Pub Date : 2024-11-15DOI: 10.1016/j.ejso.2024.109463
Luca Boldrini, Diepriye Charles-Davies, Angela Romano, Matteo Mancino, Ilaria Nacci, Huong Elena Tran, Francesco Bono, Edda Boccia, Maria Antonietta Gambacorta, Giuditta Chiloiro
<p><strong>Background: </strong>Predicting pathological complete response (pCR) from pre or post-treatment features could be significant in improving the process of making clinical decisions and providing a more personalized treatment approach for better treatment outcomes. However, the lack of external validation of predictive models, missing in several published articles, is a major issue that can potentially limit the reliability and applicability of predictive models in clinical settings. Therefore, this systematic review described different externally validated methods of predicting response to neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) patients and how they could improve clinical decision-making.</p><p><strong>Method: </strong>An extensive search for eligible articles was performed on PubMed, Cochrane, and Scopus between 2018 and 2023, using the keywords: (Response OR outcome) prediction AND (neoadjuvant OR chemoradiotherapy) treatment in 'locally advanced Rectal Cancer'.</p><p><strong>Inclusion criteria: </strong>(i) Studies including patients diagnosed with LARC (T3/4 and N- or any T and N+) by pre-medical imaging and pathological examination or as stated by the author (ii) Standardized nCRT completed. (iii) Treatment with long or short course radiotherapy. (iv) Studies reporting on the prediction of response to nCRT with pathological complete response (pCR) as the primary outcome. (v) Studies reporting external validation results for response prediction. (vi) Regarding language restrictions, only articles in English were accepted.</p><p><strong>Exclusion criteria: </strong>(i) We excluded case report studies, conference abstracts, reviews, studies reporting patients with distant metastases at diagnosis. (ii) Studies reporting response prediction with only internally validated approaches.</p><p><strong>Data collection and quality assessment: </strong>Three researchers (DC-D, FB, HT) independently reviewed and screened titles and abstracts of all articles retrieved after de-duplication. Possible disagreements were resolved through discussion among the three researchers. If necessary, three other researchers (LB, GC, MG) were consulted to make the final decision. The extraction of data was performed using the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) template and quality assessment was done using the Prediction model Risk Of Bias Assessment Tool (PROBAST).</p><p><strong>Results: </strong>A total of 4547 records were identified from the three databases. After excluding 392 duplicate results, 4155 records underwent title and abstract screening. Three thousand and eight hundred articles were excluded after title and abstract screening and 355 articles were retrieved. Out of the 355 retrieved articles, 51 studies were assessed for eligibility. Nineteen reports were then excluded due to lack of reports on external validation, while 4 wer
{"title":"Response prediction for neoadjuvant treatment in locally advanced rectal cancer patients-improvement in decision-making: A systematic review.","authors":"Luca Boldrini, Diepriye Charles-Davies, Angela Romano, Matteo Mancino, Ilaria Nacci, Huong Elena Tran, Francesco Bono, Edda Boccia, Maria Antonietta Gambacorta, Giuditta Chiloiro","doi":"10.1016/j.ejso.2024.109463","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.109463","url":null,"abstract":"<p><strong>Background: </strong>Predicting pathological complete response (pCR) from pre or post-treatment features could be significant in improving the process of making clinical decisions and providing a more personalized treatment approach for better treatment outcomes. However, the lack of external validation of predictive models, missing in several published articles, is a major issue that can potentially limit the reliability and applicability of predictive models in clinical settings. Therefore, this systematic review described different externally validated methods of predicting response to neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) patients and how they could improve clinical decision-making.