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Ultra-Low-Pass Whole-Genome Sequencing of Circulating Tumor DNA Identifies Prognostic Markers in Hepatocellular Carcinoma

Ultra-low-pass whole-genome sequencing (ULP-WGS) of circulating tumor DNA (ctDNA) can provide clinically relevant information about tumor biology in patients with hepatocellular carcinoma (HCC) under systemic treatment. The presence of ctDNA and the loss of specific genomic regions (5q and 16q) were identified as independent predictors of worse prognosis in advanced HCC patients receiving systemic therapy. These findings highlight the potential of ULP-WGS in identifying patients with HCC who carry a worse prognosis.

Journal Article by Sogbe M, Bilbao I (…) Sangro B et 9 al. in Clin Mol Hepatol

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Advances in the management of pancreatic cancer: A review of recent treatment strategies and future pathways

With a higher mortality rate compared to other cancers, pancreatic cancer poses significant challenges. However, there have been improvements in survival rates, although at a slower pace. Researchers have investigated multimodal treatment approaches involving chemotherapy, surgery, and radiotherapy. Recent advancements in treatment regimens show promise in developing new strategies. This review provides an overview of the current management of pancreatic cancer, highlighting the importance of considering local extension into major vessels. Additionally, it discusses the integration of translational and clinical research findings for future treatment pathways.

Review by Del Chiaro M, Sugawara T, Karam SD and Messersmith WA in BMJ

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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Characterization of Colorectal Carcinoma With Sarcomatoid Components and Suggestions for Differentiation

Colorectal carcinoma with sarcomatoid components is a rare and aggressive subtype of colorectal cancer. In this study, researchers reported 15 cases of this subtype and reviewed the existing literature. The tumors were predominantly found in the rectosigmoid region and presented with symptoms such as abdominal pain and gastrointestinal bleeding. The sarcomatoid component of the tumors took various forms and was usually keratin-positive. Molecular testing identified mutations in several genes. The tumors often presented at an advanced stage with poor prognosis. The study suggests specific features to distinguish this subtype from undifferentiated carcinoma.

Journal Article by Golconda U, McHugh KE (…) Gonzalez RS et 10 al. in Am J Surg Pathol

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Endoscopic Ultrasound Identifies Malignant Lymph Nodes in LT Work-up for Unresectable Perihilar Cholangiocarcinoma

The study investigated the impact of endoscopic ultrasound (EUS) in the liver transplantation (LT) work-up for patients with unresectable perihilar cholangiocarcinoma (PCCA). EUS screenings were performed on a selected group of patients, and the primary outcome was the number of patients precluded from further screening due to malignant lymph nodes (LN). The study found that EUS detected malignancy in LN in 4% of patients, with non-regional LN identified in 14% of surgical staging cases. The results suggest that systematic EUS screening of all LN stations and improved criteria for sampling suspicious lymph nodes could increase the yield.

Journal Article by de Jong DM, den Hoed CM (…) van Driel LMJW et 11 al. in Gastrointest Endosc

Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Precision Surgery Shows Promising Results for Colorectal Liver Metastases Patients with Mutras Tumors

The systematic review and meta-analysis of studies investigating the association of surgical technique with outcomes for colorectal liver metastases (crlm) found that anatomic resection (AR) was associated with improved liver-specific disease-free survival (DFS) and overall DFS in patients with mutras tumors. Specifically, AR resulted in a 40% improvement in liver-specific DFS and a 28% improvement in overall DFS in mutras tumors, while it did not have the same effect in patients with wtras tumors. These findings suggest that precision surgery, like AR, may be beneficial for crlm patients with mutras tumors.

Review by Pikoulis E, Papaconstantinou D (…) Margonis GA et 12 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Course of Segment 4 Hepatic Artery Affects Proximal Ductal Margin Status in Right Hepatectomy for Perihilar Cholangiocarcinoma

The course of the segment 4 hepatic artery affects the proximal ductal margin status in right hepatectomy for perihilar cholangiocarcinoma. The study found that the l-up type of the artery, running along the left cranial position of the umbilical portion of the left portal vein, was associated with a higher rate of negative proximal ductal margins compared to the r-up type. Bismuth-Corlette type II and IIIA and the l-up type were independent predictors of negative proximal ductal margin after a right hepatectomy for perihilar cholangiocarcinoma.

Journal Article by Togasaki K, Hosokawa I (…) Ohtsuka M et 2 al. in BMC Surg

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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Video-Based Self-Reflection in Laparoscopic Training

Researchers conducted a pilot randomized controlled trial to investigate the effectiveness of video-based self-assessment in enhancing the surgical performance of laparoscopic cholecystectomy in trainees. They found that automated video capture and storage could improve adherence, and although the a priori trial feasibility criteria were not achieved, important data were gathered to inform the design of a future adequately powered trial. The study identified the sample sizes needed and highlighted the potential of video-based self-assessment to improve trainee performance in surgical procedures.

Journal Article by Balvardi S, Kaneva P (…) Feldman LS et 6 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Adjuvant chemotherapy improves overall survival in resected stage I pancreatic cancer

A meta-analysis of six comparative studies involving 6,874 patients with resected stage I pancreatic cancer revealed that adjuvant chemotherapy is associated with significantly higher overall survival and 2-year survival rates compared to surgery alone. However, there was no statistically significant difference in 1-year, 3-year, or 5-year survival rates. This study suggests that adjuvant chemotherapy may confer survival benefits for stage I pancreatic cancer, but randomized control trials are needed to further validate these findings.

Review by Evans D, Ghassemi N (…) Athwal TS et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Improved Surgical Outcomes for Female Surgeons in Predominantly Female Patient Surgeries

Preliminary evidence from a retrospective study using the New York State SPARCS database suggests that female surgeons have better post-operative outcomes than their male colleagues in predominantly female patient surgeries. The study examined the impact of patient-surgeon gender discordance on outcomes in bariatric, foregut, and colorectal surgeries. The results showed that patient-surgeon concordance had a significant effect on patient outcomes, with negative effects observed for female patients in certain specialties, particularly in foregut surgery. This highlights the need for surgeons to be aware of the care provided to opposite gender patients and the importance of increasing female representation in surgeries with high female patient populations.

Journal Article by Smolkin C, Zhang X (…) Pryor AD et 4 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Novel System Enhances Network Latency Management in Telesurgery

Researchers conducted telesurgery simulation trials and remote adrenalectomy procedures to assess the performance of a novel network latency management system in 5G telesurgery. The system displayed stability during all procedures and had a friendly interface that was easy to operate. Comparison with the traditional “ping command” method showed no significant difference in network latency data. The system’s alarm function increased telesurgery safety, making it a simple and effective tool for monitoring network latency in telesurgery.

Journal Article by Li C, Zheng J (…) Niu H et 16 al. in Surg Endosc

© 2023. The Author(s).

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