IF 2.7 3区医学

Hpb Pub Date : 2025-03-01 DOI: 10.1016/j.hpb.2024.12.005

Ryusei Yamamoto , Shunsuke Onoe , Takashi Mizuno , Nobuyuki Watanabe , Shoji Kawakatsu , Masaki Sunagawa , Junpei Yamaguchi , Atsushi Ogura , Taisuke Baba , Tsuyoshi Igami , Mihoko Yamada , Yoshie Shimoyama , Tomoki Ebata

{"title":"Reappraisal of carcinoma in situ residue at the bile duct margin: a single-center review of 681 patients with perihilar cholangiocarcinoma","authors":"Ryusei Yamamoto , Shunsuke Onoe , Takashi Mizuno , Nobuyuki Watanabe , Shoji Kawakatsu , Masaki Sunagawa , Junpei Yamaguchi , Atsushi Ogura , Taisuke Baba , Tsuyoshi Igami , Mihoko Yamada , Yoshie Shimoyama , Tomoki Ebata","doi":"10.1016/j.hpb.2024.12.005","DOIUrl":"10.1016/j.hpb.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>A histologically involved surgical margin (R1) is often observed after resection for cholangiocarcinoma. Compared with a negative margin (R0), R1 with invasive carcinoma (R1inv) markedly worsens survival, whereas the prognostic effect of R1 with carcinoma <em>in situ</em> (R1cis) remains controversial.</div></div><div><h3>Methods</h3><div>Patients who underwent resection for perihilar cholangiocarcinoma between 2002 and 2019 were retrospectively reviewed. According to the pathological assessment, the duct margin was classified as R0, R1cis, or R1inv; radial margin positivity was treated as R1inv. Recurrence and survival were compared.</div></div><div><h3>Results</h3><div>Among the 681 patients, 457 had R0, 69 had R1cis, and 155 had R1inv. The overall five-year recurrence rate was 82.8 % with R1inv, 67.8 % with R1cis, and 47.6 % with R0 (<em>P</em> < 0.001); the local recurrence rate also significantly differed among these groups (<em>P</em> < 0.001). The five-year survival rate was significantly worse with R1cis than with R0 (37.3 % vs. 56.7 %, <em>P</em> < 0.001) and better than that with R1inv (20.9 %, <em>P</em> = 0.007). Multivariate analysis revealed that R1cis was an independent predictor of survival (hazard ratio, 1.65; <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Compared with R0, R1cis significantly deteriorated overall survival in the whole resection subset of patients with perihilar cholangiocarcinoma. However, the prognostic impact of R1cis was milder than that of R1inv.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 3","pages":"Pages 362-370"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894205","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}

引用次数: 0

Hepato-thoracic cystic echinococcosis transit. Clinical features, postoperative complications and hospital mortality. A systematic review 肝胸囊性包虫病。临床特征、术后并发症和住院死亡率。系统回顾。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-01 DOI: 10.1016/j.hpb.2024.12.001

