Textbook Outcomes and Minimally Invasive Techniques in Resectable Gallbladder Cancer: A Global Cohort Study.

Introduction: Surgery for resectable gallbladder cancer (GbC) encompasses complex operative management, and evaluating surgical quality through textbook outcome (TO) is crucial. This study aimed to assess TO incidence and impact in a global cohort, identify independent predictors, and evaluate TO rates of minimally invasive (MI) techniques, including robotic (ROB) and laparoscopic (LPS).

Materials And Methods: This cohort study included patients undergoing curative-intent hepatectomy and lymphadenectomy for GbC (T1b-T3) from 2012 to 2023 in 41 hospitals.

A New Renorrhaphy Technique Using Barbed Sutures and Elongated Pledgets for Robotic Partial Nephrectomy.

Background: Effective hemostasis and renorrhaphy with intracorporeal suturing are major technical challenges in robot-assisted partial nephrectomy (RAPN). This report outlines the authors' experience with a novel RAPN approach using renorrhaphy with barbed sutures (BSs) and elongated pledgets (R-BEP) in a video.

Methods: The R-BEP procedure comprised several steps, including a single layer of monofilament adsorbable running BSs used to close the renal parenchyma, reinforced by elongated polytetrafluoroethylene (PTFE) pledgets.

Navigating the paradox of senescence and chemoresistance in pancreatic cancer.

Cellular senescence, described as a mechanism of irreversible cell cycle arrest, has emerged as a complex and multifaceted process with significant implications in cancer biology, particularly in pancreatic ductal adenocarcinoma (PDAC). This literature review aims to explore the intricate role of senescence in PDAC, focusing on its dual nature during tumorigenesis, in addition to therapy resistance, and its potential as a therapeutic target. Senescence escape was found to play a crucial role in PDAC progression, prompting the development of various pro-senescence therapies.

Long-term recurrence of PDAC after resection for IPMN: A narrative review of the literature on clinical and biologic predictors.

Recurrence of IPMNs after surgical resection is defined as the reappearance of new cystic lesions, invasive carcinoma, or metastases, either in the remnant pancreas or other distant sites. The median 5-year cumulative incidence of residual pancreatic lesions is 10 % (range, 0-21 %) and this risk continues to increase even after five years, especially in patients with the presence of HGD at first surgery and a family history of pancreatic ductal adenocarcinoma (PDAC). The management algorithm for all IPMNs is described in the latest guidelines on IPMNs; the patient's general condition, comorbidities, and life expectancy should be considered as well in the surgical decision.

The exposome and pancreatic cancer, lifestyle and environmental risk factors for PDAC.

Pancreatic cancer (PC), particularly pancreatic ductal adenocarcinoma (PDAC), is a significant global health issue with high mortality rates. PDAC, though only 3 % of cancer diagnoses, causes 7 % of cancer deaths due to its severity and asymptomatic early stages. Risk factors include lifestyle choices, environmental exposures, and genetic predispositions.

Raman spectroscopy based diagnosis of pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma is currently the 12th most frequent form of cancer worldwide, characterized by a very low 5-year survival rate. Although several therapeutic approaches have been proposed to treat this form of pancreatic cancer, surgical resection is still commonly recognized as the most effective technique to slow down the disease progression and maximize the 5-year survival rate. Analogously, one critical issue is the ability of current diagnostic methodologies to distinguish between irregular growth of the tumor mass and surrounding inflammatory tissues.

Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.

Background: High case volumes for specific surgeries including the treatment of esophagogastric junction and distal esophageal cancer are frequently emphasized in literature to achieve better outcomes. However, recent studies have suggested that a cumulative volume of major oncologic surgeries (MOSs) can positively impact outcomes for single procedures even if below their specific thresholds. This study aimed to report outcomes from esophagogastrectomies with intrathoracic anastomosis (EGs-ITA) from a surgical unit that handles a high volume of other MOSs despite lower volumes for EGs-ITA.

Video-assessment of Surgical Performance in Robotic Gastro-enterostomy During Pancreatoduodenectomy: Evaluating the Learning Curve and Risk of Delayed Gastric Emptying.

Objective: The aim of this study is to identify learning curves for robotic gastro-enterostomy (RGE) during RPD and the predictive value of the objective structured assessment of technical skills (OSATS) score for DGE according to the Birkmeyer et al and UPMC method.

Summary Of Background Data: In some series, robotic pancreatoduodenectomy (RPD) has been associated with increased risk of delayed gastric emptying (DGE). It is unclear whether this is attributable to learning curve.

Plasma miR-379 can predict treatment response to FOLFIRINOX and gemcitabine--paclitaxel in advanced pancreatic cancer.

Background: Novel biomarkers, such as plasma microRNAs (miRs), are needed to help guide clinical decision-making for the type of chemotherapy to use in patients with advanced pancreatic ductal adenocarcinoma (PDAC). This study assessed the ability of plasma miRs to predict optimal treatment response from FOLFIRINOX or gemcitabine--paclitaxel in these patients.

Methods: Next-generation sequencing (NGS) was performed for biomarker discovery in pre-treatment plasma samples from advanced PDAC patients subsequently treated with FOLFIRINOX (n = 12) or gemcitabine--paclitaxel (n = 12).

A genome-wide association study identifies eight loci associated with intraductal papillary mucinous neoplasm progression toward malignancy.

