survival After Liver Resection for HCC
Long-term survival rates for hepatocellular carcinoma patients significantly improved following liver resection over 20 years. 5-year overall survival rates increased from 68.1% to 90.5% across three time periods (1996-2017). Short-term outcomes enhanced, with 90-day mortality dropping to just 0.3% and major complications at 5.0%. These advancements result from better surgical techniques and patient selection, allowing […]
Duodenum-Preserving Resection is Safe and Effective
Duodenum-preserving pancreatic head resection shows promising outcomes for patients with benign and premalignant neoplasms. 90-day mortality is only 0.47% across 1063 patients. Recurrence rates are low: 5.61% for intraductal papillary mucinous neoplasms, with no recurrences noted among those treated for micro-carcinoma. Consider this technique for appropriate patients to enhance surgical management of pancreatic head neoplasms. […]
New approaches in acute pancreatitis management
Early intervention and minimally invasive techniques are changing outcomes for acute pancreatitis. Early endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is critical for gallstone pancreatitis with cholangitis, followed by laparoscopic cholecystectomy. Interventional radiology enhances outcomes through percutaneous drainage and angiographic embolization for severe cases, reducing morbidity and hospital stay. Collaboration between surgery, gastroenterology, and interventional radiology […]
Outcomes of Pancreatic Tumors Differ by Cancer Type
Surgeons need to know how outcomes differ between pancreatic neuroendocrine tumors (pnet) and ductal adenocarcinoma (pdac) after surgery. After pancreatoduodenectomy, ideal outcomes were lower for pnet (44.2%) vs. pdac (56.9%), with significantly higher severe complications (31.2% vs. 19.0%) and readmission rates (23.6% vs. 15.3%). In distal pancreatectomy, pnet had better ideal outcomes (60.1% vs. 57.1%), […]
Guidelines for Better Surgical Outcomes in Hepatocellular Carcinoma
Surgical resection outperforms other treatments for hepatocellular carcinoma in survival and recurrence rates, but patient selection is critical. Expert consensus emphasizes that careful patient selection leads to better outcomes and fewer complications. Surgical resection achieves the lowest local recurrence rate and the highest survival rate, especially in suitable candidates. Optimize surgical results by adhering to […]
Rising burden of synchronous liver metastasis in cancer patients
Synchronous liver metastasis is on the rise, impacting surgical decisions and outcomes for various cancers. 6% of cancer patients developed synchronous liver metastasis between 2010 and 2021, with a 2.24% annual increase in the early years. Nearly 47.5% of cases were oligometastatic, leading to significantly better survival rates with surgery (5-year survival: 41% vs. 7.4%). […]