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Impact of Tumor Size on Outcomes of Hepatic Resection for Hepatocellular Carcinoma

The study evaluated the impact of tumor size on perioperative and long-term outcomes of liver resection for hepatocellular carcinoma (HCC). Three groups were categorized based on tumor size. Group III had larger tumors and exhibited higher incidence of unfavorable factors such as multiple tumors, organ invasion, and lymph node presence. Group III also required more extensive surgeries, longer operation time, higher blood loss, and had a higher likelihood of postoperative complications. However, tumor size did not significantly affect recurrence-free survival, indicating that HCC size should not preclude liver resection when appropriate patient selection and standardized care are ensured.

Journal Article by Shehta A, Elsabbagh AM (…) Elghawalby AN et 7 al. in BMC Surg

© 2023. The Author(s).

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Personalized Circulating Tumor DNA Predicts Recurrence in Resectable Pancreatic Cancer

Researchers evaluated the feasibility of using a personalized, tumor-informed circulating tumor DNA (ctDNA) assay to detect recurrence in patients with resectable pancreatic adenocarcinoma (PDAC). They successfully designed ctDNA assays for all patients, and found that ctDNA positivity during the immediate postoperative period was associated with significantly inferior recurrence-free survival and overall survival. This study demonstrates the potential of ctDNA as a prognostic tool for monitoring molecular residual disease and predicting recurrence in patients with PDAC.

Letter by Eckhoff AM, Kanu E (…) Allen PJ et 5 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Minimum of Ten Regional Lymph Nodes Needed to Adequately Stage Adenocarcinoma of the Appendix

The study aimed to determine the minimum number of regional lymph nodes (LNs) required to accurately stage adenocarcinoma of the appendix (AC). The researchers analyzed data from 3,602 AC patients and found that harvesting at least ten LNs was necessary to minimize the risk of missing LN-positive disease. Examining fewer than ten LNs was an independent negative prognostic factor for overall survival. Thus, an adequate number of regional LNs must be assessed to determine LN status in AC patients.

Journal Article by Lopez-Ramirez F, Sardi A (…) Gushchin V et 5 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Optimistic Long-Term Outcomes for Esophageal Cancer Patients with Pathologic Complete Response after Neoadjuvant Chemotherapy and Surgery

Patients with locally advanced esophageal squamous cell carcinoma (ESCC) who achieved a pathologic complete response (PCR) after neoadjuvant chemotherapy had a favorable prognosis in terms of long-term survival. The 5-year overall survival rate for patients with PCR was significantly higher compared to those without PCR. However, a subset of patients still experienced recurrence, particularly locoregional recurrence. Regular follow-up evaluation is necessary for this group of patients to detect and manage recurrent disease.

Journal Article by Wu YY, Dai L (…) Chen KN et 5 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Socioecological Determinants of Health Survey: Highly Acceptable and Feasible in Colorectal Surgery Patients

A comprehensive tool consisting of 88 questions measuring 31 socioecological determinants of health was developed and assessed for acceptability and feasibility in adult patients undergoing colorectal surgery. Results showed high acceptability and feasibility (>65%) for all domains, with the majority of participants reporting no trouble completing the survey, minimal burden, sufficient time, and integration into their appointment. This tool provides valuable insights into understanding and addressing surgical disparities in order to improve patient outcomes.

Journal Article by Smith B, Smith BP (…) Chu DI et 7 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Inefficiencies in Hub-and-Spoke Systems: Balancing Outcomes and Length of Stay

A multi-state cohort study examined hub and spoke healthcare systems and found that while hub hospitals had lower odds of death or serious morbidity (DSM) for complex operations, they had higher odds of prolonged length of stay (LOS) for common operations. This suggests that there is an opportunity to improve system efficiency within these healthcare systems. The study included 122,895 patients across 43 hub-and-spoke systems and analyzed data from 13 states between 2016 and 2018.

Journal Article by Brooks ES, Finn CB, Wirtalla CJ and Kelz RR in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Organ Preservation Treatment Strategies for Rectal Cancer

The OPAXX study aims to determine the rate of successful organ preservation in patients with rectal cancer who have a good clinical response after neoadjuvant therapy. The study, conducted in the Netherlands, will include 168 patients who will be randomized into two parallel single-arm phase II studies. Study arm 1 will evaluate the effectiveness of contact x-ray brachytherapy, while study arm 2 will assess an extended observation period followed by optional transanal local excision. The primary endpoint is the rate of successful organ preservation at 1 year, with secondary endpoints including toxicity, morbidity, oncological, and functional outcomes.

Journal Article by Geubels BM, van Triest B (…) Grotenhuis BA et 10 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Intra-Abdominal Abscesses After Major Liver Trauma: Unraveling Risk Factors

The study investigated risk factors associated with intra-abdominal abscesses (IAA) following major operative liver trauma. Based on a retrospective multi-center study involving 372 patients, it was found that patients with penetrating trauma, activation of intraoperative massive transfusion protocol, biloma/bile leak, longer hospital length of stay, and additional intra-abdominal injuries had a higher risk of developing IAA. No association was observed between IAA risk and other factors such as intra-abdominal drains, damage control laparotomy, blood transfusions, or blood loss during surgery. These findings contribute to refining guidelines for managing complex operative traumatic liver injuries.

Journal Article by Smith AA, Cone JT (…) Braverman MA et 8 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Extent of intramucosal involvement in gallbladder adenocarcinoma is a marker for advanced disease and poorer survival.

Patients with diffuse involvement of the gallbladder mucosa have aggressive tumor biology and worse overall survival compared to those with focal disease. This retrospective study analyzed 63 patients with non-metastatic gallbladder adenocarcinoma and found that 50.7% had diffuse cancer. There was no difference in the utilization of definitive surgery between the groups. These findings provide valuable information for clinicians and surgeons in making decisions regarding subsequent surgical and medical management for patients with gallbladder adenocarcinoma.

Journal Article by Naples R, Perlmutter BC (…) Augustin T et 9 al. in Am Surg

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Laparoscopic Approaches Have Lower Complication Rates in Oncological Right Hemicolectomy Comparison

In a study comparing open surgery, laparoscopy with intracorporeal anastomosis, and laparoscopy with extracorporeal anastomosis for oncological right hemicolectomy, researchers found that laparoscopic approaches had significantly lower complication rates than open surgery. The duration of surgery was longer in the laparoscopic groups, but the length of hospital stay was shorter. Reoperation within 30 days only occurred in the open surgery group. Overall, there were no significant differences in quality of life and recovery outcomes between the three groups.

Journal Article by Kerber KM, Hetjens S (…) Seyfried S et 2 al. in Int J Colorectal Dis

© 2024. The Author(s).

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