Zhonghua wai ke za zhi [Chinese journal of surgery]最新文献

{"title":"[A comparison of current guidelines for the management of intrahepatic cholangiocarcinoma worldwide].","authors":"Y X Yu, Z J Wu, W Tang, R Liao","doi":"10.3760/cma.j.cn112139-20221125-00495","DOIUrl":"10.3760/cma.j.cn112139-20221125-00495","url":null,"abstract":"<p><p>Intrahepatic cholangiocarcinoma (ICC) is the second most common malignancy in the human liver and its incidence rate has been steadily increasing throughout the world over the past decades. Surgical resection (R0 resection) is the preferred potentially curative treatment for patients with ICC. However, due to its concealing clinical characteristics and high invasiveness, most patients have lost the opportunity for surgical resection at the time of diagnosis. In recent years, with the rapid development of targeted therapy and immunotherapy, represented by immunocheckpoint inhibitors, clinicians are expected to provide more effective treatment options for patients with mid-stage or advanced ICC. At present, there are still controversial opinions on different guidelines on preoperative biliary drainage, the extent of hepatectomy, the definition of R0 resection, the width of the resection margin, lymph node dissection, postoperative recurrence, adjuvant therapy, etc. In this review, 12 guidelines or expert consensus published worldwide from 2012 to 2022 (including 4 Chinese guidelines, 4 European guidelines, 2 American guidelines, and 2 Japanese guidelines) were retrieved. Focusing on sorting and comparing current views on clinical management of ICC in different guidelines, this review aims to provide reference information for clinical management and decision making of ICC.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"297-304"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A nomogram for preoperative prediction of lymph node metastasis in patients with intrahepatic cholangiocarcinoma based on inflammation-related markers].","authors":"X P Yu, J L Chen, Y Tang, C Chen, Y H Qiu, H Wu, T Q Song, Y He, X H Mao, W L Zhai, Z J Cheng, X Liang, J D Li, C D Sun, K Ma, R X Lin, Z M Geng, Z H Tang, Z W Quan","doi":"10.3760/cma.j.cn112139-20230106-00009","DOIUrl":"10.3760/cma.j.cn112139-20230106-00009","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objectives:&lt;/b&gt; To construct a nomogram for the prediction of lymph node metastases of intrahepatic cholangiocarcinoma (ICC) based on inflammation-related markers,and to conduct its clinical verification. &lt;b&gt;Methods:&lt;/b&gt; Clinical and pathological data from 858 ICC patients who underwent radical resection were retrospectively collected from 10 domestic tertiary hospitals in China from January 2010 to December 2018. Among the 508 patients who underwent lymph node dissection,207 cases had complete variable clinical data to construct the nomogram,including 84 males and 123 females,109 patients≥60 years,98 patients&lt;60 years and 69 patients were pathologically diagnosed with positive lymph nodes after surgery. The receiver operating characteristic curve was drawn to calculate the accuracy of preoperative imaging examinations to determine the status of the lymph nodes,and the difference in overall survival time was compared by Log-rank test. Partial regression squares and statistically significant preoperative variables were screened by backward stepwise regression analysis. Software R was applied to construct a nomogram,clinical decision curve, clinical influence curve,and the Bootstrap method was used for internal verification. Additionally,retrospectively collecting clinical information from 107 ICC patients with intraoperative lymph node dissection admitted to 9 tertiary hospitals in China from January 2019 to June 2021 was for external verification to verify the accuracy of the nomogram. Eighty patients with complete clinical data but without lymph node dissection were divided into high-risk lymph node metastasis group and low-risk group according to the nomogram score among the 858 patients. Log-rank test was used to compare the overall survival of patients with or without lymph node metastasis diagnosed by pathology. &lt;b&gt;Results:&lt;/b&gt; The area under the curve of preoperative imaging