</p><p><strong>Method: </strong>An extensive search for eligible articles was performed on PubMed, Cochrane, and Scopus between 2018 and 2023, using the keywords: (Response OR outcome) prediction AND (neoadjuvant OR chemoradiotherapy) treatment in 'locally advanced Rectal Cancer'.</p><p><strong>Inclusion criteria: </strong>(i) Studies including patients diagnosed with LARC (T3/4 and N- or any T and N+) by pre-medical imaging and pathological examination or as stated by the author (ii) Standardized nCRT completed. (iii) Treatment with long or short course radiotherapy. (iv) Studies reporting on the prediction of response to nCRT with pathological complete response (pCR) as the primary outcome. (v) Studies reporting external validation results for response prediction. (vi) Regarding language restrictions, only articles in English were accepted.</p><p><strong>Exclusion criteria: </strong>(i) We excluded case report studies, conference abstracts, reviews, studies reporting patients with distant metastases at diagnosis. (ii) Studies reporting response prediction with only internally validated approaches.</p><p><strong>Data collection and quality assessment: </strong>Three researchers (DC-D, FB, HT) independently reviewed and screened titles and abstracts of all articles retrieved after de-duplication. Possible disagreements were resolved through discussion among the three researchers. If necessary, three other researchers (LB, GC, MG) were consulted to make the final decision. The extraction of data was performed using the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) template and quality assessment was done using the Prediction model Risk Of Bias Assessment Tool (PROBAST).</p><p><strong>Results: </strong>A total of 4547 records were identified from the three databases. After excluding 392 duplicate results, 4155 records underwent title and abstract screening. Three thousand and eight hundred articles were excluded after title and abstract screening and 355 articles were retrieved. Out of the 355 retrieved articles, 51 studies were assessed for eligibility. Nineteen reports were then excluded due to lack of reports on external validation, while 4 wer","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"109463"},"PeriodicalIF":3.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-12DOI: 10.1016/j.ejso.2024.109373
Enora Laas , Elise Dumas , Anne-Sophie Hamy , Thomas Gaillard , Paul Gougis , Fabien Reyal , François Husson , Anne-Sophie Jannot
Background
Suboptimal treatment delays is known to impact prognosis of patients with cancer but optimal timing in specific subgroups remains poorly studied. This study aimed to analyze treatment delays in young women treated for a breast cancer (BC) on and its impact on their prognosis using French Nationwide Data.
Methods
Using the CAREPAT-YBC Cohort based on the French National Healthcare System Database, we analyzed disease-free survival (DFS) in 22,093 young women (18–45 years) who underwent either surgery-chemotherapy-radiotherapy pathway (adjuvant setting, 15,433 patients) or chemotherapy-surgery-radiotherapy pathway (neoadjuvant setting, 6660 patients), according to delays between the different pathways.
Results
For the adjuvant chemotherapy-radiotherapy interval, the best timing was 17–31 days with increased risk above this delay. For the neoadjuvant setting, the optimal neoadjuvant chemotherapy-surgery interval was 17–31 days, while ≤15 days (HR 1.44, 95%CI 1.21–1.71) or ≥62 days (HR 2.07, 95%CI 1.36–3.15) showed poorer prognosis. Combining best timing into an "optimal pathway" was associated with respectively a 1.2-fold decreased risk for recurrence or mortality.
Conclusion
Optimizing treatment intervals enhance BC survival in younger age.
