JAMA Surgery’s Post

Hepatectomy: A Vital Procedure Against Liver Tumors Hepatectomy, a crucial surgical intervention, removes portions of the diseased liver, saving human lives by treating various liver disorders This surgical procedure involves partial or complete resection of the liver, depending on the severity and extent of the disease. Its primary purpose is to treat benign and malignant liver tumors, providing a valid therapeutic solution. When

Deferrable Thyroid Nodules Biopsies

I am happy to have been part of our study on the long-term outcomes, quality of life, and costs of treatment modalities for T1–T2 lip carcinomas. Early stage lip squamous cell carcinoma (lip SCC) can be treated with conventional excision, Mohs micrographic surgery (MMS), or brachytherapy. The aim of our study was to describe the medical and patient-reported outcomes, and costs of these treatments. Of 336 lip SCCs treated between 1996 and 2019, 122 were treated with excision, 139 with MMS, and 75 with brachytherapy. Locally, the recurrence rate was 2.7% and regionally 4.8%. There were 2% disease-related deaths. T2-stage and poor tumor differentiation were associated with recurrences. Posttreatment quality of life (QoL), facial function, and appearance were rated as good. Brachytherapy was the most expensive treatment modality. Early-stage lip SCC has a good prognosis, with a disease-specific survival of 98.2% after a median follow-up of 36 months. There was a high QoL and satisfaction at long-term follow-up. Based on the costs and the risk of locoregional recurrences, we believe that for most noncomplex lip SCCs, MMS would be the most logical treatment option. Please read the full article: https://lnkd.in/dYkZnc4T In collaboration with: Kira van Hof, Marlies Wakkee, Aniel Sewnaik, Aimée Herkendaal, Lisa Tans, Hetty Mast, Renate van den Bos, Marinella Offerman, and Rob Baatenburg de Jong. #headandneckcancer #lipcancer #Mohssurgery #brachytherapy #surgicaloutcomes #patientreportedoutcomes #PROMs Erasmus MC Kanker Instituut

Safety and effectiveness of indocyanine green fluorescence imaging-guided laparoscopic hepatectomy for hepatic tumor: a systematic review and meta-analysis Introduction: Previous clinical investigations have reported inconsistent findings regarding the feasibility of utilizing indocyanine green fluorescence imaging (ICGFI) in laparoscopic liver tumor removal. This meta-analysis aims to comprehensively evaluate the safety and effectiveness of ICGFI in laparoscopic hepatectomy (LH). Results: This meta-analysis encompassed eleven retrospective cohort studies, involving 959 patients in total. Our findings revealed that, in comparison to conventional laparoscopic hepatectomy, patients receiving ICGFI-guided LH exhibited a higher R0 resection rate (OR: 3.96, 95% CI: 1.28, 12.25, I2 = 0.00%, P = 0.778) and a diminished incidence of intraoperative blood transfusion (OR: 0.42, 95% CI: 0.22, 0.81, I 2 = 51.1%, P = 0.056). Additionally, they experienced shorter postoperative hospital stays (WMD: -1.07, 95% CI: -2.00, -0.14, I 2 = 85.1%, P = 0.000). No statistically significant differences emerged between patients receiving ICGFI-guided LH vs. those undergoing conventional LH in terms of minimal margin width and postoperative complications. Conclusion: ICGFI-guided LH demonstrates marked superiority over conventional laparoscopic liver tumor resection in achieving R0 resection and reducing intraoperative blood transfusion rates. This technique appears to hold substantial promise. Nonetheless, further studies are needed to explore potential long-term benefits associated with patients undergoing ICGFI-guided LH. https://lnkd.in/epvyYdeJ #ICG #indocyaninegreen #guidedsurgery #fluorescent #fluorescence #laparoscopicsurgery #surgery #surgeons #surgical #imaging #thinkgreen #Liver #tumor

