Hpb最新文献

{"title":"Textbook outcome in liver surgery after staged versus simultaneous resection for synchronous colorectal liver metastases","authors":"Zayed Rashid ,&nbsp;Abdullah Altaf ,&nbsp;Mujtaba Khalil ,&nbsp;Giovanni Catalano ,&nbsp;Shahzaib Zindani ,&nbsp;Andrea Ruzzenente ,&nbsp;Irinel Popescu ,&nbsp;Minoru Kitago ,&nbsp;George A. Poultsides ,&nbsp;Kazunari Sasaki ,&nbsp;Nazim Bhimani ,&nbsp;Tom Hugh ,&nbsp;Mathew Weiss ,&nbsp;Luca Aldrighetti ,&nbsp;Federico Aucejo ,&nbsp;Itaru Endo ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.04.014","DOIUrl":"10.1016/j.hpb.2025.04.014","url":null,"abstract":"<div><h3>Background</h3><div>We sought to define the likelihood of textbook outcome in liver surgery (TOLS) among patients undergoing simultaneous versus staged resection for sCRLM.</div></div><div><h3>Methods</h3><div>Patients with sCRLM who underwent curative-intent resection between 2000–2022 were identified from an international multi-institutional database. TOLS was defined by the absence of intraoperative grade ≥2 events, R1 resection margin, post-hepatectomy liver failure, bile leakage, major postoperative complications, in-hospital/90-day mortality, and 90-day readmission. Multivariable regression was utilized to study associations between surgical approach and TOLS.</div></div><div><h3>Results</h3><div>Among 897 patients with median age of 62 (IQR 55–69) years, 376 (41.9 %) patients underwent synchronous resection whereas 521 (58.1 %) patients had staged resection of sCRLM. 62.8 % of patients had TOLS following sCRLM resection and patients who underwent staged resection were more likely to have TOLS (staged: 65.8 % vs. simultaneous: 58.5 %, p = 0.025). Staged resection was associated with 37 % higher odds of TOLS (OR 1.37, 95 % CI 1.04–1.80) than simultaneous resection. Incidence of TOLS decreased with extensive resection (low-risk colectomy and minor hepatectomy: 69.6 % vs. high-risk colectomy and major hepatectomy: 2.8 %; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>62.8 % of patients had TOLS following sCRLM resection. Staged versus simultaneous resection was associated with 37 % higher odds of TOLS. Extent of resection should be considered when determining the optimal operative approach.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1078-1086"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965095","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}

