William Kawahara, Belen Rivera, Jeffrey Roberts, Cathleen Huang, Aishatu Ladu, George P Sorescu, Dmitry J Rabkin, Olga Kozyreva, Fernando Rotellar, Eduardo A Vega
{"title":"Laparoscopic left hemihepatectomy using the Arantius-first approach after 90Y transarterial radioembolization and immunotherapy in a cirrhotic patient.","authors":"William Kawahara, Belen Rivera, Jeffrey Roberts, Cathleen Huang, Aishatu Ladu, George P Sorescu, Dmitry J Rabkin, Olga Kozyreva, Fernando Rotellar, Eduardo A Vega","doi":"10.1093/bjs/znae305","DOIUrl":"https://doi.org/10.1093/bjs/znae305","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yang Yang, Zhichao Liu, Ian Wong, Xing Gao, Hong Zhang, Jun Liu, Ben M Eyck, Jinchen Shao, Yuchen Han, Berend J van der Wilk, Yinkai Chao, Simon Law, Bas P L Wijnhoven, J Jan B van Lanschot, Zhigang Li
{"title":"Detecting residual disease after neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma: The prospective multicentre preSINO trial.","authors":"Yang Yang, Zhichao Liu, Ian Wong, Xing Gao, Hong Zhang, Jun Liu, Ben M Eyck, Jinchen Shao, Yuchen Han, Berend J van der Wilk, Yinkai Chao, Simon Law, Bas P L Wijnhoven, J Jan B van Lanschot, Zhigang Li","doi":"10.1093/bjs/znaf004","DOIUrl":"10.1093/bjs/znaf004","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoradiotherapy (nCRT) in patients with oesophageal squamous cell carcinoma (OSCC) may lead to clinical complete response (cCR). It is important to know the accuracy of clinical response evaluations (CREs) before advocating active surveillance instead of oesophagectomy.</p><p><strong>Methods: </strong>This was a prospective, multicentre study of patients with locally advanced OSCC. They received the first CRE (bite-on-bite biopsies) 4-6 weeks after nCRT. Patients with residual tumour underwent surgery. Patients with a cCR at CRE-1 underwent a second CRE 10-12 weeks after nCRT using PET-CT, bite-on-bite biopsies and endoscopic ultrasound fine-needle aspiration (EUS-FNA). All patients without distant metastases underwent surgery. Primary endpoint was the accuracy of CREs for detecting Tumour Regression Grade (TRG)3-4 or TRG1-2 with ypN+ residual tumour with a prespecified false-negative rate (FNR) of 19.5%. Circulating-tumour DNA (ctDNA) at CREs was performed for exploratory analysis.</p><p><strong>Results: </strong>In total 309 patients were included. Eighteen of 133 patients with TRG3-4 or TRG1-2 with ypN+ residual tumours were not detected by bite-on-bite biopsies and EUS-FNA (FNR: 13.5%). Sensitivity, specificity, negative predictive value and positive predictive value of detecting any residual tumour were 81.7%, 93.2%, 68.7% and 96.5% respectively. PET-CT detected interval distant metastases in 13 (4.9%) of 268 patients presurgically. After a minimum 12-month follow-up, systemic recurrence rates were 28.0% in patients with positive ctDNA at CREs and 5.3% in those with negative ctDNA.</p><p><strong>Conclusions: </strong>Bite-on-bite biopsies and EUS-FNA were accurate in detecting residual disease after nCRT in OSCC. Positive ctDNA at CREs may indicate an increased risk of systemic metastases.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The changing landscape of multimodal treatment for locally advanced oesophageal and junctional adenocarcinoma.","authors":"Sander J M van Hootegem, Bas P L Wijnhoven","doi":"10.1093/bjs/znaf010","DOIUrl":"https://doi.org/10.1093/bjs/znaf010","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kate L Harvey, Leigh Johnson, Parisa Sinai, Nicola Mills, Paul White, Christopher Holcombe, Shelley Potter
{"title":"Patient-reported outcomes 3 and 18 months after mastectomy and immediate prepectoral implant-based breast reconstruction in the UK Pre-BRA prospective multicentre cohort study.","authors":"Kate L Harvey, Leigh Johnson, Parisa Sinai, Nicola Mills, Paul White, Christopher Holcombe, Shelley Potter","doi":"10.1093/bjs/znaf032","DOIUrl":"10.1093/bjs/znaf032","url":null,"abstract":"<p><strong>Introduction: </strong>Prepectoral techniques are becoming standard of care for implant-based breast reconstruction due to reduced impact on chest wall function and improved patient satisfaction. Evidence to support these benefits, however, is lacking. Here, patient-reported outcomes (PROs) of prepectoral breast reconstruction (PPBR) in the Pre-BRA cohort are reported.</p><p><strong>Methods: </strong>Women undergoing PPBR after mastectomy for breast cancer or risk reduction between July 2019 and December 2020 were recruited. Participants completed the BREAST-Q preoperatively and at 3 and 18 months following surgery together with a single item evaluating overall satisfaction at 18 months. Women completing at least one BREAST-Q scale at any timepoint were eligible for inclusion. Questionnaires were scored according to the developers' instructions and scores compared over time. Exploratory analysis, adjusting for baseline scores was performed to explore factors impacting PROs.