Pub Date : 2024-10-04DOI: 10.1016/j.amjsurg.2024.116000
Tal Weiss , Rotem Franko , Lauren Lahav , Guy Lifshitz , Shmuel Avital , Yaron Rudnicki
Background
We aim to investigate the impact of routine cholangiography on asymptomatic patients with percutaneous cholecystostomy (PCC) for acute cholecystitis (AC).
Methods
The study included all patients treated with PCC for AC from 2017 to 2020 at a single academic center. Patients who underwent routine cholangiography within 30 days post-discharge while asymptomatic were compared to patients who were only followed clinically.
Results
The groups (cholangiography group, n = 44, and control group, n = 145) were similar in terms of age, comorbidities, and clinical presentation. The readmission rate for biliary disease in the cholangiography group was nearly half that of the control group (22.7 % vs. 40.7 %, p = 0.05) over an average follow-up of 10.4 months. The time to drain removal, cholecystectomy rate, and time to operation were comparable between the groups (42 vs. 40 days, p = 0.47, 52.3 % vs 53.1 %, p = NS and 69 vs. 82 days, p = 0.17, respectively).
Conclusions
Routine cholangiography can help reduce biliary disease readmissions among asymptomatic patients with PCC for AC without delaying further treatment.
背景：我们旨在研究常规胆管造影对急性胆囊炎（AC）经皮胆囊造口术（PCC）无症状患者的影响：我们旨在研究常规胆管造影对急性胆囊炎（AC）经皮胆囊造口术（PCC）无症状患者的影响：研究纳入了2017年至2020年在一家学术中心接受经皮胆囊造口术治疗的所有急性胆囊炎患者。将出院后30天内接受常规胆管造影术且无症状的患者与仅接受临床随访的患者进行比较：两组患者（胆管造影组，n = 44；对照组，n = 145）的年龄、合并症和临床表现相似。在平均 10.4 个月的随访期间，胆管造影组的胆道疾病再入院率几乎是对照组的一半（22.7% 对 40.7%，P = 0.05）。两组患者移除引流管的时间、胆囊切除率和手术时间相当（分别为42天 vs. 40天，p = 0.47；52.3% vs. 53.1%，p = NS；69天 vs. 82天，p = 0.17）：常规胆管造影有助于减少无症状的 AC PCC 患者的胆道疾病再入院率，同时不会延误进一步治疗。
{"title":"The impact of routine cholangiography for asymptomatic patients after cholecystostomy insertion for acute cholecystitis","authors":"Tal Weiss , Rotem Franko , Lauren Lahav , Guy Lifshitz , Shmuel Avital , Yaron Rudnicki","doi":"10.1016/j.amjsurg.2024.116000","DOIUrl":"10.1016/j.amjsurg.2024.116000","url":null,"abstract":"<div><h3>Background</h3><div>We aim to investigate the impact of routine cholangiography on asymptomatic patients with percutaneous cholecystostomy (PCC) for acute cholecystitis (AC).</div></div><div><h3>Methods</h3><div>The study included all patients treated with PCC for AC from 2017 to 2020 at a single academic center. Patients who underwent routine cholangiography within 30 days post-discharge while asymptomatic were compared to patients who were only followed clinically.</div></div><div><h3>Results</h3><div>The groups (cholangiography group, n = 44, and control group, n = 145) were similar in terms of age, comorbidities, and clinical presentation. The readmission rate for biliary disease in the cholangiography group was nearly half that of the control group (22.7 % vs. 40.7 %, p = 0.05) over an average follow-up of 10.4 months. The time to drain removal, cholecystectomy rate, and time to operation were comparable between the groups (42 vs. 40 days, p = 0.47, 52.3 % vs 53.1 %, p = NS and 69 vs. 82 days, p = 0.17, respectively).</div></div><div><h3>Conclusions</h3><div>Routine cholangiography can help reduce biliary disease readmissions among asymptomatic patients with PCC for AC without delaying further treatment.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"238 ","pages":"Article 116000"},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The Gender Equity Initiative in Global Surgery organization launched a mentorship program to address the limited opportunities available in low-and-middle-income countries (LMICs). We aimed to evaluate the utility of the virtual program in bridging this critical gap.
