A multicenter study developed a machine learning model to predict early recurrence in patients with perihilar cholangiocarcinoma (PCCA) after curative surgery. The model, leveraging five key factors, including carbohydrate antigen 19-9 and tumor size, achieved superior predictive performance, particularly with the random forest algorithm (AUC: 0.983) compared to others. High-risk patients showed significantly different recurrence-free […]
Category: HPB & Spleen
Postoperative survival in cholangiocarcinoma has significantly improved.
Surgical strategies implemented after the launch of the cholangiocarcinoma screening and care program led to a significant increase in postoperative survival rates. Median survival time more than doubled from 14 months (2002-2013) to 40 months (2014-2021). Enhanced early-stage detection rose to 29.1%, with surgical margins improving notably (40% vs. 53.7%). These findings underscore the effectiveness […]
Discontinuing Surveillance for Stable IPMNs Can Save Costs
In a study analyzing intraductal pancreatic mucinous neoplasms (IPMNs), findings suggest that patients with stable IPMNs have a comparable risk of pancreatic cancer to the general population. Of 746 patients studied, only 3 (0.4%) developed pancreatic cancer after a median surveillance period of 48 months. The researchers advocate for possibly discontinuing surveillance after 5 years […]
New tool predicts liver metastasis risks in neuroendocrine tumors
A novel Liver Metastasis Score (LMS) effectively predicts liver metastasis risk for patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) post-surgery. Among 724 patients studied, 9.1% developed liver metastasis, significantly impacting survival rates (63.6% vs. 95.8% for no metastasis). Key risk factors identified include Ki-67 index, vascular invasion, lymph node metastases, and absence of adjuvant therapy. The […]
Splenomegaly identified as key risk factor for liver failure
Among 107 patients with initially unresectable colorectal liver metastases undergoing conversion surgery, posthepatectomy liver failure (PHLF) occurred in 14% of cases. Multivariate analysis indicated that preoperative splenomegaly (greater than 135%) was an independent risk factor for PHLF, with an odds ratio of 14.30. Other contributing factors included lower platelet counts, increased blood loss, and extensive […]
Fibrinogen to pre-albumin ratio predicts prognosis in PDAC
A study of 563 patients with pancreatic ductal adenocarcinoma revealed that the preoperative fibrinogen to pre-albumin ratio (FPR) serves as an independent prognostic indicator for recurrence-free survival (RFS) and overall survival (OS) following radical resection. With an optimal threshold of 14.77, patients were stratified into low and high FPR groups. High FPR levels were associated […]
Deep learning accurately classifies colorectal liver metastasis growth patterns
A new deep learning algorithm successfully distinguishes between desmoplastic and non-desmoplastic histopathological growth patterns in colorectal liver metastases, achieving high discriminatory power with area under the curve values of 0.93 and 0.95 during development and external validation, respectively. This automated classification parallels manual scoring regarding overall survival outcomes, ensuring its potential utility in routine histopathological […]
Eosinophil counts are causally linked to pancreatic cancer.
A comprehensive study using MR-PheWAS and mendelian randomization demonstrated a causal association between pancreatic cancer and eosinophil counts, highlighting a notable correlation. Among 776 phenotypes analyzed, 41 showed significance, with specially validated results indicating that genetically predicted pancreatic cancer was linked to elevated eosinophils. This suggests a self-reinforcing relationship between the two. The findings call […]
Standardized Trocar Technique Improves Outcomes in Robotic Surgery
Implementation of a standardized trocar placement method using a 5-cm umbilicus incision combined with two robotic ports resulted in successful outcomes for robotic liver resection (RLR) and robotic pancreaticoduodenectomy (RPD) across a cohort of 60 patients. The approach achieved 82.8% uptake for RLR and 100% for RPD, with no serious postoperative complications, including hepatic insufficiency […]
Liver resection improves survival in colorectal metastases with extrahepatic disease
A population-based analysis of 170,978 patients revealed that liver resection significantly enhances overall survival for those with colorectal liver metastases and concurrent extrahepatic disease. Among 62,003 patients with this dual condition, only 6% underwent liver resection, yet they experienced markedly better median overall survival (52 months) compared to those without resection (27 months). Factors influencing […]