{"title":"The influence of treatment intervals on prognosis in young breast cancer patients: Insights from the French National cohort","authors":"Enora Laas , Elise Dumas , Anne-Sophie Hamy , Thomas Gaillard , Paul Gougis , Fabien Reyal , François Husson , Anne-Sophie Jannot","doi":"10.1016/j.ejso.2024.109373","DOIUrl":"10.1016/j.ejso.2024.109373","url":null,"abstract":"<div><h3>Background</h3><div>Suboptimal treatment delays is known to impact prognosis of patients with cancer but optimal timing in specific subgroups remains poorly studied. This study aimed to analyze treatment delays in young women treated for a breast cancer (BC) on and its impact on their prognosis using French Nationwide Data.</div></div><div><h3>Methods</h3><div>Using the CAREPAT-YBC Cohort based on the French National Healthcare System Database, we analyzed disease-free survival (DFS) in 22,093 young women (18–45 years) who underwent either surgery-chemotherapy-radiotherapy pathway (adjuvant setting, 15,433 patients) or chemotherapy-surgery-radiotherapy pathway (neoadjuvant setting, 6660 patients), according to delays between the different pathways.</div></div><div><h3>Results</h3><div>For the adjuvant chemotherapy-radiotherapy interval, the best timing was 17–31 days with increased risk above this delay. For the neoadjuvant setting, the optimal neoadjuvant chemotherapy-surgery interval was 17–31 days, while ≤15 days (HR 1.44, 95%CI 1.21–1.71) or ≥62 days (HR 2.07, 95%CI 1.36–3.15) showed poorer prognosis. Combining best timing into an \"optimal pathway\" was associated with respectively a 1.2-fold decreased risk for recurrence or mortality.</div></div><div><h3>Conclusion</h3><div>Optimizing treatment intervals enhance BC survival in younger age.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109373"},"PeriodicalIF":3.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-10DOI: 10.1016/j.ejso.2024.109377
Allen Wei-Jiat Wong , Nadia Hui Shan Sim , Stella Jinran Zhan , Jung-Ju Huang
Breast cancer related lymphedema (BCRL) is a common complication following mastectomy and axillary lymph node dissection (ALND). Patients with BCRL are often fraught with restricted mobility of the upper limb and higher risk of infections which negatively impact their quality of life. Immediate lymphatic reconstruction (ILR) has gained popularity in recent years due to its positive results in lowering BCRL rates. The objective of this study is to summarize evidence from the current available literature on the efficacy of ILR in preventing BCRL following ALND. A comprehensive search across PubMed and Web of Science was conducted. Studies involving ILR performed at the time of ALND for breast cancer were included. Exclusion criteria included secondary lymphatic reconstruction for established BCRL, literature reviews, animal studies, case reports and studies detailing surgical technique. To evaluate the efficacy of ILR, only studies with both intervention groups (ILR) and control groups were included. A systematic search yielded data from 10 studies and 1487 breast cancer patients who underwent ALND at the time of surgery. Meta-analysis revealed that in the ILR group, 50 of 637 (7.85 %) patients developed BCRL whereas in the control group, 177 of 850 patients (20.8 %) developed BCRL. Patients treated with ILR in this analysis had a relative risk of 0.31 (95 % CI, 0.19 to 0.51) for developing BCRL when compared to the controls (p < 0.0001). ILR decreases the risk of developing lymphedema following ALND for breast cancer.
{"title":"The efficacy of immediate lymphatic reconstruction after axillary lymph node dissection – A meta-analysis","authors":"Allen Wei-Jiat Wong , Nadia Hui Shan Sim , Stella Jinran Zhan , Jung-Ju Huang","doi":"10.1016/j.ejso.2024.109377","DOIUrl":"10.1016/j.ejso.2024.109377","url":null,"abstract":"<div><div>Breast cancer related lymphedema (BCRL) is a common complication following mastectomy and axillary lymph node dissection (ALND). Patients with BCRL are often fraught with restricted mobility of the upper limb and higher risk of infections which negatively impact their quality of life. Immediate lymphatic reconstruction (ILR) has gained popularity in recent years due to its positive results in lowering BCRL rates. The objective of this study is to summarize evidence from the current available literature on the efficacy of ILR in preventing BCRL following ALND. A comprehensive search across PubMed and Web of Science was conducted. Studies involving ILR performed at the time of ALND for breast cancer were included. Exclusion criteria included secondary lymphatic reconstruction for established BCRL, literature reviews, animal studies, case reports and studies detailing surgical technique. To evaluate the efficacy of ILR, only studies with both intervention groups (ILR) and control groups were included. A systematic search yielded data from 10 studies and 1487 breast cancer patients who underwent ALND at the time of surgery. Meta-analysis revealed that in the ILR group, 50 of 637 (7.85 %) patients developed BCRL whereas in the control group, 177 of 850 patients (20.8 %) developed BCRL. Patients treated with ILR in this analysis had a relative risk of 0.31 (95 % CI, 0.19 to 0.51) for developing BCRL when compared to the controls (p < 0.0001). ILR decreases the risk of developing lymphedema following ALND for breast cancer.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109377"},"PeriodicalIF":3.5,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.ejso.2024.109376
S. Vancoillie , E. Willems , C. De Meyere , I. Parmentier , C. Verslype , Mathieu D'Hondt
Purpose
A repeat liver resection is considered a technically challenging procedure and therefor an open approach is frequently preferred. With the introduction of minimally invasive liver surgery, laparoscopic repeat liver resection demonstrates favorable results, however, limited data on robotic repeat liver resections exists. Our aim is to compare the robotic approach with the laparoscopic one for a repeat liver resection.
