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Article ; Online: Liver Resection for Hepatocellular Carcinoma and the Barcelona Clinic Liver Cancer Criteria: Is It Time to Push the Limits?

Naar, Leon / Hatzaras, Ioannis

2020 Volume 27, Issue 7, Page(s) 2122–2124

MeSH term(s)	Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Hepatectomy ; Humans ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Neoplasm Staging ; Treatment Outcome
Language	English
Publishing date	2020-04-15
Publishing country	United States
Document type	Editorial
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-020-08459-w
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Article ; Online: Retroperitoneal mass.

Leon Guerrero, Alexandra / Hatzaras, Ioannis

JAMA surgery

2015 Volume 150, Issue 2, Page(s) 175–176

MeSH term(s)	Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Cysts/diagnostic imaging ; Cysts/pathology ; Cysts/surgery ; Female ; Humans ; Middle Aged ; Radiography ; Retroperitoneal Neoplasms/diagnostic imaging ; Retroperitoneal Neoplasms/pathology ; Retroperitoneal Neoplasms/surgery
Language	English
Publishing date	2015-02
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2014.364
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Article ; Online: Pancreaticoduodenectomy as a feasible choice for periampullary malignancy in octogenarians.

Parasyris, Stavros / Hatzaras, Ioannis / Ntella, Vasiliki / Sidiropoulos, Theodoros / Margaris, Ioannis / Pantazis, Nikos / Kokoropoulos, Panagiotis / Vassiliu, Panteleimon / Matsota, Paraskevi / Smyrniotis, Vasileios / Arkadopoulos, Nikolaos

Molecular and clinical oncology

2022 Volume 17, Issue 4, Page(s) 148

Abstract: The efficacy and safety of pancreaticoduodenectomy (PD) has not been yet studied in octogenarians in Greece. The present study reviewed records of all consecutive patients that underwent PD at the 4th Surgical Department of Attikon University Hospital ( ... ...

Abstract	The efficacy and safety of pancreaticoduodenectomy (PD) has not been yet studied in octogenarians in Greece. The present study reviewed records of all consecutive patients that underwent PD at the 4th Surgical Department of Attikon University Hospital (Athens, Greece) between January 1st, 2010 and December 31st, 2019. Differences between two age groups (group Y <80 years; group O >80 years) were analyzed. Study endpoints were length of stay, overall morbidity, 30-day mortality and overall survival (OS). There were 198 patients in Group Y (mean age, 65 years) and 20 patients in Group O (mean age, 82 years). Octogenarians had worse American Society of Anesthesiology score (>2; 31.3 vs. 65%; P=0.018). Median stay was not significantly different between the two groups (14 days vs. 16 days; P=0.307), neither was the 30-day mortality (6.1 vs. 5.0%; P>0.99). Median OS was similar between the two groups (35 months vs. 28 months; P=0.577). In a tertiary center in Greece, morbidity and mortality rates after PD were similar between the two groups. Patients should not be denied a PD, solely based on advanced age.
Language	English
Publishing date	2022-08-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2796865-0
ISSN	2049-9469 ; 2049-9450
ISSN (online)	2049-9469
ISSN	2049-9450
DOI	10.3892/mco.2022.2581
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Article ; Online: Identification of patients who may benefit the most from adjuvant chemotherapy following resection of incidental gallbladder carcinoma.

Xiang, Jun-Xi / Zhang, Xu-Feng / Weber, Sharon M / Poultsides, George / Fields, Ryan C / Hatzaras, Ioannis / Weiss, Matthew / Scoggins, Charles / Idrees, Kamron / Shen, Perry / Maithel, Shishir K / Pawlik, Timothy M

Journal of surgical oncology

2021 Volume 123, Issue 4, Page(s) 978–985

Abstract: Background: To develop a scoring system to identify the subset of patients who may benefit the most from adjuvant chemotherapy following curative-intent resection for incidental gallbladder cancer (IGBC).: Methods: A novel scoring system was utilized ...