{"title":"Unraveling the obesity paradox in hepatocellular carcinoma: relative role of elevated body mass index on detrimental effects of postoperative complications","authors":"Miho Akabane ,&nbsp;Jun Kawashima ,&nbsp;Abdullah Altaf ,&nbsp;Selamawit Woldesenbet ,&nbsp;François Cauchy ,&nbsp;Federico Aucejo ,&nbsp;Irinel Popescu ,&nbsp;Minoru Kitago ,&nbsp;Guillaume Martel ,&nbsp;Francesca Ratti ,&nbsp;Luca Aldrighetti ,&nbsp;George A. Poultsides ,&nbsp;Yuki Imaoka ,&nbsp;Andrea Ruzzenente ,&nbsp;Itaru Endo ,&nbsp;Ana Gleisner ,&nbsp;Hugo P. Marques ,&nbsp;Sara Oliveira ,&nbsp;Jorge Balaia ,&nbsp;Vincent Lam ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.05.005","DOIUrl":"10.1016/j.hpb.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>The “obesity paradox” suggests higher body mass index (BMI) may correlate with better long-term outcomes in cancers. The impact of BMI on hepatocellular carcinoma (HCC) resection, regarding postoperative complications, remains unclear. We examined the interplay between BMI and complications on recurrence-free survival (RFS) among patients undergoing HCC resection.</div></div><div><h3>Methods</h3><div>Patients undergoing hepatectomy for HCC (2000–2023) were identified from an international database. Kaplan-Meier and Cox analyses assessed the protective impact of high BMI on RFS, considering interactions with complications.</div></div><div><h3>Results</h3><div>Among 1,588 patients (median BMI: 25.2 kg/m²; BMI &gt; 25.0:793, BMI ≤ 25.0:795), 560 (35.3%) experienced complications. BMI &gt; 25.0kg/m² was linked to better 5-year RFS than BMI ≤ 25.0kg/m² (50.3% vs 45.4%; p = 0.006). Patients without complications had better 5-year RFS than those with complications (51.7% vs 40.7%; p &lt; 0.001). Among patients without complications, RFS was comparable among BMI groups (52.9% vs 50.6%; p = 0.215), but among patients with complications BMI &gt; 25.0kg/m² was associated with better RFS (45.6% vs 34.2%; p &lt; 0.001). Patients with complications and BMI &gt; 25.0 kg/m² had RFS comparable to patients without complications, regardless of BMI. Multivariable analysis identified complications (HR:1.31 [1.08–1.60]; p = 0.007) as a predictor of worse RFS, while BMI &gt; 25.0 kg/m² (HR: 0.79 [0.68–0.96]; p = 0.020) was protective. Spline analysis demonstrated recurrence risk declined with increasing BMI among patients with complications, crossing below 1 around 25.0kg/m². Stratifying the complication cohort (BMI ≤ 25.0/25.0–30.0/&gt;30.0 kg/m²) demonstrated dose-dependent RFS improvement (p = 0.005).</div></div><div><h3>Conclusion</h3><div>High BMI correlated with better RFS following HCC resection among patients with complications. Concerns about complications should not deter surgery among high-BMI patients.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1103-1112"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316822","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}

{"title":"Highlights in this issue","authors":"","doi":"10.1016/S1365-182X(25)00649-5","DOIUrl":"10.1016/S1365-182X(25)00649-5","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Page iii"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738627","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}

{"title":"Update to the role of staging laparoscopy in the assessment of resectability of perihilar cholangiocarcinoma: have improvements in cross-sectional and functional imaging rendered it redundant?","authors":"Lawrence O'Leary ,&nbsp;Ella Botzenhardt ,&nbsp;Timothy M. Gilbert ,&nbsp;Leonard M. Quinn ,&nbsp;Rafael Díaz-Nieto ,&nbsp;Robert P. Jones ,&nbsp;Louise Jones ,&nbsp;Margaret Griffin ,&nbsp;Rachel Stanley ,&nbsp;Adele Leppert ,&nbsp;Hassan Z. Malik ,&nbsp;Stephen W. Fenwick","doi":"10.1016/j.hpb.2025.05.008","DOIUrl":"10.1016/j.hpb.2025.05.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Perihilar cholangiocarcinoma has poor prognosis. Accurate staging is paramount in stratifying patients to appropriate treatment: curative surgery or palliative systemic anti-cancer therapy. Conventional CT and MRI are insufficiently sensitive at identifying peritoneal or liver metastases. Since 2020, [¹⁸F]fluorodeoxyglucose positron emission tomography-computerised tomography (FDG PET-CT) has been incorporated into staging, prompting reassessment of staging laparoscopy's role in determining resectability.</div></div><div><h3>Methods</h3><div>This retrospective study reviewed patients referred with suspected perihilar cholangiocarcinoma to a UK hepatobiliary centre between 2020 and 2024 (<em>n</em> = 304). Those with potentially resectable disease on conventional CT and MRI were compared to a matched 2016–2019 cohort (<em>n</em> = 57).</div></div><div><h3>Results</h3><div>Between 2020 and 2024, CT and MRI identified inoperable disease in 248/304 patients. FDG PET-CT further excluded 16/56 patients. Staging laparoscopy in 40 patients excluded 5. Among 35 proceeding to laparotomy, 33 completed curative-intent resection. In 2016–2019, all 57 underwent staging laparoscopy, excluding 9. Of 48 proceeding to laparotomy, 40 completed resection.</div></div><div><h3>Conclusions</h3><div>Advances in cross-sectional imaging, including FDG PET-CT, have improved radiological staging. However, at 1-in-8, the diagnostic yield of staging laparoscopy remains high, justifying its continued role in evaluating resectability.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1113-1123"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283748","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}

