Background In the present study, we conducted a multicenter nationwide survey to investigate the effects of preoperative fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). Methods From 16 Japanese LT centers, data were collected on 182 recipients with HCC who underwent living donor liver transplantation (LDLT) between February 2005 and November 2013. PET-positive status was defined as increased uptake of FDG in the tumor compared to the surrounding non-tumor liver tissue. The median follow-up after LDLT was 54.5 months (range 1-125 months). Results Postoperative HCC recurrence occurred in 23 patients. Multivariate analysis revealed that exceeding the Milan criteria (MC), alpha-fetoprotein (AFP) level ≥115 ng/ml, and PET-positive status were significant and independent risk factors for recurrence. In the over-MC group, a subgroup of patients with AFP level <115 ng/ml and PET-negative status (n = 22) had a significantly lower 5-year recurrence rate than the other patients (n = 27, 19% vs. 53%, P = 0.019). Conclusions These results suggest that preoperative FDG-PET status offers additional information on HCC recurrence risk after LT. Over-MC patients with PET-negative status and lower AFP level may achieve successful outcome comparable to that of within-MC patients.

New human leukemia cell lines from 4 patients have been established. All are characterized by preferential growth in small clumps and large flat plaques of cells. The cell lines were adapted to suspension cultures and grown in one‐ to 200‐liter containers. The design of practical automated units for continuous culture of leukemia cells has been accomplished. Some of the nutritional requirements of these cell lines are summarized. Cytological studies revealed that all of the cell lines have a normal diploid karyotype with few aberrant cells. None of the cultured cells derived from chronic myelocytic leukemia retained the Ph chromosome. Electron microscopy has shown virus‐like particles in several of these cell lines. Preliminary studies of the value of these cultured leukemia cells in biochemical, viral and clinical immunological studies are discussed.

Background: Controversy continues as to whether single-incision laparoscopic cholecystectomy, with the somewhat larger incision at the umbilicus, may lead to a worse postoperative quality of life and more pain compared with the more classic 4-port laparoscopic cholecystectomy. The aim of this study was to compare single-incision and 4-port laparoscopic cholecystectomy from the perspective of quality of life. Methods: This study was a multicenter, parallel-group, open-label, randomized clinical trial. A total of 120 patients who were scheduled to undergo elective cholecystectomy were randomly assigned 1:1 into the single-incision laparoscopic cholecystectomy or the 4-port laparoscopic cholecystectomy group and then assessed continuously for 2 weeks during the postoperative period. The primary outcome was quality of life, defined as the time to resume normal daily activities. Postoperative pain was also assessed. To explore the heterogeneity of treatment effects, we assessed the interactions of sex, age, and working status on recovery time. Results: A total of 58 patients in the single-incision group and 53 in the 4-port group (n = 111, 47 male, mean age 57 years) were analyzed. The mean time to resume daily activities was 10.2 days and 8.8 days, respectively, for single-incision and 4-port laparoscopic cholecystectomy (95% confidence interval-0.4 to 3.2, P = .12). Similarly, the time to relief from postoperative pain did not differ significantly between the groups. Statistically insignificant but qualitative interactions were noted; in the subgroups of women, full-time workers, and patients younger than 60 years, recovery tended to be slower after single-incision laparoscopic cholecystectomy. Conclusion: Postoperative quality of life did not differ substantially between single-incision laparoscopic cholecystectomy and 4-port laparoscopic cholecystectomy. Patients younger than 60 years, women, and full-time workers tended to have a somewhat slower recovery after single-incision laparoscopic cholecystectomy.

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Results: Preoperative characteristics of patients and disease were comparable between MILS and Open Group. Laparoscopic series resulted in a statistically significant lower blood loss (200 vs 350, p=0.03), minor intraoperative blood transfusions (3.2% vs 7.9%, p=0.04) and postoperative blood transfusions (10.5% vs 15.8%), other than shorter lenght of stay (4 vs 6 days, p=0.04). Number of retrieved nodes was 8 vs 7 (p=ns); particularly, percentage of patients who achieved the recommended AJCC cutoff of six lymph nodes harvested were 93.7% vs 85.8% (p=0.05). Morbidity was lower in MILS group (16.8% vs 22.1%, p=0.02). Median disease free survival was 33 vs 36 months and disease recurrence occurred in 45.3% vs 55.3% of patients in MILS and Open Groups respectively. Conclusion: Laparoscopic approach for lymphadenectomy is a valid option in patients with biliary cancers since it allows to maintain the advantages of minimally invasive approach, without compromising the accuracy and the outcomes of nodal dissection.