Background:Textbook outcome(TO)can guide decision-making among patients and clinicians during preoperative patient selection and postoperative quality improvement.We explored the factors associated with achieving a TO...Background:Textbook outcome(TO)can guide decision-making among patients and clinicians during preoperative patient selection and postoperative quality improvement.We explored the factors associated with achieving a TO for gallbladder carcinoma(GBC)after curative-intent resection and analyzed the effect of adjuvant chemotherapy(ACT)on TO and non-TO patients.Methods:A total of 540 patients who underwent curative-intent resection for GBC at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi’an Jiaotong University from January 2011 to December 2020 were retrospectively analyzed.Multivariable logistic regression was used to investigate the factors associated with TO.Results:Among 540 patients with GBC who underwent curative-intent resection,223 patients(41.3%)achieved a TO.The incidence of TO ranged from 19.0%to 51.0%across the study period,with a slightly increasing trend over the study period.The multivariate analysis showed that non-TO was an independent risk factor for prognosis among GBC patients after resection(P=0.003).Age≤60 years(P=0.016),total bilirubin(TBIL)level≤34.1 mmol/L(P<0.001),well-differentiated tumor(P=0.008),no liver involvement(P<0.001),and T1-2 stage disease(P=0.006)were independently associated with achieving a TO for GBC after resection.Before and after propensity score matching(PSM),the overall survival outcomes of non-TO GBC patients who received ACT and those who did not were statistically significant;ACT improved the prognosis of patients in the non-TO group(P<0.05).Conclusion:Achieving a TO is associated with a better long-term prognosis among GBC patients after curative-intent resection,and ACT can improve the prognosis of those with non-TO.展开更多
As the third leading cause of cancer-related deaths worldwide,hepatocellular carcinoma(HCC)represents a significant global health challenge.This paper provides an introduction and comprehensive review of transarterial...As the third leading cause of cancer-related deaths worldwide,hepatocellular carcinoma(HCC)represents a significant global health challenge.This paper provides an introduction and comprehensive review of transarterial radioembolization(TARE)with Yttrium-90(Y90),a widely performed transcatheter procedure for HCC patients who are not suitable candidates for surgery.TARE involves the targeted delivery of radioactive microspheres to liver tumors,offering a promising treatment option for managing HCC across various stages of the disease.By evaluating Y90 TARE outcomes across early,intermediate,and advanced stages of HCC,the review aims to present a thorough understanding of its efficacy and safety.Additionally,this paper highlights future research directions focusing on the potential of combination therapies with systemic and immunotherapies,as well as personalized treatments.The exploration of these innovative approaches aims to improve treatment outcomes,reduce adverse events,and provide new therapeutic opportunities for HCC patients.The review underscores the importance of ongoing research and clinical trials to optimize TARE further and integrate it into comprehensive HCC treatment paradigms.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.62076194)the Key Research and Development Program of Shaanxi Province(Nos.2021-SF-016,2022-SF-410,and 2022-SF-606)+1 种基金the Central University Basic Research Business Fund(No.xzy012020113)the Clinical Research Fund of the First Affiliated Hospital of Xi’an Jiaotong University(No.XJTU1AF-CRF-2018-022).
文摘Background:Textbook outcome(TO)can guide decision-making among patients and clinicians during preoperative patient selection and postoperative quality improvement.We explored the factors associated with achieving a TO for gallbladder carcinoma(GBC)after curative-intent resection and analyzed the effect of adjuvant chemotherapy(ACT)on TO and non-TO patients.Methods:A total of 540 patients who underwent curative-intent resection for GBC at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi’an Jiaotong University from January 2011 to December 2020 were retrospectively analyzed.Multivariable logistic regression was used to investigate the factors associated with TO.Results:Among 540 patients with GBC who underwent curative-intent resection,223 patients(41.3%)achieved a TO.The incidence of TO ranged from 19.0%to 51.0%across the study period,with a slightly increasing trend over the study period.The multivariate analysis showed that non-TO was an independent risk factor for prognosis among GBC patients after resection(P=0.003).Age≤60 years(P=0.016),total bilirubin(TBIL)level≤34.1 mmol/L(P<0.001),well-differentiated tumor(P=0.008),no liver involvement(P<0.001),and T1-2 stage disease(P=0.006)were independently associated with achieving a TO for GBC after resection.Before and after propensity score matching(PSM),the overall survival outcomes of non-TO GBC patients who received ACT and those who did not were statistically significant;ACT improved the prognosis of patients in the non-TO group(P<0.05).Conclusion:Achieving a TO is associated with a better long-term prognosis among GBC patients after curative-intent resection,and ACT can improve the prognosis of those with non-TO.
文摘As the third leading cause of cancer-related deaths worldwide,hepatocellular carcinoma(HCC)represents a significant global health challenge.This paper provides an introduction and comprehensive review of transarterial radioembolization(TARE)with Yttrium-90(Y90),a widely performed transcatheter procedure for HCC patients who are not suitable candidates for surgery.TARE involves the targeted delivery of radioactive microspheres to liver tumors,offering a promising treatment option for managing HCC across various stages of the disease.By evaluating Y90 TARE outcomes across early,intermediate,and advanced stages of HCC,the review aims to present a thorough understanding of its efficacy and safety.Additionally,this paper highlights future research directions focusing on the potential of combination therapies with systemic and immunotherapies,as well as personalized treatments.The exploration of these innovative approaches aims to improve treatment outcomes,reduce adverse events,and provide new therapeutic opportunities for HCC patients.The review underscores the importance of ongoing research and clinical trials to optimize TARE further and integrate it into comprehensive HCC treatment paradigms.
