Biliary tract cancers are now seeing transformative therapies that enhance patient outcomes. Chemo-immunotherapy is the new first-line standard of care. Targeted therapies, especially for intrahepatic cholangiocarcinoma with FGFR2 fusions, show high response rates with drugs like pemigatinib and futibatinib. IDH1-mutant cholangiocarcinoma can be treated effectively with ivosidenib. Surgeons should prioritize biomarker testing to personalize treatment […]
Category: HPB & Spleen
Rising Liver Cancer Rates Demand Surgical Vigilance
Primary liver cancer cases are increasing rapidly, demanding enhanced screening and surgical readiness. Incidence and deaths have surged 59.4% and 55.8% from 2000 to 2023, respectively. Hepatitis B and C remain key causes, but rates have rebounded since 2020 despite prior declines. Surgeons must prioritize patient selection and intervention strategies, especially for patients with metabolic […]
Neoadjuvant Strategies Yield Similar Results in Pancreatic Cancer
A meta-analysis finds that neoadjuvant chemoradiotherapy and chemotherapy have comparable outcomes for pancreatic ductal adenocarcinoma. Surgical resection rates were nearly identical: 68.9% for chemoradiotherapy versus 71.5% for chemotherapy. R0 resection rates were also similar: 70.7% for chemoradiotherapy and 64.2% for chemotherapy. Both treatment modalities produced similar one-year survival rates (71.3% versus 72.4%) and overall survival […]
Urine DNA Enhances Diagnosis of IPMN
A new study shows urine cell-free DNA can aid in diagnosing intraductal papillary mucinous neoplasms (IPMN), which may improve patient management. Urine cfDNA detected GNAS mutations in 32% and KRAS mutations in 58% of IPMN cases, compared to just 10% and 19% in plasma, respectively. Main pancreatic duct diameter ≥10 mm and urine mutations significantly […]
Resecting Colorectal Liver Metastases in Progressive Disease Improves Survival
Surgery for colorectal liver metastases after chemotherapy failure can offer survival benefits. Patients with progressive disease underwent hepatectomy showed a 5-year overall survival rate of 42.7%. This is lower than those with controlled disease (62.0% in complete/partial response and 55.5% in stable disease, p<0.001). However, resected progressive disease patients had better survival (46.5%) than non-resected […]
Robotic Resection Works for Large Central Hepatic Tumors
Robotic liver surgery proves effective for complex resections of benign liver tumors like focal nodular hyperplasia. A 24-year-old woman underwent robotic partial hepatectomy for a growing 7 cm FNH with critical hilar involvement. The procedure lasted 3 hours with minimal blood loss (100 cc) and no complications. She was discharged on postoperative day 3, and […]
Navigating Evidence for Post-Pancreatoduodenectomy Fistulas
Surgeons need to balance level 1 evidence and experiential insight in mitigating pancreatic fistulas after pancreatoduodenectomy. Analysis of 37 randomized controlled trials reveals low patient inclusion rates (39.6%) and significant discord in findings for 6 of 7 mitigation techniques. Meta-analyses provided more consistent conclusions than individual trials, yet rates of clinically relevant fistulas differed notably […]
Radical Resection with Intestinal Autotransplantation Improves Outcomes in Pancreatic Cancer
Surgeons treating locally advanced pancreatic cancer (LAPC) can improve patient survival by using radical resection combined with intestinal autotransplantation after systemic treatment. Patients who underwent radical resection and autotransplantation had a median overall survival of 25.8 months, compared to 14.2 months for those who did not have surgery. Median progression-free survival was also better at […]
Medicaid Expansion Lowers Death Rate in Colorectal Cancer Patients
Medicaid expansion is linked to improved survival rates in younger colorectal cancer patients with liver metastasis, impacting surgical decision-making. 3-year disease-specific mortality dropped from 75% to 68% in expansion states after 6+ years. Risk of death reduced by 5-10% in expansion states compared to non-expansion, particularly benefiting those who underwent liver metastasectomy (HR 0.71-0.85). Access […]
Navigating Neoadjuvant Assessment for Pancreatic Cancer
Assessing neoadjuvant therapy response in pancreatic cancer is crucial for improving surgical outcomes. A 50% decrease in CA19-9 levels correlated with better overall survival (32 months vs 24 months, p = 0.0028). Combining CA19-9 response with major pathologic response was linked to the best survival (40 months, p = 0.0086), though this occurred in only […]