ObjectiveTo evaluate the efficacy and safety of 177Lu-FAP-2286 radioligand therapy (RLT) in advanced digestive system malignancies and explore its clinical potential as a novel targeted therapeutic approach. MethodsThis retrospective analysis examined clinical data from 19 patients with advanced digestive system tumors who received 177Lu-FAP-2286 treatment at the Affiliated Hospital of Southwest Medical University between June 2023 and December 2024. Treatment response was assessed using response evaluation criteria in solid tumor (RECIST) 1.1 criteria and modified PERCIST（PET response criteria in solid tumor, PERCIST） 1.0 guidelines. Adverse events (AEs) were graded according to CTCAE v5.0. ResultsAt the last follow-up, consistent therapeutic outcomes were observed between RECIST 1.1 and PERCIST 1.0 evaluations, we observed 2 cases of partial response / partial metabolic response, 4 cases of stable disease / stable metabolic disease, and 13 cases of progressive disease / progressive metabolic disease, demonstrating an objective response rate of 10.5% (2/19) and disease control rate of 31.6% (6/19). Post-treatment monitoring revealed 7 AEs of grade 2 and 1 AE of grade 1, with no occurrence of grade 3–4 haematological or hepatorenal toxicities. Common treatment-related symptoms, including nausea, decreased appetite, and fatigue, showed spontaneous resolution over time. ConclusionsPreliminary findings indicate that 177Lu-FAP-2286 exhibits favourable safety and tolerability in patients with advanced digestive system malignancies while demonstrating efficacy in controlling disease progression for a subset of patients. However, multicenter prospective studies with larger cohorts are warranted to further validate its long-term efficacy and identify clinical characteristics of digestive system malignancy patients who may benefit.
ObjectiveTo explore transcatheter arterial chemoembolization (TACE) influences on prognosis of patients with BCLC stage 0–A hepatocellular carcinoma (HCC).MethodsThe clinicopathologic data of BCLC stage 0–A HCC patients underwent the radical resection in the Affiliated Hospital of Southwest Medical University from January 2006 to June 2018 were retrospectively analyzed. These patients were divided into a preoperative TACE treatment group (PTT group, n=365) and a directly surgical resection group (DSR group, n=365). The Kplan-Meier method was used to compare the overall survival (OS) and disease free survival (DFS) between the two groups. The Cox proportional hazard model was used to analyze whether the preoperative TACE was an independent factor affecting the prognosis of patient with BCLC stage 0–A HCC.ResultsA total of 465 patients with BCLC stage 0–A HCC were enrolled, including 365 patients in the DSR group and 100 patients in the PTT group. The baseline data of the two groups were similar（P>0.050）. In the cohort, the 1-, 3-, 5-, 10-year OS rates and DFS rates were 95.3%, 83.5%, 74.3%, 56.8% and 88.0%, 63.8%, 51.1%, 36.4%, respectively in the DSR group, which were 92.7%, 72.9%, 52.3%, 35.3% and 78.1%, 54.2%, 40.4%, 31.2%, respectively in the PTT group. The Kplan-Meier survival analysis showed that the OS and DFS in the DSR group were significantly better than those in the PTT group (P=0.009, P=0.033). The multivariate Cox proportional hazard model analysis showed that the preoperative TACE was the independent risk factor for the poor prognosis in the patients with BCLC stage 0–A HCC [ HR=1.389, 95% CI (1.158, 2.199), P=0.021].ConclusionsFor patients with BCLC stage 0–A HCC, preoperative TACE doesn’t improve patient’s prognosis and might reduce survival rate. If there is no special reason, direct surgery should be performed.