Methods
In a single-center retrospective analysis, we report the data of all minimally invasive repeat liver resections performed between September 2011 and August 2023. Short-term outcomes – including procedure time, blood loss, conversion rate, morbidity and mortality – were compared for a laparoscopic and a robotic approach.
Results
A total of 136 minimally invasive repeat liver resections were performed, of which 56 robotic procedures and 80 laparoscopic procedures. Both groups were similar in baseline demographics, diagnosis and surgical procedure. While the mean procedure time was slightly longer in the robotics group by 15 min (145min and 130min, p = 0.04), the median blood loss was significantly lower in the robotic group (30 ml and 80 ml, p < 0.001). Additionally, there was a trend towards less conversions in the robotic group (n = 0 and n = 6, p = 0.42). Post-operative morbidity and mortality were similar in both groups.
Conclusion
The robotic approach for minimally invasive repeat liver surgery is both safe and feasible, while also demonstrating favorable short-term outcomes. In our experience, the ‘tunnel technique’ – which avoids dissection of intra-abdominal adhesions – is a key advantage of this approach.
{"title":"Robotic versus laparoscopic repeat hepatectomy: A comparative single-center study of perioperative outcomes","authors":"S. Vancoillie , E. Willems , C. De Meyere , I. Parmentier , C. Verslype , Mathieu D'Hondt","doi":"10.1016/j.ejso.2024.109376","DOIUrl":"10.1016/j.ejso.2024.109376","url":null,"abstract":"<div><h3>Purpose</h3><div>A repeat liver resection is considered a technically challenging procedure and therefor an open approach is frequently preferred. With the introduction of minimally invasive liver surgery, laparoscopic repeat liver resection demonstrates favorable results, however, limited data on robotic repeat liver resections exists. Our aim is to compare the robotic approach with the laparoscopic one for a repeat liver resection.</div></div><div><h3>Methods</h3><div>In a single-center retrospective analysis, we report the data of all minimally invasive repeat liver resections performed between September 2011 and August 2023. Short-term outcomes – including procedure time, blood loss, conversion rate, morbidity and mortality – were compared for a laparoscopic and a robotic approach.</div></div><div><h3>Results</h3><div>A total of 136 minimally invasive repeat liver resections were performed, of which 56 robotic procedures and 80 laparoscopic procedures. Both groups were similar in baseline demographics, diagnosis and surgical procedure. While the mean procedure time was slightly longer in the robotics group by 15 min (145min and 130min, p = 0.04), the median blood loss was significantly lower in the robotic group (30 ml and 80 ml, p < 0.001). Additionally, there was a trend towards less conversions in the robotic group (n = 0 and n = 6, p = 0.42). Post-operative morbidity and mortality were similar in both groups.</div></div><div><h3>Conclusion</h3><div>The robotic approach for minimally invasive repeat liver surgery is both safe and feasible, while also demonstrating favorable short-term outcomes. In our experience, the ‘tunnel technique’ – which avoids dissection of intra-abdominal adhesions – is a key advantage of this approach.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109376"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.ejso.2024.109371
Hajra Asad, Owais Ahmad, Enjizab Fatima
{"title":"Letter to editor: Optimized machine learning model for predicting unplanned reoperation after rectal cancer anterior resection","authors":"Hajra Asad, Owais Ahmad, Enjizab Fatima","doi":"10.1016/j.ejso.2024.109371","DOIUrl":"10.1016/j.ejso.2024.109371","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109371"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.ejso.2024.109378
Chen-Hao He , Zong-Ze Li , Hao-Wen Ke , Wen-Bo Zhai , Xia-Lin Yan , Wen-Tao Xi , Gao-Feng Wu , Yue-Yue Zheng , Xian Shen , Dong-Dong Huang
Background
Stair climbing test (SCT) and gait speed test (GST) are two physical performance measures, both of which are associated with postoperative outcomes. However, few studies have compared these two tests for the prognostic value.
