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Specific risk factors identified for suicide in colorectal cancer patients

A study analyzed 309,561 colorectal cancer patients, revealing that male sex, non-Hispanic ethnicity, low income, and metastatic disease significantly increase suicide risk. The suicide rate decreased from 1% in 2000-2010 to 0.05% in 2011-2020. Among those diagnosed in the latter period, the risk of suicide reduced substantially. The findings suggest that targeted screening for suicidality in vulnerable groups should be integrated into oncologic care to address these risk factors effectively.

Journal Article by Dourado J, Emile SH (…) Wexner SD et 5 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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The U.S. leads global surgery research productivity.

A comprehensive analysis of 665,668 surgical publications from 110 countries reveals that the United States significantly dominates global research productivity, contributing 30.78% of first authors and 31.32% of senior authors over a 12-year span. The study, utilizing a web-scraping algorithm, indicates other notable contributors include the United Kingdom, China, Japan, and Italy. Research output varies widely by population, with disparities in publications per 100,000 people highlighting the uneven landscape of surgical research productivity.

Journal Article by Karamitros G and Goulas S in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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Combination of hepaticogastrostomy and stenting enhances outcomes

A systematic review assessed the effectiveness of hepaticogastrostomy with antegrade stenting (hgas) compared to hepaticogastrostomy alone (hgs) for malignant biliary obstruction. Findings revealed pooled clinical success rates of 94% for hgas versus 88% for hgs, while re-intervention needs were significantly lower with hgas (OR=0.37). Although overall adverse events were similar, hgas led to reduced bile leakage and increased stent dysfunction duration. No change in overall survival was observed between the two approaches.

Journal Article by Paraskevopoulos P, Obeidat M (…) Erőss B et 7 al. in Therap Adv Gastroenterol

© The Author(s), 2024.

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Recognition of Borderline Resectable Colorectal Liver Metastases as a Distinct Entity

The review delineates ‘borderline resectable colorectal liver metastases’ (BR-CRLM) as a distinct category, integrating both surgical and oncological criteria for optimal decision-making. Current treatments highlight the necessity of pre-operative chemotherapy and advanced surgical interventions, which now offer substantial long-term survival benefits. By emphasizing this classification, clinicians can better tailor therapeutic strategies, involving locoregional therapies and targeted approaches, enhancing outcomes for patients who previously faced limited options.

Review by Varty GP, Patkar S (…) Goel M et 2 al. in J Gastrointest Surg

Copyright © 2024. Published by Elsevier Inc.

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Machine learning model predicts malignant potential of gastric tumors

A novel machine-learning model effectively predicts the malignant potential of gastric gastrointestinal stromal tumors (GISTs), identifying key risk factors such as endoscopic ultrasound features, tumor margin clarity, diameter, and monocyte-to-lymphocyte ratio. Tested with 318 patients, the logistic classification model achieved high performance with area under the curve values of 0.919 and 0.925 for training and test sets, respectively. This tool supports personalized decision-making and enhances preoperative risk assessment in clinical settings.

Journal Article by Liang SQ, Cui YT (…) Wang XF et 5 al. in J Gastrointest Surg

Copyright © 2024. Published by Elsevier Inc.

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Compliance with Quality Performance Indicators in Acute Pancreatitis

The PANORAMA study aims to assess how well New Zealand hospitals adhere to quality performance indicators (QPIs) for acute pancreatitis management. Researchers will gather data from adult patients diagnosed over a three-month period to evaluate compliance levels. In addition, the study will explore the connection between QPI compliance and early clinical outcomes, such as complications and mortality, providing critical insights for future clinical practices and quality improvement efforts in acute pancreatitis care.

Letter by None None; None None; None None in HPB (Oxford)

Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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Ecart AI tool outperforms other warning scores for patient deterioration

In a cohort study of 362,926 hospital encounters, the Ecart early warning score demonstrated superior performance in identifying patient clinical deterioration, achieving an area under the receiver operating characteristic curve of 0.895. The study compared three artificial intelligence scores and three traditional scores, revealing that Ecart provided better predictive values and lead time for interventions. Notably, the non-AI National Early Warning Score (NEWS) outperformed the Epic Deterioration Index in accuracy.

Journal Article by Edelson DP, Churpek MM (…) Rhodes DJ et 6 al. in JAMA Netw Open

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Standardized management strategies established for failed fundoplications

An international expert panel formulated 33 statements addressing the definition and management of post-fundoplication symptoms. With over 80% agreement, the consensus focuses on resolving symptoms rather than achieving normal physiology. Key areas addressed include dysphagia, heartburn, and the appropriateness of revisional surgeries, along with necessary investigations for symptomatic patients. This initiative marks the first global consensus aimed at standardizing approaches to the complications arising from fundoplication, a common treatment for gastroesophageal reflux disease.

Journal Article by Kohn GP, Hassan C (…) Wijnhoven BP et 14 al. in Dis Esophagus

© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus.

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ctDNA provides a reliable alternative to tissue genomic profiling

In a study involving 102 advanced biliary tract cancer patients, circulating tumor DNA (ctDNA) demonstrated an 84.8% sensitivity and a 79.4% positive predictive value compared to tissue genomic profiling. Targetable alterations were identified in 34.3% of patients, including mutations such as FGFR2 fusion and BRCA1/2 mutations. Notably, a novel FGFR2-TNS1 fusion was detected via ctDNA analysis, which was absent in tissue assessments. High somatic variant allele frequency correlated with poor prognosis post-chemotherapy, underscoring ctDNA’s potential as a complementary tool.

Journal Article by Hwang S, Woo S (…) Chon HJ et 9 al. in J Hepatol

Copyright © 2024. Published by Elsevier B.V.

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High preoperative HbA1c levels correlate with poorer outcomes in GEP-NET patients

Higher preoperative glycosylated hemoglobin A1C (HbA1c) levels significantly affect long-term outcomes in patients undergoing resection for nonfunctional gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A study involving 190 patients revealed that those with HbA1c ≥ 6.5% experienced increased complications and markedly reduced median overall survival (89.8 months vs. not reached for low HbA1c). This association highlights the need for enhanced monitoring and management of elevated HbA1c post-surgery.

Journal Article by Li MX, Lopez-Aguiar AG (…) Pawlik TM et 8 al. in J Surg Oncol

© 2024 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.

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