Methods: A retrospective review of program surveys containing quantitative and qualitative questions from 2022 to 2023 was performed.
Results: Of n = 193 applicants, 81.3 % (157/193) identified as women, and 69.4 % (134/193) reported no prior mentorship. Applicants were from 41 countries (35 LMICs). The most requested specialties were general surgery (27.9 %, 54/193), neurosurgery (18.1 %, 35/193), and cardiothoracic surgery (11.4 %, 22/193). 55.9 % (108/193) preferred mentors from other countries (United States, United Kingdom, Canada), while 13.9 % (27/193) preferred mentors from their country. Ultimately, 48 applicants were matched with 13 mentors.
Conclusions: Demand for the program surpassed capacity, highlighting a need for mentorship opportunities for women overall, particularly in LMICs.
{"title":"Implementing a global mentoring program: A call to action for mentorship in surgery.","authors":"Joanna Chen, Anisa Nazir, Ayla Gerk, Pedra Rabiee, Isabella Faria, Kaela Blake, Tanaz Vaghaiwalla","doi":"10.1016/j.amjsurg.2024.115997","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115997","url":null,"abstract":"<p><strong>Background: </strong>The Gender Equity Initiative in Global Surgery organization launched a mentorship program to address the limited opportunities available in low-and-middle-income countries (LMICs). We aimed to evaluate the utility of the virtual program in bridging this critical gap.</p><p><strong>Methods: </strong>A retrospective review of program surveys containing quantitative and qualitative questions from 2022 to 2023 was performed.</p><p><strong>Results: </strong>Of n = 193 applicants, 81.3 % (157/193) identified as women, and 69.4 % (134/193) reported no prior mentorship. Applicants were from 41 countries (35 LMICs). The most requested specialties were general surgery (27.9 %, 54/193), neurosurgery (18.1 %, 35/193), and cardiothoracic surgery (11.4 %, 22/193). 55.9 % (108/193) preferred mentors from other countries (United States, United Kingdom, Canada), while 13.9 % (27/193) preferred mentors from their country. Ultimately, 48 applicants were matched with 13 mentors.</p><p><strong>Conclusions: </strong>Demand for the program surpassed capacity, highlighting a need for mentorship opportunities for women overall, particularly in LMICs.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115997"},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-03DOI: 10.1016/j.amjsurg.2024.115992
Aimee N Di Marco
{"title":"Thyroidectomy outcomes in admitted patients are indeed worse than for outpatents: Providers must now acknowledge and respond.","authors":"Aimee N Di Marco","doi":"10.1016/j.amjsurg.2024.115992","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115992","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115992"},"PeriodicalIF":2.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1016/j.amjsurg.2024.115991
Polina Zmijewski, Chibueze Nwaiwu, Hayato Nakanishi, Soroush Farsi, Jessica Fazendin, Brenessa Lindeman, Herbert Chen, Andrea Gillis
Introduction: Racial disparities in surgical outcomes are well described, but a paucity of literature exists examining trends in outcomes of thyroid cancer. We performed a systematic review of studies on thyroid cancer outcomes to better delineate the impact of race.
Methods: A comprehensive search strategy was performed in several academic databases for articles on thyroid cancer and surgical outcomes in accordance with PRISMA guidelines. A total of 1771 abstracts were reviewed. Abstracts were screened by two independent reviewers with disagreements resolved by a third. Studies that were based in the United States, included single center, unique data, focused on outcomes of differentiated thyroid cancer, were performed on adults >18 years old, and reported race in their results were included. Chi square statistics with Yates correction were calculated on the compiled data. The protocol was registered on PROSPERO (CRD42022300021).
Results: Twelve studies met inclusion criteria with data on 7,221patients. Among the included studies, our study consists of 67 % White patients, 22 % Black patients, 7 % Hispanic patients, and 3 % Asian patients. Extrathyroidal extension was observed in 8.4 % (n = 13) of White patients. In comparison to White patients, Black (18.4 %, n = 21, p = 0.024) and Hispanic patients (28.3 %, n = 30, p < 0.001) had a higher incidence of extrathyroidal extension, while a similar incidence was observed in Asian patients (14.0 %, n = 8, p = 0.336). Compared to White patients (22.2 %, n = 34), Black (12.4 %, n = 13, p = 0.065), Hispanic (16.0 %, n = 15, p = 0.301), and Asian (18.4 %, n = 9, p = 0.709) patients had a similar incidence of T1a stage. White patients had 10.1 % (n = 54) recurrence rates, and Black (13.5 %, n = 7, p = 0.595), Hispanic (10.5 %, n = 2, p = 1.000), and Asian (11.1 %, n = 3, p = 1.000) patients had similar recurrence rates.