{"title":"Distal pancreatectomy with celiac axis resection (DP-CAR) for pancreatic ductal adenocarcinoma in a retrospective monocentric cohort: neoadjuvant treatment and three-axis embolization of the celiac axis are key factors of success","authors":"Thibaud Bertrand ,&nbsp;Safi Dokmak ,&nbsp;Béatrice Aussilhou ,&nbsp;Louis de Mestier ,&nbsp;Olivia Hentic ,&nbsp;Jérome Cros ,&nbsp;Vinciane Rebours ,&nbsp;Maxime Ronot ,&nbsp;Mickael Lesurtel ,&nbsp;Alain Sauvanet","doi":"10.1016/j.hpb.2025.04.009","DOIUrl":"10.1016/j.hpb.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Distal pancreatectomy with celiac axis resection (DP-CAR) carries severe morbidity and risk of gastric and liver ischemia. We present the results of three axis embolization of celiac axis (CA) before DP-CAR.</div></div><div><h3>Methods</h3><div>A prospectively maintained single-institution database was queried for patients operated on for potentially resectable locally advanced pancreatic cancer (LAPC) invading the CA.</div></div><div><h3>Results</h3><div>From 2008 to 2023, DP-CAR was considered in 27 patients with distal LAPC. All 27 patients had received neoadjuvant treatment (NAT), including 7 who had no resection because of tumor progression and 20 patients who had DP-CAR; 19 had pre-operative three-axis embolization after laparoscopic exploration (LE), and one patient needed arterial reconstruction. There was one death from hepatic ischemia, but no patients had gastric ischemia, with 7 of patients suffering from 90-day severe morbidity. R0 resection was achieved in 16 patients and 13 patients received adjuvant chemotherapy. With 74 months of median follow-up, median disease-free survival was 36 months. Median overall survival was 52 for patients who underwent DP-CAR.</div></div><div><h3>Conclusions</h3><div>DP-CAR for LAPC is associated with high morbidity. However, NAT and LE may prevent unnecessary surgery for patients with progressive disease. Three-axis embolization of CA may prevent ischemic complications.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1048-1059"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183628","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}

{"title":"Long-term survival and recurrence after pancreatoduodenectomy for pancreas cancer","authors":"Chris Varghese,&nbsp;Elizabeth B Habermann,&nbsp;Patrick Starlinger,&nbsp;Susanne G Warner,&nbsp;Rory L Smoot,&nbsp;Michael L Kendrick,&nbsp;Mark J Truty,&nbsp;Cornelius A Thiels","doi":"10.1016/j.hpb.2025.04.013","DOIUrl":"10.1016/j.hpb.2025.04.013","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1128-1130"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981809","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}

{"title":"Applicability of current nodal staging system for resected pancreatic cancer after neoadjuvant therapy: a retrospective study","authors":"Woohyung Lee ,&nbsp;Jeein Park ,&nbsp;Aram Shin ,&nbsp;Mirang Lee ,&nbsp;Min Kyu Sung ,&nbsp;Kwangpyo Hong ,&nbsp;Yejong Park ,&nbsp;Ki Byung Song ,&nbsp;Jae Hoon Lee ,&nbsp;Dae Wook Hwang ,&nbsp;Song Cheol Kim","doi":"10.1016/j.hpb.2025.04.011","DOIUrl":"10.1016/j.hpb.2025.04.011","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic value of nodal staging in patients undergoing surgery for borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) remains unclear. This study evaluated a novel system based on metastatic lymph nodes (nMLN).</div></div><div><h3>Methods</h3><div>Patients who underwent surgery were categorized into upfront surgery (UP) and neoadjuvant chemotherapy (NAT) groups. In the NAT group, the nMLN system was developed using K-adaptive partitioning, classifying patients by the number of metastatic lymph nodes (nMLN0: 0; nMLN1: 1–4; nMLN2: ≥5). Prognostic performance was compared between the nMLN and AJCC 8th edition systems using time-dependent area under the curve (AUC) analyses.</div></div><div><h3>Results</h3><div>A total of 730 UP and 347 NAT patients were included. Compared to the UP group, the NAT group had fewer N1 cases (<em>P</em> = 0.032) and less lymphovascular invasion (<em>P</em> &lt; 0.001). The nMLN system significantly stratified overall survival (OS) and recurrence-free survival (RFS) in NAT (P &lt; 0.001) and UP groups (<em>P</em> &lt; 0.001). Prognostic performance was comparable between the nMLN and AJCC 8th systems for OS (AUC: 0.628 vs. 0.629) and RFS (AUC: 0.643 vs. 0.649).</div></div><div><h3>Conclusion</h3><div>Both the nMLN and AJCC 8th staging systems provide effective prognostic stratification and are applicable in NAT and UP settings.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1070-1077"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019362","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}