📃Scientific paper: Multifocal Fibrosing Thyroiditis: an Under-recognized Mimicker of Papillary Thyroid Carcinoma Abstract: Multifocal fibrosing thyroiditis (MFT) is an enigmatic entity, characterized by multiple fibrotic scar-like lesions with a paucicellular fibrotic center surrounded by a cellular peripheral area with reactive-appearing follicular cell atypia and variable chronic inflammation. Although poorly recognized and likely underreported in surgical pathology, the entity is considered rare with only 65 cases to date–including the current one reported to expand on the preoperative findings of this under-recognized entity. The average age of the patients is 46.8 years (range 15–71 years), 94% are female, with female to male ratio of 15:1. Individual MFT lesions typically have a superficial location. The average number of fibrotic lesions is 15.4 (range 2–51 per MFT case). Their average size is 3.1 mm (range 0.4–15.1). MFT is a disorder of diseased thyroids, typically found postoperatively in glands removed for other reasons, such as chronic lymphocytic/Hashimoto thyroiditis (32.3%), follicular nodular disease (nodular hyperplasia) (30.1%), hyperthyroidism/diffuse hyperplasia (Graves disease) (9.2%). Intriguing is the association with papillary thyroid carcinoma–present in 38.5% of MFT cases, and particularly with sub-centimetric and multifocal papillary thyroid carcinoma, with which MFT can be confused. Cases where MFT is the only thyroid pathology (7.7%) can be preoperatively mistaken for papillary thyroid carcinoma, due to worrisome ultrasound (US) and cytologic features, both ... Continued on ES/IODE ➡️ https://etcse.fr/KtL2 ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

📚 CIRCULATE-Japan GALAXY Study Findings shows huge potential of liquid biopsy application in cancer treatments🌍 👉 ctDNA monitoring can help doctors decide on the best follow-up treatment after surgery. #liquidbiopsy #colorectalcancer #ctDNA #ngs #oncology #cancer https://lnkd.in/d993Gibc

📃Scientific paper: Multifocal Fibrosing Thyroiditis: an Under-recognized Mimicker of Papillary Thyroid Carcinoma Abstract: Multifocal fibrosing thyroiditis (MFT) is an enigmatic entity, characterized by multiple fibrotic scar-like lesions with a paucicellular fibrotic center surrounded by a cellular peripheral area with reactive-appearing follicular cell atypia and variable chronic inflammation. Although poorly recognized and likely underreported in surgical pathology, the entity is considered rare with only 65 cases to date–including the current one reported to expand on the preoperative findings of this under-recognized entity. The average age of the patients is 46.8 years (range 15–71 years), 94% are female, with female to male ratio of 15:1. Individual MFT lesions typically have a superficial location. The average number of fibrotic lesions is 15.4 (range 2–51 per MFT case). Their average size is 3.1 mm (range 0.4–15.1). MFT is a disorder of diseased thyroids, typically found postoperatively in glands removed for other reasons, such as chronic lymphocytic/Hashimoto thyroiditis (32.3%), follicular nodular disease (nodular hyperplasia) (30.1%), hyperthyroidism/diffuse hyperplasia (Graves disease) (9.2%). Intriguing is the association with papillary thyroid carcinoma–present in 38.5% of MFT cases, and particularly with sub-centimetric and multifocal papillary thyroid carcinoma, with which MFT can be confused. Cases where MFT is the only thyroid pathology (7.7%) can be preoperatively mistaken for papillary thyroid carcinoma, due to worrisome ultrasound (US) and cytologic features, both ... Continued on ES/IODE ➡️ https://etcse.fr/KtL2 ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