Carlos Manterola , Josue Rivadeneira , Tamara Otzen , Claudio Rojas-Pincheira

{"title":"Hepato-thoracic cystic echinococcosis transit. Clinical features, postoperative complications and hospital mortality. A systematic review","authors":"Carlos Manterola , Josue Rivadeneira , Tamara Otzen , Claudio Rojas-Pincheira","doi":"10.1016/j.hpb.2024.12.001","DOIUrl":"10.1016/j.hpb.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Hepato-thoracic hydatid transit (HTT) is an evolutionary complication of hepatic cystic echinococcosis. This study aimed to report the available evidence regarding postoperative complications (POC) and hospital mortality (HM).</div></div><div><h3>Methods</h3><div>Systematic review. Studies related to HTT were included. Searches were performed in Trip Database, SciELO, BIREME-BVS, WoS, PubMed, EMBASE and SCOPUS. Primary outcomes: POC and HM. Secondary outcomes: publication date, origin and designs, number of patients, cyst type, hospital stance, treatments; and methodological quality (MQ) of studies applying MInCir-T and MInCir-Pr<sub>2</sub> scales. Descriptive statistics, weighted means (WM) and their comparison using least squares logistic regression, and meta-analysis of prevalence of POC and HM were applied.</div></div><div><h3>Results</h3><div>604 studies were retrieved (101 met selection criteria, representing 1020 patients). WM age: 42.6 years, 58.3 % male. Reports are mainly from Spain (19.8 %) and Turkey (17.8 %). With a WM of 18.3 days of hospital stance, it was verified 28.9 % of POC, 12.6 % needed re-interventions, and 9.7 % died. MQ of studies: 9.1 ± 1.9 (MInCir-T) and 13.2 ± 2.9 (MInCir-Pr<sub>2</sub>). Comparing the behavior of variables in two periods (1983–2002 vs. 2003–2024), statistically significant differences were observed in POC, HM, and reinterventions.</div></div><div><h3><strong>Conclusion</strong></h3><div>HTT is associated with high POC, and significant HM, despite the passage of time.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 3","pages":"Pages 330-342"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894204","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}

引用次数: 0

Significance of frailty in mortality and complication after hepatectomy for patients with liver cancer: a systematic review and meta-analysis 虚弱在肝癌患者肝切除术后死亡率和并发症中的意义：一项系统回顾和荟萃分析。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-01 DOI: 10.1016/j.hpb.2024.12.009

Fei Zhang , Ying Yan , Baifeng Li , Chunlin Ge

{"title":"Significance of frailty in mortality and complication after hepatectomy for patients with liver cancer: a systematic review and meta-analysis","authors":"Fei Zhang , Ying Yan , Baifeng Li , Chunlin Ge","doi":"10.1016/j.hpb.2024.12.009","DOIUrl":"10.1016/j.hpb.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Frailty has been associated with increased mortality and complications among liver cancer patients. However, the frailty prevalence and outcomes in frail populations with primary liver cancer have not been systematically validated.</div></div><div><h3>Methods</h3><div>Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in liver cancers from inception until October 26, 2023. The pooled prevalence, hazard ratio (HR), and odds ratio (OR) corresponding to 95 % confidence intervals (CI) in mortality and major complication estimates were conducted.</div></div><div><h3>Results</h3><div>A total of 18 studies containing 38,157 primary liver cancer patients were included. The prevalence of frailty in liver cancer was 35 % (95 % CI = 25–46; <em>p</em> = 0.000). Frailty was associated with an increased hazard ratio for 30-day mortality (HR = 7.03; 95 % CI = 0.71–69.45; <em>p</em> = 0.97) and 90-day mortality (HR = 4.59; 95 % CI = 1.76–11.95; <em>p</em> = 0.38). Furthermore, frailty was associated with an increased odds ratio for major complications in liver cancer patients (OR = 4.01; 95 % CI = 2.25–7.14; <em>p</em> = 0.49).</div></div><div><h3>Conclusion</h3><div>Frailty is frequent in liver cancer patients and may predict adverse outcomes in primary liver cancer patients with hepatectomy. Our findings highlight the importance of frailty assessment in this population.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 3","pages":"Pages 279-288"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894206","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}

引用次数: 0

Outcome following pylorus resecting pancreaticoduodenectomy versus classical Whipple’s pancreaticoduodenectomy: a randomised controlled trial 幽门切除胰十二指肠切除术与经典惠普尔胰十二指肠切除术的结果：一项随机对照试验。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-01 DOI: 10.1016/j.hpb.2024.12.011