{"title":"Assessment of two different criteria for post-pancreatectomy acute pancreatitis: a single-center retrospective analysis and literature review","authors":"Asahi Sato ,&nbsp;Akie Tani ,&nbsp;Yusuke Mishima ,&nbsp;Takahito Ohmine ,&nbsp;Jun Ichikawa ,&nbsp;Masaki Tani ,&nbsp;Kosuke Toda ,&nbsp;Takefumi Yazawa ,&nbsp;Ben Sasaki ,&nbsp;Hidenori Ohe ,&nbsp;Masahiro Yamada ,&nbsp;Kenya Yamanaka","doi":"10.1016/j.hpb.2025.04.010","DOIUrl":"10.1016/j.hpb.2025.04.010","url":null,"abstract":"<div><h3>Background</h3><div>The significance of postoperative acute pancreatitis (postoperative pancreatitis [POP] as defined by Connor and post-pancreatectomy acute pancreatitis [PPAP] as defined by the International Study Group for Pancreatic Surgery [ISGPS]) has not been determined because of the transition of definitions, a lack of prospective studies and ignorance regarding appropriate management.</div></div><div><h3>Methods</h3><div>The incidence of POP/PPAP were retrospectively analyzed. Additionally, the clinicopathological parameters and outcomes were compared between patients with and without POP/PPAP.</div></div><div><h3>Results</h3><div>Using Connor’s criteria, 46% of patients (70/151) showed Grade A POP and 17% (26/151) displayed clinically relevant (CR)-POP. Using ISGPS criteria, the prevalences of postoperative hyperamylasemia and CR-PPAP were 12% (18/151) and 10% (15/151), respectively. The duration of antibiotics and carbapenem were longer in CR-POP (p &lt; 0.001). Total health care cost was significantly higher in CR-POP compared with other grades in Connor’s criteria (p = 0.010), whereas no difference was seen in the ISGPS criteria (p = 0.677). The frequencies of complications including pancreatic fistula (Non-POP vs. Grade A POP vs. CR-POP, 22% vs. 36% vs. 81%, p &lt; 0.001), reoperation and length of hospital stay tended to be greater as Connor’s grade of POP increased.</div></div><div><h3>Discussion</h3><div>Connor's definition appeared more closely associated with postoperative worse outcomes than the ISGPS definition.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1060-1069"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963267","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}