Methods
A prospective study was conducted in patients undergoing radical gastrectomy for gastric cancer. Handgrip strength (HGS) test, 7-steps SCT and 6-m GST were performed before surgery. Body compositions were analyzed using abdominal computed tomography (CT). Sarcopenia was diagnosed by low HGS plus either low muscle mass or quality.
Results
A total of 548 patients were included in this study. Time of GST and SCT were both significantly correlated with HGS, skeletal muscle index and skeletal muscle density, but not with subcutaneous or visceral fat area. Low SCT performance (SCT time ≥12.65s) was associated with higher incidence of postoperative complications and longer postoperative length of stay, whereas low GST performance (GST time ≥5.45s) did not. Low performance in SCT and GST were both associated with worse overall survival (OS) and disease-free survival (DFS) after surgery. Low SCT performance was an independent predictor for postoperative complications, OS, and DFS, whereas low GST performance was not significant in multivariate analyses adjusting for the same covariates. The combination of sarcopenia with low SCT performance showed higher accuracy in predicting postoperative complications and mortality compared with sarcopenia combined with low GST performance.
Conclusion
SCT outperformed GST in predicting outcomes after radical gastrectomy for gastric cancer, either as a singular indicator or in combination with sarcopenia assessments.
{"title":"Stair climbing outperforms gait speed in predicting postoperative outcomes in patients undergoing radical gastrectomy for gastric cancer: A prospective study","authors":"Chen-Hao He , Zong-Ze Li , Hao-Wen Ke , Wen-Bo Zhai , Xia-Lin Yan , Wen-Tao Xi , Gao-Feng Wu , Yue-Yue Zheng , Xian Shen , Dong-Dong Huang","doi":"10.1016/j.ejso.2024.109378","DOIUrl":"10.1016/j.ejso.2024.109378","url":null,"abstract":"<div><h3>Background</h3><div>Stair climbing test (SCT) and gait speed test (GST) are two physical performance measures, both of which are associated with postoperative outcomes. However, few studies have compared these two tests for the prognostic value.</div></div><div><h3>Methods</h3><div>A prospective study was conducted in patients undergoing radical gastrectomy for gastric cancer. Handgrip strength (HGS) test, 7-steps SCT and 6-m GST were performed before surgery. Body compositions were analyzed using abdominal computed tomography (CT). Sarcopenia was diagnosed by low HGS plus either low muscle mass or quality.</div></div><div><h3>Results</h3><div>A total of 548 patients were included in this study. Time of GST and SCT were both significantly correlated with HGS, skeletal muscle index and skeletal muscle density, but not with subcutaneous or visceral fat area. Low SCT performance (SCT time ≥12.65s) was associated with higher incidence of postoperative complications and longer postoperative length of stay, whereas low GST performance (GST time ≥5.45s) did not. Low performance in SCT and GST were both associated with worse overall survival (OS) and disease-free survival (DFS) after surgery. Low SCT performance was an independent predictor for postoperative complications, OS, and DFS, whereas low GST performance was not significant in multivariate analyses adjusting for the same covariates. The combination of sarcopenia with low SCT performance showed higher accuracy in predicting postoperative complications and mortality compared with sarcopenia combined with low GST performance.</div></div><div><h3>Conclusion</h3><div>SCT outperformed GST in predicting outcomes after radical gastrectomy for gastric cancer, either as a singular indicator or in combination with sarcopenia assessments.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109378"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.ejso.2024.109375
Shaoru Liu , Zongfeng Wu , Chenwei Wang , Liang Qiao , Zhenkun Huang , Yichuan Yuan , Ruhai Zou , Wei He , Binkui Li , Yunfei Yuan , Jiliang Qiu
Background
Hepatectomy is the optimal treatment for less than 20 % patients with hepatocellular carcinoma (HCC). A combination of hepatic artery infusion chemotherapy and systemic therapy-based conversion therapy provides a chance of resection for those with unresectable HCC. Yet, the prognosis for those successfully conversion resection is still unknown. The study is to determine the factors predicted prognosis of patients after conversion hepatic resection.