Ameet Kumar , Rajesh Panwar , Sujoy Pal , Nihar R. Dash , Peush Sahni

{"title":"Outcome following pylorus resecting pancreaticoduodenectomy versus classical Whipple’s pancreaticoduodenectomy: a randomised controlled trial","authors":"Ameet Kumar , Rajesh Panwar , Sujoy Pal , Nihar R. Dash , Peush Sahni","doi":"10.1016/j.hpb.2024.12.011","DOIUrl":"10.1016/j.hpb.2024.12.011","url":null,"abstract":"<div><h3>Objective</h3><div>To compare pylorus resecting pancreaticoduodenectomy (PRPD) with classical pancreaticoduodenectomy (classical PD) in terms of short term outcomes.</div></div><div><h3>Background</h3><div>There is some evidence that Pylorus resecting PD (PRPD) is associated with lesser incidence of DGE when compared to pylorus preserving PD (PPPD). However, no study has previously compared PRPD with classical PD.</div></div><div><h3>Methods</h3><div>Patients requiring PD were randomly assigned to either PRPD or classical PD after intraoperative assessment to rule out metastases and unresectable disease. Occurrence of DGE was the primary end point.</div></div><div><h3>Results</h3><div>A total of 154 patients (103 males; Mean age:53.3 ± 12.2 years) were included in the final analysis (PRPD = 78, classical PD = 76). PRPD group had significantly shorter operation [Mean difference: 41 min (95 % CI:18–65)]. There was no significant difference in the incidence of DGE [32 (41.0 %)vs37 (48.7 %); <em>p</em> = 0.339] and clinically significant DGE [22 (28.2 %)vs19 (25.0 %); <em>p</em> = 0.789] between PRPD and classical PD. There was also no difference in the rates of clinically relevant pancreatic fistula [20 (25.6 %)vs22 (28.9 %); <em>p</em> = 0.780], severe morbidity [21 (26.9 %)vs19 (25.0 %); <em>p</em> = 0.930], operative mortality [6 (7.7 %)vs2 (2.6 %); <em>p</em> = 0.157] and median postoperative stay [12 (5–47) days vs 12 (6–56) days; <em>p</em> = 0.861].</div></div><div><h3>Conclusion</h3><div>We found no significant difference in the early postoperative outcomes between PRPD and classical PD. PRPD was found to be significantly faster than the classical PD.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 3","pages":"Pages 385-392"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931353","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}

引用次数: 0

Assessment and treatment considerations for patients with colorectal liver metastases: AHPBA consensus guideline and update for surgeons 结直肠肝转移患者的评估和治疗考虑：AHPBA共识指南和外科医生的更新。

IF 2.7 3区医学

Hpb Pub Date : 2025-03-01 DOI: 10.1016/j.hpb.2024.12.006

{"title":"Assessment and treatment considerations for patients with colorectal liver metastases: AHPBA consensus guideline and update for surgeons","authors":"","doi":"10.1016/j.hpb.2024.12.006","DOIUrl":"10.1016/j.hpb.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer most commonly metastasizes to the liver. While various treatment strategies have been developed, surgical management of these patients has vital implications on the prognosis and survival of this group of patients. There remains a need for a consensus guideline regarding the surgical evaluation and management of patients with colorectal liver metastases (CRLM).</div></div><div><h3>Methods</h3><div>This review article is a consensus guideline established by the members of the AHPBA Professional Standards Committee, as an amalgamation of existent literature and a guide to surgeons managing this complex disease.</div></div><div><h3>Results</h3><div>These guidelines reports the benefits and shortcomings of various diagnostic modalities including imaging and next-generation sequencing in the management of patients with CRLM. While surgery has established survival benefits in patients with resectable disease, this report notes the importance of treatment sequencing with non-surgical modalities as well as between colon and liver resection. Finally, the guidelines address the various treatment modalities for patients with unresectable disease, that may have significant impact on survival.</div></div><div><h3>Conclusion</h3><div>CRLM is a complex diagnosis which warrants multidisciplinary approach with early surgical involvement in both assessment and management of the disease, to optimize patient outcomes and survival.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 3","pages":"Pages 263-278"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Presentation, treatment and long-term outcomes of hepatocellular carcinoma in patients with and without HIV: a comparative observational cohort study.