examinations for the assessment of lymph node status of 440 patients was 0.615,with a false negative rate of 62.8% (113/180) and a false positive rate of 14.2% (37/260). The median survival time of 207 patients used to construct a nomogram with positive or negative postoperative pathological lymph node metastases was 18.5 months and 27.1 months,respectively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Five variables related to lymph node metastasis were screened by a stepwise backward regression analysis,which were combined calculi,neutrophil/lymphocyte ratio,albumin,invasion of the liver capsule and the systemic immune inflammation index,according to which a nomogram was constructed with concordance index(C-index) of 0.737 (95%&lt;i&gt;CI&lt;/i&gt;: 0.667 to 0.806). The C-index of external verification was 0.674 (95%&lt;i&gt;CI&lt;/i&gt;:0.569 to 0.779). The calibration prediction curve was in good agreement with the reference curve. The results of the clinical decision curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set at about 0.32,the maximum net benefit could be ","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"321-329"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical management of choledochal cyst: status quo and hot issues].","authors":"X Wang, Y J Zhang","doi":"10.3760/cma.j.cn112139-20221121-00486","DOIUrl":"10.3760/cma.j.cn112139-20221121-00486","url":null,"abstract":"<p><p>Choledochal cyst is one of the most common congenital diseases in the biliary tract system,which can affect both children and adults. While surgical management has changed markedly in recent years, researchers' understanding related to the nomenclature,diagnosis and classification of choledochal cysts remains inadequate. Anatomical variations and stricture of the intrahepatic bile duct are prone to be overlooked during surgery. Furthermore, it is still controversial in the treatment of intrapancreatic choledochal cyst and the extent of resection related to dilated bile ducts. Along with the advancement of laparoscopic or robotic-assisted procedures,there is also an increase in reoperations for patients with choledochal cyst,which underscores the importance of long-term biliary patency. This state-of-the-art review on choledochal cyst aims to further improve the diagnosis and treatment of this benign but intractable disease.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"283-290"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of postoperative adjuvant chemotherapy on prognosis of patients with intrahepatic cholangiocarcinoma:a multicenter retrospective study].","authors":"Q Z Lin, H Z Liu, W P Zhou, Z J Cheng, J Y Lou, S G Zheng, X Y Bi, J M Wang, W Guo, F Y Li, J Wang, Y M Zheng, J D Li, S Cheng, Y Y Zeng","doi":"10.3760/cma.j.cn112139-20230106-00010","DOIUrl":"10.3760/cma.j.cn112139-20230106-00010","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objectives:&lt;/b&gt; To examine the influence of adjuvant chemotherapy after radical resection on the survival of patients with intrahepatic cholangiocarcinoma(ICC) and identify patients who may benefit from it. &lt;b&gt;Methods:&lt;/b&gt; The clinical and pathological data of 654 patients with ICC diagnosed by postoperative pathology from December 2011 to December 2017 were collected retrospectively in 13 hospitals in China. According to inclusion and exclusion criteria,455 patients were included in this study,including 69 patients (15.2%) who received adjuvant chemotherapy and 386 patients (84.8%) who did not receive adjuvant chemotherapy. There were 278 males and 177 females,with an age of 59 (16) years (&lt;i&gt;M&lt;/i&gt;(IQR))(range:23 to 88 years). The propensity score matching (PSM) method was used to balance the difference between the adjuvant chemotherapy group and the non-adjuvant chemotherapy group. The Kaplan-Meier method was used to plot the survival curve,the Log-rank test was used to compare the difference of overall survival(OS) and recurrence free survival(RFS) between the two groups. Univariate analysis was used to determine prognostic factors for OS. Then, multivariate Cox proportional hazards models were performed for prognostic factors with &lt;i&gt;P&lt;/i&gt;&lt;0.10 to identify potential independent risk