Conclusions: Race is seldom reported in outcomes on studies of thyroid cancer. From our analysis we conclude that non-White patients may have a higher risk of more advanced local disease at presentation. More data with granular detail on race is necessary to better understand racial disparities in thyroid cancer outcomes and how to alleviate them.
{"title":"Racial disparities in thyroid cancer outcomes: A systematic review.","authors":"Polina Zmijewski, Chibueze Nwaiwu, Hayato Nakanishi, Soroush Farsi, Jessica Fazendin, Brenessa Lindeman, Herbert Chen, Andrea Gillis","doi":"10.1016/j.amjsurg.2024.115991","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115991","url":null,"abstract":"<p><strong>Introduction: </strong>Racial disparities in surgical outcomes are well described, but a paucity of literature exists examining trends in outcomes of thyroid cancer. We performed a systematic review of studies on thyroid cancer outcomes to better delineate the impact of race.</p><p><strong>Methods: </strong>A comprehensive search strategy was performed in several academic databases for articles on thyroid cancer and surgical outcomes in accordance with PRISMA guidelines. A total of 1771 abstracts were reviewed. Abstracts were screened by two independent reviewers with disagreements resolved by a third. Studies that were based in the United States, included single center, unique data, focused on outcomes of differentiated thyroid cancer, were performed on adults >18 years old, and reported race in their results were included. Chi square statistics with Yates correction were calculated on the compiled data. The protocol was registered on PROSPERO (CRD42022300021).</p><p><strong>Results: </strong>Twelve studies met inclusion criteria with data on 7,221patients. Among the included studies, our study consists of 67 % White patients, 22 % Black patients, 7 % Hispanic patients, and 3 % Asian patients. Extrathyroidal extension was observed in 8.4 % (n = 13) of White patients. In comparison to White patients, Black (18.4 %, n = 21, p = 0.024) and Hispanic patients (28.3 %, n = 30, p < 0.001) had a higher incidence of extrathyroidal extension, while a similar incidence was observed in Asian patients (14.0 %, n = 8, p = 0.336). Compared to White patients (22.2 %, n = 34), Black (12.4 %, n = 13, p = 0.065), Hispanic (16.0 %, n = 15, p = 0.301), and Asian (18.4 %, n = 9, p = 0.709) patients had a similar incidence of T1a stage. White patients had 10.1 % (n = 54) recurrence rates, and Black (13.5 %, n = 7, p = 0.595), Hispanic (10.5 %, n = 2, p = 1.000), and Asian (11.1 %, n = 3, p = 1.000) patients had similar recurrence rates.</p><p><strong>Conclusions: </strong>Race is seldom reported in outcomes on studies of thyroid cancer. From our analysis we conclude that non-White patients may have a higher risk of more advanced local disease at presentation. More data with granular detail on race is necessary to better understand racial disparities in thyroid cancer outcomes and how to alleviate them.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115991"},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.amjsurg.2024.115994
Janelle Cyprich , Amy H. Kaji , George A. Singer , Alexander C. Schwed , Jessica A. Keeley
Introduction
Adolescent trauma patients are at increased risk of venous thromboembolism (VTE). It is unclear whether VTE prophylaxis practice patterns differ across trauma center types.
Methods
The ACS-TQP database was queried for patients aged 12-17 admitted to a pediatric, adult, or mixed level I/II trauma center. VTE prophylaxis was compared between center types. Preplanned subgroup analyses were performed to evaluate guideline adherence.
Results
Of 101,010 patients included, 35 % were treated at a pediatric trauma center (PTC), 43 % at a mixed trauma center (MTC), and 22 % at an adult trauma center (ATC). VTE prophylaxis was more common at ATCs and MTCs compared to PTCs (51.0 % vs 24.9 % vs 5.0 %,p < 0.001). This trend persisted in subgroup analyses of patients aged 16–17 (63.8 % vs 40.5 % vs 6.4 %,p < 0.001) and with injury severity score greater than 25 (83.8 % vs 74.0 % vs 35.1 %,p < 0.001).