Methods
A total of 343 HCC patients underwent hepatectomy following conversion therapy from August 2018 to April 2023. Univariate and multivariate analysis were used to screen for independent factors affecting patients’ prognosis.
Results
One hundred and fifty-seven (45.8 %) patients developed recurrence or metastasis at a median time of 16.7 months (95 % CI 12.4–21.0 months) from hepatectomy. Univariate and multivariate analysis identified tumor number, alpha fetoprotein (AFP) response, tumor response, and successful downstaging were independent recurrent-free survival related predictors. Albumin bilirubin (ALBI) score and AFP response were independent death related predictors.
Conclusions
Clinical parameters reflecting the depth of conversion therapy response, were promising in predicting prognosis for HCC patients after conversion hepatic resection.
背景：对于不到 20% 的肝细胞癌（HCC）患者来说，肝切除术是最佳治疗方法。肝动脉灌注化疗和基于全身治疗的转换疗法相结合，为那些无法切除的 HCC 患者提供了切除的机会。然而，成功转化切除者的预后仍然未知。本研究旨在确定预测转换肝切除术后患者预后的因素：2018年8月至2023年4月，共有343名HCC患者在转换疗法后接受了肝切除术。采用单变量和多变量分析筛选影响患者预后的独立因素：157例（45.8%）患者在肝切除术后的中位时间16.7个月（95% CI 12.4-21.0个月）时出现复发或转移。单变量和多变量分析表明，肿瘤数量、甲胎蛋白（AFP）反应、肿瘤反应和成功降期是与复发无生存期相关的独立预测因素。白蛋白胆红素（ALBI）评分和甲胎蛋白反应是与死亡相关的独立预测因素：反映转化治疗反应深度的临床参数有望预测转化肝切除术后 HCC 患者的预后。
{"title":"Prognosis predictors of hepatocellular carcinoma after hepatectomy following conversion therapy","authors":"Shaoru Liu , Zongfeng Wu , Chenwei Wang , Liang Qiao , Zhenkun Huang , Yichuan Yuan , Ruhai Zou , Wei He , Binkui Li , Yunfei Yuan , Jiliang Qiu","doi":"10.1016/j.ejso.2024.109375","DOIUrl":"10.1016/j.ejso.2024.109375","url":null,"abstract":"<div><h3>Background</h3><div>Hepatectomy is the optimal treatment for less than 20 % patients with hepatocellular carcinoma (HCC). A combination of hepatic artery infusion chemotherapy and systemic therapy-based conversion therapy provides a chance of resection for those with unresectable HCC. Yet, the prognosis for those successfully conversion resection is still unknown. The study is to determine the factors predicted prognosis of patients after conversion hepatic resection.</div></div><div><h3>Methods</h3><div>A total of 343 HCC patients underwent hepatectomy following conversion therapy from August 2018 to April 2023. Univariate and multivariate analysis were used to screen for independent factors affecting patients’ prognosis.</div></div><div><h3>Results</h3><div>One hundred and fifty-seven (45.8 %) patients developed recurrence or metastasis at a median time of 16.7 months (95 % CI 12.4–21.0 months) from hepatectomy. Univariate and multivariate analysis identified tumor number, alpha fetoprotein (AFP) response, tumor response, and successful downstaging were independent recurrent-free survival related predictors. Albumin bilirubin (ALBI) score and AFP response were independent death related predictors.</div></div><div><h3>Conclusions</h3><div>Clinical parameters reflecting the depth of conversion therapy response, were promising in predicting prognosis for HCC patients after conversion hepatic resection.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109375"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.ejso.2024.109370
Fuji Lai, Sheng Li
{"title":"Comment on “optimized machine learning model for predicting unplanned reoperation after rectal cancer anterior resection”","authors":"Fuji Lai, Sheng Li","doi":"10.1016/j.ejso.2024.109370","DOIUrl":"10.1016/j.ejso.2024.109370","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109370"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.ejso.2024.109361
