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Downstaging After Preoperative Chemoradiation Improves Survival in Locally Advanced Rectal Cancer

Patients with locally advanced rectal cancer who experience significant downstaging after preoperative chemoradiation have better overall survival compared to those with true pathologic stage 0-1 disease treated with upfront surgery. This was determined through a retrospective review of the national cancer database, which included a study population of 59,884 patients. The findings suggest that response to chemoradiotherapy can identify a subgroup of rectal cancer patients with a particularly favorable prognosis.

Journal Article by Kasheri E, Artinyan A (…) Nasseri Y et 7 al. in Int J Colorectal Dis

© 2024. The Author(s).

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High-grade Solid Pseudopapillary Neoplasms of the Pancreas Have Distinct Clinicopathological and Genetic Features

A study comparing high-grade solid pseudopapillary neoplasms (hg-SPNs) with conventional SPNs (c-SPNs) found that hg-SPNs exhibit more aggressive malignant characteristics, such as larger tumor size, true necrosis, high-grade nuclear atypia, and lymphatic and/or venous invasion. All hg-SPN patients died of the disease, while c-SPN patients were alive without recurrence. Genetic analysis showed ctnnb1 mutations in all hg-SPNs, and some cases displayed mutations in rb1 and tp53 genes. Differentiating between hg-SPNs and c-SPNs is crucial due to their distinctive features and genetic alterations.

Journal Article by Honda S, Yamaguchi H (…) Nagao T et 10 al. in Am J Surg Pathol

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Molecular profiling improves overall survival in patients with intrahepatic cholangiocarcinoma

In a comprehensive multidisciplinary clinic, molecular profiling of intrahepatic cholangiocarcinoma (ICC) identified actionable molecular alterations in 45% of patients, including mutations and amplifications. Among 120 patients with molecular profiling, the detection of these alterations significantly improved mean overall survival (OS) by 10.5 months. Additionally, in 70 patients with non-metastatic ICC, the detection of actionable molecular alterations improved mean OS by 4.6 months. These findings highlight the clinical utility of molecular profiling in guiding targeted therapies and suggest further exploration of targeted therapy in multi-center studies.

Journal Article by Purchla J, Ghabi EM (…) He J et 7 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Using Circulating Tumor DNA as a Biomarker for Early Cancer Recurrence after Surgery

Researchers conducted a systematic review on the feasibility of using circulating tumor DNA (ctDNA) as a biomarker in the immediate postoperative period. Eight cohort studies across six different cancer types showed that patients with detectable ctDNA after surgery had an increased risk of cancer recurrence. This suggests that early postoperative time points could be used to determine minimal residual disease. However, further studies are needed to understand the kinetics of ctDNA clearance in different cancer types and determine optimal postoperative time points.

Review by Efthymiou V, Queenan N (…) Faden DL et 3 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Impact of Guideline Adherence on the Prognosis of Stage B Hepatocellular Carcinoma

South Korean patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) showed significant variations in adherence to treatment guidelines over the study period of 2008-2016. Adherence to guidelines, particularly those recommended by the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD), declined over time. However, adherence to the guidelines of the Asian Pacific Association for the Study of the Liver (APASL) remained consistently high. Curative treatments such as liver resection, liver transplantation, or radiofrequency ablation significantly improved survival compared to adherence to guidelines, highlighting the impact of guideline adherence on the prognosis of stage B HCC in South Korea.

Journal Article by Han JE, Cho HJ (…) Kim SS et 5 al. in World J Gastroenterol

©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

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Faculty Perception Misaligned with Resident Behaviors in the Operating Room

Researchers conducted a study to determine if faculty perception aligned with resident self-perception of intraoperative behaviors in order to enhance intraoperative learning. They found that faculty were not able to accurately perceive residents’ motivational style, as evidenced by the lack of correlation between resident self-perception and faculty perception of resident behavior in eight out of ten evaluated behaviors. Inconsistent correlations were also observed when behaviors were assessed based on self-reported gender and race. Strategies to improve faculty perception of resident motivational style may facilitate better intraoperative learning experiences.

Journal Article by Millar JK, Matusko N, Evans J and Sandhu G in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Impact of Patient Transfer on Perforated Peptic Ulcer Disease Outcomes: Prolonged Hospital Stay

A study examined the impact of patient transfer for definitive surgical intervention in cases of perforated peptic ulcer disease (PPUD). The analysis found that transferred patients had a significantly longer length of stay compared to non-transfer patients. The average length of hospital stay for transferred patients was over twice as long, with an average of 41 days compared to 20 days for non-transfer patients. Although not statistically significant, transfer patients had higher rates of intensive care unit (ICU) care requirement. Further investigation is needed to identify modifiable variables that can improve outcomes and reduce hospital stay in transferred patients.

Journal Article by Schneider R, Perugini R (…) Carroll JE et 6 al. in Surg Endosc

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Efficacy of Nissen Sleeve Gastrectomy in Long-Term Barrett’s Esophagus Regression

Results of a bicentric retrospective study involving 692 patients who underwent Nissen Sleeve Gastrectomy (NSG) demonstrated that NSG led to the healing of known Barrett’s Esophagus (BE) in approximately 64.1% of patients at a 2-year follow-up. The incidence of de novo BE post NSG was found to be nil among the 234 patients who underwent a follow-up endoscopy within 2 years. These findings suggest that NSG is associated with significant improvement in GERD and the regression of BE in the medium term.

Journal Article by Brinas P, Joumaa S (…) Nocca D et 6 al. in Obes Surg

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Hiatal hernia significantly increases the risk of Barrett’s esophagus, particularly long-segment Barrett’s esophagus

This meta-analysis examined the association between hiatal hernia and Barrett’s esophagus (BE) using 47 studies involving 131,517 participants. The unadjusted data showed that hiatal hernia was significantly associated with an increased risk of any length BE. Furthermore, hiatal hernia was found to be a significant risk factor for BE, particularly long-segment Barrett’s esophagus. These findings highlight the importance of recognizing hiatal hernia as a risk factor for BE and emphasize the need for proper management and surveillance for individuals with hiatal hernia.

Journal Article by Ma S, Tong Z (…) Qi X et 3 al. in Therap Adv Gastroenterol

© The Author(s), 2024.

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Association between Neutrophil to Lymphocyte Ratio and Anastomotic Leak after Gastrointestinal Surgeries

Patients who developed an anastomotic leak (AL) after gastrointestinal surgeries had significantly higher neutrophil to lymphocyte ratio (NLR) levels compared to those who did not. This association was observed in retrospective studies and among white patients, but not consistently in prospective studies and among East Asian patients. These findings suggest a potential link between preoperative NLR and postoperative AL. However, further research with larger and more diverse cohorts is needed to validate these results and explore contributing factors.

Journal Article by Haghi SE, Khanzadeh M (…) Khanzadeh S et 7 al. in BMC Surg

© 2024. The Author(s).

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