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  1. Article ; Online: Solid Pseudopapillary Neoplasms of the Pancreas: a Single-Center Experience and Review of the Literature.

    Allam, Moustafa / Hidalgo Salinas, Camila / Machairas, Nikolaos / Kostakis, Ioannis D / Watkins, Jennifer / Fusai, Giuseppe Kito

    Journal of gastrointestinal cancer

    2021  Volume 53, Issue 2, Page(s) 460–465

    Abstract: Purpose: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare borderline tumours mainly affecting young female patients. The number of patients diagnosed with SPNs has increased significantly in the last decades owing to the increased use of cross- ...

    Abstract Purpose: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare borderline tumours mainly affecting young female patients. The number of patients diagnosed with SPNs has increased significantly in the last decades owing to the increased use of cross-sectional imaging investigating different abdominal symptoms, whilst a significant proportion are incidentally discovered during the process of evaluating other pathologies. We herein present our institutional experience of patients with SPN who underwent curative resection focusing on clinical, pathological features, and the long-term outcomes.
    Methods: All patients undergoing pancreatectomy in our institution for SPN from January 2010 until December 2018 were included. Clinical, perioperative, histological, and long-term outcomes were collected and analysed.
    Results: During the inclusion period, a total of 19 patients had a pathological diagnosis of SPNs after surgical resection. Sixteen of them were female (84%), while the median patient age was 30 (range 16-66) years. Nine patients (47%) underwent distal pancreatectomy and splenectomy, 2 (11%) underwent spleen preserving distal pancreatectomy, 6 (32%) underwent pancreatoduodenectomy, one (5%) underwent total pancreatectomy, and one (5%) central pancreatectomy. Seventeen patients underwent R0 resection. During a median follow-up of 23 months, no tumour recurrence or death was recorded.
    Conclusion: In our experience, SPNs are rare tumours with low malignant potentials. Surgical resection remains the gold standard treatment and is associated with good prognosis.
    MeSH term(s) Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/surgery ; Pancreas/pathology ; Pancreatectomy/methods ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Retrospective Studies ; Young Adult
    Language English
    Publishing date 2021-04-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2452514-5
    ISSN 1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
    ISSN (online) 1941-6636 ; 1559-0739
    ISSN 1941-6628 ; 1537-3649
    DOI 10.1007/s12029-021-00638-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Oncological outcomes after pancreatoduodenectomy for pancreatic ductal adenocarcinoma in octogenarians: case-control study.

    Pande, Rupaly / Attard, Joseph A / Al-Sarireh, Bilal / Bhogal, Ricky Harminder / Farrugia, Alexia / Fusai, Giuseppe / Harper, Simon / Hidalgo-Salinas, Camila / Jah, Asif / Marangoni, Gabriele / Mortimer, Matthew / Pizanias, Michail / Prachialias, Andreas / Roberts, Keith J / Hee, Chloe Sew / Soggiu, Fiammetta / Srinivasan, Parthi / Chatzizacharias, Nikolaos A

    BJS open

    2023  Volume 7, Issue 4

    Abstract: Background: By the end of this decade, 70 per cent of all diagnosed pancreatic ductal adenocarcinomas will be in the elderly. Surgical resection is the only curative option. In the elderly perioperative mortality is higher, while controversy still ... ...

    Abstract Background: By the end of this decade, 70 per cent of all diagnosed pancreatic ductal adenocarcinomas will be in the elderly. Surgical resection is the only curative option. In the elderly perioperative mortality is higher, while controversy still exists as to whether aggressive treatment offers any survival benefit. This study aimed to assess the oncological benefit of pancreatoduodenectomy in octogenarians with pancreatic ductal adenocarcinoma.
    Method: Retrospective multicentre case-control study of octogenarians and younger controls who underwent pancreatoduodenectomy for pancreatic ductal adenocarcinoma between 2008 and 2017. The primary endpoint was overall survival and the secondary endpoint was disease-free survival.
    Results: Overall, 220 patients were included. Although the Charlson co-morbidity index was higher in octogenerians, Eastern Cooperative Oncology Group performance status, ASA and pathological parameters were comparable. Adjuvant therapy was more frequently delivered in the younger group (n = 80, 73 per cent versus n = 58, 53 per cent, P = 0.006). There was no significant difference between octogenarians and controls in overall survival (20 versus 29 months, P = 0.095) or disease-free survival (19 versus 22 months, P = 0.742). On multivariable analysis, age was not an independent predictor of either oncological outcome measured.
    Conclusion: Octogenarians with pancreatic ductal adenocarcinoma of the head and uncinate process may benefit from comparable oncological outcomes to younger patients with surgical treatment. Due to the age- and disease-related frailty and co-morbidities, careful preoperative assessment and patient selection is of paramount importance.
    MeSH term(s) Aged ; Aged, 80 and over ; Humans ; Case-Control Studies ; Pancreaticoduodenectomy ; Octogenarians ; Pancreatic Neoplasms/surgery ; Carcinoma, Pancreatic Ductal/surgery ; Pancreatic Neoplasms
    Language English
    Publishing date 2023-07-11
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ISSN 2474-9842
    ISSN (online) 2474-9842
    DOI 10.1093/bjsopen/zrad053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Management of hilum infiltrating tumors of the liver: The impact of experience and standardization on outcome.