factors. The study population was stratified by included study variables and the AJCC staging system,and a subgroup analysis was performed using the Kaplan-Meier method to explore the potential benefit subgroup population of adjuvant chemotherapy. &lt;b&gt;Results:&lt;/b&gt; After 1∶1 PSM matching,69 patients were obtained in each group. There were no significant differences in baseline data between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). After PSM, the Cox multivariate analysis showed that lymph node metastasis (&lt;i&gt;HR&lt;/i&gt;=3.06,95%&lt;i&gt;CI&lt;/i&gt;:1.52 to 6.16,&lt;i&gt;P&lt;/i&gt;=0.039),width of resection margin (&lt;i&gt;HR&lt;/i&gt;=0.56,95%&lt;i&gt;CI&lt;/i&gt;:0.32 to 0.99,&lt;i&gt;P&lt;/i&gt;=0.044) and adjuvant chemotherapy (&lt;i&gt;HR&lt;/i&gt;=0.51,95%&lt;i&gt;CI&lt;/i&gt;:0.29 to 0.91,&lt;i&gt;P&lt;/i&gt;=0.022) were independent prognostic factors for OS. Kaplan-Meier analysis showed that the median OS time of the adjuvant chemotherapy group was significantly longer than that of the non-adjuvant chemotherapy group (&lt;i&gt;P&lt;/i&gt;&lt;0.05). There were no significant differences in the RFS time between the adjuvant chemotherapy group and the non-adjuvant chemotherapy group (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The subgroup analysis showed that the OS of female patients,without HBV infection,carcinoembryonic antigen&lt;9.6 μg/L,CA19-9≥200 U/ml,intraoperative bleeding&lt;400 ml,tumor diameter&gt;5 cm, negative microvascular invasion, without lymph node metastasis,and AJCC stage Ⅲ patients could benefit from adjuvant chemotherapy (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). &lt;b&gt;Conclusion:&lt;/b&gt; Adjuvant chemotherapy can prolong the OS time in patients with ICC after radical resection,and patients with tumor diameter&gt;5 cm,without lymph node metastasis,AJCC stage Ⅲ,and negative microvascular invasion are more likely to ","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"305-312"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress of radical resection of pancreatic cancer].","authors":"Z H Jia, Y B Liu","doi":"10.3760/cma.j.cn112139-20220608-00259","DOIUrl":"10.3760/cma.j.cn112139-20220608-00259","url":null,"abstract":"<p><p>Pancreatic cancer is a malignant disease with an extremely poor prognosis. For now, radical resection is the only long-term survival approach. Therefore, for complete resection of different types of pancreatic neoplasms, scholars and surgeons have innovated and applied numerous surgical methods. Aiming at various situations, a large amout of methods and principles have been suggested. Unresectable neoplasms have been challenged day by day. Meanwhile, with the progression of technology, minimally invasive techniques have been applied to resection of pancreatic neoplasms. This article mainly reviews the innovation of surgical methods and technology in radical surgery of pancreatic cancer in recent years.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"344-348"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9905489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of safety and efficacy of laparoscopic surgery for gallbladder carcinoma].","authors":"X Wu, T G Xie, B L Li, C J Zheng, X D He, W Liu, T Hong","doi":"10.3760/cma.j.cn112139-20221225-00543","DOIUrl":"10.3760/cma.j.cn112139-20221225-00543","url":null,"abstract":"<p><p><b>Objective:</b> To examine the efficacy and safety of laparoscopic surgery for gallbladder carcinoma. <b>Methods:</b> Data from 197 gallbladder carcinoma patients admitted to Peking Union Medical College Hospital between January 2012 and September 2022 were analyzed retrospectively. There were 86 males and 111 females,with an age of (64.4±9.8)years(range: 35 to 89 years). The patients were divided into laparoscopic group(<i>n</i>=53) and open group(<i>n</i>=144) according to different surgical methods. The general information of the two groups was matched by propensity score matching,and the clinical data and the prognosis were compared between the two groups. Categorical variables were analyzed using χ² test or Fisher's exact test,as appropriate. Continuous variables with and without normal distribution were analyzed using the <i>t</i>-test and the