Hpb最新文献

{"title":"“Biological R2” resection for intrahepatic cholangiocarcinoma: identification of patients at risk for poor oncologic outcomes after curative-intent resection","authors":"Jun Kawashima ,&nbsp;Yutaka Endo ,&nbsp;Selamawit Woldesenbet ,&nbsp;Mujtaba Khalil ,&nbsp;Miho Akabane ,&nbsp;François Cauchy ,&nbsp;Feng Shen ,&nbsp;Shishir Maithel ,&nbsp;Irinel Popescu ,&nbsp;Minoru Kitago ,&nbsp;Matthew J. Weiss ,&nbsp;Guillaume Martel ,&nbsp;Carlo Pulitano ,&nbsp;Luca Aldrighetti ,&nbsp;George Poultsides ,&nbsp;Andrea Ruzzente ,&nbsp;Todd W. Bauer ,&nbsp;Ana Gleisner ,&nbsp;Hugo Marques ,&nbsp;Bas Groot Koerkamp ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.hpb.2025.01.006","DOIUrl":"10.1016/j.hpb.2025.01.006","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to define a cohort of patients with “biological R2” (bR2) resection, defined as recurrence within 12 weeks, following curative-intent resection for intrahepatic cholangiocarcinoma (ICC). In addition, we sought to identify factors associated with bR2 risk.</div></div><div><h3>Methods</h3><div>Patients who underwent upfront curative-intent surgery for ICC were identified from an international, multi-institutional database. The weighted beta-coefficients of preoperative risk factors were used to construct an online tool to predict bR2.</div></div><div><h3>Results</h3><div>Among 1138 patients, 106 (9.3 %) patients had a bR2 resection. Patients with bR2 were more likely to be younger (OR 0.97) and non-White (OR 2.19), as well as more often had cirrhosis (OR 2.11), a higher neutrophil-to-lymphocyte ratio (OR 1.07), a higher tumor burden score (OR 1.16), and metastatic nodal disease on preoperative imaging (OR 1.92). Patients categorized as low-risk had a 3.2 % risk of bR2, intermediate-risk patients had an 11.1 % risk of bR2, whereas patients in the high-risk category had a 27.6 % risk of bR2 (p &lt; 0.001). An online tool was made available at <span><span>https://junkawashima.shinyapps.io/bR2_ICC/</span><svg><path></path></svg></span>, <span><span>https://junkawashima.shinyapps.io/CRLMfollwingchemotherapy/</span><svg><path></path></svg></span>.</div></div><div><h3>Conclusions</h3><div>Approximately one in ten patients with resectable ICC had a bR2 resection. An online calculator can may help clinicians identify patients with ICC at highest risk of a bR2 resection.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 619-629"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364485","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":"Residency robotic biotissue curriculum: the next frontier in robotic surgical training","authors":"Sarah B. Hays ,&nbsp;Kristine Kuchta ,&nbsp;Aram E. Rojas ,&nbsp;Syed A. Mehdi ,&nbsp;Jason L. Schwarz ,&nbsp;Mark S. Talamonti ,&nbsp;Melissa E. Hogg","doi":"10.1016/j.hpb.2025.01.014","DOIUrl":"10.1016/j.hpb.2025.01.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Virtual reality has been shown to be a strong introduction to the robot. However, we hypothesized that a biotissue curriculum including common surgical anastomoses can further enhance robotic technical skills in surgical residents.</div></div><div><h3>Methods</h3><div>Post-graduate-year three (PGY-3) general surgery residents completed a two-week robotic simulation rotation. The inanimate exercises used biotissue to simulate common robotic anastomoses, including the running hepaticojejunostomy (RHJ), gastrojejunostomy (GJ), interrupted hepaticojejunostomy (IHJ), and pancreaticojejunostomy (PJ). Drills were timed and graded according to modified Objective Structured Assessment of Technical Skills (OSATS; range 6–30).</div></div><div><h3>Results</h3><div>32 residents completed the curriculum. 