    Ratti, Francesca / Cipriani, Federica / Fiorentini, Guido / Hidalgo Salinas, Camila / Catena, Marco / Paganelli, Michele / Aldrighetti, Luca

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

    2018  Volume 51, Issue 1, Page(s) 135–141

    Abstract: Background: The primary endpoint of this study was to evaluate the outcome of surgery for perihilar cholangiocarcinoma in a high-volume tertiary referral center.: Methods: The study population consisted of 196 consecutive patients with histologically ...

    Abstract Background: The primary endpoint of this study was to evaluate the outcome of surgery for perihilar cholangiocarcinoma in a high-volume tertiary referral center.
    Methods: The study population consisted of 196 consecutive patients with histologically confirmed perihilar cholangiocarcinoma-PHC-who were candidates to surgical treatment. Factors affecting postoperative morbidity were evaluated in the whole series (primary endpoint) and after stratification of patients according to the following criteria: (a) perioperative management protocol implementation; (b) monocentric management (secondary endpoint).
    Results: The postoperative morbidity rate was 51.5% and mortality 4.1%. The most frequent cause of death was postoperative liver failure. At multivariate analysis, factors affecting the risk of morbidity were: side of hepatectomy, liver volume, intraoperative blood loss, preoperative optimization and single-center management. Patients treated according to preoperative optimization protocol, as well as patients with monocentric management experienced a significant reduction of postoperative morbidity. Preoperative optimization and single-center management significantly affected even long term outcome of patients.
    Conclusion: Despite continuous improvement in the surgical field, hilum-infiltrating tumors still remain associated with therapeutic and management challenges: a correct preoperative management in a tertiary referral center provides a benefit in terms of morbidity and mortality, thus improving long term results.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/mortality ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/surgery ; Disease-Free Survival ; Female ; Hepatectomy/methods ; Humans ; Klatskin Tumor/mortality ; Klatskin Tumor/pathology ; Klatskin Tumor/surgery ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Postoperative Complications/mortality ; Postoperative Complications/prevention & control ; Preoperative Care/standards ; Retrospective Studies ; Statistics, Nonparametric
    Language English
    Publishing date 2018-07-17
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1459373-7
    ISSN 1878-3562 ; 1125-8055
    ISSN (online) 1878-3562
    ISSN 1125-8055
    DOI 10.1016/j.dld.2018.07.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Short-term outcomes after pancreatoduodenectomy in octogenarians: multicentre case-control study.

    Attard, Joseph A / Al-Sarireh, Bilal / Bhogal, Ricky Harminder / Farrugia, Alexia / Fusai, Giuseppe / Harper, Simon / Hidalgo-Salinas, Camila / Jah, Asif / Marangoni, Gabriele / Mortimer, Matthew / Pizanias, Michail / Prachialias, Andreas / Roberts, Keith J / Sew Hee, Chloe / Soggiu, Fiammetta / Srinivasan, Parthi / Chatzizacharias, Nikolaos A

    The British journal of surgery

    2021  Volume 109, Issue 1, Page(s) 89–95

    Abstract: Background: Pancreatoduodenectomy (PD) is frequently the surgical treatment indicated for a number of pathologies. Elderly patients may be denied surgery because of concerns over poor perioperative outcomes. The aim of this study was to evaluate ... ...

