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Radical resection for T2 and T3 disease resulted in a significant survival advantage compared with simple cholecystectomy. Patients who undergo radical re-resection after an incidentally discovered gallbladder cancer experience the same survival benefit as primarily resected patients. Radical resection for T2N(-), T2N(+), and T3N0 cases can achieve long-term survival. Conversely, the prognosis for T3N(+) and T4 patients is poor, and improved outcome for this group will likely depend on the development of multi-institutional neoadjuvant clinical trials that can identify effective systemic regimens.

This recommendation on a standardized delivery of HIPEC in patients with colorectal cancer represents an important first step in enhancing research in this field. Studies directed at maximizing the efficacy of each of the seven key elements will need to follow.

Key Points Question What are the morbidity and mortality of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) compared with other major oncologic surgical procedures? Findings In this cohort study of 1822 patients who received CRS/HIPEC compared with patients who received other high-risk surgical oncology procedures, overall 30-day mortality was lower in CRS/HIPEC (1.1%) compared with pancreaticoduodenectomy (2.5%), right lobe hepatectomy (2.9%), esophagectomy (3.0%), and trisegmental hepatectomy (3.9%). Meaning Comparative analysis revealed CRS/HIPEC to be safe across the spectrum of National Surgical Quality Improvement Project safety metrics when compared with oncologic procedures with similar inherent risk.

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The introducer technique is the safest method for PEG tube placement in head and neck cancer patients. The overall rate of complications is low and PEG site infectious complications are rare. The introducer technique should be the method of choice for PEG tubes in head and neck cancer patients.

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