Mann-Whitney <i>U</i> test,respectively. Kaplan-Meier curves with Log-rank test were used to analyze the cumulative survival rates. <b>Results:</b> Forty-eight pairs of patients were matched successfully. There were no differences in general information,cholecystolithiasis,partial hepatectomy,and tumor stage between the two groups(all <i>P</i>>0.05). The laparoscopic group had a shorter operation time(<i>t</i>=-3.987,<i>P</i><0.01),less bleeding(<i>Z</i>=-4.862,<i>P</i><0.01),a shorter total(<i>Z</i>=-5.009,<i>P</i><0.01) and postoperative(<i>Z</i>=-5.412,<i>P</i><0.01) hospital stay. Seventeen patients had postoperative complications. According to the Clavien-Dindo system,there were 4,11,1,and 1 patient with grade Ⅰ,Ⅱ,Ⅲa,and Ⅲb,respectively. All complications improved after active treatment. After a follow-up(<i>M</i>(IQR)) of 24(36) months(range: 3 to 130 months),56 patients(58.3%) survived without tumor,7 patients(7.3%) survived with tumor,and 33 patients(34.4%) died. According to the Kaplan-Meier curves,there was no significant difference between the laparoscopic and open groups in disease free(χ²=0.399,<i>P</i>=0.528) and overall(χ²=0.672,<i>P</i>=0.412) survival rates. <b>Conclusions:</b> Laparoscopic surgery is safe and effective in selected patients with gallbladder carcinoma. It can reduce surgical trauma and improve patient recovery without increasing complication. Its prognosis is similar to that of open surgery.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"330-335"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Survival analysis of patients with intrahepatic cholangiocarcinoma treated with adjuvant chemotherapy after radical resection based on CoxPH model and deep learning algorithm].","authors":"J L Chen, X P Yu, Y Tang, C Chen, Y H Qiu, H Wu, T Q Song, Y He, X H Mao, W L Zhai, Z J Cheng, J D Li, Z M Geng, Z H Tang, Z W Quan","doi":"10.3760/cma.j.cn112139-20230105-00007","DOIUrl":"10.3760/cma.j.cn112139-20230105-00007","url":null,"abstract":"<p><p><b>Objective:</b> To establish a predictive model for the survival benefit of patients with intrahepatic cholangiocarcinoma (ICC) who received adjuvant chemotherapy after radical resection. <b>Methods:</b> The clinical and pathological data of 249 patients with ICC who underwent radical resection and adjuvant chemotherapy in 8 hospitals in China from January 2010 to December 2018 were retrospectively collected. There were 121 males and 128 females,with 88 cases>60 years and 161 cases≤60 years. Feature selection was performed by univariate and multivariate Cox regression analysis. Overall survival time and survival status were used as outcome indicators,then the target clinical features were selected. Patients were stratified into high-risk group and low-risk group,survival differences between the two groups were analyzed. Using the selected clinical features, the traditional CoxPH model and deep learning DeepSurv survival prediction model were constructed, and the performance of the models was evaluated according to the concordance index(C-index). <b>Results:</b> Portal vein invasion, carcinoembryonic antigen>5 μg/L,abnormal lymphocyte count, low grade tumor pathological differentiation and positive lymph nodes>0 were independent adverse prognostic factors for overall survival in 249 patients with adjuvant chemotherapy after radical resection (all <i>P</i><0.05). The survival benefit of adjuvant chemotherapy in the high-risk group was significantly lower than that in the low-risk group (<i>P</i><0.05). Using the above five features, the traditional CoxPH model and the deep learning DeepSurv survival prediction model were constructed. The C-index values of the training set were 0.687 and 0.770, and the C-index values of the test set were 0.606 and 0.763,respectively. <b>Conclusion:</b> Compared to the traditional Cox model, the DeepSurv model can more accurately predict the survival probability of patients with ICC undergoing adjuvant chemotherapy at a certain time point and more accurately judge the survival benefit of adjuvant chemotherapy.