    Abstract Background: Pancreatoduodenectomy (PD) is frequently the surgical treatment indicated for a number of pathologies. Elderly patients may be denied surgery because of concerns over poor perioperative outcomes. The aim of this study was to evaluate postoperative clinical outcomes and provide evidence on current UK practice in the elderly population after PD.
    Methods: This was a multicentre retrospective case-control study of octogenarians undergoing PD between January 2008 and December 2017, matched with younger controls from seven specialist centres in the UK. The primary endpoint was 90-day mortality. Secondary endpoints were index admission mortality, postoperative complications, and 30-day readmission rates.
    Results: In total, 235 octogenarians (median age 81 (range 80-90) years) and 235 controls (age 67 (31-79) years) were included in the study. Eastern Cooperative Oncology Group performance status (median 0 (range 0-3) versus 0 (0-2); P = 0.010) and Charlson Co-morbidity Index score (7 (6-11) versus 5 (2-9); P = 0.001) were higher for octogenarians than controls. Postoperative complication and 30-day readmission rates were comparable. The 90-day mortality rate was higher among octogenarians (9 versus 3 per cent; P = 0.030). Index admission mortality rates were comparable (4 versus 2 per cent; P = 0.160), indicating that the difference in mortality was related to deaths after hospital discharge. Despite the higher 90-day mortality rate in the octogenarian population, multivariable Cox regression analysis did not identify age as an independent predictor of postoperative mortality.
    Conclusion: Despite careful patient selection and comparable index admission mortality, 90-day and, particularly, out-of-hospital mortality rates were higher in octogenarians.
    MeSH term(s) Adult ; Age Factors ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy/adverse effects ; Pancreaticoduodenectomy/mortality ; Pancreaticoduodenectomy/statistics & numerical data ; Patient Readmission/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Sex Factors ; United Kingdom/epidemiology
    Language English
    Publishing date 2021-11-08
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znab374
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Liver resection and ablation for squamous cell carcinoma liver metastases.

    Engstrand, J / Abreu de Carvalho, L F / Aghayan, D / Balakrishnan, A / Belli, A / Björnsson, B / Dasari, B V M / Detry, O / Di Martino, M / Edwin, B / Erdmann, J / Fristedt, R / Fusai, G / Gimenez-Maurel, T / Hemmingsson, O / Hidalgo Salinas, C / Isaksson, B / Ivanecz, A / Izzo, F /
    Knoefel, W T / Kron, P / Lehwald-Tywuschik, N / Lesurtel, M / Lodge, J P A / Machairas, N / Marino, M V / Martin, V / Paterson, A / Rystedt, J / Sandström, P / Serrablo, A / Siriwardena, A K / Taflin, H / van Gulik, T M / Yaqub, S / Özden, I / Ramia, J M / Sturesson, C

    BJS open

    2021  Volume 5, Issue 4

    Abstract: Background: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ ...

    Abstract Background: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS).
    Method: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS.
    Results: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30).
    Conclusion: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.
    MeSH term(s) Carcinoma, Squamous Cell/surgery ; Cohort Studies ; Humans ; Liver Neoplasms/surgery ; Neoplasm Recurrence, Local/surgery ; Retrospective Studies
    Language English
    Publishing date 2021-08-24
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ISSN 2474-9842
    ISSN (online) 2474-9842
    DOI 10.1093/bjsopen/zrab060
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation.

    Manuel-Vázquez, Alba / Balakrishnan, Anita / Agami, Paul / Andersson, Bodil / Berrevoet, Frederik / Besselink, Marc G / Boggi, Ugo / Caputo, Damiano / Carabias, Alberto / Carrion-Alvarez, Lucia / Franco, Carmen Cepeda / Coppola, Alessandro / Dasari, Bobby V M / Diaz-Mercedes, Sherley / Feretis, Michail / Fondevila, Constantino / Fusai, Giuseppe Kito / Garcea, Giuseppe / Gonzabay, Victor /
    Bravo, Miguel Ángel Gómez / Gorris, Myrte / Hendrikx, Bart / Hidalgo-Salinas, Camila / Kadam, Prashant / Karavias, Dimitrios / Kauffmann, Emanuele / Kourdouli, Amar / La Vaccara, Vincenzo / van Laarhoven, Stijn / Leighton, James / Liem, Mike S L / Machairas, Nikolaos / Magouliotis, Dimitris / Mahmoud, Adel / Marino, Marco V / Massani, Marco / Requena, Paola Melgar / Mentor, Keno / Napoli, Niccolò / Nijhuis, Jorieke H T / Nikov, Andrej / Nistri, Cristina / Nunes, Victor / Ruiz, Eduardo Ortiz / Pandanaboyana, Sanjay / Saborido, Baltasar Pérez / Pohnán, Radek / Popa, Mariuca / Pérez, Belinda Sánchez / Bueno, Francisco Sánchez / Serrablo, Alejandro / Serradilla-Martín, Mario / Skipworth, James R A / Soreide, Kjetil / Symeonidis, Dimitris / Zacharoulis, Dimitris / Zelga, Piotr / Aliseda, Daniel / Santiago, María Jesús Castro / Mancilla, Carlos Fernández / Fragua, Raquel Latorre / Hughes, Daniel Llwyd / Llorente, Carmen Payá / Lesurtel, Mickaël / Gallagher, Tom / Ramia, José Manuel