Conclusion
VTE prophylaxis is administered more frequently to adolescent trauma patients treated at ATCs and MTCs compared to PTCs despite published guidelines. Prospective studies are needed to assess the clinical utility of VTE prophylaxis in the adolescent trauma population.
{"title":"Practice variation in venous thromboembolism prophylaxis in adolescent trauma patients: A comparative analysis of pediatric, adult, and mixed trauma centers","authors":"Janelle Cyprich , Amy H. Kaji , George A. Singer , Alexander C. Schwed , Jessica A. Keeley","doi":"10.1016/j.amjsurg.2024.115994","DOIUrl":"10.1016/j.amjsurg.2024.115994","url":null,"abstract":"<div><h3>Introduction</h3><div>Adolescent trauma patients are at increased risk of venous thromboembolism (VTE). It is unclear whether VTE prophylaxis practice patterns differ across trauma center types.</div></div><div><h3>Methods</h3><div>The ACS-TQP database was queried for patients aged 12-17 admitted to a pediatric, adult, or mixed level I/II trauma center. VTE prophylaxis was compared between center types. Preplanned subgroup analyses were performed to evaluate guideline adherence.</div></div><div><h3>Results</h3><div>Of 101,010 patients included, 35 % were treated at a pediatric trauma center (PTC), 43 % at a mixed trauma center (MTC), and 22 % at an adult trauma center (ATC). VTE prophylaxis was more common at ATCs and MTCs compared to PTCs (51.0 % vs 24.9 % vs 5.0 %,p < 0.001). This trend persisted in subgroup analyses of patients aged 16–17 (63.8 % vs 40.5 % vs 6.4 %,p < 0.001) and with injury severity score greater than 25 (83.8 % vs 74.0 % vs 35.1 %,p < 0.001).</div></div><div><h3>Conclusion</h3><div>VTE prophylaxis is administered more frequently to adolescent trauma patients treated at ATCs and MTCs compared to PTCs despite published guidelines. Prospective studies are needed to assess the clinical utility of VTE prophylaxis in the adolescent trauma population.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"238 ","pages":"Article 115994"},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.amjsurg.2024.115993
Juliet C Dalton, Samantha M Thomas, Akiko Chiba, Ton Wang, E Shelley Hwang, Jennifer K Plichta
Background: Breast atypia increases overall breast cancer risk, potentially necessitating future interventions. This study examines the frequency and outcomes of additional percutaneous biopsies after an atypia diagnosis.
Methods: Adult patients with breast atypia (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ) at a single institution were reviewed for subsequent core needle biopsies (CNBs) and corresponding malignant outcomes.
Results: Among 432 patients, median age at diagnosis was 54.8 y. Seventy-one (71/432, 16.4 %) patients developed a breast malignancy. During a median follow-up of 7.4 y, 113 patients underwent 149 additional CNBs. Twenty-six patients (26/113, 23.0 %) had >2 additional CNBs. Approximately half (79/149, 53.0 %) of all additional CNBs occurred within 5 years after breast atypia diagnosis.
Conclusion: A considerable number of patients with breast atypia undergo additional percutaneous biopsies, especially within 5 years post-atypia diagnosis. Our study highlights the significant burden of surveillance and the need for tailored follow-up strategies.
