The British journal of surgery
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Multicenter Study
Identification of patients with branch-duct intraductal papillary mucinous neoplasm and very low risk of cancer: multicentre study.
Different surveillance strategies for patients with low-risk branch-duct (BD) intraductal papillary neoplasm (IPMN) have been described. The aim of this study was to describe the natural history of low-risk BD-IPMN, and to identify risk factors for the development of worrisome features (WF)/high-risk stigmata (HRS) and of pancreatic malignancies. ⋯ Conservative management of patients with low-risk BD-IPMN is safe and feasible.
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The optimal treatment for patients with locally recurrent rectal cancer (LRRC) is controversial. The aim of this study was to investigate different treatment strategies in two leading tertiary referral hospitals in Europe. ⋯ In radiotherapy-naive patients, neoadjuvant full-course chemoradiation confers the best oncological outcome. However, neoadjuvant therapy does not diminish the need for extended radical surgery to increase R0 resection rates.
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The molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status. ⋯ Patients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers.
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This study aimed to evaluate how performance variability contributes to perioperative sentinel events occurring within the Dutch healthcare system. Although performance variability was identified as a contributing factor in almost all analysis reports, it remains unrecognized by the sentinel event analysis team. Strengthening the integration of performance variability in sentinel event analyses could improve the analyses performed, and lead to more effective improvement measures specifically aimed at optimizing human performance within the healthcare system.