Abstract	Background: To develop a scoring system to identify the subset of patients who may benefit the most from adjuvant chemotherapy following curative-intent resection for incidental gallbladder cancer (IGBC). Methods: A novel scoring system was utilized to stratify patients relative to overall survival (OS), as well as potential benefit from adjuvant chemotherapy following curative resection for IGBC. Results: Among 266 patients with IGBC, a total of 99 (37.2%) patients received adjuvant chemotherapy. Five risk factors were used to develop an integer-based score to predict OS. Risk of death at 5-years incrementally increased among patients in the low (n = 42, 69.0%), medium (n = 64, 56.3%) and high-risk groups (n = 40, 30.0%) (median OS, 99.4 vs. 33.5 vs. 15.6 months, all p < .001). Use of adjuvant chemotherapy did not provide a survival benefit among patients in the low-risk group (median survival, 99.4 vs. 60.7 months, p = .56). In contrast, utilization of adjuvant chemotherapy was associated with an improvement in survival among medium- (median survival, 21.7 vs. 59.5 months, p = .04) and high-risk patients (median survival, 11.6 vs. 20.1 months, p = .01). Conclusions: While low-risk patients did not benefit from adjuvant chemotherapy, individuals with medium or high-risk scores had an improved survival with the utilization of adjuvant chemotherapy.
MeSH term(s)	Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemotherapy, Adjuvant/mortality ; Female ; Follow-Up Studies ; Gallbladder Neoplasms/drug therapy ; Gallbladder Neoplasms/pathology ; Gallbladder Neoplasms/surgery ; Humans ; Incidental Findings ; Male ; Middle Aged ; Patient Selection ; Prognosis ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2021-01-26
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.26389
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Article ; Online: The Impact of Primary Care Providers on Patient Screening Mammography and Initial Presentation in an Underserved Clinical Setting.

Keshinro, Ajaratu / Hatzaras, Ioannis / Rifkind, Kenneth / Dhage, Shubhada / Joseph, Kathie-Ann

Annals of surgical oncology

2017 Volume 24, Issue 3, Page(s) 692–697

Abstract: Introduction: Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are ... ...

Abstract	Introduction: Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. Methods: We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis. Additional variables included race, age at diagnosis, family history of breast and ovarian cancer, and medical comorbidities. Results: Patients with a PCP received more mammograms (SMG) compared with patients without a PCP (61 vs. 37 %; p = 0.003). The majority (73 %) of patients without a PCP presented symptomatically with a palpable mass versus 42 % of patients with a PCP. A significant difference was noted with regard to final pathologic stage of breast cancer between the two groups (p = 0.019), and Caucasian and African American patients were more likely to have locally advanced breast cancer. Conclusions: Underserved patients with a PCP are more likely to present asymptomatically and at an earlier stage of breast cancer compared with patients without a PCP. Community engagement programs that build relationships with patients may help bring vulnerable patients into the healthcare system for routine screening. Moreover, PCP education regarding the subtleties of breast cancer screening guidelines and referral to a breast specialist is also critical in improving outcomes of underserved patients.
Language	English
Publishing date	2017-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-016-5618-0
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Article ; Online: Surgical Strategies for Bismuth Type I and II Hilar Cholangiocarcinoma: Impact on Long-Term Outcomes.

Zhang, Xu-Feng / Zhang, Nan / Tsilimigras, Diamantis I / Weber, Sharon M / Poultsides, George / Hatzaras, Ioannis / Fields, Ryan C / He, Jin / Scoggins, Charles / Idrees, Kamron / Shen, Perry / Maithel, Shishir K / Pawlik, Timothy M

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2021 Volume 25, Issue 12, Page(s) 3084–3091

Abstract: Background: The surgical approach to treat Bismuth type I and II hilar cholangiocarcinoma (HCCA) has been a topic of debate. We sought to characterize whether bile duct resection (BDR) with or without concomitant hepatic resection (HR) was associated ... ...

