IF 2.7 3区医学

Hpb Pub Date : 2024-09-28 DOI: 10.1016/j.hpb.2024.09.011

Alexander Loftus, Victoria S Wu, Mohamedraed Elshami, Jonathan J Hue, Lee M Ocuin

{"title":"Hospital charge and resource use analysis of extended-spectrum penicillin antibiotic therapy after pancreatoduodenectomy in intermediate- and high-risk patients.","authors":"Alexander Loftus, Victoria S Wu, Mohamedraed Elshami, Jonathan J Hue, Lee M Ocuin","doi":"10.1016/j.hpb.2024.09.011","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.09.011","url":null,"abstract":"<p><strong>Background: </strong>We previously reported that an extended antibiotic mitigation pathway following pancreatoduodenectomy in patients with intermediate-/high-risk glands is associated with 83 % lower odds of clinically relevant postoperative pancreatic fistula (CR-POPF). We now describe associations between the pathway, resource utilization, and hospital charges.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients who underwent elective pancreatoduodenectomy with soft gland texture and fistula risk score (FRS) ≥3 who received standard or extended antibiotics. Hospital charges and resource utilization within 90 days of surgery were compared by CR-POPF status and antibiotic pathway.</p><p><strong>Results: </strong>A total of 34 patients received extended antibiotics and 53 received standard antibiotics. In patients with CR-POPF, patients who received extended antibiotics had lower likelihood of surgical or percutaneous reintervention (75.0 % vs. 100.0 %, p = 0.022). Ninety-day postoperative charges associated with CR-POPF were higher than no CR-POPF ($60,527 vs. $25,631, p = 0.028). Our risk-based model predicted a $15,825 decrease in hospital charges per patient receiving extended antibiotics.</p><p><strong>Conclusions: </strong>CR-POPF is associated with higher 90-day hospital charges. Extended antibiotic therapy following pancreatoduodenectomy in patients with soft gland texture and FRS ≥3 is associated with fewer reinterventions in patients who develop CR-POPF. These outcomes will be formally tested in a randomized controlled trial (NCT05753735).</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464200","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

Protocol for a national, multicentre prospective study of acute pancreatitis management and outcomes: the PANORAMA study. 全国性多中心急性胰腺炎管理和预后前瞻性研究：PANORAMA 研究协议。

IF 2.7 3区医学

Hpb Pub Date : 2024-09-26 DOI: 10.1016/j.hpb.2024.09.008

{"title":"Protocol for a national, multicentre prospective study of acute pancreatitis management and outcomes: the PANORAMA study.","authors":"","doi":"10.1016/j.hpb.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.09.008","url":null,"abstract":"<p><strong>Aim: </strong>The primary aim of this study is to determine compliance with key quality performance indicators (QPIs) for the management of acute pancreatitis. The secondary aim is to examine the relationship between compliance to QPIs and clinical outcomes with factors that influence this.</p><p><strong>Methods: </strong>This prospective cohort study will be conducted via the trainee-led STRATA collaborative network. All public hospitals in Aotearoa New Zealand will be eligible to participate. Data will be collected on all adult patients who are diagnosed with acute pancreatitis over a 3 month period. The primary outcome is compliance with the QPIs for the different domains of acute pancreatitis management. Secondary outcomes include early (30-days from index admission) clinical outcomes including incidence of locoregional complications, interventions, organ failure, and mortality.</p><p><strong>Conclusion: </strong>This protocol describes the methodology for a nationwide prospective cohort study in Aotearoa New Zealand to evaluate compliance based on QPIs derived from the literature. These data will lay the foundation for future registry studies, clinical trials, and quality improvement initiatives.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499458","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

Artificial intelligence in the detection of choledocholithiasis: a systematic review. 人工智能在胆总管结石检测中的应用：系统综述。

