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Article ; Online: Transition from open and laparoscopic to robotic pancreaticoduodenectomy in a UK tertiary referral hepatobiliary and pancreatic centre - Early experience of robotic pancreaticoduodenectomy.

Gall, Tamara Mh / Pencavel, Tim D / Cunningham, David / Nicol, David / Jiao, Long R

HPB : the official journal of the International Hepato Pancreato Biliary Association

2020 Volume 22, Issue 11, Page(s) 1637–1644

Abstract: Background: Pancreaticoduodenectomy is performed using an open technique (OPD) as the gold standard. An increase in those performed laparoscopically (LPD) and robotically (RPD) are now reported. We compared the short-term outcomes of RPD cases with LPD ... ...

Abstract	Background: Pancreaticoduodenectomy is performed using an open technique (OPD) as the gold standard. An increase in those performed laparoscopically (LPD) and robotically (RPD) are now reported. We compared the short-term outcomes of RPD cases with LPD and OPD. Methods: A retrospective review of a prospectively collected database was undertaken of our first consecutive RPD, our first LPD and consecutive OPD cases. Those requiring venous and/or arterial resection were excluded. Results: RPD (n = 25) had longer median operating times (461 (IQR 358-564) mins) than LPD (n = 41) (330 (IQR 262.5-397.5) mins) and OPD (n = 37) (330 (IQR 257-403) mins, p < 0.0001). Estimated blood loss and transfusion requirement was less after RPD and LPD compared to OPD (p = 0.012 and p < 0.0001 respectively). No RPD cases required conversion to open operation compared to 24.4% of LPD. Morbidity was comparable with a Clavien Dindo score ≥3 in 20.00%, 24.39% and 18.92% for RPD, LPD and OPD respectively (p = 0.83). Post-operative pancreatic fistula rates were seen in 16.00%, 29.27% and 21.62% of our RPD, LPD and OPD cohorts respectively (p = 0.81). 90-day mortality was seen in 0.97% of the total cohort. Length of hospital stay (LOS) was shorter for RPD compared to both LPD (p = 0.030) and OPD (p = 0.002). Conclusion: RPD is safe to perform with comparable outcomes to LPD and OPD. Further evidence is provided that a randomised controlled trial for PD techniques is required.
MeSH term(s)	Humans ; Laparoscopy/adverse effects ; Length of Stay ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy/adverse effects ; Postoperative Complications/etiology ; Referral and Consultation ; Retrospective Studies ; Robotic Surgical Procedures/adverse effects ; United Kingdom
Language	English
Publishing date	2020-04-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2020.03.008
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Article ; Online: Which patients benefit from preoperative biliary drainage in resectable pancreatic cancer?

Blacker, Sarah / Lahiri, Rajiv P / Phillips, Mary / Pinn, Graham / Pencavel, Tim D / Kumar, Rajesh / Riga, Angela T / Worthington, Tim R / Karanjia, Nariman D / Frampton, Adam E

Expert review of gastroenterology & hepatology

2021 Volume 15, Issue 8, Page(s) 855–863

Abstract: Recent studies have indicated that preoperative biliary drainage (PBD) should not be routinely performed in all patients suffering from obstructive jaundice before pancreatic surgery. The severity of jaundice that mandates PBD has yet to be defined. The ... ...