{"title":"Subsequent percutaneous breast biopsies after initial atypia diagnosis: The patient burden of long-term follow up.","authors":"Juliet C Dalton, Samantha M Thomas, Akiko Chiba, Ton Wang, E Shelley Hwang, Jennifer K Plichta","doi":"10.1016/j.amjsurg.2024.115993","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115993","url":null,"abstract":"<p><strong>Background: </strong>Breast atypia increases overall breast cancer risk, potentially necessitating future interventions. This study examines the frequency and outcomes of additional percutaneous biopsies after an atypia diagnosis.</p><p><strong>Methods: </strong>Adult patients with breast atypia (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ) at a single institution were reviewed for subsequent core needle biopsies (CNBs) and corresponding malignant outcomes.</p><p><strong>Results: </strong>Among 432 patients, median age at diagnosis was 54.8 y. Seventy-one (71/432, 16.4 %) patients developed a breast malignancy. During a median follow-up of 7.4 y, 113 patients underwent 149 additional CNBs. Twenty-six patients (26/113, 23.0 %) had >2 additional CNBs. Approximately half (79/149, 53.0 %) of all additional CNBs occurred within 5 years after breast atypia diagnosis.</p><p><strong>Conclusion: </strong>A considerable number of patients with breast atypia undergo additional percutaneous biopsies, especially within 5 years post-atypia diagnosis. Our study highlights the significant burden of surveillance and the need for tailored follow-up strategies.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115993"},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-26DOI: 10.1016/j.amjsurg.2024.115990
Annika Kay
{"title":"Edgar J. Poth memorial lecture: The power of partnership.","authors":"Annika Kay","doi":"10.1016/j.amjsurg.2024.115990","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115990","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115990"},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1016/j.amjsurg.2024.115989
Tega Ebeye, Chantal R Valiquette, Natalia Ziolkowski
{"title":"Exploring consent for animal-derived products in surgery.","authors":"Tega Ebeye, Chantal R Valiquette, Natalia Ziolkowski","doi":"10.1016/j.amjsurg.2024.115989","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115989","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115989"},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.amjsurg.2024.115988
Shiye Yang , Haishun Ni , Aixian Zhang , Jixiang Zhang , Huoqi Liang , Xing Li , Jiayi Qian , Hong Zang , Zhibing Ming
Purpose
To examine the relationship between microvascular invasion (MVI) grading severity and long-term outcomes in early-stage hepatocellular carcinoma (HCC) patients undergoing laparoscopic liver resection (LLR).
Methods
Patients who had LLR for early-stage HCC were enrolled. According to the grading severity of MVI, patients were classified into M0, M1 and M2. Recurrence-free survival (RFS) and overall survival (OS) among the groups were compared. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors of OS and RFS.
Results
Among 233 patients, MVI grading as M0, M1, and M2 accounts for 122 (52.4 %), 84 (36 %), and 27 (11.6 %) patients, respectively. The median OS and RFS in patients with M0, M1, and M2 were 84.9, 40.1, and 25.2 months; and 76.9, 27.0, and 18.8 months, respectively. Multivariable analyses identified both M1 and M2 to be independent risk factors for OS and RFS.
Conclusion
Grading severity of MVI was independently associated with RFS and OS after LLR for early-stage HCC. Patients with MVI, especially those with M2, should receive stringent recurrence surveillance and active adjuvant therapy.
{"title":"Grading severity of MVI impacts long-term outcomes after laparoscopic liver resection for early-stage hepatocellular carcinoma: A multicenter study","authors":"Shiye Yang , Haishun Ni , Aixian Zhang , Jixiang Zhang , Huoqi Liang , Xing Li , Jiayi Qian , Hong Zang , Zhibing Ming","doi":"10.1016/j.amjsurg.2024.115988","DOIUrl":"10.1016/j.amjsurg.2024.115988","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the relationship between microvascular invasion (MVI) grading severity and long-term outcomes in early-stage hepatocellular carcinoma (HCC) patients undergoing laparoscopic liver resection (LLR).</div></div><div><h3>Methods</h3><div>Patients who had LLR for early-stage HCC were enrolled. According to the grading severity of MVI, patients were classified into M0, M1 and M2. Recurrence-free survival (RFS) and overall survival (OS) among the groups were compared. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors of OS and RFS.</div></div><div><h3>Results</h3><div>Among 233 patients, MVI grading as M0, M1, and M2 accounts for 122 (52.4 %), 84 (36 %), and 27 (11.6 %) patients, respectively. The median OS and RFS in patients with M0, M1, and M2 were 84.9, 40.1, and 25.2 months; and 76.9, 27.0, and 18.8 months, respectively. Multivariable analyses identified both M1 and M2 to be independent risk factors for OS and RFS.</div></div><div><h3>Conclusion</h3><div>Grading severity of MVI was independently associated with RFS and OS after LLR for early-stage HCC. Patients with MVI, especially those with M2, should receive stringent recurrence surveillance and active adjuvant therapy.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"238 ","pages":"Article 115988"},"PeriodicalIF":2.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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