IF 2.7 3区医学

Hpb Pub Date : 2024-09-25 DOI: 10.1016/j.hpb.2024.09.009

Joshua Blum, Lewis Wood, Richard Turner

{"title":"Artificial intelligence in the detection of choledocholithiasis: a systematic review.","authors":"Joshua Blum, Lewis Wood, Richard Turner","doi":"10.1016/j.hpb.2024.09.009","DOIUrl":"https://doi.org/10.1016/j.hpb.2024.09.009","url":null,"abstract":"<p><strong>Importance: </strong>Choledocholithiasis is a potentially life-threatening manifestation of acute biliary dysfunction (ABD) often requiring magnetic resonance cholangiopancreatography (MRCP) for diagnosis when standard investigation findings are inconclusive. Machine learning models (MLMs) may offer alternatives to diagnose choledocholithiasis.</p><p><strong>Objective: </strong>This systematic review seeks to evaluate the performance of MLMs in predicting choledocholithiasis and to compare this performance with the American Society of Gastrointestinal Endoscopy (ASGE) guidelines.</p><p><strong>Review: </strong>This review adhered to PRISMA guidelines. Four databases were searched for relevant records published between January 2000 and April 2024. Two researchers appraised records. MLM performance and ASGE guideline efficacy were compared, and the clinical utility of MLMs was assessed.</p><p><strong>Findings: </strong>408 records were screened; eight were eligible. Model accuracy ranged from 19 % to 97 %. Several records demonstrated a moderate-to-high risk of bias; of those featuring low risk of bias, peak accuracies ranged from 70 % to 85 %. Most MLMs outperformed ASGE guidelines. Important predictor variables included age, total bilirubin, and common bile duct diameter.</p><p><strong>Conclusions: </strong>MLMs outperform ASGE guidelines in predicting choledocholithiasis. Nonetheless, biases in study design and reporting limit their prospective applicability. Current MLMs do not yet rival MRCP in detecting choledocholithiasis. Future guideline development should consider MLM-driven insights for better risk prediction.</p>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464199","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

Landscape of donor cause of death and its impact on liver transplant outcomes: a ten-year analysis from the UNOS database 捐献者死因及其对肝移植结果的影响：UNOS 数据库的十年分析。

IF 2.7 3区医学

Hpb Pub Date : 2024-09-01 DOI: 10.1016/j.hpb.2024.05.019

{"title":"Landscape of donor cause of death and its impact on liver transplant outcomes: a ten-year analysis from the UNOS database","authors":"","doi":"10.1016/j.hpb.2024.05.019","DOIUrl":"10.1016/j.hpb.2024.05.019","url":null,"abstract":"<div><h3>Background</h3><p>Cause of death (COD) is a predictor of liver transplant (LT) outcomes independent of donor age, yet has not been recently reappraised.</p></div><div><h3>Methods</h3><p>Analyzing UNOS database (2013-2022), the study explored COD trends and impacts on one-year post-LT graft survival<span> (GS) and hazard ratios (HR) for graft failure.</span></p></div><div><h3>Results</h3><p>Of 80,282 brain-death donors, 55,413(69.0%) underwent initial LT. Anoxia became the predominant COD in 2015, increasing from 29.0% in 2013 to 45.1% in 2021, with notable increases in drug intoxication<span><span>. Survival differences between anoxia and cerebrovascular accidents (CVA) recently became insignificant (P=0.95). Further analysis showed improved GS from intracranial hemorrhage/stroke (previously worse; P<0.01) (P=0.70). HRs for post-1-year graft failure showed reduced significance of CVA (vs.Anoxia) and intracranial hemorrhage/stroke (vs.any other COD) recently. Donors with intracranial hemorrhage/stroke, showing improved survival and HR, were allocated to recipients with lower MELD-Na, contrasting the trend for </span>drug intoxication CODs.</span></p></div><div><h3>Discussion</h3><p>CVA, traditionally linked with poorer outcomes, shows improved GS and HRs (vs.Anoxia). This could be due to rising drug intoxication cases and the allocation of donors with drug intoxication to recipients with higher MELD-Na, and those with CVA to recipients with lower scores. While COD remains crucial in donor selection, proper matching can mitigate differences among CODs.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1141-1147"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327468","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

Safety and use of late-turndown liver allografts to increase rate of transplantation 晚期肝脏同种异体移植的安全性和使用，以提高移植率。