81.3% of residents reported prior experience at the surgeon console (median=5 operations). Across all drills the average time to completion decreased from first to fourth attempt (RHJ: 33.7±8.9 vs. 26.3±8.1 min, p&lt;0.001; GJ: 57.2±15.1 vs. 44.6±9.5 min, p&lt;0.001; IHJ: 32.6±7.2 vs. 27.1±7.7 min, p&lt;0.001; PJ: 44.2±9.3 vs. 35.6±10.5 min, p&lt;0.001). Average OSATS score increased across all drills as well (RHJ: 16.0±3.8 vs. 23.3±3.4, p&lt;0.001; GJ: 19.4±2.1 vs. 26.0±2.5, p&lt;0.001; IHJ: 16.9±2.7 vs. 23.2±3.6, p&lt;0.001, PJ: 17.9±2.6 vs. 23.6±3.6, p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>The robotic biotissue curriculum improves resident performance on robotic anastomoses. With the rise of the robotic platform, training in robotic procedures should be incorporated during surgical residency.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 688-695"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382355","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":"Minimally invasive versus open liver resection for nonmetastatic hepatocellular carcinoma staged BCLC – B and – C: an Italian multicentric analysis","authors":"Gianluca Cassese ,&nbsp;Mariano C. Giglio ,&nbsp;Alessandro Vitale ,&nbsp;Andrea Lauterio ,&nbsp;Matteo Serenari ,&nbsp;Federica Cipriani ,&nbsp;Francesco Ardito ,&nbsp;Pasquale Perri ,&nbsp;Daniele Nicolini ,&nbsp;Giulio Di Gioia ,&nbsp;Andrea Pierluigi Fontana ,&nbsp;Quirino Lai ,&nbsp;Simone Conci ,&nbsp;Luca Fumagalli ,&nbsp;Maurizio Iaria ,&nbsp;Mattia Garancini ,&nbsp;Sarah Molfino ,&nbsp;Matteo Zanello ,&nbsp;Giuliano La Barba ,&nbsp;Maria Conticchio ,&nbsp;Renato Patrone","doi":"10.1016/j.hpb.2025.01.009","DOIUrl":"10.1016/j.hpb.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>Recent papers report significant survival gain after liver resection in BCLC-B and -C HCC patients. The results of minimally invasive liver surgery (MILS) in such patients have not been widely investigated so far.</div></div><div><h3>Methods</h3><div>Data regarding patients undergoing MILS or open liver resection (OLR) for HCC staged BCLC -B and -C were extracted from the HERCOLES database. An inverse probability of treatment weighting (IPTW) method was adopted to balance the confounders. The primary outcome was a composite endpoint including post-hepatectomy liver failure, severe postoperative complications and in-hospital mortality.</div></div><div><h3>Results</h3><div>627 patients were included (459 undergoing OLR and 168 receiving MILS). After IPTW, no difference was found in the composite endpoint between MILS and OLR (OR 0.86 [95%CI 0.46-1-60]; p = 0.62). MILS reduced the risk of receiving intra-operative transfusions (OR 0.28 [95%CI 0.13-0.58]; p &lt; 0.001) and of developing postoperative ascites (OR 0.56 [95%CI 0,32-0,98]; p = 0.039), with reduced length of stay (OR 0.82 [95%CI 0.66-1.01]; p = 0.045). The survival analysis showed no differences between MILS and OLR for both OS (p = 0.13) and DFS (p = 0.491).</div></div><div><h3>Conclusion</h3><div>MILS was shown to be safe and feasible for selected non-metastatic HCC patients staged BCLC B and C, reducing the risk of perioperative transfusions and postoperative ascites, and shortening the length of stay.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 649-659"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433179","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":"A 10-year (2013–2023) analysis of incidence, etiology and mortality of acute pancreatitis in England","authors":"James Lucocq ,&nbsp;Fraser Barbour ,&nbsp;Kim Keltie ,&nbsp;Edward O'Toole ,&nbsp;Manu Nayar ,&nbsp;Sanjay Pandanaboyana","doi":"10.1016/j.hpb.2025.02.003","DOIUrl":"10.1016/j.hpb.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of the present study was to report epidemiological data on the incidence of acute pancreatitis (AP) in England between 2013 and 2023 and report contemporary post-AP outcomes.</div></div><div><h3>Methods</h3><div>A search of patients admitted with AP (2013–2023) was performed within the Hospital Episode Statistics (HES) which covers all admitted patients within England using diagnosis (ICD-10) code K85.