Surgery for Retroperitoneal Soft Tissue Sarcoma is Safe Following Multimodal Treatment with Regional Hyperthermia.

Background: Multimodal treatment has been suggested to improve outcomes in retroperitoneal soft tissue sarcoma (RPS). This study assessed the impact of neoadjuvant radiotherapy, chemotherapy, and the combination with regional hyperthermia (RHT) on postoperative morbidity using the Comprehensive Complication Index (CCI).

Patients And Methods: This single-center retrospective cohort study analyzed 335 surgeries for primary and recurrent RPS (2009-2022).

Textbook Outcome After Major Liver Resection for Primary and Secondary Liver Tumors at Specialized German Hepatobiliary Centers: Analysis of the StuDoQ Liver Registry.

Background: Textbook outcome (TO) represents the most desirable outcome of surgical quality and care. This study examined the TO of cholangiocarcinoma (CCC), hepatocellular carcinoma (HCC), and colorectal liver metastasis (CRLM) from the StuDoQ liver registry as well as factors that may affect the TO.

Methods: All major liver resections (≥ 3 segments) for CCC, HCC, and CRLM entered in the multicentric StuDoQ liver registry between 2019 and 2022 were retrospectively analyzed.

Precision Oncology in Rare Endocrine and Neuroendocrine Neoplasms: Experiences and Challenges of the CCCMunich Molecular Tumor Board.

Background: Comprehensive genomic profiling (CGP) has become more generally accessible to patients with rare cancer, but data on the results and benefits are limited.

Objective: Our objective was to gain a real-world understanding of the molecular landscape and targeted treatment options in neuroendocrine tumors, neuroendocrine carcinomas, adrenocortical carcinomas, pheochromocytomas, and carcinoids.

Patients And Methods: In this retrospective cohort study, we analyzed CGP results and clinical data from patients with neuroendocrine tumors, neuroendocrine carcinomas, adrenocortical carcinomas, pheochromocytomas, and carcinoids who were discussed in the CCCMunich Molecular Tumor Board (MTB) between May 2017 and April 2023.

Metabolomic profiling of renal cyst fluid in advanced ADPKD: insights from dialysis and transplantation cohorts.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disorder characterized by progressive renal cyst formation, often leading to end-stage kidney disease (ESKD). In contrast to the urinary metabolome in ADPKD, the composition of renal cyst fluid remains largely unexplored.

Methods: We conducted a comprehensive metabolomic analysis of renal cyst fluid from 26 ADPKD patients (20 on dialysis, six with kidney transplants) using ¹H-NMR spectroscopy and liquid chromatography-mass spectrometry (LC-MS).

Strong Hsp90α/β Protein Expression in Advanced Primary CRC Indicates Short Survival and Predicts Response to the Hsp90α/β-Specific Inhibitor Pimitespib.

The prognosis of advanced (UICC IIb-IV) primary colorectal cancer (pCRC) remains poor. More effective targeted therapies are needed. Heat shock protein 90 alpha/beta (Hsp90α/β) expression was immunohistologically quantified in 89 pCRCs and multivariately correlated with survival.

The Presence and Significance of Bacteria and Fungi in Bile Aspirated During ERC-A Retrospective Analysis.

Infections of the biliary tract are found frequently in pathologically or surgically altered bile ducts. Mostly these infections result from the ascent of bacteria or fungi from the small bowel, although hematogeneous infections of the biliary system may also occur. The biliary sphincter and the continuous flow of bile are thought to prevent or limit ascending infections.

Management of Metastatic Colorectal Cancer in Pregnancy: A Systematic Review of a Multidisciplinary Challenge.

Background: The global incidence of colorectal cancer (CRC) in patients under 50 years of age, also referred to as "early-onset" CRC (EO-CRC), has increased significantly in recent decades. According to current projections, CRC is expected to become the leading cause of cancer-related deaths among individuals aged 20-49 by 2030. The American Cancer Society noted a significant rise in the proportion of CRC cases in adults under 55, increasing from 11% in 1995 to 20% by 2019.

Validation of two plasma multimetabolite signatures for patients at risk of or with suspected pancreatic ductal adenocarcinoma (METAPAC): a prospective, multicentre, investigator-masked, enrichment design, phase 4 diagnostic study.

Background: Earlier diagnosis of pancreatic ductal adenocarcinoma is key to improving overall survival in patients with this hard-to-treat cancer. We independently validated two previously identified plasma-based metabolic signatures for exclusion of pancreatic ductal adenocarcinoma in cohorts with an increased annual risk.

Methods: The METAPAC study was a prospective, multicentre, investigator-masked, enrichment design, phase 4 trial done in 23 centres in Germany.

[Specialty-specific knowledge as prerequisite for effective treatment of critically ill patients].

Since the last meeting of the German Medical Association in May 2024, there has been a discussion in Germany about the shortening of primary specialty training and a transfer of the contents of additional supra-specialty training to the existing primary specialty training. This also affects intensive care medicine, with the prospect of creating a subspecialty for subspecialties in intensive care medicine (e.g.

Soluble CD46 improves detection of hepatic steatosis by contrast-enhanced computed tomography before liver surgery.

