36 research outputs found

    Surgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort study

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    Background Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC).Methods The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity.Findings On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84-1.29], p = 0.711 and HR 1.18 [0.95-1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79-1.17], p = 0.67 and HR 1.48 [1.16-1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02-1.74], p = 0.037) and OS (HR 1.26 [1.03-1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3-3.52], p < 0.0010), resection of additional organs (OR 2.22 [1.62-3.02], p < 0.0010) and major hepatectomy (OR 3.81 [2.55-5.73], p < 0.0010) were all associated with increased morbidity and mortality. Compared to LMIC, patients in HIC were associated with poorer RFS (HR 1.18 [1.02-1.37], p = 0.031) but not OS (HR 1.05 [0.91-1.22], p = 0.48). Adjuvant and neoadjuvant treatments were infrequently used.Interpretation In this large, multicentre analysis of GBC surgical outcomes, liver resection was not conclusively associated with improved survival, and extended resections were associated with greater morbidity and mortality without oncological benefit. Aggressive upfront resections do not benefit higher stage GBC, and international col-laborations are needed to develop evidence-based neoadjuvant and adjuvant treatment strategies to minimise surgical morbidity and prioritise prognostic benefit.Funding Cambridge Hepatopancreatobiliary Department Research Fund.Copyright & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

    D. Die einzelnen romanischen Sprachen und Literaturen.

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    Search for CPCP violation in D0^0\to KS0^0_\mathrm{S}KS0^0_\mathrm{S} decays in proton-proton collisions at s\sqrt{s} = 13 TeV

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    International audienceA search is reported for charge-parity D0^0\to KS0^0_\mathrm{S}KS0^0_\mathrm{S}CPCP violation in D0^0\to KS0^0_\mathrm{S}KS0^0_\mathrm{S} decays, using data collected in proton-proton collisions at s\sqrt{s} = 13 TeV recorded by the CMS experiment in 2018. The analysis uses a dedicated data set that corresponds to an integrated luminosity of 41.6 fb1^{-1}, which consists of about 10 billion events containing a pair of ẖadrons, nearly all of which decay to charm hadrons. The flavor of the neutral D meson is determined by the pion charge in the reconstructed decays D+^{*+}\to D0π+^0\pi^+ and D^{*-}\to D0π^0\pi^-. The D0^0\to KS0^0_\mathrm{S}KS0^0_\mathrm{S}CPCP asymmetry in D0^0\to KS0^0_\mathrm{S}KS0^0_\mathrm{S} is measured to be ACPA_{CP}( KS0^0_\mathrm{S}KS0^0_\mathrm{S}) = (6.2 ±\pm 3.0 ±\pm 0.2 ±\pm 0.8)%, where the three uncertainties represent the statistical uncertainty, the systematic uncertainty, and the uncertainty in the measurement of the D0^0 \to KS0^0_\mathrm{S}KS0^0_\mathrm{S} CPCP asymmetry in the D0^0 \to KS0π+π^0_\mathrm{S}\pi^+\pi^- decay. This is the first D0^0 \to KS0^0_\mathrm{S}KS0^0_\mathrm{S} CPCP asymmetry measurement by CMS in the charm sector as well as the first to utilize a fully hadronic final state

    Observation of the J/ψ\psi \to μ+μμ+μ\mu^+\mu^-\mu^+\mu^- decay in proton-proton collisions at s\sqrt{s} = 13 TeV

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    International audienceThe J/ψ\psi\toμ+μμ+μ\mu^+\mu^-\mu^+\mu^- decay has been observed with a statistical significance in excess of five standard deviations. The analysis is based on an event sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the CMS experiment in 2018 and corresponding to an integrated luminosity of 33.6 fb1{-1}. Normalizing to the J/ψ\psi\toμ+μ\mu^+\mu^- decay mode leads to a branching fraction [10.12.7+3.3^{+3.3}_{-2.7} (stat) ±\pm 0.4 (syst) ]×\times 107^{-7}, a value that is consistent with the standard model prediction

    Enriching the physics program of the CMS experiment via data scouting and data parking

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    International audienceSpecialized data-taking and data-processing techniques were introduced by the CMS experiment in Run 1 of the CERN LHC to enhance the sensitivity of searches for new physics and the precision of standard model measurements. These techniques, termed data scouting and data parking, extend the data-taking capabilities of CMS beyond the original design specifications. The novel data-scouting strategy trades complete event information for higher event rates, while keeping the data bandwidth within limits. Data parking involves storing a large amount of raw detector data collected by algorithms with low trigger thresholds to be processed when sufficient computational power is available to handle such data. The research program of the CMS Collaboration is greatly expanded with these techniques. The implementation, performance, and physics results obtained with data scouting and data parking in CMS over the last decade are discussed in this Report, along with new developments aimed at further improving low-mass physics sensitivity over the next years of data taking

    Observation of the J/ψ\psi\toμ+μμ+μ\mu^+\mu^-\mu^+\mu^- decay in proton-proton collisions at s\sqrt{s} = 13 TeV

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    International audienceThe J/ψ\psi\toμ+μμ+μ\mu^+\mu^-\mu^+\mu^- decay has been observed with a statistical significance in excess of five standard deviations. The analysis is based on an event sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the CMS experiment in 2018 and corresponding to an integrated luminosity of 33.6 fb1{-1}. Normalizing to the J/ψ\psi\toμ+μ\mu^+\mu^- decay mode leads to a branching fraction [10.12.7+3.3^{+3.3}_{-2.7} (stat) ±\pm 0.4 (syst) ]×\times 107^{-7}, a value that is consistent with the standard model prediction

    Search for the Z boson decay to ττμμ\tau\tau\mu\mu in proton-proton collisions at s\sqrt{s} = 13 TeV

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    International audienceThe first search for the Z boson decay to ττμμ\tau\tau\mu\mu at the CERN LHC is presented, based on data collected by the CMS experiment at the LHC in proton-proton collisions at a center-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 138 fb1^{-1}. The data are compatible with the predicted background. For the first time, an upper limit at the 95% confidence level of 6.9 times the standard model expectation is placed on the ratio of the Z \to ττμμ\tau\tau\mu\mu to Z \to 4μ\mu branching fractions. Limits are also placed on the six flavor-conserving four-lepton effective-field-theory operators involving two muons and two tau leptons, for the first time testing all such operators

    Search for soft unclustered energy patterns in proton-proton collisions at 13 TeV

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    International audienceThe first search for soft unclustered energy patterns (SUEPs) is performed using an integrated luminosity of 138 fb1^{-1} of proton-proton collision data at s\sqrt{s} = 13 TeV collected in 2016-2018 by the CMS detector at the LHC. Such SUEPs are predicted by Hidden Valley models with a new, confining force with a large 't Hooft coupling. In events with boosted topologies, selected by high-threshold hadronic triggers, the multiplicity and sphericity of clustered tracks are used to reject the background from standard model quantum chromodynamics. With no observed excess of events over the standard model expectation, limits are set on the cross section for production via gluon fusion of a scalar mediator with SUEP-like decays
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