IF 2.7 3区医学

Hpb Pub Date : 2024-09-01 DOI: 10.1016/j.hpb.2024.06.008

{"title":"Safety and use of late-turndown liver allografts to increase rate of transplantation","authors":"","doi":"10.1016/j.hpb.2024.06.008","DOIUrl":"10.1016/j.hpb.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><p><span>The demand for liver transplants (LT) in the United States far surpasses the availability of </span>allografts. New allocation schemes have resulted in occasional difficulties with allograft placement and increased intraoperative turndowns. We aimed to evaluate the outcomes related to use of late-turndown liver allografts.</p></div><div><h3>Methods</h3><p>A review of prospectively collected data of LTs at a single center from July 2019 to July 2023 was performed. Late-turndown placement was defined as an open offer 6 h prior to donation, intraoperative turndown by primary center, or post-cross-clamp turndown.</p></div><div><h3>Results</h3><p>Of 565 LTs, 25.1% (n = 142) received a late-turndown liver allograft. There were no significant differences in recipient age, gender, BMI<span><span>, or race (all p > 0.05), but MELD<span> was lower for the late-turndown LT recipient group (median 15 vs 21, p < 0.001). No difference in 30-day, 6-month, or 1-year survival was noted on logistic regression<span>, and no difference in patient or graft survival was noted on Cox </span></span></span>proportional hazard regression. Late-turndown utilization increased during the study from 17.2% to 25.8%, and median waitlist time decreased from 77 days in 2019 to 18 days in 2023 (p < 0.001).</span></p></div><div><h3>Conclusion</h3><p>Use of late-turndown livers has increased and can increase transplant rates without compromising post-transplant outcomes with appropriate selection.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1148-1154"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497921","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

Towards a ‘step-up approach’ for the treatment of recurrent non-stenotic cholangitis after hepaticojejunostomy: systematic review 肝空肠吻合术后复发性非狭窄性胆管炎治疗的 "阶梯式方法"：系统综述

IF 2.7 3区医学

Hpb Pub Date : 2024-09-01 DOI: 10.1016/j.hpb.2024.05.018

{"title":"Towards a ‘step-up approach’ for the treatment of recurrent non-stenotic cholangitis after hepaticojejunostomy: systematic review","authors":"","doi":"10.1016/j.hpb.2024.05.018","DOIUrl":"10.1016/j.hpb.2024.05.018","url":null,"abstract":"<div><h3>Background</h3><p><span>Recurrent non-stenotic cholangitis (NSC) is a difficult-to-treat complication after </span>hepaticojejunostomy<span> (HJ) leading to multiple hospital admissions. The optimal treatment strategy is unclear as a systematic review is lacking.</span></p></div><div><h3>Methods</h3><p>A systematic review was performed including studies detailing treatment strategies and outcomes for recurrent NSC in patients with a surgical HJ in PubMed, Embase, and Cochrane Library (inception – September 2023). Primary outcome was resolution of NSC as defined by the included studies.</p></div><div><h3>Results</h3><p>Overall, 72 patients with recurrent NSC after HJ were included from seven retrospective studies. The rate of recurrent NSC (specified in five studies) was 4% (46/1143 HJs). Diagnosis of NSC was mostly made after excluding HJ stenosis and assessing bile reflux. Initial treatment consisted of short-course antibiotics for all patients. Second step treatment consisted of prolonged antibiotic therapy (n = 10, 13.8%). Third step treatment consisted of surgery (n = 9, n = 12.5%); mostly lengthening of the biliary loop. Together, the overall reported resolution-rate of recurrent NSC was 66.6% (n = 48).</p></div><div><h3>Conclusion</h3><p>A ‘step-up approach’ may be effective in two-thirds of patients with recurrent NSC after HJ, starting with short-course antibiotics, and eventually adding prolonged antibiotic therapy and, ultimately, surgery aimed at preventing intestinal content and food reflux. Prospective studies are needed.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1114-1122"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254396","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

Robotic versus laparoscopic liver resection for posterosuperior segments: a systematic review and meta-analysis 机器人与腹腔镜肝后段切除术：系统回顾与元分析。

