Journal of the American College of Surgeons
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Immunotherapy has achieved effective antitumor activity in advanced GC patients. However, the rate of response to ICI therapy is disappointing, T cell exhaustion may contribute to this phenomenon. EBI3 is an emerging immunosuppressive factor, and the association between EBI3 and T cell exhaustion is not clear. In this study, we aimed to explore the expression of EBI3 in GC, and reveal the function of EBI3 in T cell exhaustion. ⋯ Our study indicated that EBI3 is an important cytokine in the development of GC, and EBI3 may promote the development of GC by inducing T cell exhaustion in the tumor microenvironment.
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Hemipelvectomy is a complex surgery that is usually performed with curative intent. It is rarely performed for palliation in patients with advanced cancer, and its efficacy in achieving palliation is unknown. ⋯ Palliative-intent hemipelvectomy provided palliation in a minority of patients, did not improve function, and had high morbidity and mortality. Patients with small anterior pelvic tumors may benefit from palliative hemipelvectomy; for others, less invasive approaches should be considered whenever feasible.
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The knowledge required to manage surgical patients has expanded considerably over the past 40 years. Simultaneously, the cost of medical education has increased substantially. Surgical trainees are at particular disadvantage due to the time demands of training. We aim to determine whether surgeon compensation over time has adequately accounted for increasing student debt burden. ⋯ The rate of debt accumulation has outpaced the rate of salary growth for general surgeons to a significant degree.