Abstract	Recent studies have indicated that preoperative biliary drainage (PBD) should not be routinely performed in all patients suffering from obstructive jaundice before pancreatic surgery. The severity of jaundice that mandates PBD has yet to be defined. The evaluated paper examines the impact of PBD on intra-operative, and post-operative outcomes in patients initially presenting with severe obstructive jaundice (bilirubin ≥250 μmol/L). In this key paper evaluation, the impact of PBD versus a direct surgery (DS) approach is discussed. The arguments for and against each approach are considered with regards to drainage associated morbidity and mortality, resection rates, survival and the impact of chemotherapy and malnutrition. Concentrating on resectable head of pancreas tumors, this mini-review aims to scrutinize the authors' recommendations, alongside those of prominent papers in the field.
MeSH term(s)	Aged ; Bilirubin/blood ; Drainage ; Female ; Humans ; Jaundice, Obstructive/blood ; Jaundice, Obstructive/etiology ; Jaundice, Obstructive/mortality ; Jaundice, Obstructive/surgery ; Male ; Middle Aged ; Pancreatic Neoplasms/blood ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/surgery ; Preoperative Care/mortality ; Retrospective Studies
Chemical Substances	Bilirubin (RFM9X3LJ49)
Language	English
Publishing date	2021-05-26
Publishing country	England
Document type	Comparative Study ; Journal Article ; Review
ZDB-ID	2481021-6
ISSN	1747-4132 ; 1747-4124
ISSN (online)	1747-4132
ISSN	1747-4124
DOI	10.1080/17474124.2021.1915127
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Article: Pancreatic Incidentalomas on CT Colonography: Ignore, Follow up or Investigate?

Mallappa, Sreelakshmi / Pencavel, Tim / Poo, Stephanie / Gall, Tamara / Cunningham, David / Tekkis, Paris / Jiao, Long R

Chirurgia (Bucharest, Romania : 1990)

2022 Volume 117, Issue 3, Page(s) 278–285

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Carcinoma, Pancreatic Ductal ; Colonography, Computed Tomographic ; Cross-Sectional Studies ; Follow-Up Studies ; Humans ; Pancreatic Cyst/diagnostic imaging ; Pancreatic Cyst/epidemiology ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/epidemiology ; Treatment Outcome ; Pancreatic Neoplasms
Language	English
Publishing date	2022-07-02
Publishing country	Romania
Document type	Journal Article
ZDB-ID	419244-8
ISSN	1842-368X ; 1221-9118 ; 0009-4730 ; 0377-5003
ISSN (online)	1842-368X
ISSN	1221-9118 ; 0009-4730 ; 0377-5003
DOI	10.21614/chirurgia.2723
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Article: A totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy assisted with radiofrequency (radiofrequency assisted liver partition with portal vein ligation) for staged liver resection.

Jiao, Long R / Hakim, David N / Gall, Tamara M H / Fajardo, Ana / Pencavel, Tim D / Fan, Ruifang / Sodergren, Mikael H

Hepatobiliary surgery and nutrition

2016 Volume 5, Issue 4, Page(s) 382–387

Abstract: In order to induce liver hypertrophy to enable liver resection in patients with a small future liver remnant (FLR), various methods have been proposed in addition to portal vein embolisation (PVE). Most recently, the associating liver partition and ... ...

Abstract	In order to induce liver hypertrophy to enable liver resection in patients with a small future liver remnant (FLR), various methods have been proposed in addition to portal vein embolisation (PVE). Most recently, the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique has gained significant international interest. This technique is limited by the high morbidity associated with an in situ liver splitting and the patient undergoing two open operations. We present the case of a variant ALPPS technique performed entirely laparoscopically with no major morbidity or mortality. An increased liver volume of 57.9% was seen after 14 days. This technique is feasible to perform and compares favourably to other ALPPS methods whilst gaining the advantages of laparoscopic surgery.
Language	English
Publishing date	2016-07-22
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn.2016.05.02
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Article ; Online: Does the two-week rule pathway improve the diagnosis of soft tissue sarcoma? A retrospective review of referral patterns and outcomes over five years in a regional sarcoma centre.

Pencavel, Tim D / Strauss, Dirk C / Thomas, Greg P / Thomas, J Meirion / Hayes, Andrew J

Annals of the Royal College of Surgeons of England

2010 Volume 92, Issue 5, Page(s) 417–421

Abstract: Introduction: The NHS Cancer Plan was introduced in 2000 and included guidelines for the rapid assessment and referral of cases of suspected malignancy. We wished to assess the efficiency and appropriateness of patients referred under the Department of ... ...