IF 2.7 3区医学

Hpb Pub Date : 2024-09-01 DOI: 10.1016/j.hpb.2024.06.003

{"title":"Robotic versus laparoscopic liver resection for posterosuperior segments: a systematic review and meta-analysis","authors":"","doi":"10.1016/j.hpb.2024.06.003","DOIUrl":"10.1016/j.hpb.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><p>Minimally invasive hepatectomy for difficult lesions located in posterosuperior segments (segments I, IVa, VII and VIII) remains challenging. The value of robotic liver resection (RLR) compared with laparoscopic liver resection (LLR) for posterosuperior segments is controversial. Therefore, we performed this meta-analysis to validate the safety and efficacy of RLR in posterosuperior segments.</p></div><div><h3>Methods</h3><p>The Medline, Embase, Web of Science, and Cochrane Library electronic databases were searched to identify available research published up to October 2023. Statistical analysis was performed with RevMan software version 5.3.</p></div><div><h3>Results</h3><p>Six studies with a total of 2289 patients (RLR: <em>n</em> = 749; LLR: <em>n</em> = 1540) were included in this meta-analysis. The RLR group had less intraoperative blood loss (WMD = −119.54 ml, 95% CI: −178.89 to −60.19, <em>P</em><span> < 0.0001), fewer blood transfusions (OR = 0.56, 95% CI: 0.39 to 0.80, </span><em>P</em> = 0.001), a lower conversion rate (OR = 0.37, 95% CI: 0.23 to 0.61, <em>P</em> < 0.0001), and a shorter operative time (WMD = −27.16 min, 95% CI: −35.95 to −18.36, <em>P</em> < 0.00001).</p></div><div><h3>Discussion</h3><p>Compared with LLR, RLR for lesions in the posterosuperior segments could be safe and effective, and it has superior surgical outcomes.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1089-1102"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404830","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

Meta-analysis of survival after pulmonary resection for isolated metachronous pancreatic cancer metastasis: a promising, albeit infrequent, approach 孤立的胰腺癌转移灶肺切除术后存活率的荟萃分析：一种前景广阔但并不常见的方法

IF 2.7 3区医学

Hpb Pub Date : 2024-09-01 DOI: 10.1016/j.hpb.2024.05.015

{"title":"Meta-analysis of survival after pulmonary resection for isolated metachronous pancreatic cancer metastasis: a promising, albeit infrequent, approach","authors":"","doi":"10.1016/j.hpb.2024.05.015","DOIUrl":"10.1016/j.hpb.2024.05.015","url":null,"abstract":"<div><h3>Background</h3><p><span>To evaluate survival outcomes of pulmonary resection for isolated metachronous pancreatic </span>cancer metastasis.</p></div><div><h3>Methods</h3><p>A systematic search of electronic data sources and reference lists were conducted. Proportion meta-analysis model was constructed to quantify 1- to 5-year survival after pulmonary resection for isolated metachronous pancreatic cancer metastasis. Random-effects modelling was applied to calculate pooled outcome data.</p></div><div><h3>Results</h3><p><span><span><span>Twenty-four retrospective studies were included reporting a total of 168 patients who underwent pulmonary resection for isolated pancreatic cancer metastasis. The nature of the index pancreatic surgery included 65% </span>pancreaticoduodenectomies<span><span>, 17.5% distal pancreatectomies, 0.5% </span>total pancreatectomy<span>, and 17% unspecified. Adjuvant chemotherapy was given to 88% of the patients. The median disease-free interval was 35 (8–96) months. The type of pulmonary resection included 54% </span></span></span>wedge resections, 26% </span>lobectomies<span>, 4% segmentectomies, 1% pneumonectomies, and 15% unspecified. Pulmonary resection was associated with 1-year survival of 91.1% (95% CI 86.6%–95.5%), 2-year survival of 77.5% (95% CI 68.9%–86.0%), 3-year survival of 65.0% (95% CI 50.7%–79.3%), 4-year survival of 52.0% (95% CI 37.2%–66.9%), and 5-year survival of 37.0% (95% CI 25.0%–49.1%).</span></p></div><div><h3>Conclusion</h3><p>Pulmonary resection for isolated pancreatic cancer metastasis is associated with acceptable overall patient survival. We recommend selective pulmonary resection for isolated pulmonary metastasis from pancreatic cancer. Our findings may encourage conduction of better-quality studies in this context to help establishment of definitive treatment strategies.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1103-1113"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254439","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 by a multidisciplinary team conference affects treatment strategy and overall survival in patients with synchronous colorectal liver metastases 多学科小组会议的评估影响同步结直肠肝转移患者的治疗策略和总生存率

