Surgery最新文献

{"title":"Information for authors","authors":"","doi":"10.1016/S0039-6060(24)01093-6","DOIUrl":"10.1016/S0039-6060(24)01093-6","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 109106"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress on animal models of peritoneal adhesion","authors":"Zhenjun Pu MM ,&nbsp;Hongyu Nian MM ,&nbsp;Zhiyuan Li MM ,&nbsp;Pengfei Zhong MM ,&nbsp;Shengxu Ma MM ,&nbsp;Junliang Li MD","doi":"10.1016/j.surg.2024.10.020","DOIUrl":"10.1016/j.surg.2024.10.020","url":null,"abstract":"<div><div>Peritoneal adhesion is a common complication of abdominal and pelvic surgery that can cause various clinical symptoms, including abdominal pain, intestinal obstruction, and female infertility, significantly impacting patient quality of life. Animal models of peritoneal adhesion are important tools for studying the mechanisms of adhesion formation and evaluating the effectiveness of prevention and treatment. Various methods for constructing animal models of peritoneal adhesion include physical injury, chemical injury, ischemia, infection, foreign body stimulation, and simulated surgery; however, none can fully simulate peritoneal adhesion in patients clinically. Therefore, this review aimed to explore previous methods used to construct peritoneal adhesion animal models and summarize their principles, characteristics, and applications. Similarly, it summarizes macroscopic and microscopic evaluation indicators, such as peritoneal adhesion gross assessment, histological scoring, and molecular markers. On the basis of this, we proposed a new animal model of peritoneal adhesion that simulates the factors contributing to peritoneal adhesion formation in clinical surgery. peritoneal adhesion formation was stable and standardized using our proposed model, providing a foundation for the establishment and application of peritoneal adhesion animal models.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108929"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying health insurance eligibility impact on interhospital transfers of injured patients: Evidence from the affordable care act’s dependent coverage provision","authors":"Joseph Tanenbaum MD, PhD ,&nbsp;Susheel Reddy MPH ,&nbsp;John Slocum MPH ,&nbsp;Colin Cantrell MD ,&nbsp;Bennet Butler MD ,&nbsp;Alexander Lundberg PhD ,&nbsp;Anne M. Stey MD, MSc","doi":"10.1016/j.surg.2024.10.012","DOIUrl":"10.1016/j.surg.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Observational studies reported that nontrauma/low-level trauma centers less frequently transferred insured injured patients to high-level centers. The dependent coverage provision of the Affordable Care Act was a natural experiment expanding insurance eligibility in 2010 by allowing young adults to remain on their parents’ insurance until age 26 years old. The objective was to determine whether expanded insurance eligibility reduced interhospital transfers.</div></div><div><h3>Methods</h3><div>This observational, retrospective cohort study of the 2007–2013 National Trauma Data Bank used a difference-in-differences design to compare the change in interhospital transfer rates before and after dependent coverage provision implementation between dependent coverage provision–eligible (aged 19–25 years) and dependent coverage provision–ineligible (aged 27–34 years) injured patients. The exposure of interest was the dependent coverage provision. The main outcome was yearly rate of interhospital transfer. Least-squares linear regression modeled interhospital transfer rates and quantified association with the age-based dependent coverage provision eligibility binary interaction term in the pre–dependent coverage provision versus post–dependent coverage provision time periods.