{"title":"Stratifying the risk in liver surgery: performance in an Italian cohort of 3.280 liver resection for HCC","authors":"Guido Costa ,&nbsp;Matteo Donadon ,&nbsp;Federica Cipriani ,&nbsp;Matteo Serenari ,&nbsp;Francesco Ardito ,&nbsp;Andrea Fontana ,&nbsp;Daniele Nicolini ,&nbsp;Pasquale Perri ,&nbsp;Maurizio Iaria ,&nbsp;Mattia Garancini ,&nbsp;Ottavia Cicerone ,&nbsp;Matteo Zanello ,&nbsp;Quirino Lai ,&nbsp;Simone Conci ,&nbsp;Sarah Molfino ,&nbsp;Cecilia Ferrari ,&nbsp;Paola Germani ,&nbsp;Mauro Zago ,&nbsp;Giuseppe Zimmitti ,&nbsp;Giuliano La Barba ,&nbsp;Maria Conticchio","doi":"10.1016/j.hpb.2025.04.005","DOIUrl":"10.1016/j.hpb.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Liver resection classifications have traditionally been based on the number of segments resected. However, with advancements in techniques and the diffusion of minimally invasive surgery (MiLS), these classifications may no longer adequately represent the complexities of modern liver surgery. This study evaluates five liver resection classifications using a multicenter Italian database of hepatocellular carcinoma resections with the main focus of catching surgical outcomes, rather than technical complexity.</div></div><div><h3>Methods</h3><div>The study included 3280 resections (2436 open, 844 MiLS) from 25 Italian centers. Five classifications were assessed: Minor-Major, Segment-based, GK-LLR, S-L OLR, and CLISCO. Outcomes included morbidity, liver failure, and 90-day mortality. Chi-square or Fisher's exact tests were used for comparisons.</div></div><div><h3>Results</h3><div>All classifications showed increased morbidity and mortality with higher complexity. For open resections, Minor-Major and Segment-based classifications successfully stratified patients for all outcomes, outperforming other systems. However, all classifications performed poorly for MiLS patients.</div></div><div><h3>Discussion</h3><div>Minor-Major and Segment-based classifications remain the most accurate for predicting risks in open liver resections. The poor performance for MiLS patients highlights the need for a separate risk stratification tool for this approach. Current classifications do not always accurately represent the technical complexity and technological evolution in liver resection, particularly for MiLS procedures.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1028-1035"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119368","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}

{"title":"Adenosquamous carcinoma of the gallbladder: a Bi-institutional experience in managing this rare entity","authors":"Gurudutt P. Varty ,&nbsp;Shraddha Patkar ,&nbsp;Sujat Lele ,&nbsp;Swapnil Patel ,&nbsp;Gauri Deshpande ,&nbsp;Ipsita Dhal ,&nbsp;Mufaddal Kazi ,&nbsp;Akash Pawar ,&nbsp;Vikas Ostwal ,&nbsp;Anant Ramaswamy ,&nbsp;Prabhat Bhargava ,&nbsp;Mahesh Goel","doi":"10.1016/j.hpb.2025.02.004","DOIUrl":"10.1016/j.hpb.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Adenosquamous Gallbladder Cancers (ASGBC) are rare variety of GBCs. Relative paucity of data with regards to the management of ASGBC exists.</div></div><div><h3>Methods</h3><div>Patients with diagnosis of ASGBC from January 2012 to March 2022 were categorised into ‘Early’, ‘Locally advanced (LA)’ and ‘Metastatic (M)’ ASGBC as per the predefined ‘TMH Criteria’.</div></div><div><h3>Results</h3><div>A total of 196 patients included were categorised into early ASGBC (n = 19,9.7%), LA – ASGBC (n = 53,27%) and M – ASGBC (n = 124,63.3%) with median overall survival (OS) being worst for M – ASGBC (3.9 months) and best for early ASGBC (not reached). The 1-year and 3-year OS of LA-ASGBC patients who underwent surgery was significantly higher than those with non-surgical treatment (72.6%, 35.6% vs 25.1%, 0%, p &lt;0.001). Although, the median OS of resected ASGBC was less as compared to resected gallbladder adenocarcinomas (GBACs) (40.8 vs. 56.1 months), it did not reach statistical significance (<em>p</em>=0.06). However, at higher stages of resected LA – ASGBC (Stage III), the median OS was significantly lower as compared to stage-matched resected GBACs (14.5 vs. 30.1 months, <em>p</em>= 0.006).</div></div><div><h3>Conclusion</h3><div>Multimodality treatment consisting of margin negative surgical resection with perioperative chemotherapy offers the best chance of long-term survival in ASGBC.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 8","pages":"Pages 1036-1047"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537076","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}