At present, the application of extended radical surgery in hilar cholangiocarcinoma (hCCA) remained controversial. The author reviewed the relevant literatures published in recent years and combined with his own experience, preliminarily discussed the application value of extended radical surgery in hCCA, and believed that: for some strictly selected cases of hCCA, under the premise of ensuring patient safety, extended radical surgery was an important treatment method for hCCA patients to obtain R0 removal, and the survival status of patients was better than that of palliative surgery, but the indications need to be strictly mastered. For patients with hCCA, whether to adopt extended radical surgery and the specific scope of surgical resection should be based on the scope of lesions and the involved organs, tissues and blood vessels to implement an individualized surgical program on the premise of comprehensive evaluation and full preparation before surgery. Do not blindly carry out extended radical surgery.
ObjectiveTo analyze the effects of preoperative protein level on the survival prognosis of patients underwent colorectal cancer (CRC) surgery in the current Database from Colorectal Cancer (DACCA). MethodsAccording to the established screening criteria, the patient information was extracted from the updated version of DACCA on November 24, 2024. The survival curves of the patients with and without preoperative hypoproteinemia were plotted by Kaplan-Meier method and the log-rank test was used to compare. The univariate and multivariate Cox regression analysis were used to analyze the preoperative hypoproteinemia affecting postoperative survival (overall survival and disease-specific survival) of patients with CRC. The test level was α=0.05. ResultsA total of 1 217 patients with CRC were included, and 252 of 1 217 patients with preoperative hypoproteinemia, with an incidence of 20.7%. The survival curves showed that the overall survival and disease-specific survival of the patients with preoperative hypoproteinemia were worse than those without preoperative hypoproteinemia (χ2=43.411, P<0.001; χ2=41.171, P<0.001). However, the multivariate Cox regression analysis did not find that the preoperative hypoproteinemia was a risk factor for postoperative survival (overall survival and disease-specific survival as observed indicators) in the patients with CRC [overall survival: HR (95%CI)=1.013 (0.741, 1.385), P=0.938; disease-specific survival: HR (95%CI)=1.003 (0.719, 1.399), P=0.987]. ConclusionThe results of this study suggest that the incidence rate of preoperative hypoproteinemia in patients with CRC is higher, and the survival prognosis is worse than that in patients without preoperative hypoproteinemia.