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In This Issue of JAMA Surgery
March 2019


JAMA Surg. 2019;154(3):193. doi:10.1001/jamasurg.2018.3797

Complicated acute appendicitis sometimes presents with periappendicular abscess. The established initial treatment is antibiotic therapy, but the need of subsequent interval appendectomy has been unclear. In the Finnish multicenter Peri–Appendicitis Acuta randomized clinical trial, Mällinen and colleagues compared interval appendectomy with follow-up with magnetic resonance imaging after initial treatment. Owing to the high appendiceal neoplasm rate in the group receiving interval appendectomy, the study was terminated early.

Invited Commentary

Little is known about later recurrence (after >2 years) after resection for hepatocellular carcinoma. In this multicenter retrospective study of 734 patients at 6 Chinese hospitals, Xu and colleagues found that late recurrence was associated with sex, cirrhosis, and some aggressive characteristics of the initial tumor. The results indicate that postoperative regular surveillance improves survival outcomes in patients with late recurrence.