</div></div><div><h3>Results</h3><div>A total of 535,036 dependent coverage provision–eligible and 431,462 dependent coverage provision–ineligible patients were identified. The median Injury Severity Score was 6.0 (interquartile range = 4.0–13.0) for both cohorts. Private insurance rates increased from 28.1% to 38.7% among the dependent coverage provision–eligible cohort and from 27.0% to 30.5% among the older cohort between the pre–dependent coverage provision to post–dependent coverage provision time period. The average yearly interhospital transfer rate was not significantly different between the cohorts in the pre–dependent coverage provision (2.3% lower among dependent coverage provision–eligible) and the post–dependent coverage provision time periods (2.9% lower among dependent coverage provision–eligible). Difference-in-differences analysis revealed nonsignificant 14.6 fewer transfers/10,000 patients (95% confidence interval = 33.7 fewer to 4.4 more transfers/10,000 patients).</div></div><div><h3>Conclusion</h3><div>Policies expanding insurance eligibility do not reduce interhospital transfers in a mature trauma system.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108921"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine's role in inflammation and pain post video-assisted thoracoscopic surgery for lung cancer","authors":"Wei-Zhen Tang MD,&nbsp;Wen-Xin Deng MD,&nbsp;Tai-Hang Liu PhD","doi":"10.1016/j.surg.2024.08.044","DOIUrl":"10.1016/j.surg.2024.08.044","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108821"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence and prognostic predictors in pathologic T1N0 esophageal squamous cell carcinoma treated with surgery alone","authors":"Manato Ohsawa MD,&nbsp;Yoichi Hamai MD, PhD,&nbsp;Manabu Emi MD, PhD,&nbsp;Yuta Ibuki MD, PhD,&nbsp;Tomoaki Kurokawa MD,&nbsp;Ryosuke Hirohata MD,&nbsp;Nao Kitasaki MD,&nbsp;Morihito Okada MD, PhD","doi":"10.1016/j.surg.2024.09.019","DOIUrl":"10.1016/j.surg.2024.09.019","url":null,"abstract":"<div><h3>Background</h3><div>Patients diagnosed with pathologic T1N0 esophageal squamous cell carcinoma and treated with surgery alone have a good prognosis and are generally followed up without adjuvant therapy. However, recurrence has been observed in this patient group. Therefore, this study aimed to identify recurrence and prognostic factors in patients with pathologic T1N0 esophageal squamous cell carcinoma who were treated with surgery alone.</div></div><div><h3>Methods</h3><div>Of the 532 patients who underwent esophagectomy with R0 resection at Hiroshima University Hospital between August 2003 and November 2018, 124 who underwent only esophagectomy and had pathological T1N0 esophageal squamous cell carcinoma were included in the study. Recurrence and prognostic factors were analyzed and details of recurrence were evaluated.</div></div><div><h3>Results</h3><div>The 5-year recurrence-free survival and 5-year overall survival rates were 84.7% and 87.2%, respectively. Recurrence was observed in 12 (9.7%) patients. Univariate and multivariate analyses showed that the histologic type (poorly differentiated compared with others) and lymphatic and/or vascular invasion (positive compared with negative) were statistically significant for recurrence-free survival. Kaplan–Meier curves for recurrence-free survival and overall survival showed that prognosis was significantly stratified according to these factors. All patients with poorly differentiated and positive lymphatic and/or vascular invasion experienced recurrence and recurrence pattern is all distant metastases.</div></div><div><h3>Conclusions</h3><div>Poorly differentiated and lymphatic and/or vascular invasion are important recurrence and prognostic predictors in pathologic T1N0 esophageal squamous cell carcinoma treated with surgery alone. Patients with these prognostic factors experienced increased recurrence rates, often with distant metastasis. Therefore, adjuvant therapy may be beneficial for such patients and follow-ups should be performed at closer intervals.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108863"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic pancreatoduodenectomy is safe for the treatment of pancreatic ductal adenocarcinoma treated by chemoradiotherapy compared with open pancreatoduodenectomy: A matched case-control study","authors":"Elias Karam MD ,&nbsp;Charlotte Rondé-Roupie MD ,&nbsp;Béatrice Aussilhou MD ,&nbsp;Olivia Hentic MD ,&nbsp;Vinciane Rebours MD, PhD ,&nbsp;Mickaël Lesurtel MD, PhD ,&nbsp;Alain Sauvanet MD, PhD ,&nbsp;Safi Dokmak MD, PhD","doi":"10.1016/j.surg.2024.09.041","DOIUrl":"10.1016/j.surg.2024.09.041","url":null,"abstract":"<div><h3>Background</h3><div>Few studies compared laparoscopic and open pancreatoduodenectomy for pancreatic ductal adenocarcinoma after neoadjuvant chemoradiotherapy.