IF 2.7 3区医学

Hpb Pub Date : 2025-02-21 DOI: 10.1016/j.hpb.2025.02.012

Sanju Sobnach, Muhammad Emmamally, Keith Venter, C Wendy Spearman, Inae Kim, Marc Bernon, Mark Sonderup, Urda Kotze, Rajshree Segobin, Dale Creamer, Rufaida Khan, Stefano Cacciatore, Luiz F Zerbini, Eduard Jonas

{"title":"Presentation, treatment and long-term outcomes of hepatocellular carcinoma in patients with and without HIV: a comparative observational cohort study.","authors":"Sanju Sobnach, Muhammad Emmamally, Keith Venter, C Wendy Spearman, Inae Kim, Marc Bernon, Mark Sonderup, Urda Kotze, Rajshree Segobin, Dale Creamer, Rufaida Khan, Stefano Cacciatore, Luiz F Zerbini, Eduard Jonas","doi":"10.1016/j.hpb.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.012","url":null,"abstract":"<p><strong>Background: </strong>This study explores the epidemiology, treatment and outcomes of hepatocellular carcinoma (HCC) in a sub-Saharan cohort, comparing patients with and without human immunodeficiency virus (HIV).</p><p><strong>Methods: </strong>A retrospective cohort study of patients treated for HCC from 1 February 2011 to 29 February 2024 at Groote Schuur Hospital, South Africa was performed.</p><p><strong>Results: </strong>Of the 501 HCC patients, 75 (15.0 %) were people living with HIV (PLWH). The PLWH were younger (43.7 ± 9.7 vs. 52.9 ± 15.3 years, p < 0.00001), had more frequent chronic hepatitis B virus (HBV) co-infection (85.3 % vs. 51.6 %, p < 0.00001) and no hepatitis C virus co-infection (0 % vs. 6.8 %, p = 0.013). More PLWH presented with Barcelona Clinic Liver Cancer Stage D disease (43.6 % vs. 27.7 %, p = 0.007). Similar proportions of PLWH and HIV-negative patients received curative-intended treatments, life-prolonging therapies and best supportive care. In PLWH, the median survival was lower (44 [IQR: 16-163.7] vs. 78 [IQR: 26-191] days, p = 0.010), and patients with HIV-HBV co-infection had the lowest survival (39 [IQR: 14.7-155.2] days).</p><p><strong>Conclusion: </strong>In a sub-Saharan HCC cohort, patients with HIV were significantly younger, had more advanced disease and HBV co-infection resulted in the lowest survival. Earlier detection through aggressive HCC screening is key to improving outcomes in PLWH.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566936","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}

引用次数: 0

Navigating new frontiers: onsite machine perfusion in US liver transplantation.

IF 2.7 3区医学

Hpb Pub Date : 2025-02-21 DOI: 10.1016/j.hpb.2025.02.011

Miho Akabane, Yuki Bekki, Allison J Kwong, Carlos O Esquivel, W R Kim, Marc L Melcher, Kazunari Sasaki