IF 2.7 3区医学

Hpb Pub Date : 2024-09-01 DOI: 10.1016/j.hpb.2024.05.008

{"title":"Assessment by a multidisciplinary team conference affects treatment strategy and overall survival in patients with synchronous colorectal liver metastases","authors":"","doi":"10.1016/j.hpb.2024.05.008","DOIUrl":"10.1016/j.hpb.2024.05.008","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this retrospective observational study was to investigate the geographical or sex differences in patients with synchronous colorectal liver metastases (sCRLM) in terms of assessment by a multidisciplinary team conference (MDT), curative treatment, and overall survival.</p></div><div><h3>Method</h3><p>All sCRLM patients in the South-East Health Care Region of Sweden from 2009 to 2015 were included (n = 615). Data were derived from the Swedish Colorectal Cancer Registry, Swedish Registry of Liver and Bile Surgery and medical records.</p></div><div><h3>Results</h3><p>Patients who had a hepatobiliary unit (HBU) at the nearest hospital were more likely to undergo liver surgery (HBU+, 37% (n = 106), compared to HBU−, 22% (n = 60); <em>p</em> = 0.001) and had a better median survival (<em>p</em> < 0.001). No sex differences were observed. In multivariate Cox regression analyses of overall survival, assessment by an MDT that included a liver surgeon was independently linked to better survival (HR 0.574, 0.433–0.760).</p></div><div><h3>Conclusion</h3><p>There were no sex differences in access to liver surgery or overall survival, however, there were geographical inequalities, where residency near a hospital with HBU was associated with increased overall survival and the possibility to receive liver surgery. Assessment at MDT with liver surgeon present was associated with greater survival, indicating its important role for treatment.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1131-1140"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1365182X24017349/pdfft?md5=48ed769a80facf8b934320460ed6e234&pid=1-s2.0-S1365182X24017349-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141134938","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

Comparison of age-stratified survival outcomes of gallbladder cancers in an Indian population 印度人群胆囊癌的年龄分层生存结果比较。

IF 2.7 3区医学

Hpb Pub Date : 2024-09-01 DOI: 10.1016/j.hpb.2024.05.011

{"title":"Comparison of age-stratified survival outcomes of gallbladder cancers in an Indian population","authors":"","doi":"10.1016/j.hpb.2024.05.011","DOIUrl":"10.1016/j.hpb.2024.05.011","url":null,"abstract":"<div><h3>Background</h3><p>Gallbladder cancers (GBCs) occur a decade earlier in India in comparison to the global occurrence, limiting the applicability of existing literature on age adjusted outcomes.</p></div><div><h3>Methods</h3><p>Patients who underwent surgery between 01.01.2010 and 31.12.2020 for GBC were analyzed. Patients were divided into three age groups: group 1(≤40 years), group 2(41–60 years), group 3(>60 years) and their outcomes were compared.</p></div><div><h3>Results</h3><p><span>Total of 6190 patients were treated for suspected or diagnosed GBC with a median age of 57 years. Curative resection was performed in 749 (67.9%) patients, of whom 114 (16.2%), 471 (62.9%), and 164 (21.9%) patients were in groups 1, 2, and 3, respectively. 5-year disease-free survival (DFS) [46.8% vs. 58.5%, p = 0.031] and overall survival (OS)[53.5% vs. 66.6%, p = 0.05] of group 3 were significantly lower than group 1. Patient age (HR 1.021), AJCC stage (HR 6.413), pathologic </span>residual disease in the gallbladder fossa (HR 2.44), and extranodal tumor deposits (HR 1.762) were identified as independent predictors of poor OS.</p></div><div><h3>Conclusions</h3><p>Gallbladder cancers in the Indian population show poorer outcomes with advancing age. Higher proportion of males in the elderly group with a more advanced stage at presentation are plausible reasons for poorer outcomes.</p></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"26 9","pages":"Pages 1155-1163"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141145564","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

Hpb最新文献