Abstract	Background: The surgical approach to treat Bismuth type I and II hilar cholangiocarcinoma (HCCA) has been a topic of debate. We sought to characterize whether bile duct resection (BDR) with or without concomitant hepatic resection (HR) was associated with R0 margin status, as well as define the impact of HR+BDR versus BDR alone on long-term survival. Methods: Patients who underwent curative-intent HR+BDR for HCCA between 2000 and 2014 were identified from a multi-institutional database. Perioperative and long-term outcomes were compared among patients who underwent BDR only, BDR+left hepatic resection (LHR), and BDR+right hepatic resection (RHR) for Bismuth type I and II HCCA. Results: Among 257 patients with HCCA, 61 (23.7%) patients had a Bismuth type I (n=25, 41.0%) or II (n=36, 59.0%) lesion. The incidence of R0 resection after BDR only was the same as among patients after LHR and RHR (BDR 70.0% vs. BDR+LHR 71.4% vs. BDR+RHR 76.5%, p=0.891). In contrast, severe complications were more likely after LHR and RHR than BDR only (BDR 21.4% vs. BDR+LHR 60.0% and BDR+RHR 50.0%, p=0.041). Overall (median: BDR 20.9 vs. BDR+LHR 23.2 and BDR+RHR 25.0 months, p=0.213) and recurrence-free (median: BDR 13.4 vs. BDR+LHR 15.3 and BDR+RHR 25.0, p= 0.109) survival were comparable. On multivariable analysis, while CA19-9>37.0U/ml (Ref. CA19-9≤37.0U/ml, HR 3.2, 95% CI 1.1-9.4, p=0.035) and AJCC T3-T4 disease (Ref. T1-T2, HR 4.6, 95% CI 1.5-13.7, p=0.007) were associated with long-term survival, surgical approach was not (BDR+LHR: HR 1.0, 95% CI 0.5-2.2, p=0.937; BDR+RHR: HR 0.6, 95% CI 0.3-1.3, p=0.197). Conclusion: R0 resection, overall survival, and recurrence-free survival were comparable among well-selected patients who had BDR versus BDR+HR for Bismuth type I and II HCCA.
MeSH term(s)	Bile Duct Neoplasms/surgery ; Bile Ducts ; Cholangiocarcinoma/surgery ; Hepatectomy ; Humans ; Klatskin Tumor/surgery ; Neoplasm Staging ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-06-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-021-05049-3
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Zs.A 5207: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Survival benefit of lymphadenectomy for gallbladder cancer based on the therapeutic index: An analysis of the US extrahepatic biliary malignancy consortium.

Sahara, Kota / Tsilimigras, Diamantis I / Maithel, Shishir K / Abbott, Daniel E / Poultsides, George A / Hatzaras, Ioannis / Fields, Ryan C / Weiss, Matthew / Scoggins, Charles / Isom, Chelsea A / Idrees, Kamran / Shen, Perry / Endo, Itaru / Pawlik, Timothy M

Journal of surgical oncology

2020 Volume 121, Issue 3, Page(s) 503–510

Abstract: Background: The survival benefit of lymphadenectomy among patients with gallbladder cancer (GBC) remains poorly understood.: Methods: Patients who underwent resection for GBC between 2000 and 2015 were identified from a US multi-institutional ... ...

Abstract	Background: The survival benefit of lymphadenectomy among patients with gallbladder cancer (GBC) remains poorly understood. Methods: Patients who underwent resection for GBC between 2000 and 2015 were identified from a US multi-institutional database. The therapeutic index (LNM rate multiplied by 3-year overall survival [OS]) was determined to assess the survival benefit of lymphadenectomy. Results: Among 449 patients, less than half had LNM (N = 183, 40.8%). The median number of evaluated and metastatic lymph nodes (LNs) was 3 (interquartile range [IQR]: 1-6) and 1 (IQR: 0-1), respectively. 3-year OS among patients with LNM in the entire cohort was 26.8%. The therapeutic index was lower among patients with T4 (5.9) or T1 (6.0) tumors as well as carbohydrate antigen (CA19-9) ≥200 UI/mL (6.0). Of note, a therapeutic index difference ≥10 was noted relative to CA19-9 (<200: 18.7 vs ≥200: 6.0), American Joint Committee on Cancer T Stage (T1: 6.0 vs T2: 17.8 vs T4: 5.9) and number of LNs examined (1-2: 6.9 vs ≥6: 16.9). Concomitant common bile duct resection was not associated with a higher therapeutic index among patients with either T2 or T3 disease. Conclusion: Certain clinicopathological factors including T1 or T4 tumor and CA19-9 ≥200 UI/mL were associated with a low therapeutic index. Resection of six or more LNs was associated with a meaningful therapeutic index benefit among patients with LNM.
MeSH term(s)	Aged ; Cohort Studies ; Common Bile Duct/surgery ; Databases, Factual ; Female ; Gallbladder Neoplasms/mortality ; Gallbladder Neoplasms/pathology ; Gallbladder Neoplasms/surgery ; Humans ; Kaplan-Meier Estimate ; Lymph Node Excision/methods ; Lymph Node Excision/mortality ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Male ; Middle Aged ; Neoplasm Staging ; Survival Rate ; Therapeutic Index ; United States/epidemiology
Language	English
Publishing date	2020-01-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.25825
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Article ; Online: Antigen-Directed Cancer Surgery for Primary Colorectal Cancer: 15-Year Survival Analysis: A Reply.