Objective To investigate the value of indocyanine green fluorescence imaging in common bile duct reexploration. Methods The clinical data of 32 patients who underwent open common bile duct reexploration in the Affiliated Hospital of Southwest Medical University from January 2018 to December 2020 were collected retrospectively. All patients divided into the control group (conventional exploration group, 20 patients) and the fluorescence imaging group (using indocyanine green fluorescence imaging, 12 patients) according to the operational manner. The intraoperative and postoperative results of two groups were analyzed. Results The operative time [(165.2±6.9) min vs. (130.8±5.5) min], the time to find extrahepatic bile duct [(43.9±3.8) min vs. (23.1±4.1) min] and the amount of bleeding [(207.7±7.7) mL vs. (127.5±15.3) mL] in the control group were longer or more than those in the fluorescence imaging group (P<0.05). The incidence of postoperative infection in the control group [7 cases (35.0%) vs. 0 cases (0.0%)] and the length of hospital stay [(10.8±2.8) d vs. (7.1±1.3) d] were higher or longer than those in the fluorescence imaging group (P<0.05). There were no significant difference between the two groups in the incidence of postoperative bile fistula [6 cases (30.0%) vs. 2 cases (16.7%)] and the incidence of residual stones [3 cases (15.0%) vs. 3 cases (25.0%), P＞0.05]. Conclusion Indocyanine green fluorescence imaging appears to be a feasible, expeditious, useful, and effective imaging method while performing reexploration.
Objective The aim of this article is to verify the clinical effect of the near-infrared fluorescent liver cancer surgery projection navigation system without display screen. Methods Three patients who need to undergo open hepatectomy for liver cancer in the Affiliated Hospital of Southwest Medical University from March 2021 to May 2021 were included, verifying the accuracy, stability, and time delay effect of the self-developed near-infrared fluorescence projection navigation system for the location of tumor in surgeries. Results The intraoperative tumor location could be accurately displayed by the near-infrared fluorescence projection system and there was no significant difference between the location of the tumor displayed by intraoperative ultrasound. The tumor location displayed by the near-infrared fluorescence projection system was not influenced by the tumor movement and had no visual-time delay. Postoperative pathology confirmed that the projection range was consistent with the tumor range. Conclusion This near-infrared fluorescence projection technology innovates the intraoperative tumor imaging mode and can accurately navigate open hepatectomy in small sample trials, and it is expected to achieve wide clinical application through subsequent iterative optimization and verification.
ObjectiveTo understand the authors, countries/regions, institutions, journals and hot topics about the application research of indocyanine green (ICG) in hepatobiliary surgery. MethodsThis study conducted a bibliometric analysis of the literatures on the application of ICG in hepatobiliary surgery in the Web of Science Core Collection from 2008 to 2024. CiteSpace software was used to evaluate and visualize collaborative networks and hot topics. ResultsA total of 2 267 literatures were included in this study, with a citation frequency of 50 463 times. The literatures from Japan accounted for the highest proportion, and most of the papers (13.50%) were published by Kokudo N. In China, Tian Jie had published the largest number of papers (33 articles). The research hotspots focused on liver resection, bile duct surgery, liver transplantation, and tumors, with recent hotspots including “liver preservation” and “rejection” frequently appearing. ConclusionThis study aims to present the overall state and trend of the application research of ICG in hepatobiliary surgery through data capture and induction, and providing valuable references for clinicians and researchers.
ObjectiveTo explore value of multidisciplinary team (MDT) discussion in comprehensive downstaging treatment of liver cancer.MethodThe clinical data of 2 patients with liver cancer who could not undergo the radical surgery admitted to the Affiliated Hospital of Southwest Medical University were analyzed retrospectively.ResultsCase 1 was diagnosed as the liver cancer with extensive double lung metastasis at admission. The clinical stage was stage Ⅲb; After MDT discussion, the patient was treated with chemotherapy and embolization via hepatic artery and bronchial artery; At the same time, the patient was treated with apatinib; At present, the metastasis of both lungs disappeared completely; The clinical stage was stage ⅡB, and the radical resection was proposed. Case 2 was diagnosed as the right liver cancer at admission. The clinical stage was stage Ⅰ b. The preoperative examination showed that the hepatic reserve function was poor and the patient could not tolerate the half hepatectomy; After MDT discussion, the patient was treated with the combination of chemotherapy and embolization via the hepatic artery and apatinib in the same period; At the same time, the patient was treated with liver protection. The clinical stage was reduced to stage Ⅰ a. The hepatic reserve function improved and the laparoscopic right hemihepatectomy was performed, no recurrence or metastasis was found after 3 months follow-up.ConclusionComprehensive downstaging treatment based on MDT model could bring better clinical outcomes for patients with liver cancer who are unable to undergo one-stage radical surgery.