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Triple-negative breast cancer (TNBC) is the most aggressive breast cancer. Neoadjuvant chemotherapy was widely accepted for treating TNBC. This systematic review and meta-analysis aimed to evaluate the efficacy, safety, and survival benefit of platinum-based adjuvant therapy (PBAT) in treating TNBC. The keywords were searched in Medline, Embase, Pubmed, and Cochrane Library database up to July 24, 2022. All the randomized control trials (RCTs) comparing PBAT and non-PBAT in treating TNBC were included in our study. The pathological complete remission (pCR) and complications were compared by odds ratio (OR) and 95% confidence intervals (CIs). The overall survival (OS) and relapse-free survival (RFS) were compared by hazard ratio (HR) and 95% CIs. A total of 19 RCTs were included in our meta-analysis, among which 2,501 patients were treated with PBAT and 2,290 with non-PBAT. The patients treated with PBAT combined a significantly higher pCR rate compared to those patients treated with non-PBAT (49.8% versus 36.4%, OR = 1.27, 95%CI = 1.14-1.43, Plt; 0.001). Besides, patients treated with PBAT had a significantly better RFS (HR = 0.78, 95%CI = 0.63-0.95, P = 0.016), but not in OS (HR = 0.84, P = 0.304). Although the occurrence of neutropenia and nausea were slightly different between the PBAT group (51.5% and 24.4%) and the non-PBAT group (47.0% and 29.4%), the complications were acceptable in the two treatments groups. Our results demonstrated that TNBC patients treated with PBAT could achieve a higher pCR rate and better RFS benefit without a higher complication rate.bHighlights/bPlatinum-based adjuvant therapy provided a higher pCR rate for TNBC.Platinum-based adjuvant therapy prolonged the RFS but without prolongingthe OS.Neutropenia and nausea rate was different between group PBAT and non-PBAT.

Background Partial hepatectomy is the most definitive treatment for hepatolithiasis. Laparoscopic liver resection, however, presents unique technical challenges. The objectives of this study were to evaluate and compare the safety and perioperative and long-term outcomes of laparoscopic left hemihepatectomy (LLH) versus open left hemihepatectomy (OLH) for left intrahepatic duct stones. Methods From March 2009–October 2014, 97 consecutive patients with left intrahepatic duct stones who underwent LLH ( n = 46) or OLH ( n = 51) were evaluated. We retrospectively reviewed the clinical outcomes and the stone clearance rates of the 97 patients in this study. Results The median surgical procedure times were 254 min (188–396 min) in the LLH group and 236 min (192–395 min) in the OLH group. No significant difference was found in the surgical procedure times between the two groups. The intraoperative blood loss of the LLH group was less than the OLH group (332 mL [247–914 mL] versus 369 mL [221–996 mL], P = 0.13), but there was no statistical significance. A shorter length of postoperative hospital stay was noticed in laparoscopy group (11 d [8–21 d] versus 12 d [9–24 d], P = 0.01). Postoperative complications were observed in six of the 46 patients (13.0%) after LLH and in 11 of the 51 patients (21.6%) after OLH ( P = 0.27). Laparoscopy was comparable with laparotomy in the effectiveness of stone clearance during the first attempt (93.5% versus 94.1%, P = 1.00). Conclusions In left-sided hepatolithiasis, LLH was safe and effective: it resulted in low postoperative morbidity, no mortality, and a high stone clearance rate. The potential benefit of LLH was a shorter hospital stay. If consideration is given to the appropriate indication criteria, including the extent of hepatectomy and the location and distribution of lesions, LLH may be an excellent choice for treatment of left-sided hepatolithiasis.