    Langenbeck's archives of surgery

    2022  Volume 407, Issue 8, Page(s) 3447–3455

    Abstract: Purpose: A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort.: Methods: An ... ...

    Abstract Purpose: A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort.
    Methods: An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included.
    Results: A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score ≥ 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07-1.77), with a sensitivity of 57.1% and specificity of 64.4%.
    Conclusion: Patients with a Shin score ≤ 1 should undergo surveillance, while patients with a score ≥ 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.
    Language English
    Publishing date 2022-10-06
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-022-02687-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: REDISCOVER International Guidelines on the Perioperative Care of Surgical Patients With Borderline-resectable and Locally Advanced Pancreatic Cancer.

    Boggi, Ugo / Kauffmann, Emanuele / Napoli, Niccolò / Barreto, S George / Besselink, Marc G / Fusai, Giuseppe K / Hackert, Thilo / Abu Hilal, Mohammad / Marchegiani, Giovanni / Salvia, Roberto / Shrikhande, Shailesh / Truty, Mark / Werner, Jens / Wolfgang, Christopher / Bannone, Elisa / Capretti, Giovanni / Cattelani, Alice / Coppola, Alessandro / Cucchetti, Alessandro /
    De Sio, Davide / Di Dato, Armando / Di Meo, Giovanna / Fiorillo, Claudio / Gianfaldoni, Cesare / Ginesini, Michael / Hidalgo Salinas, Camila / Lai, Quirino / Miccoli, Mario / Montorsi, Roberto / Pagnanelli, Michele / Poli, Andrea / Ricci, Claudio / Sucameli, Francesco / Tamburrino, Domenico / Viti, Virginia / Addeo, Pietro F / Alfieri, Sergio / Bachellier, Philippe / Baiocchi, Gianluca / Balzano, Gianpaolo / Barbarello, Linda / Brolese, Alberto / Busquets, Juli / Butturini, Giovanni / Caniglia, Fabio / Caputo, Damiano / Casadei, Riccardo / Chunhua, Xi / Colangelo, Ettore / Coratti, Andrea / Costa, Francesca / Crafa, Francesco / Dalla Valle, Raffaele / De Carlis, Luciano / de Wilde, Roeland F / Del Chiaro, Marco / Di Benedetto, Fabrizio / Di Sebastiano, Pierluigi / Domak, Safi / Hogg, Melissa / Egorov, Vyacheslav I / Ercolani, Giorgio / Ettorre, Giuseppe Maria / Falconi, Massimo / Ferrari, Giovanni / Ferrero, Alessandro / Filauro, Marco / Giardino, Alessandro / Grazi, Gian Luca / Gruttaduaria, Salvatore / Izbicki, Jakob R / Jovine, Elio / Katz, Matthew / Keck, Tobias / Khatkov, Igor / Kiguchi, Gozo / Kooby, David / Lang, Hauke / Lombardo, Carlo / Malleo, Giuseppe / Massani, Marco / Mazzaferro, Vincenzo / Memeo, Riccardo / Miao, Yi / Mishima, Kohei / Molino, Carlo / Nagakawa, Yuichi / Nakamura, Masafumi / Nardo, Bruno / Panaro, Fabrizio / Pasquali, Claudio / Perrone, Vittorio / Rangelova, Elena / Riu, Long / Romagnoli, Renato / Romito, Raffaele / Rosso, Edoardo / Schulick, Richard / Siriwardena, Ajith / Spampinato, Marcello / Strobel, Oliver / Testini, Mario / Troisi, Roberto / Uzunoglo, Faik G / Valente, Roberto / Veneroni, Luigi / Zerbi, Alessandro / Vicente, Emilio / Vistoli, Fabio / Vivarelli, Marco / Wakabayashi, Go / Zanus, Giacomo / Zureikat, Amer / Zyromski, Nicholas J / Coppola, Roberto / D'Andrea, Vito / Davide, José / Dervenis, Christos / Frigerio, Isabella / Konlon, Kevin C / Michelassi, Fabrizio / Montorsi, Marco / Nealon, William / Portolani, Nazario / Sousa Silva, Donzília / Bozzi, Giuseppe / Ferrari, Viviana / Trivella, Maria G / Cameron, John / Clavien, Pierre-Alain / Asbun, Horacio J

    Annals of surgery

    2024  

    Abstract: Objective: The REDISCOVER consensus conference aimed at developing and validate guidelines on the perioperative care of patients with borderline resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC).: Summary background ... ...