Abstract	Introduction: The NHS Cancer Plan was introduced in 2000 and included guidelines for the rapid assessment and referral of cases of suspected malignancy. We wished to assess the efficiency and appropriateness of patients referred under the Department of Health's general practitioner referral guidelines implemented for sarcomas in December 2000. Patients and methods: A retrospective case-note review was performed of all patients referred to our regional soft tissue sarcoma unit between 1 January 2004 and 31 December 2008. Patients referred under the two-week guidelines and all patients referred routinely were analysed. The main outcome measures were the total number of patients referred on the basis of the two-week guidelines and the proportion they constitute of all referrals. The referring criteria were noted and compared to the observed criteria recorded. The final histological diagnosis of patients referred on the basis of the two-week guidelines are documented. Results: A total of 2746 referrals for suspected sarcoma were made from January 2004 to December 2008. Of these, 154 referrals were made under the two-week rule of which 102 were referred purely on the clinical criteria for suspected soft tissue sarcoma. The remaining patients were referred after non-urgent special investigations indicated the possibility of sarcoma. Twelve patients referred under the two-week rule were proved to have sarcoma, nine after specific investigations including imaging or histological diagnosis. Of the 102 patients referred on clinical suspicion of a sarcoma, two patients had proven soft tissue sarcomas and one patient a cutaneous sarcoma. Between 2004 and 2008, the number of 2-week referrals rose 25-fold but accounted for an increase of less than 1% of the sarcomas treated in this unit. Conclusions: The numbers of all referrals for suspected sarcoma are increasing; however, the rate of increase of 2-week referrals is increasing faster than routine referrals and will exceed it in 2012 if current trends continue. There has not been a commensurate rise in the detection of sarcoma or, more specifically, diagnosis of the deep sarcomas associated with worse prognosis. Current clinical guidelines have essentially had no impact on the early diagnosis and treatment of soft tissue sarcoma, and may negatively impact on the treatment of patients with proven sarcoma by delaying treatment within a regional centre because of redirection of a large number of patients with benign abnormalities to such centres.
MeSH term(s)	Early Diagnosis ; Guideline Adherence ; Health Services Research/methods ; Humans ; London ; Outcome Assessment, Health Care ; Practice Guidelines as Topic ; Referral and Consultation/standards ; Referral and Consultation/statistics & numerical data ; Retrospective Studies ; Sarcoma/diagnosis ; Soft Tissue Neoplasms/diagnosis ; State Medicine/standards ; State Medicine/statistics & numerical data ; Time Factors ; Workload/statistics & numerical data
Language	English
Publishing date	2010-05-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/003588410X12664192075972
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Article ; Online: Isolated limb perfusion with melphalan, tumour necrosis factor-alpha and oncolytic vaccinia virus improves tumour targeting and prolongs survival in a rat model of advanced extremity sarcoma.

Pencavel, Tim D / Wilkinson, Michelle J / Mansfield, David C / Khan, Aadil A / Seth, Rohit / Karapanagiotou, Eleni M / Roulstone, Victoria / Aguilar, Richard J / Chen, Nanhai G / Szalay, Aladar A / Hayes, Andrew J / Harrington, Kevin J

International journal of cancer

2015 Volume 136, Issue 4, Page(s) 965–976

Abstract: Isolated limb perfusion (ILP) is a treatment for advanced extremity sarcoma and in-transit melanoma. Advancing this procedure by investigating the addition of novel agents, such as cancer-selective oncolytic viruses, may improve both the therapeutic ... ...