Jingyun Guo , Maobing Wang , Shuyi Xue , Qinlei Wang , Meng Wang , Zhaowei Sun , Juan Feng , Yujie Feng
Objectives
The research aimed to create and verify a nomogram model that can predict the likelihood of cholangiocarcinoma with microvascular invasion (MVI).
Methods
The clinical data of 476 patients with surgically confirmed cholangiocarcinoma were collected retrospectively. This included 240 cases of intrahepatic cholangiocarcinoma (iCCA), 85 cases of perihilar cholangiocarcinoma (pCCA), and 151 cases of extrahepatic cholangiocarcinoma (eCCA). Using this data, we conducted forward multivariate regression analysis to identify the factors that influence the risk of preoperative MVI in patients with cholangiocarcinoma. And using these variables, we developed three nomogram models.
Results
The variables in the model for predicting MVI of iCCA were lymph node metastasis, distant metastases, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.831 and 0.781, respectively. The variables in the model for predicting MVI of pCCA were lymph node metastasis, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.791 and 0.747. And the variables in eCCA were lymph node metastasis, distant metastases, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.834 and 0.830.
Conclusions
we have developed and validated a preoperative nomogram model for predicting MVI in patients with iCCA, pCCA, and eCCA.
{"title":"Establishment a nomogram model for preoperative prediction of the risk of cholangiocarcinoma with microvascular invasion","authors":"Jingyun Guo , Maobing Wang , Shuyi Xue , Qinlei Wang , Meng Wang , Zhaowei Sun , Juan Feng , Yujie Feng","doi":"10.1016/j.ejso.2024.109361","DOIUrl":"10.1016/j.ejso.2024.109361","url":null,"abstract":"<div><h3>Objectives</h3><div>The research aimed to create and verify a nomogram model that can predict the likelihood of cholangiocarcinoma with microvascular invasion (MVI).</div></div><div><h3>Methods</h3><div>The clinical data of 476 patients with surgically confirmed cholangiocarcinoma were collected retrospectively. This included 240 cases of intrahepatic cholangiocarcinoma (iCCA), 85 cases of perihilar cholangiocarcinoma (pCCA), and 151 cases of extrahepatic cholangiocarcinoma (eCCA). Using this data, we conducted forward multivariate regression analysis to identify the factors that influence the risk of preoperative MVI in patients with cholangiocarcinoma. And using these variables, we developed three nomogram models.</div></div><div><h3>Results</h3><div>The variables in the model for predicting MVI of iCCA were lymph node metastasis, distant metastases, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.831 and 0.781, respectively. The variables in the model for predicting MVI of pCCA were lymph node metastasis, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.791 and 0.747. And the variables in eCCA were lymph node metastasis, distant metastases, carcinoembryonic antigen, and tumor size, all of which had a significance level of P < 0.05. The internal and external validation consistency index (C-index) were 0.834 and 0.830.</div></div><div><h3>Conclusions</h3><div>we have developed and validated a preoperative nomogram model for predicting MVI in patients with iCCA, pCCA, and eCCA.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109361"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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