As the world population is continuously aging, the number of older patients requiring liver surgery is also on the rise. Data have shown that age should not be a limiting factor for liver resection, as it cannot accur...As the world population is continuously aging, the number of older patients requiring liver surgery is also on the rise. Data have shown that age should not be a limiting factor for liver resection, as it cannot accurately predict postoperative outcomes. Instead, frailty can serve as a more reliable measure of the patient's overall health and functional reserves. Several frailty assessment tools have been implemented for preoperative risk stratification before liver surgery, and higher scores have commonly been associated with postoperative morbidity, mortality, and length of hospital stay. However, no consensus has been reached on the most useful screening tool. Future studies should focus on comparing the currently available assessment tools, constructing a liver resection-specific tool, and assessing the role of frailty assessment tools in preoperative patient optimization.展开更多
Liver transplantation is the only potentially curative option for unresectable hepatoblastoma.The introduction of platinum-based chemotherapy drastically improved the survival outcomes of patients with hepatoblastoma....Liver transplantation is the only potentially curative option for unresectable hepatoblastoma.The introduction of platinum-based chemotherapy drastically improved the survival outcomes of patients with hepatoblastoma.However,the use of neoadjuvant chemotherapy and the optimal number of cycles required in patients listed for liver transplantation,as well as the potential use of adjuvant chemotherapy,remain unclear.Additionally,the shortage of donor liver grafts,along with the lack of clear consensus on the management of metastatic hepatoblastoma,makes the decision on whether to proceed to liver transplantation even more complex and challenging.Technological advances may optimize intraoperative imaging of both the primary tumor and metastatic sites,thus facilitating complete resection.Such improvements,along with the wider use of social media platforms to increase public awareness,could potentially pave the way for more optimal implementation of liver transplantation for the treatment of patients with unresectable hepatoblastoma.展开更多
文摘As the world population is continuously aging, the number of older patients requiring liver surgery is also on the rise. Data have shown that age should not be a limiting factor for liver resection, as it cannot accurately predict postoperative outcomes. Instead, frailty can serve as a more reliable measure of the patient's overall health and functional reserves. Several frailty assessment tools have been implemented for preoperative risk stratification before liver surgery, and higher scores have commonly been associated with postoperative morbidity, mortality, and length of hospital stay. However, no consensus has been reached on the most useful screening tool. Future studies should focus on comparing the currently available assessment tools, constructing a liver resection-specific tool, and assessing the role of frailty assessment tools in preoperative patient optimization.
文摘Liver transplantation is the only potentially curative option for unresectable hepatoblastoma.The introduction of platinum-based chemotherapy drastically improved the survival outcomes of patients with hepatoblastoma.However,the use of neoadjuvant chemotherapy and the optimal number of cycles required in patients listed for liver transplantation,as well as the potential use of adjuvant chemotherapy,remain unclear.Additionally,the shortage of donor liver grafts,along with the lack of clear consensus on the management of metastatic hepatoblastoma,makes the decision on whether to proceed to liver transplantation even more complex and challenging.Technological advances may optimize intraoperative imaging of both the primary tumor and metastatic sites,thus facilitating complete resection.Such improvements,along with the wider use of social media platforms to increase public awareness,could potentially pave the way for more optimal implementation of liver transplantation for the treatment of patients with unresectable hepatoblastoma.