Abstract	Isolated limb perfusion (ILP) is a treatment for advanced extremity sarcoma and in-transit melanoma. Advancing this procedure by investigating the addition of novel agents, such as cancer-selective oncolytic viruses, may improve both the therapeutic efficacy of ILP and the tumour-targeted delivery of oncolytic virotherapy. Standard in vitro assays were used to characterise single agent and combinatorial activities of melphalan, tumour necrosis factor-alpha (TNF-α) and Lister strain vaccinia virus (GLV-1h68) against BN175 rat sarcoma cells. An orthotopic model of advanced extremity sarcoma was used to evaluate survival of animals after ILP with combinations of TNF-α, melphalan and GLV-1h68. We investigated the efficiency of viral tumour delivery by ILP compared to intravenous therapy, the locoregional and systemic biodistribution of virus after ILP, and the effect of mode of administration on antibody response. The combination of melphalan and GLV-1h68 was synergistic in vitro. The addition of virus to standard ILP regimens was well tolerated and demonstrated superior tumour targeting compared to intravenous administration. Triple therapy (melphalan/TNF-α/GLV-1h68) resulted in increased tumour growth delay and enhanced survival compared to other treatment regimens. Live virus was recovered in large amounts from perfused regions, but in smaller amounts from systemic organs. The addition of oncolytic vaccinia virus to existing TNF-α/melphalan-based ILP strategies results in survival advantage in an immunocompetent rat model of advanced extremity sarcoma. Virus administered by ILP has superior tumour targeting compared to intravenous delivery. Further evaluation and clinical translation of this approach is warranted.
MeSH term(s)	Animals ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Apoptosis ; Cell Line, Tumor ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Hindlimb/drug effects ; Hindlimb/pathology ; Humans ; Male ; Melphalan/administration & dosage ; Neoplasm Transplantation ; Oncolytic Viruses/physiology ; Rats, Inbred Strains ; Sarcoma, Experimental/blood supply ; Sarcoma, Experimental/pathology ; Sarcoma, Experimental/therapy ; Tumor Necrosis Factor-alpha/administration & dosage ; Vaccinia virus/physiology
Chemical Substances	Tumor Necrosis Factor-alpha ; Melphalan (Q41OR9510P)
Language	English
Publishing date	2015-02-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	218257-9
ISSN	1097-0215 ; 0020-7136
ISSN (online)	1097-0215
ISSN	0020-7136
DOI	10.1002/ijc.29059
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Zs.A 478: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Optimising measles virus-guided radiovirotherapy with external beam radiotherapy and specific checkpoint kinase 1 inhibition.

Touchefeu, Yann / Khan, Aadil A / Borst, Gerben / Zaidi, Shane H / McLaughlin, Martin / Roulstone, Victoria / Mansfield, David / Kyula, Joan / Pencavel, Tim / Karapanagiotou, Eleni M / Clayton, Jamie / Federspiel, Mark J / Russell, Steve J / Garrett, Michelle / Collins, Ian / Harrington, Kevin J

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2013 Volume 108, Issue 1, Page(s) 24–31

Abstract: Background and purpose: We previously reported a therapeutic strategy comprising replication-defective NIS-expressing adenovirus combined with radioiodide, external beam radiotherapy (EBRT) and DNA repair inhibition. We have now evaluated NIS-expressing ...