</div></div><div><h3>Results</h3><div>A total of 260,009 patients (median age, 59 years; IQR, 30; F:M, 1.02:1) were identified from 185 NHS trusts (2013–2023), with an incidence of 456 cases per million and an annual increase of 2.6 %. A total of 8.0 % patients required ITU admission. The AP readmission rate was 30.2 % after a median follow-up time of 45 months (Q1-Q3, 17–80 months). The in-hospital mortality rate was 4.5 % (n = 11,711). The overall survival at 1, 2, 5 and 10 years was 88.9 [95%CI 88.7,89], 85.2 [85.1,85.4], 76.1 [75.9,76.3] and 63.9 [63.6,64.2]. Long-term survival (10-year) was higher with biliary aetiology (p &lt; 0.01), younger age groups (p &lt; 0.05) and those without ITU admission (p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>The incidence of AP in England is increasing and in-hospital mortality rates remain significant. These findings have implications for resource allocation to mitigate risk factors for developing AP in addition to the need for long-term follow-up for at-risk groups.</div></div><div><h3>Clinical trial registration</h3><div>N/A.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 723-731"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537070","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":"Retrospective comparative analyses of liver transplantation for intrahepatic cholangiocarcinoma and combined hepatocellular cholangiocarcinoma versus hepatocellular carcinoma in Brazil","authors":"Iron P. De Abreu Neto ,&nbsp;Vincenzo Pugliese ,&nbsp;Paulo C.B. Massarollo ,&nbsp;Bárbara B. Benini ,&nbsp;Mirella M.M. Marta ,&nbsp;Vanessa S. Takenaka ,&nbsp;Francisco Monteiro ,&nbsp;João Luis E. Pessoa ,&nbsp;Raymundo.S. De Azevedo Neto ,&nbsp;Adriano M. Gonzalez","doi":"10.1016/j.hpb.2025.01.008","DOIUrl":"10.1016/j.hpb.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Despite the growing interest in liver transplantation for cholangiocarcinomas (CCA), conclusive evidence is lacking. We sought to evaluate the outcomes of liver transplantation for intrahepatic cholangiocarcinoma in Brazil.</div></div><div><h3>Methods</h3><div>Retrospective database analysis of patients undergoing liver transplantation for hepatocellular carcinoma (HCC) within Milan criteria in São Paulo, Brazil. Anatomopathological examination of the explanted liver with the presence of intrahepatic cholangiocarcinoma (iCCA) or combined hepatocellular-cholangiocarcinoma (cHCC-CCA) comprised the study group (50 patients). They were compared to a 1:3 HCC-matched cohort.</div></div><div><h3>Results</h3><div>Study group had lower survival rates than HCC controls (survival at 1, 3, and 5 years, 70.0 %, 57.5 %, and 57.5 % versus 78.7 %, 71.4 %, and 66.6 %, p = 0.019). 5-year survival rates of the control group, cHCC-CCA, and iCCA group were 66.6 %, 59.6 %, and 50.0 % (p = 0.017). There was no statistically significant difference in survival for study group patients with tumors up to 3 cm compared to their controls (p = 0.086).</div></div><div><h3>Discussion</h3><div>Patients with CCA had worse outcomes after liver transplantation than those with HCC. Interesting results were found in the more individualized analyses, but because of the limited number of patients, caution should be taken when analyzing them.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 640-648"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074211","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":"Visual assessment of liver steatosis at retrieval predicts long term liver transplant outcomes in donation following circulatory death","authors":"Ning X. Ho ,&nbsp;Samuel J. Tingle ,&nbsp;Georgios Kourounis ,&nbsp;Balaji Mahendran ,&nbsp;Rebecca Bramley ,&nbsp;Emily R. Thompson ,&nbsp;Aimen Amer ,&nbsp;Rodrigo Figueiredo ,&nbsp;Stuart McPherson ,&nbsp;Steve White ,&nbsp;Colin Wilson","doi":"10.1016/j.hpb.2025.01.007","DOIUrl":"10.1016/j.hpb.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>The demand for liver transplantation is rising, as is the prevalence of steatotic liver disease. Steatotic grafts have inferior outcomes post-transplantation, due to increased sensitivity to ischaemia-reperfusion injury. We aimed to formally evaluate the impact of visually assessed liver steatosis in grafts donated following brainstem (DBD) versus circulatory death (DCD).