</p><p><strong>Results: </strong>In total 338 of 343 (98.5%) women undergoing PPBR at 40 UK centres were included in the analysis. Compared with baseline scores, women reported statistically significant and clinically meaningful decreases in both 'Physical' and 'Sexual well-being' at 3 and 18 months. Adjusting for baseline, at 18 months, those experiencing implant loss or having surgery for malignancy reported lower scores in all BREAST-Q domains. Overall, two-thirds of women (167/251) rated the outcome of their reconstruction as 'excellent/very good', but experiencing major complications, implant loss, and being dissatisfied with wrinkling/rippling in the reconstructed breast were associated with reduced satisfaction.</p><p><strong>Conclusions: </strong>PPBR impacts postoperative physical well-being and PROs are variable. These findings should be discussed with patients to support informed decision-making based on realistic expectations of outcome.</p><p><strong>Study registration: </strong>ISRCTN11898000.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeffrey M Breton, Stefan T Prvulovic, Rocco A Armonda, Yurii Cherednychenko, Andrii Sirko
{"title":"Penetrating traumatic brain injury: a video case presentation.","authors":"Jeffrey M Breton, Stefan T Prvulovic, Rocco A Armonda, Yurii Cherednychenko, Andrii Sirko","doi":"10.1093/bjs/znae324","DOIUrl":"https://doi.org/10.1093/bjs/znae324","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Onida, Matthew Tan, Valeria Balan, Francine Heatley, Sarrah Peerbux, Layla Bolton-Saghdaoui, Tristan Lane, David Epstein, Manjit Gohel, John Norrie, Robert Lee, Richard Lomas, Alun H Davies
{"title":"Decellularized dermis allograft for the treatment of venous leg ulceration: the DAVE RCT.","authors":"Sarah Onida, Matthew Tan, Valeria Balan, Francine Heatley, Sarrah Peerbux, Layla Bolton-Saghdaoui, Tristan Lane, David Epstein, Manjit Gohel, John Norrie, Robert Lee, Richard Lomas, Alun H Davies","doi":"10.1093/bjs/znae330","DOIUrl":"10.1093/bjs/znae330","url":null,"abstract":"<p><strong>Background: </strong>Venous leg ulcers (VLUs) cause significant impairment to patients' quality of life (QoL) and up to 30% do not heal at 6 months. Decellularized dermis (DCD) allografts have been shown to be effective in improving healing rates of diabetic foot ulcers in RCTs. The DAVE RCT aimed to determine whether DCD is an effective, safe, and cost-effective treatment adjunct for VLUs.</p><p><strong>Methods: </strong>This was a multicentre RCT performed in the UK. Patients with lower limb ulcers ≥18 years with VLU, venous incompetence on duplex ultrasound, an ankle : brachial pressure index ≥ 0.8 and an index VLU present for at least 3 months and ≥2 cm2 in size were included. Patients were randomized to either the intervention (DCD graft and standard of care) or control arm (standard of care alone). The primary outcome was the proportion of patients with a healed index ulcer at 12 weeks.</p><p><strong>Results: </strong>From October 2019 to October 2022, 36 and 35 participants were randomized into the intervention and control arms respectively. Patient characteristics at baseline were similar between groups. Healing was recorded in 5.7% of the intervention group and 15.2% in the control group (OR 0.34, 95% c.i. 0.03 to 2.31). There were no significant differences in the secondary outcomes including the percentage change in ulcer area, time to healing, recurrence rates, and QoL. There were five serious adverse events attributed to DCD application. Early trial termination was advised after the interim data analysis due to a lower-than-expected primary outcome rate (11.3%).</p><p><strong>Conclusions: </strong>Decellularized dermis grafts did not improve healing rates of venous leg ulcers, although the trial was terminated early due to poor healing rates in both the intervention and control arms. Important clinical benefits or harms of decellularized dermis grafts could not be excluded due to the small sample size.</p><p><strong>Trial registration: </strong>ISRCTN 21541209.</p>","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Disease-specific survival outcomes for patients after locoregional treatment for ductal carcinoma in situ: observational cohort study.","authors":"","doi":"10.1093/bjs/znaf045","DOIUrl":"https://doi.org/10.1093/bjs/znaf045","url":null,"abstract":"","PeriodicalId":136,"journal":{"name":"British Journal of Surgery","volume":"112 2","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}