Abstract	Background and purpose: We previously reported a therapeutic strategy comprising replication-defective NIS-expressing adenovirus combined with radioiodide, external beam radiotherapy (EBRT) and DNA repair inhibition. We have now evaluated NIS-expressing oncolytic measles virus (MV-NIS) combined with NIS-guided radioiodide, EBRT and specific checkpoint kinase 1 (Chk1) inhibition in head and neck and colorectal models. Materials and methods: Anti-proliferative/cytotoxic effects of individual agents and their combinations were measured by MTS, clonogenic and Western analysis. Viral gene expression was measured by radioisotope uptake and replication by one-step growth curves. Potential synergistic interactions were tested in vitro by Bliss independence analysis and in in vivo therapeutic studies. Results: EBRT and MV-NIS were synergistic in vitro. Furthermore, EBRT increased NIS expression in infected cells. SAR-020106 was synergistic with EBRT, but also with MV-NIS in HN5 cells. MV-NIS mediated (131)I-induced cytotoxicity in HN5 and HCT116 cells and, in the latter, this was enhanced by SAR-020106. In vivo studies confirmed that MV-NIS, EBRT and Chk1 inhibition were effective in HCT116 xenografts. The quadruplet regimen of MV-NIS, virally-directed (131)I, EBRT and SAR-020106 had significant anti-tumour activity in HCT116 xenografts. Conclusion: This study strongly supports translational and clinical research on MV-NIS combined with radiation therapy and radiosensitising agents.
MeSH term(s)	Animals ; Cell Line, Tumor ; Checkpoint Kinase 1 ; Colorectal Neoplasms/therapy ; Combined Modality Therapy ; Head and Neck Neoplasms/therapy ; Humans ; Iodine Radioisotopes/therapeutic use ; Isoquinolines/therapeutic use ; Measles virus/physiology ; Mice ; Oncolytic Virotherapy ; Protein Kinase Inhibitors/therapeutic use ; Protein Kinases/physiology ; Pyrazines/therapeutic use ; Radiation-Sensitizing Agents/therapeutic use ; Symporters/genetics ; Virus Replication ; Xenograft Model Antitumor Assays
Chemical Substances	Iodine Radioisotopes ; Isoquinolines ; Protein Kinase Inhibitors ; Pyrazines ; Radiation-Sensitizing Agents ; SAR 020106 ; Symporters ; sodium-iodide symporter (4XE5NDT4K1) ; Protein Kinases (EC 2.7.-) ; CHEK1 protein, human (EC 2.7.11.1) ; Checkpoint Kinase 1 (EC 2.7.11.1) ; Chek1 protein, mouse (EC 2.7.11.1)
Language	English
Publishing date	2013-07-09
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2013.05.036
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Article ; Online: Oncolytic vaccinia virus combined with radiotherapy induces apoptotic cell death in sarcoma cells by down-regulating the inhibitors of apoptosis.

Wilkinson, Michelle J / Smith, Henry G / McEntee, Gráinne / Kyula-Currie, Joan / Pencavel, Tim D / Mansfield, David C / Khan, Aadil A / Roulstone, Victoria / Hayes, Andrew J / Harrington, Kevin J

Oncotarget

2016 Volume 7, Issue 49, Page(s) 81208–81222

Abstract: Advanced extremity melanoma and sarcoma present a significant therapeutic challenge, requiring multimodality therapy to treat or even palliate disease. These aggressive tumours are relatively chemo-resistant, therefore new treatment approaches are ... ...

Abstract	Advanced extremity melanoma and sarcoma present a significant therapeutic challenge, requiring multimodality therapy to treat or even palliate disease. These aggressive tumours are relatively chemo-resistant, therefore new treatment approaches are urgently required. We have previously reported on the efficacy of oncolytic virotherapy (OV) delivered by isolated limb perfusion. In this report, we have improved therapeutic outcomes by combining OV with radiotherapy. In vitro, the combination of oncolytic vaccinia virus (GLV-1h68) and radiotherapy demonstrated synergistic cytotoxicity. This effect was not due to increased viral replication, but mediated through induction of intrinsic apoptosis. GLV-1h68 therapy downregulated the anti-apoptotic BCL-2 proteins (MCL-1 and BCL-XL) and the downstream inhibitors of apoptosis, resulting in cleavage of effector caspases 3 and 7. In an in vivo ILP model, the combination of OV and radiotherapy significantly delayed tumour growth and prolonged survival compared to single agent therapy. These data suggest that the virally-mediated down-regulation of anti-apoptotic proteins may increase the sensitivity of tumour cells to the cytotoxic effects of ionizing radiation. Oncolytic virotherapy represents an exciting candidate for clinical development when delivered by ILP. Its ability to overcome anti-apoptotic signals within tumour cells points the way to further development in combination with conventional anti-cancer therapies.
Language	English
Publishing date	2016-12-06
Publishing country	United States
Document type	Journal Article
ISSN	1949-2553
ISSN (online)	1949-2553
DOI	10.18632/oncotarget.12820
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