Goals And Background: The role of preventive lymphadenectomy has not yet been determined for hepatocellular carcinoma (HCC) patients. We designed a study to evaluate the effect of hepatectomy combined with preventive lymphadenectomy on HCC patients.
Study: Patients were randomly divided into group A (treated with hepatectomy alone) and group B (underwent hepatectomy combined with lymphadenectomy). The postoperative complications and oncologic prognoses were analyzed.
Results: Of the 85 patients enrolled into this study, 79 cases (38 in group A and 41 in group B) were pathologically confirmed to have HCC and received curative resection. One hundred and sixteen lymph nodes were dissected and evaluated as negative by the pathologist. The 12-, 36-, and 60-month disease-free survival rates of group A were 81.6%, 68.4%, and 63.2%, respectively, whereas they were 78.0%, 65.9%, and 63.4%, respectively, for group B. The 12-, 36-, and 60-month overall survival rates in group A were 94.7%, 78.9%, and 65.8%, respectively, whereas they were 87.8%, 78.0%, and 70.7%, respectively, in group B. The differences in the disease-free survival and overall survival between the 2 groups were not statistically significant according to the log-rank test (P=0.811 and P=0.881, respectively). The difference in the surgical complication rate between groups A and B was not statistically significant (47.4% vs. 36.6%, P=0.332).
Conclusions: Although hepatectomy combined with regional lymphadenectomy is a safe procedure, preventive lymphadenectomy may not decrease the rate of tumor recurrence nor improve the prognosis in early-stage HCC patients.
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http://dx.doi.org/10.1097/MCG.0000000000000277 | DOI Listing |
JAMA Netw Open
January 2025
Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Importance: Secondary lymphedema is a common, harmful side effect of breast cancer treatment. Robust risk models that are externally validated are needed to facilitate clinical translation. A published risk model used 5 accessible clinical factors to predict the development of breast cancer-related lymphedema; this model included a patient's mammographic breast density as a novel predictive factor.
View Article and Find Full Text PDFAgri
January 2025
Department of Anesthesiology and Reanimation, İstanbul Medipol University Faculty of Medicine, İstanbul, Türkiye.
Objectives: Breast-conserving surgery is a common breast operation type in the world. Patients may feel severe postoperative pain after the surgery. Several regional anesthesia methods are used for postoperative pain control as a part of multimodal analgesia management after breast surgery.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Division of Cardiac Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
This case report describes the management of a 30-year-old male patient with a history of an advanced nonseminomatous germ cell tumor, hip fracture complicated by extensive deep vein thrombosis and pulmonary embolism, and on apixaban presenting with asymptomatic intracardiac teratoma and abdominopelvic metastases. Multidisciplinary intervention, including successful surgical excision of the intracardiac mass, highlights the importance of coordinated care and vigilant follow-up in optimizing patient outcomes and preventing life-threatening complications.
View Article and Find Full Text PDFJ Gastric Cancer
January 2025
Department of Gastroenterological Surgery, Cancer Institute Hospital Ariake, Tokyo, Japan.
Proximal gastrectomy (PG) has reemerged as a viable surgical option for managing proximal gastric cancer and gastroesophageal junction cancer, particularly for early-stage tumors, offering potential advantages over total gastrectomy (TG). This review examines the evolution of PG, emphasizing surgical techniques and outcomes. Although PG was initially abandoned due to postoperative complications such as reflux esophagitis, advances in reconstruction methods, such as the double-flap technique and double-tract reconstruction, have significantly improved patient quality of life and reduced complications.
View Article and Find Full Text PDFAnn Ital Chir
January 2025
Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China.
Aim: This study aims to investigate the impact of fast-track surgery (FTS), based on nutritional support, on postoperative rehabilitation and nutritional status in patients undergoing radical thyroidectomy and lateral lymphadenectomy.
Methods: This retrospective study included 112 patients who underwent radical thyroid cancer surgery and lateral neck lymph node dissection at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, between April 2021 and April 2023. Based on various nursing methods, patients were divided into two groups, with 58 patients included in the observation group (FTS care based on nutritional support), and 54 patients in the control group (routine perioperative care).
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