Povoski, Stephen P / Hatzaras, Ioannis S / Mojzisik, Cathy M / Arnold, Mark W / Hitchcock, Charles L / Martin, Edward W

Annals of surgical oncology

2017 Volume 24, Issue Suppl 3, Page(s) 610–611

MeSH term(s)	Colorectal Neoplasms ; Humans ; Survival Analysis
Language	English
Publishing date	2017-10-30
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-017-6201-z
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Article ; Online: Treatment options and surveillance strategies after therapy for hepatocellular carcinoma.

Hatzaras, Ioannis / Bischof, Danielle A / Fahy, Bridget / Cosgrove, David / Pawlik, Timothy M

Annals of surgical oncology

2014 Volume 21, Issue 3, Page(s) 758–766

Abstract: Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the third leading cause of cancer death worldwide. Recurrence rates after curative intent treatment for HCC are high; 5-year disease-free survival ranges from only 19 ... ...

Abstract	Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the third leading cause of cancer death worldwide. Recurrence rates after curative intent treatment for HCC are high; 5-year disease-free survival ranges from only 19 to 81 %. There is no direct evidence to guide the optimal frequency and method of surveillance for recurrent HCC after curative intent treatment. In contrast, there is strong evidence supporting both primary screening for HCC in patients with chronic liver disease. After resection, HCC tends to recur locally, whereas the pattern after transplantation is more at extrahepatic sites. In theory, if an HCC recurrence is discovered early, more therapeutic options are available for treatment of the recurrent HCC. As such, close surveillance after curative intent therapy may have the potential to prolong survival. We herein review the available literature derived from primary surveillance of patients with cirrhosis, as well as data on postoperative surveillance of HCC patients. In aggregate, although data remain scarce, close surveillance with α-fetoprotein and cross-sectional imaging every 3-4 months for 3 years after curative intent therapy, followed by surveillance every 6-12 months thereafter, seems the most prudent approach to follow-up of patients with HCC in the postsurgical setting.
MeSH term(s)	Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/therapy ; Combined Modality Therapy ; Continuity of Patient Care ; Diagnostic Tests, Routine/statistics & numerical data ; Diagnostic Tests, Routine/trends ; Follow-Up Studies ; Humans ; Liver Neoplasms/diagnosis ; Liver Neoplasms/mortality ; Liver Neoplasms/therapy ; Neoplasm Recurrence, Local/diagnosis ; Population Surveillance ; Prognosis ; Survival Rate ; Survivors
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-013-3254-5
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Article ; Online: Oncologic theranostics: recognition of this concept in antigen-directed cancer therapy for colorectal cancer with anti-TAG-72 monoclonal antibodies.

Povoski, Stephen P / Hatzaras, Ioannis S / Mojzisik, Cathy M / Martin, Edward W

Expert review of molecular diagnostics

2011 Volume 11, Issue 7, Page(s) 667–670

MeSH term(s)	Antibodies, Monoclonal/immunology ; Antibodies, Monoclonal/therapeutic use ; Antigens, Neoplasm/immunology ; Antineoplastic Agents/immunology ; Antineoplastic Agents/therapeutic use ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/immunology ; Colorectal Neoplasms/therapy ; Glycoproteins/antagonists & inhibitors ; Glycoproteins/immunology ; Humans
Chemical Substances	Antibodies, Monoclonal ; Antigens, Neoplasm ; Antineoplastic Agents ; Glycoproteins ; tumor-associated antigen 72
Language	English
Publishing date	2011-09
Publishing country	England
Document type	Editorial
ZDB-ID	2112530-2
ISSN	1744-8352 ; 1473-7159
ISSN (online)	1744-8352
ISSN	1473-7159
DOI	10.1586/erm.11.54
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