INTRODUCTION Hepatolithiasis is a prevalent disease in the southeastern coastal regions of China. Partial hepatectomy is the most definitive treatment for hepatolithiasis. This study evaluated the safety and efficacy of the laparoscopic left hemihepatectomy (LLH) for left-sided hepatolithiasis. METHODS The clinical data of 37 consecutive patients who underwent pure LLH for left-sided hepatolithiasis at Yinzhou Second Hospital between March 2009 and December 2013 were reviewed retrospectively. RESULTS Pure LLH was performed successfully in 36 patients. Because of severe adhesions from previous choledochotomy, 1 patient was converted to open procedure. The mean operative time was 257.9 minutes (range, 188 to 396 min). The mean duration of postoperative hospital stay was 11.7 days (range, 8 to 21 d). There were 2 (5.4 %) cases of postoperative bile leakage, 2 (5.4%) cases of intra-abdominal fluid collection, and 1 (2.7%) case of incisional infection, which were successfully managed conservatively. Residual stones were observed in 2 (5.4%) patients. The residual stones were located in the common bile duct in these cases and were removed through the T-tube tract by choledochoscopy. During a mean follow-up of 31.3 months (range, 6 to 63 mo), recurrent stones were detected in 2 (5.4%) patients and were successfully treated with endoscopic sphincterotomy. CONCLUSIONS LLH for left-sided hepatolithiasis is feasible and safe in selected patients.

Laparoscopic surgery for common bile duct stones varies procedurally from a transcystic approach to laparoscopic choledochotomy (LC) with or without biliary drainage. However, LC is a difficult procedure with higher documented morbidity than the transcystic approach. We retrospectively investigated risk factors for adverse outcomes of LC.We used logistic regression models to assess 4 categories of adverse outcomes: overall, complications, conversion to open operation and failed surgical clearance. We calculated the area under the receiver operating characteristic curve to evaluate diagnostic accuracy.We included 201 patients who underwent LC in our analysis. Adverse outcomes occurred in 48 (23.9%) patients, complications occurred in 43 (21.4%), retained stones were observed in 8 (4%), and conversion to laparotomy occurred in 7 (3.5%). Multivariate analysis showed that total bilirubin (BIL) and the presence of medical risk factors (MRFs) were significant predictors of adverse outcomes and complications. We calculated the probability of adverse outcomes (p) using the following formula: logit(p) = 0.977 (MRFs) + 0.014 (BIL) - 2.919. p = EXP (logit(p)) ÷ [1+EXP (logit(p))]. According to their logit(p), all patients were divided into a low-risk group (logit(p) ≤ -1.32, n = 130) and a high-risk group (logit(p)-1.32, n = 71). Patients in the low-risk group had about a 1 in 10 chance (12 of 130) of adverse outcomes developing. Of the 71 patients in the high-risk group, 36 (50.7%) experienced adverse outcomes.High BIL and the presence of MRFs could predict adverse outcomes in patients undergoing LC.La chirurgie laparoscopique pour extraction de calculs biliaires logés dans le cholédoque diffère sur le plan technique de la cholédochotomie laparoscopique (CL) par approche transcystique avec ou sans drain biliaire. Toutefois, la CL est une intervention délicate, qui s'accompagne d'un taux de morbidité documenté plus élevé comparativement à l'extraction transcystique. Nous avons analysé rétrospectivement les facteurs de risque à l'égard d'une issue négative de la CL.Nous avons utilisé des modèles de régression logistique pour évaluer 4 catégories d'issue négative : issue négative globale, complications, conversion vers une chirurgie ouverte et échec de l'extraction chirurgicale. Nous avons calculé l'aire sous la courbe de la fonction d'efficacité du récepteur pour évaluer la précision diagnostique.Nous avons inclus dans notre analyse 201 patients soumis à une CL. Une issue négative est survenue chez 48 patients (23,9 %), des complications chez 43 (21,4 %), la persistance des calculs chez 8 (4 %) et la conversion vers la laparotomie chez 7 (3,5 %). L'analyse multivariée a montré que la bilirubine totale (BIL) et la présence de facteurs de risque médicaux (FRM) étaient des prédicteurs significatifs d'une issue négative et de complications. Nous avons calculé la probabilité de survenue d'une issue négative (Un taux de BIL élevé et la présence de FRM pourraient prédire l'issue négative chez des patients soumis à une CL.