</div></div><div><h3>Methods</h3><div>Retrospective cohort of patients who underwent laparoscopic or open pancreatoduodenectomy for resectable or borderline resectable pancreatic ductal adenocarcinoma after chemoradiotherapy between 2012 and 2023 was analyzed. Open pancreatoduodenectomy patients could theoretically benefit from the laparoscopic approach. We used a 1:2 (laparoscopic-to-open pancreatoduodenectomy) propensity score matching analysis stratified on age, gender, and body mass index.</div></div><div><h3>Results</h3><div>We included 128 patients (33 laparoscopic and 95 open pancreatoduodenectomy), and after propensity score matching, 33 laparoscopic pancreatoduodenectomy and 66 open pancreatoduodenectomy were compared. There was no difference in demographic data except for lower tobacco use in laparoscopic pancreatoduodenectomy group (9% vs 30%, <em>P</em> = .023) with similar clinical presentation. Laparoscopic pancreatoduodenectomy compared to open pancreatoduodenectomy showed a longer median operative duration (380 vs 255 minutes, <em>P</em> &lt; .001), shorter median length of resected vein (15 vs 23 mm, <em>P</em> = .01), longer median venous clamping time (29 vs 15 minutes, <em>P</em> = .005), similar median blood loss (300 vs 300 mL, <em>P</em> = .223), similar rate of hard pancreas (97% vs 85%, <em>P</em> = .094), and a larger median size of Wirsung duct (5 vs 4 mm, <em>P</em> = .02). Postoperative outcomes showed similar 90-day mortality rates (3% vs 3%, <em>P</em> &gt; .99), Clavien-Dindo III-IV complications (6% vs 14%, <em>P</em> = .158), median lengths of hospital stay (12 vs 13 days, <em>P</em> = .409), and readmission rates (9% vs 18%, <em>P</em> = .366). Pathologic data showed similar R0 resection rates (88% vs 82%, <em>P</em> = .568). With a similar rate of adjuvant chemotherapy (<em>P</em> = .324) and shorter median follow-up with laparoscopic pancreatoduodenectomy (18 vs 34 months, <em>P</em> = .004), 3-year overall (<em>P</em> = .768) and disease-free (<em>P</em> = .839) survival rates were similar.</div></div><div><h3>Conclusion</h3><div>In selected patients, laparoscopic pancreatoduodenectomy for pancreatic ductal adenocarcinoma after neoadjuvant chemoradiotherapy appears to be safe and feasible when performed in experienced centers.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108892"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“The Gordian knot of it he will unloose”: Lessons learned from studies of half-hitch surgical knots and implications for practicing surgeons: A systematic review","authors":"Thomas J. O'Keefe MD ,&nbsp;Charissa Lake MD ,&nbsp;Louis A. Perkins MD ,&nbsp;Sean A. Perez MD ,&nbsp;Isabella Guajardo MD ,&nbsp;Simone Carlson Hyman MD ,&nbsp;Laura M. Adams MD ,&nbsp;Bard C. Cosman MD, MPH ,&nbsp;William D. Ardill MD ,&nbsp;Bruce M. Potenza MD, MPH","doi":"10.1016/j.surg.2024.10.023","DOIUrl":"10.1016/j.surg.2024.10.023","url":null,"abstract":"<div><h3>Background</h3><div>Insecure surgical knots can cause surgical complications ranging from wound dehiscence to massive exsanguination and death. Most surgeons tie half-hitch knots, of which some configurations are prone to slippage. We aim to characterize the securities of different half-hitch knot configurations.</div></div><div><h3>Methods</h3><div>A literature search was conducted using PubMed and Embase for studies in which comparisons of knot security were made between different half-hitch knot configurations. Two reviewers screened and selected articles.</div></div><div><h3>Results</h3><div>From 2,204 abstracts identified, 14 were selected for inclusion. In all 8 of the studies in which there was a direct comparison between knots tied with opposite throws on the same post, which are tied when greater tension is applied to the same strand end, and knots tied with any throws on alternating posts which are tied when the strand on which greater tension is applied switches between the strand ends, there was at least one comparison of configurations in which any throws on alternating posts knots were more secure than opposite throws on the same post knots. There was also less variability in the securities of any throws on alternating posts knots than opposite throws on the same post knots. Knots tied with identical throws on the same post were less secure than opposite throws on the same post and any throws on alternating posts.