</div></div><div><h3>Methods</h3><div>NHS registry on adult liver transplantation was reviewed retrospectively (2006–2019). We used multiple-imputation for missing data and adjusted regression models with interaction terms to compare the impact of visually assessed donor graft steatosis on transplant outcome.</div></div><div><h3>Results</h3><div>9217 recipients of deceased donor grafts were included (DBD = 7349; DCD = 1868). Multivariable cox regression revealed that the negative impact on graft survival was significantly different in DCD and DBD livers (interaction <em>P</em> = 0.011 and <em>P</em> = 0.043). The largest impact was in DCD livers (moderate steatosis: aHR = 1.851, 1.296–2.645, <em>P</em> = 0.001 and aHR = 5.426; severe steatosis: 1.723–17.090, <em>P</em> = 0.004). Visually assessed steatosis did not predict longer-term graft survival in the DBD cohort.</div></div><div><h3>Conclusion</h3><div>The impact of visually assessed steatosis on post-transplant outcome is far greater in DCD grafts, despite an identical method of steatosis assessment. This highlights novel therapeutics should be considered for steatotic DCD grafts to allow this growing sector of the donor pool to be safely utilised.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 630-639"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370816","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":"Arterial and anastomotic wrapping in pancreaticoduodenectomy as a strategy to reduce complications: a systematic review and meta-analysis","authors":"Gabriele E. Lech ,&nbsp;Patrícia Viana ,&nbsp;Camila M. de Paiva Reis ,&nbsp;Ana P. Valério-Alves ,&nbsp;João L.R. Freitas ,&nbsp;Raquel O. de Sousa Silva ,&nbsp;Rafael Morriello","doi":"10.1016/j.hpb.2025.02.001","DOIUrl":"10.1016/j.hpb.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy is associated with high morbidity, with pancreatic fistulas and hemorrhages being the most dangerous complications. We performed a systematic review and meta-analysis to evaluate the efficacy of arterial and anastomotic wrapping in pancreaticoduodenectomy.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane Central from inception to February 2024 for studies comparing omental or ligament flaps for arterial or pancreaticojejunostomy coverage in pancreaticoduodenectomies, evaluating common postoperative complications. Odds ratio (OR) was used for categorical variables and mean difference (MD) for continuous variables. We considered as significant <em>p</em>-values &lt; 0.05.</div></div><div><h3>Results</h3><div>We included 15 studies, comprising 3232 patients. The intervention successfully reduced the rates of postpancreatectomy hemorrhage (OR 0.47; <em>p</em> &lt; 0.001), with an additional reduction in postoperative pancreatic fistula when considering the use of omental wrapping (OR 0.48; <em>p</em> = 0.002). Delayed gastric emptying was not associated with a reduction when using the wrapping technique (OR 0.69; <em>p</em> = 0.06).</div></div><div><h3>Conclusion</h3><div>Our findings showed that the wrapping technique decreased the rate of major complications associated with pancreaticoduodenectomy without increasing operative time or reoperation rates.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 591-598"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887665","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":"IHPBA White Paper - The improvement of management pathways and access to care in sub-Saharan Africa for patients with hepatocellular carcinoma","authors":"Eduard Jonas ,&nbsp;Martin Smith ,&nbsp;Chris Kassianides ,&nbsp;Emmanuel Luyirika ,&nbsp;C. Wendy Spearman","doi":"10.1016/j.hpb.2025.02.007","DOIUrl":"10.1016/j.hpb.2025.02.007","url":null,"abstract":"<div><div>During its 2022 World Congress in New York the International Hepato-Pancreato-Biliary Association (IHPBA) launched the Legacy Initiative, aiming to create sustainable, positive impacts in host countries or regions by addressing critical healthcare challenges in the field of Hepato-Pancreato-Biliary