The British journal of surgery
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Meta Analysis
Impact of genetic alterations on long-term outcomes in resectable intrahepatic cholangiocarcinoma: meta-analysis.
Intrahepatic cholangiocarcinoma is a public health threat because of its aggressiveness. Its genetic background differs from other biliary cancers. The aim of this study was to investigate the impact of genetic alterations on long-term outcomes. ⋯ Determining the overall prevalence of the most common actionable and undruggable mutations may help to expand target therapy indications in the adjuvant setting. Inconsistent results have been found for some infrequent gene alterations; their rare involvement could potentially bias their prognostic meaning.
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Multicenter Study
Chest wall perforator flaps are safe and can decrease mastectomy rates in breast cancer surgery: multicentre cohort study.
Chest wall perforator flaps are emerging in oncoplastic breast conservation, mostly as an alternative to mastectomy. However, standardization and consensus on patient selection, techniques, and outcomes have not yet been reached. The aim of this international multicentre collaborative study was to explore practice patterns and outcomes in high-volume centres from different countries. ⋯ Chest wall perforator flaps are a useful option to allow more women to avoid mastectomy. In experienced hands, the procedure is safe and should be offered to suitable patients.
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A juxtarenal abdominal aortic aneurysm is defined as a short (less than 4 mm) or no-neck aneurysm, which is often treated with open or complex endovascular repair. The evidence to support the best treatment strategy is scarce. The aim of this study was to assess the short- and mid-term outcomes of elective open surgical repair or fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysms in Sweden. ⋯ This nationwide study reveals considerable variations in volume and treatment strategy between Swedish centres performing juxtarenal abdominal aortic aneurysm repairs. Survival is comparable for open surgical repair and fenestrated endovascular aneurysm repair, although there are significant baseline demographic differences between patients selected for the two treatment modalities.
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Gallbladder cancer is often associated with poor prognosis, especially when patients experience early recurrence after surgery. Machine learning may improve prediction accuracy by analysing complex non-linear relationships. The aim of this study was to develop and evaluate a machine learning model to predict early recurrence risk after resection of gallbladder cancer. ⋯ Machine learning-based prediction of early recurrence after resection of gallbladder cancer may help stratify patients, as well as help inform postoperative adjuvant therapy and surveillance strategies.