Soluble CD46 (sCD46) has recently been shown to be an effective biomarker of steatotic liver disease (SLD), which is highly prevalent in the western world. Since SLD directly affects outcomes after major hepatectomies and liver transplantation, accurate appraisal of this condition is crucial before liver surgery. In the present study, we asked whether sCD46 measurement in patient plasma could augment the pre-surgical prediction of SLD performed by contrast-enhanced computed tomography.

Efficacy of a Shortened Oral Antibiotic Bowel Decontamination in Minimally Invasive Surgery for Diverticular Disease.

Introduction: Infectious complications, such as anastomotic leakage (AL) and surgical site infections (SSIs), remain a significant challenge in colorectal surgery. Consequently, there is growing interest in oral antibiotic bowel decontamination with nonabsorbable antibiotics (selective digestive decontamination or SDD), which can reduce perioperative complications while also minimizing antibiotic use. This study aimed to determine whether a 3-day SDD regimen is as effective as a 7-day regimen in preventing postoperative complications in laparoscopic diverticular surgery.

Validation of body composition parameters extracted via deep learning-based segmentation from routine computed tomographies.

Sarcopenia and body composition metrics are strongly associated with patient outcomes. In this study, we developed and validated a flexible, open-access pipeline integrating available deep learning-based segmentation models with pre- and postprocessing steps to extract body composition measures from routine computed tomography (CT) scans. In 337 surgical oncology patients, total skeletal muscle tissue (SM), psoas muscle tissue (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were quantified both manually and using the pipeline.

TRANSMIT: Utilizing discarded livers from donors with a history of cancer for patients lacking access to standard allocation - A compassionate use exploratory study.

Background: A substantial number of viable donor livers are discarded due to the donor's underlying malignancy. Concurrently, patients with certain liver malignancies - such as unresectable colorectal cancer liver metastases (CRC-LM), unresectable intrahepatic or perihilar cholangiocarcinoma (iCCC/phCCC), or unresectable hepatocellular carcinoma (HCC) responding to immunotherapy - often face poor survival outcomes and are deemed ineligible for potentially curative liver transplantation. In this context, a rational risk-benefit analysis suggests that transplanting an organ with a theoretical risk of tumor transmission may be justifiable for these patients facing otherwise short-term fatal outcomes.

Clinical Features in Patients With Early-Onset Colorectal Cancer: An Evaluation of Data From the StuDoQ Database.

Background: The incidence of colorectal cancer (CRC) in patients who are less than 50 years old (early-onset colorectal cancer, EO-CRC) has risen markedly around the world in recent decades. Because of a lack of early detection programs for young patients, EO-CRC is often not detected until it has reached an advanced stage. In this study, we compared surgical patients with EO-CRC to those with so-called average-onset CRC (> 50 years; AO-CRC) using data from a large patient collective.

Ideal Outcome after Left Pancreatectomy in North America, Germany, the Netherlands, and Sweden.

Background: Composite outcome measures aim to provide a more holistic view when determining the effectiveness and safety of surgical interventions. Recently, 'Ideal Outcome' (IO) harmonized the European and American composite outcome of pancreatic surgery. The rate of IO after pancreatoduodenectomy was 54% but is unknown after left pancreatectomy(LP).

Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome.

Hypothermic oxygenated machine perfusion (HOPE) has become an integral technique to enhance donor graft function in liver transplantation (LiTx). This study compares early posttransplant outcomes of mono-HOPE (portal vein perfusion only) versus dual- HOPE (both portal vein and hepatic artery perfusion). A retrospective analysis was conducted on 183 LiTx recipients, with 90 receiving mono-HOPE and 93 receiving dual-HOPE grafts.

The Acute Abdomen: Structured Diagnosis and Treatment.

Background: The acute abdomen is a life-threatening clinical entity that requires immediate diagnostic evaluation and appropriate treatment. 15-20% of emergency room patients with acute abdominal pain need interventional or surgical treatment.

Methods: This narrative review is based on publications retrieved by a PubMed search, current textbooks and guidelines, and the authors' personal experience.

Five-Gene Expression Signature Associated With Acquired FOLFIRI Resistance and Survival in Metastatic Colorectal Cancer.

FOLFIRI, a combination of folinic acid, 5-fluorouracil, and irinotecan, is one of the recommended first-line chemotherapeutic treatments for metastatic colorectal cancer. Unfortunately, acquired FOLFIRI resistance represents a common obstacle in the treatment of metastatic colorectal cancer patients. Thus, we aimed to identify mechanisms, gene alterations, and gene expression signatures contributing to acquired FOLFIRI resistance by mimicking this problem in a cell culture model and subsequent translation in clinical data sets.

Bots in white coats: are large language models the future of patient education? A multicenter cross-sectional analysis.

Objectives: Every year, around 300 million surgeries are conducted worldwide, with an estimated 4.2 million deaths occurring within 30 days after surgery. Adequate patient education is crucial, but often falls short due to the stress patients experience before surgery.

Perioperative Chemotherapy or Preoperative Chemoradiotherapy in Esophageal Cancer.

Background: The best multimodal approach for resectable locally advanced esophageal adenocarcinoma is unclear. An important question is whether perioperative chemotherapy is preferable to preoperative chemoradiotherapy.

Methods: In this phase 3, multicenter, randomized trial, we assigned in a 1:1 ratio patients with resectable esophageal adenocarcinoma to receive perioperative chemotherapy with FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) plus surgery or preoperative chemoradiotherapy (radiotherapy at a dose of 41.