surgery. The 2024 Legacy Initiative focused on hepatocellular carcinoma (HCC) in sub-Saharan Africa (SSA), a region disproportionately burdened by this disease due to a high incidence, limited healthcare infrastructure and resources, lack of screening programs, low awareness, and financial constraints. HCC, the sixth most common malignancy globally, is often diagnosed at advanced stages in SSA, leading to dismal outcomes. The initiative aims to improve management pathways and access to care through a multidisciplinary approach, emphasizing prevention, early diagnosis, curative treatments, potentially life-prolonging treatments, and palliative care. Key strategies include expanding healthcare infrastructure, implementing screening programs, raising awareness, and advocating for policy reforms. The IHPBA has partnered with the African Viral Hepatitis Convention and the African Palliative Care Association to address risk factors for developing HCC, in particular viral hepatitis, a major HCC risk factor. The initiative also highlights the need for capacity building, research, and collaboration with regional and international stakeholders. The 2024 Legacy Initiative aims to drive meaningful change, improve HCC outcomes, and reduce the disease burden in SSA, aligning with the IHPBA’s mission to create long-lasting, positive impacts in global HPB healthcare.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 585-590"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556737","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":"Decision to operate on hepatocellular cancer patients is not driven by comorbidities in Louisiana","authors":"Annie Talbot ,&nbsp;Denise Danos ,&nbsp;Yong Yi ,&nbsp;Lauren Maniscalco ,&nbsp;Xiao-Cheng Wu ,&nbsp;Omeed Moaven ,&nbsp;Mary Maluccio ,&nbsp;John Lyons III","doi":"10.1016/j.hpb.2025.01.013","DOIUrl":"10.1016/j.hpb.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>The mortality rate of Hepatocellular cancer (HCC) in Louisiana is second worst in the United States. This has been linked to underutilization of curative treatment (CT). This study aimed to identify risk factors associated with underutilization of CT in Louisiana.</div></div><div><h3>Methods</h3><div>Patients with AJCC T1 HCC diagnosed from 2011 to 2020 were identified from the Louisiana Tumor Registry (LTR) using site and histology codes. Patients who underwent CT (ablation, resection, and transplantation) were compared to those who did not undergo CT. Logistic regression was performed and results reported as adjusted odds ratios.</div></div><div><h3>Results</h3><div>CT was utilized in 462 (37 %) of 1247 patients with T1 HCC. There were no significant differences observed in age, race, BMI, poverty, or rurality between CT and non-CT patients. The percentage of cirrhosis was similar in both groups (35.3 % vs. 37.7 %, NS). On multivariant analysis, lack of CT was independently associated with low socioeconomic status (SES; <em>p</em> = 0.040), treatment outside a COC center (<em>p</em> &lt; 0.001), and lack commercial/private insurance (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Utilization of CT is driven not by comorbidities, but by insurance type, low SES, and treatment facility indicating the profound effect that care disparities have on HCC treatment.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 679-687"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482799","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":"IHPBA Legacy Declaration - The improvement of management pathways and access to care in sub-Saharan Africa for patients with hepatocellular carcinoma","authors":"Eduard Jonas ,&nbsp;Martin Smith ,&nbsp;Chris Kassianides ,&nbsp;Emmanuel Luyirika ,&nbsp;C. Wendy Spearman","doi":"10.1016/j.hpb.2025.02.006","DOIUrl":"10.1016/j.hpb.2025.02.006","url":null,"abstract":"","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 5","pages":"Pages 583-584"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572943","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}