</div></div><div><h3>Conclusions</h3><div>The securities of half-hitch knots exist on a spectrum. any throws on alternating posts knots were consistently the most secure independent of whether throws were opposite or identical, and identical throws on the same post knots were less secure than opposite throws on the same post and any throws on alternating posts. Surgeons should consider any throws on alternating posts knots as opposed to the more commonly utilized opposite throws on the same post knots.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108932"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expedited discharge and risk of readmission after ostomy construction","authors":"Kaitlin G. Burge MD, MBA ,&nbsp;Hannah Ficarino Sheffer MD, MSPH ,&nbsp;Mary Smithson MD, MS ,&nbsp;Chandler McLeod PhD ,&nbsp;Daniel Chu MD, MSPH, FACS ,&nbsp;Robert H. Hollis MD, MSPH, FACS","doi":"10.1016/j.surg.2024.10.031","DOIUrl":"10.1016/j.surg.2024.10.031","url":null,"abstract":"<div><h3>Background</h3><div>Expedited discharge after surgery with construction of an ostomy may leave patients less prepared for home self-care, leading to increased hospital readmissions. We evaluated whether readmission rates were greater for patients with an expedited discharge (1–2 days) compared with nonexpedited discharge (3–5 days) after ostomy construction.</div></div><div><h3>Methods</h3><div>A retrospective analysis of a prospective database of patients undergoing ostomy construction was performed using the American College of Surgeons National Safety and Quality Improvement Project data between years 2019 and 2020. Inclusion criteria included age &gt;18 years, discharge to home, and postoperative length of stay 1–5 days. Patients were grouped into either expedited or nonexpedited discharge by postoperative length of stay. The primary outcome was 30-day postoperative readmission. Analysis included multivariable logistic regression models and partial effects analysis.</div></div><div><h3>Results</h3><div>Of 13,628 patients included, 14.5% (<em>n</em> = 1,980) had an expedited discharge. Rates of 30-day readmission were 13.6% in the expedited group and 14.2% in the nonexpedited group (<em>P</em> = .51). Adjusting for patient and procedure factors, there was no significant difference in readmission rates between expedited and nonexpedited discharge groups (odds ratio, 1.08; 95% confidence interval, 0.94–1.25). In stratified analysis, there was no difference in readmission by discharge timing for any procedure type. The top 3 contributors to having an expedited discharge, as assessed by partial effects analysis, were procedure type, elective surgery, and pre-operative sepsis.</div></div><div><h3>Conclusions</h3><div>Early discharge within 1–2 days of ostomy construction was not associated with increased 30-day hospital readmissions. These findings support expedited discharges after ostomy construction in carefully selected, eligible patients.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108948"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative risk-stratified analysis: External versus internal pancreatic stents in pancreatoduodenectomy","authors":"Tomotaka Kato MD, PhD ,&nbsp;Yuichiro Watanabe MD, PhD ,&nbsp;Yasutaka Baba MD, PhD ,&nbsp;Yuhei Oshima MD ,&nbsp;Kenichiro Takase MD, PhD ,&nbsp;Yukihiro Watanabe MD, PhD ,&nbsp;Katsuya Okada MD, PhD ,&nbsp;Masayasu Aikawa MD, PhD ,&nbsp;Kojun Okamoto MD, PhD ,&nbsp;Isamu Koyama MD, PhD","doi":"10.1016/j.surg.2024.09.007","DOIUrl":"10.1016/j.surg.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Several risk-stratified studies have compared the outcomes of external and internal pancreatic stents in pancreatoduodenectomy (PD), but no resolute standard for a fistula-mitigation strategy exists. The study investigated the efficacy of these stents in a preoperative risk-stratified setting.