Impact of circumferential resection margin on survival in ampullary cancer: retrospective analysis ➡️ https://lnkd.in/dv-TM2Aj 🏺🦀Ampullary carcinoma is a rare tumour entity with different histological subtypes. Identification of risk factors influencing postresection survival is essential for treatment strategies. 234😷, 2002-2017 ⚡️Five-year overall survival was significantly different for pancreatobiliary compared to intestinal histology (51.7 per cent versus 72.8 per cent, P = 0.0087). Furthermore, R0 resections (CRM clearance >1 mm) significantly improved 5-year overall survival compared to CRM+ (<1 mm) and R1 resections. 💡💡Postresection survival of ampullary carcinoma patients is determined by histological subtype and surgical radicality. True R0-resection is a prognostic key determinant in both entities, achieving 5-year survival in two-thirds of patients. Great work by Anna Nießen , Prof. Dr. med Martin Loos, Katja Neumueller, Manuel Feißt, Ulla Klaiber, Amila Cizmic, Mohammed Al-Saeedi, Susanne Roth, Dr. Martin Schneider, Markus Wolfgang Buechler, Hackert Thilo from Universitätsklinikum Heidelberg (UKHD) & Universitätsklinikum Hamburg Eppendorf #SoMe4Surgery #MedTwitter #SurgEd #Surgery #some4hpb #some4tpl #PancreaticCancer #PanCANawareness #cholangiocarcinoma

Incidental gallbladder carcinoma (IGBC), often diagnosed after cholecystectomy for benign indications, poses significant challenges for staging and prognosis. This study, conducted from January 2010 to July 2020 at a tertiary-care center, aimed to evaluate the utility of 2-fluro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the management of IGBC. The study included 280 participants (mean age: 52 years, predominantly female) who had undergone cholecystectomy, with 52.1% having open surgery and the rest laparoscopic procedures. Residual disease in the gallbladder fossa was more frequent in open surgery patients (54.8% vs. 36.6%, p = 0.002), as was liver infiltration (32.9% vs. 22.4%, p = 0.05), whereas laparoscopic surgery showed a higher incidence of anterior abdominal wall deposits (35.1% vs. 24%, p = 0.041). FDG-PET/CT altered the management in 10% of cases compared to contrast-enhanced CT. The median survival of IGBC patients was 14 months. FDG-PET/CT was found to be an effective tool for identifying residual and metastatic disease, leading to appropriate treatment decisions. Higher disease stage on FDG-PET/CT (locoregional disease HR 4.86, p = 0.006; metastatic disease HR 7.53, p < 0.001) and liver infiltration (HR 1.92, p = 0.003) were independent predictors of poor survival outcomes. In conclusion, FDG-PET/CT plays a crucial role in detecting residual and metastatic disease in IGBC patients, facilitating proper management decisions, and providing valuable prognostic information for survival. Krishnaraju, V.S., Kumar, R., Mittal, B.R. et al. Incidentally Detected Gallbladder Carcinoma: Can F-18 FDG PET/CT Aid in Staging and Prognostication?. Nucl Med Mol Imaging (2024). doi: 10.1007/s13139-024-00841-w #GallbladderCancer #FDGPETCT #Prognostication #MedicalResearch #FDGPET #Oncology #CancerTreatment #MedicalImaging #SurvivalOutcomes #CancerDiagnosis #Cholecystectomy #CancerStaging

[Article review] - EUS-RFA for pancreatic adenocarcinoma "In our institutional experience, this treatment protocol appears safe as patients tolerated the combination of chemotherapy and ablation. Patients underwent pancreatic resection with uneventful recovery. This novel neoadjuvant approach may provide a more effective alternative to chemotherapy alone." by Nirav Thosani Curtis Wray University of Texas Health Science Center at Houston, McGovern Medical School, Department of Surgery, Houston, Texas #pancreas #adenocarcinoma #radiofrequencyablation #endoscopy #ulstrasoundguidance #EUSRFA #EUSRA #TaeWoong #TaeWoongMedical TaeWoong Medical TaeWoong Medical USA Pancreatic cancer treatment continues to pose challenges, yet there's a gradual accumulation of data indicating the efficacy of EUS-RFA, which I personally regard as the most promising therapeutic avenue. I'm particularly looking forward to seeing such research outcomes emerge in the United States.