{"title":"Navigating new frontiers: onsite machine perfusion in US liver transplantation.","authors":"Miho Akabane, Yuki Bekki, Allison J Kwong, Carlos O Esquivel, W R Kim, Marc L Melcher, Kazunari Sasaki","doi":"10.1016/j.hpb.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.011","url":null,"abstract":"<p><strong>Background: </strong>The increasing demand for liver transplantation (LT) necessitates optimal utilization of marginal donors including donation after cardiac death (DCD), older, and steatotic donors. Onsite machine perfusion (OMP) might make previously non-utilized organs useable. Comprehensive studies on OMP's safety in LT, using the US national database, are lacking.</p><p><strong>Methods: </strong>This study aimed to assess OMP usage and implications in LT, using the UNOS database (2016-2023). The impact on recipient outcomes of marginal donor quality as assessed by the donor organ discard index (DSRI) was examined.</p><p><strong>Results: </strong>Of 50,458 LT cases identified, 1263 (2.5 %) utilized OMP. OMP usage had surged since 2022, exceeding a 10.0 % proportion in early 2023 (Jan-June). In DBD, OMP livers had higher median DSRI than non-OMP livers (2.33vs1.73, P < 0.01) but had comparable graft survival (GS). DCD livers had better 90-day/1-year GS when OMP was used despite having a higher DSRI (24.3vs18.6, P < 0.01). For DCD donors with high DSRI (>13), OMP utilization correlated with a significantly lower hazard ratio (HR) than non-utilization. OMP cases with macrosteatosis≥30 % reported no graft failures. OMP did not exhibit a linear increase in HR with donor age.</p><p><strong>Conclusion: </strong>OMP's usage in LT significantly increased after its commercialization, offering comparable outcomes with non-OMP despite higher DSRI. It holds promise in optimizing marginal donor use, potentially expanding the donor pool.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572945","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}

引用次数: 0

Challenges in early career for HPB surgeons: an international practice survey.

IF 2.7 3区医学

Hpb Pub Date : 2025-02-20 DOI: 10.1016/j.hpb.2025.02.010

Giampaolo Perri, Marcello Di Martino, Rebecca Minter, Sanket Srinivasa, Timothy Newhook, Alexandra Roch, Rachel Guest, Asmund Fretland, Leanne Prodehl, Asara Thepbunchonchai, Julie Hallet

{"title":"Challenges in early career for HPB surgeons: an international practice survey.","authors":"Giampaolo Perri, Marcello Di Martino, Rebecca Minter, Sanket Srinivasa, Timothy Newhook, Alexandra Roch, Rachel Guest, Asmund Fretland, Leanne Prodehl, Asara Thepbunchonchai, Julie Hallet","doi":"10.1016/j.hpb.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.010","url":null,"abstract":"<p><strong>Background: </strong>Understanding the needs of early-career surgeons is essential for developing strategies for support. This study examined perceived needs of early-career HPB surgeons worldwide.</p><p><strong>Methods: </strong>A self-administered web-based survey of early career HPB surgeons (aged ≤45 years old or practicing for ≤5 years) was conducted. A questionnaire was developed through items generation and reduction, followed by pilot testing. Quantitative data were reported with descriptive statistics and qualitative responses analysed using open coding.</p><p><strong>Results: </strong>There were 282 respondents. Six main areas of challenges were identified: mentorship opportunities, continued skills acquisition and training, research and collaboration, leadership and career development, clinical knowledge exchange, and accessibility including financial barriers. Specifically, highest rated challenges were ebalancing work and personal life (mean 6.98, SD 2.92), research (mean 6.79, SD 2.50), career development/mentorship (mean 6.70, SD 2.30), networking/collaboration (mean 6.16, SD 2.71), leadership and (mean 6.09, SD 2.53). Rating of research as a challenge was higher in Africa and Central/South America (p = 0.01), and that of leadership was higher in Asia, Oceania, and the Middle East (p = 0.02).</p><p><strong>Conclusions: </strong>This survey highlights the multiple challenges faced by early-career HPB surgeons worldwide. These results provide insights into how to better support early-career HPB surgeons to fully develop their specialty.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537079","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}

引用次数: 0

Liver transplantation for hepatocellular carcinoma: differences in pre-transplant radiology versus explant pathology and impact on survival.