Background: Intraductal papillary mucinous neoplasms (IPMNs) are precursors to pancreatic cancer, but not all IPMNs progress to cancer. The objective of this study was to identify the germline genetic variants associated with IPMN clinical progression by conducting the first genome-wide association study (GWAS) and computing a polygenic hazard score (PHS) in 338 patients with IPMN.

Methods: The study population was divided into two subsets, and a Cox analysis adjusted for sex, age, cyst size at diagnosis, and the top 10 principal components was performed.

Polymorphisms within autophagy-related genes as susceptibility biomarkers for pancreatic cancer: A meta-analysis of three large European cohorts and functional characterization.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with patients having unresectable or metastatic disease at diagnosis, with poor prognosis and very short survival. Given that genetic variation within autophagy-related genes influences autophagic flux and susceptibility to solid cancers, we decided to investigate whether 55,583 single nucleotide polymorphisms (SNPs) within 234 autophagy-related genes could influence the risk of developing PDAC in three large independent cohorts of European ancestry including 12,754 PDAC cases and 324,926 controls. The meta-analysis of these populations identified, for the first time, the association of the BID variant with an increased risk of developing the disease (OR = 1.

The Current Role of Single-Site Robotic Approach in Liver Resection: A Systematic Review.

Background: Liver resection is a critical surgical procedure for treating various hepatic pathologies. Minimally invasive approaches have gradually gained importance, and, in recent years, the introduction of robotic surgery has transformed the surgical landscape, providing potential advantages such as enhanced precision and stable ergonomic vision. Among robotic techniques, the single-site approach has garnered increasing attention due to its potential to minimize surgical trauma and improve cosmetic outcomes.

IRON: A retrospective international multicenter study on robotic versus laparoscopic versus open approach in gallbladder cancer.

Objective: For patients with T1b gallbladder cancer or greater, an adequate lymphadenectomy should include at least 6 nodes. Studies comparing short- and long-term outcomes of the open approach with those of laparoscopy and robotic approaches are limited, with small sample sizes, and there are none comparing laparoscopic and robotic approaches. This study compared patients who underwent robotic, laparoscopic, and open resection of gallbladder cancer, evaluating short- and long-term outcomes.

Unlocking the diagnostic power of plasma extracellular vesicle miR-200 family in pancreatic ductal adenocarcinoma.

Background: Distinguishing benign from malignant pancreaticobiliary disease is challenging because of the absence of reliable biomarkers. Circulating extracellular vesicles (EVs) have emerged as functional mediators between cells. Their cargos, including microRNAs (miRNAs), are increasingly acknowledged as an important source of potential biomarkers.

Exploring Splicing Modulation as an Innovative Approach to Combat Pancreatic Cancer: SF3B1 Emerges as a Prognostic Indicator and Therapeutic Target.

Pancreatic ductal adenocarcinoma (PDAC) poses significant challenges in terms of prognosis and treatment. Recent research has identified splicing deregulation as a new cancer hallmark. Herein, we investigated the largely uncharacterized alternative splicing profile and the key splicing factor SF3B1 in PDAC pancreatic cells and tissues as a potential discovery source of plausible drug targets and new predictive biomarkers of clinical outcome.

Robotic Hepatectomy plus Biliary Reconstruction for Bismuth Type III and Type IV Hilar Cholangiocarcinoma: State of the Art and Literature Review.

Background: In Bismuth type III and IV Hilar Cholangiocarcinoma (III-IV HC), surgical resection is the only chance for long-term survival. As the surgical procedure is complex and Robotic-Assisted Surgery (RAS) may be particularly suitable in this setting, the aim of this study is to evaluate the potential benefits of RAS in III-IV HC in terms of post-operative outcomes.

Methods: We conducted a systematic review using the PRISMA checklist for article selection.

Prediction Model for Early-Stage Pancreatic Cancer Using Routinely Measured Blood Biomarkers.

Importance: Accurate risk prediction models using routinely measured biomarkers-eg, carbohydrate antigen 19-9 (CA19-9) and bilirubin serum levels-for pancreatic cancer could facilitate early detection of pancreatic cancer and prevent potentially unnecessary diagnostic tests for patients at low risk. An externally validated model using CA19-9 and bilirubin serum levels in a larger cohort of patients with pancreatic cancer or benign periampullary diseases is needed.

Objective: To assess the discrimination, calibration, and clinical utility of a prediction model using readily available blood biomarkers (carbohydrate antigen 19-9 [CA19-9] and bilirubin) to distinguish early-stage pancreatic cancer from benign periampullary diseases.

Role of exosomes in transferring chemoresistance through modulation of cancer glycolytic cell metabolism.

Chemoresistance constitute a major obstacle in cancer treatment, leading to limited options and decreased patient survival. Recent studies have revealed a novel mechanism of chemoresistance acquisition: the transfer of information via exosomes, small vesicles secreted by various cells. Exosomes play a crucial role in intercellular communication by carrying proteins, nucleic acids, and metabolites, influencing cancer cell behavior and response to treatment.

Prognostic Significance of Integrin Subunit Alpha 2 (ITGA2) and Role of Mechanical Cues in Resistance to Gemcitabine in Pancreatic Ductal Adenocarcinoma (PDAC).

Introduction: PDAC is an extremely aggressive tumor with a poor prognosis and remarkable therapeutic resistance. The dense extracellular matrix (ECM) which characterizes PDAC progression is considered a fundamental determinant of chemoresistance, with major contributions from mechanical factors. This study combined biomechanical and pharmacological approaches to evaluate the role of the cell-adhesion molecule ITGA2, a key regulator of ECM, in PDAC resistance to gemcitabine.