Annals of surgery
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To examine the optimal method of assessing response to neoadjuvant therapy (NAT) in operable pancreatic ductal adenocarcinoma (PDAC) patients. ⋯ CA19-9 response to NAT alone is not enough to identify long-term post-resection PDAC survivors. The co-existence of CA19-9 and major pathologic response was predictive of the most optimal survival outcome.
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To develop and validate a signature to precisely predict prognosis in pancreatic ductal adenocarcinoma (PDAC) undergoing resection and adjuvant chemotherapy. ⋯ The ChemoResist signature could precisely predict survival in PDAC undergoing resection and chemotherapy, and its predictive value surpassed TNM stage and other clinicopathologic factors. Moreover, the ChemoResist classifier could assist with identifying patients who would more likely benefit from adjuvant chemotherapy.
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To investigate the incidence and risk factors of portomesenteric venous thrombosis (PVT) after pancreatic cancer surgery with portomesenteric venous resection (PVR). ⋯ Early PVT after pancreatectomy with PVR is rare. Late PVT is associated with neoadjuvant radiotherapy and local recurrence. These findings may inform risk assessment in pancreatic cancer patients undergoing PVR.
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The efficacy of enhanced recovery after surgery (ERAS) to improve the prognosis of patients who undergo laparoscopic distal gastrectomy (LDG) for gastric cancer is uncertain. This randomized study compared oncological outcomes in LDG after ERAS or conventional care. ⋯ Patients undergoing ERAS LDG had fewer overall complications, shorter hospital stay, decreased medical expenses, and improved 3-year OS and DFS rates, particularly in cases with stage III gastric cancer.
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To identify the risk factors, manifestations, and clinical implications of chyle leak (CL) after pancreatic surgery, and to reappraise the International Study Group for Pancreatic Surgery (ISGPS) definition and classification of CL. ⋯ Minimally invasive approach and daily maximum drainage volume were independent risk factors for CL in this cohort. Post-pancreatectomy patients with large-volume, TG-rich but non-milky drainage should be treated like clinically relevant CL.