</div></div><div><h3>Methods</h3><div>Data from 285 patients who underwent PD with pancreaticojejunostomy using an external or internal stent from 2015 to 2023 were analyzed. The preoperative pancreatic fistula score (preFRS) was used to classify patients into low-risk (preFRS: 0–5) and high-risk (preFRS: 6–8) groups.</div></div><div><h3>Results</h3><div>PreFRS accurately predicted the risk of clinically relevant postoperative pancreatic fistula (CR-POPF) as 0% and &gt;40% in patients with preFRS ≤1 and ≥7, respectively. Although no significant difference was observed in postoperative outcomes in low-risk patients, the external stent significantly reduced CR-POPF (21% vs 44%, <em>P</em> = .024) and postpancreatectomy hemorrhage (PPH, 0% vs 19%, <em>P</em> = .02) in high-risk patients, leading to the superiority of the external stent in the entire cohort in terms of CR-POPF (12% vs 24%, <em>P</em> = .033) and PPH (1% vs 11%, <em>P</em> = .013). There were no significant differences in stent-related complications or pancreatic dysfunction. External stent malfunction occurred in 14% and significantly affected CR-POPF development in both low- (20% vs 0%, <em>P</em> &lt; .01) and high-risk groups (60% vs 14%, <em>P</em> = .021).</div></div><div><h3>Conclusion</h3><div>The external pancreatic stent showed a more beneficial effect on CR-POPF and PPH, especially in high-risk patients, without increasing other complications. Risk-stratified strategy and improving stent management might enhance postoperative outcomes.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108845"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involvement of β-catenin expression in hepatocellular carcinoma prognosis in a cohort of patients undergoing curative treatment","authors":"Noelia De-Armas-Conde PhD, MD ,&nbsp;Francisco Javier González-Rico PhD ,&nbsp;Isabel Jaén-Torrejimeno PhD, MD ,&nbsp;Jaime M. Merino PhD ,&nbsp;Diego López-Guerra PhD, MD ,&nbsp;Ana Ordiales-Talavero PhD, MD ,&nbsp;Adela Rojas-Holguín MD ,&nbsp;Beatriz Marín-Díaz ,&nbsp;Julen Ramón-Rodríguez PhD, MD ,&nbsp;Laura Ordóñez-Mata ,&nbsp;Pedro M. Fernández-Salguero PhD ,&nbsp;Gerardo Blanco-Fernández PhD, MD","doi":"10.1016/j.surg.2024.09.035","DOIUrl":"10.1016/j.surg.2024.09.035","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma is a tumor of epithelial origin that arises from the action of different carcinogens on the hepatocytes and has a high worldwide incidence. The prognostic markers of this disease have not been completely established. Mutations in the gene encoding β-catenin are overexpressed in hepatocellular carcinoma. The objective of our study was to correlate the molecular expression of β-catenin in hepatocellular carcinoma with the already known prognostic markers.</div></div><div><h3>Methods</h3><div>We conducted an observational and prospective cohort study on adult patients diagnosed with hepatocellular carcinoma from whom samples of nontumor and tumor liver parenchyma were taken intraoperatively to correlate the molecular expression of β-catenin in hepatocellular carcinoma with the known prognostic markers.</div></div><div><h3>Results</h3><div>A total of 81 samples were collected, of which 48 met the inclusion criteria. The final sample was divided into patients with a diagnosis of hepatocellular carcinoma on a cirrhotic liver, corresponding to 31 patients (64.6%), and patients with a diagnosis of hepatocellular carcinoma on a noncirrhotic liver, corresponding to 17 patients (35.4%). We found that overexpression of β-catenin and the neutrophil/lymphocyte ratio are independently related to disease-free survival, and both overexpression and molecular repression of β-catenin are independently related.</div></div><div><h3>Conclusion</h3><div>Molecular overexpression of β-catenin in hepatocellular carcinoma compared with nontumor tissue is associated with worse disease-free survival, and its combination with a high neutrophil-lymphocyte ratio worsens this prognosis.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"178 ","pages":"Article 108885"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}