IF 2.7 3区医学

Hpb Pub Date : 2025-02-20 DOI: 10.1016/j.hpb.2025.02.009

Diana A Wu, James Vassallo, Calum Worsley, Chris Bellamy, Jim Gordon-Smith, Anya Adair

{"title":"Liver transplantation for hepatocellular carcinoma: differences in pre-transplant radiology versus explant pathology and impact on survival.","authors":"Diana A Wu, James Vassallo, Calum Worsley, Chris Bellamy, Jim Gordon-Smith, Anya Adair","doi":"10.1016/j.hpb.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>Suitability for liver transplantation in patients with hepatocellular carcinoma (HCC) is based on Milan imaging criteria developed several decades ago. We sought to compare pre-transplant imaging with explant liver histopathology in a national retrospective observational study.</p><p><strong>Methods: </strong>All patients who underwent liver transplantation for HCC at the Scottish Liver Transplant Unit (2015-2020) were included. Per-lesion sensitivity of imaging, proportion of patients transplanted outwith UK transplant criteria and two-year survival outcomes were analysed.</p><p><strong>Results: </strong>140 patients were included. Per-lesion sensitivity was 70 % (38 % for lesions <10 mm). Histopathology of 36 (26 %) patients were outwith UK transplant criteria. 19 (14 %) livers contained >5 HCCs, median lesion size was 9 mm. 9 (6 %) livers contained cholangiocarcinoma. Two-year survival rates: cholangiocarcinoma 100 %, combined HCC-cholangiocarcinoma 100 %, HCC within criteria 90.8 %, HCC outwith criteria 87.5 %, >5 HCCs 77.8 % (p = 0.010).</p><p><strong>Conclusion: </strong>Current pre-operative imaging for liver transplantation has suboptimal sensitivity, particularly for sub-centimetre lesions. A quarter of transplanted patients are subsequently found to be outwith transplant criteria on explant histopathology, but most have good short-term survival (including cholangiocarcinoma), except for patients with multi-focal small HCCs. Further research is needed to better identify this cohort and to explore whether transplant criteria should be revised.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585548","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}

引用次数: 0

A systematic review of clinical outcome reporting for curative surgical treatment of patients with pancreatic adenocarcinoma.

IF 2.7 3区医学

Hpb Pub Date : 2025-02-20 DOI: 10.1016/j.hpb.2025.02.008

Emily Britton, Matthew Kobetic, Eleanor McNally, Sarah Rudd, Shelley Potter, Robert Hinchliffe, Jonathan Rees

{"title":"A systematic review of clinical outcome reporting for curative surgical treatment of patients with pancreatic adenocarcinoma.","authors":"Emily Britton, Matthew Kobetic, Eleanor McNally, Sarah Rudd, Shelley Potter, Robert Hinchliffe, Jonathan Rees","doi":"10.1016/j.hpb.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.hpb.2025.02.008","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer is a leading cause of cancer-related death. Surgery (with systemic therapy) provides the only chance for long-term survival, but carries a high risk of morbidity and mortality. Robust evidence from meta-analyses, essential in informing decisions, is thwarted by inconsistencies between studies. This systematic review determines the nature and degree of heterogenous outcome reporting in research evaluating curative pancreatic cancer surgery.</p><p><strong>Methods: </strong>A literature search of Medline, Embase, Cochrane Central and clinicaltrials.gov from 2017 to 2023 for eligible randomised and prospective studies adhering to a PROSPERO registered protocol.</p><p><strong>Results: </strong>Included were 156 studies reporting a total of 2088 outcomes which deduplicated to 399 unique endpoints. No single outcome was reported in all studies. 45 % were not defined. Adverse events and delivery of care measures (typically technical aspects of surgery) accounted for 60 % and 32 % of outcomes respectively, compared to 6 % evaluating physical functioning post-surgery.</p><p><strong>Conclusion: </strong>The vast number and diversity of outcomes in use demonstrates lack of discernment in choice and disparity over domains of importance. Further work is needed to embed uniform outcome definitions, harmonise data collection and refocus research on fewer outcomes of proven relevance. Developing consensus on these critical outcomes through a Core Outcome Set is recommended.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692001","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}

引用次数: 0

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