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"313-320"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on technical specifications for the clinical application of photodynamic therapy for cholangiocarcinoma].","authors":"","doi":"10.3760/cma.j.cn112139-20230115-00023","DOIUrl":"10.3760/cma.j.cn112139-20230115-00023","url":null,"abstract":"<p><p>Photodynamic therapy(PDT) is an effective,minimally invasive method for tumor treatment. It can be applied to the treatment of cholangiocarcinoma in combination with the implementation of biliary stent/external biliary drainage or with systemic treatments, including chemotherapy. In addition, it is a primary application in the treatment of unresectable cholangiocarcinoma as well as an adjuvant treatment of residual postoperatively or locally recurrent tumors. It can control local tumor progression effectively,relieve biliary obstruction,improve quality of life, and prolong survival,with the advantages of being minimally invasive,precise and repeatable. To date, evidence-based clinical medicine for the application of PDT to treat cholangiocarcinoma has been limited,and there has been a lack of clinical specifications and consensus regarding the technique. Based on this,Group of Operative Surgery,Branch of Surgery,Chinese Medical Association, Group of Biliary Surgery, Branch of Surgery,Chinese Medical Association and Chinese Committee of Biliary Surgeons organized experts to discuss indications, contraindications, technical protocol, evaluation of efficacy, and management of complications when using PDT to treat cholangiocarcinoma. The consensus aims to provide a reference for promoting the clinical application of PDT in the treatment of cholangiocarcinoma.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"265-276"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Whole view of the immune microenvironment of biliary tract cancer].","authors":"J K Wang, L Zheng, N S Cheng, F Y Li","doi":"10.3760/cma.j.cn112139-20221212-00526","DOIUrl":"10.3760/cma.j.cn112139-20221212-00526","url":null,"abstract":"<p><p>Biliary tract cancer is a group of malignancies that originate in the biliary epithelium, and adenocarcinoma is the main pathological type. Although surgical resection is the only radical treatment strategy, most patients with biliary tract cancer are diagnosed at a locally advanced stage or with distant metastases. Biliary tract cancer is highly resistant to conventional chemoradiotherapy and emerging immunotherapy including immune checkpoint inhibitors, due to the suppressive immune microenvironment. In general, this paper discussed the anti-tumor and tumor-promoting immune responses of various immune cells and stromal cells in the immune microenvironment of biliary tract cancer, as well as their correlation with prognosis. Understanding the whole view of the immune microenvironment in patients with biliary tract cancer could further inform the design of clinical trials of immunotherapy or combination therapy.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"291-296"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploring the significance of chemotherapy in the perioperative application of biliary tract carcinomas].","authors":"Z H Tang, Y Tang, X P Yu, J L Chen, Z W Quan","doi":"10.3760/cma.j.cn112139-20230109-00013","DOIUrl":"10.3760/cma.j.cn112139-20230109-00013","url":null,"abstract":"<p><p>Biliary tract cancer is extremely malignant with a poor prognosis. At the moment, the only curative method available is radical resection. Targeted and immunotherapy are currently advancing rapidly, but chemotherapy still holds a key role in the perioperative treatment of biliary cancer. Perioperative chemotherapy aims to decrease tumor volume prior to surgery so that patients can have their tumors surgically removed or have a higher radical resection rate. It also aims to remove any remaining tumor cells after surgery and prevent the growth of new tumors. Combination treatments based on chemotherapy have been increasingly investigated in recent years to improve perioperative care and patient survival. From the point of view of chemotherapy regimens and clinical trial success in the perioperative phase of radical surgery, the value of chemotherapy in the perioperative period of biliary tract cancer was explored in this paper.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"277-282"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}