    Abstract Objective: The REDISCOVER consensus conference aimed at developing and validate guidelines on the perioperative care of patients with borderline resectable (BR-) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC).
    Summary background data: Coupled with improvements in chemotherapy and radiation, the contemporary approach to pancreatic surgery supports resection of BR-PDAC and, to a lesser extent, LA-PDAC. Guidelines outlining the selection and perioperative care for these patients are lacking.
    Methods: The Scottish Intercollegiate Guidelines Network (SIGN) methodology was used to develop the REDISCOVER guidelines and create recommendations. The Delphi approach was used to reach consensus (agreement ≥80%) among experts. Recommendations were approved after a debate and vote among international experts in pancreatic surgery and pancreatic cancer management. A Validation Committee used the AGREE II-GRS tool to assess the methodological quality of the guidelines. Moreover, an independent multidisciplinary advisory group revised the statements to ensure adherence to non-surgical guidelines.
    Results: Overall, 34 recommendations were created targeting centralization, training, staging, patient selection for surgery, possibility of surgery in uncommon scenarios, timing of surgery, avoidance of vascular reconstruction, details of vascular resection/reconstruction, arterial divestment, frozen section histology of perivascular tissue, extent of lymphadenectomy, anticoagulation prophylaxis and role of minimally invasive surgery. The level of evidence was however low for 29 of 34 clinical questions. Participants agreed that the most conducive mean to promptly advance our understanding in this field is to establish an international registry addressing this patient population ( https://rediscover.unipi.it/ ).
    Conclusions: The REDISCOVER guidelines provide clinical recommendations pertaining to pancreatectomy with vascular resection for patients with BR- and LA-PDAC, and serve as the basis of a new international registry for this patient population.
    Language English
    Publishing date 2024-02-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000006248
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Perihilar Cholangiocarcinoma - Novel Benchmark Values for Surgical and Oncological Outcomes From 24 Expert Centers.

    Mueller, Matteo / Breuer, Eva / Mizuno, Takashi / Bartsch, Fabian / Ratti, Francesca / Benzing, Christian / Ammar-Khodja, Noémie / Sugiura, Teiichi / Takayashiki, Tsukasa / Hessheimer, Amelia / Kim, Hyung Sun / Ruzzenente, Andrea / Ahn, Keun Soo / Wong, Tiffany / Bednarsch, Jan / D'Silva, Mizelle / Koerkamp, Bas Groot / Jeddou, Heithem / López-López, Victor /
    de Ponthaud, Charles / Yonkus, Jennifer A / Ismail, Warsan / Nooijen, Lynn E / Hidalgo-Salinas, Camila / Kontis, Elissaios / Wagner, Kim C / Gunasekaran, Ganesh / Higuchi, Ryota / Gleisner, Ana / Shwaartz, Chaya / Sapisochin, Gonzalo / Schulick, Richard D / Yamamoto, Masakazu / Noji, Takehiro / Hirano, Satoshi / Schwartz, Myron / Oldhafer, Karl J / Prachalias, Andreas / Fusai, Giuseppe K / Erdmann, Joris I / Line, Pål-Dag / Smoot, Rory L / Soubrane, Olivier / Robles-Campos, Ricardo / Boudjema, Karim / Polak, Wojciech G / Han, Ho-Seong / Neumann, Ulf P / Lo, Chung-Mau / Kang, Koo Jeong / Guglielmi, Alfredo / Park, Joon Seong / Fondevila, Constantino / Ohtsuka, Masayuki / Uesaka, Katsuhiko / Adam, René / Pratschke, Johann / Aldrighetti, Luca / De Oliveira, Michelle L / Gores, Gregory J / Lang, Hauke / Nagino, Masato / Clavien, Pierre-Alain

    Annals of surgery

    2021  Volume 274, Issue 5, Page(s) 780–788

    Abstract: Objective: The aim of this study was to define robust benchmark values for the surgical treatment of perihilar cholangiocarcinomas (PHC) to enable unbiased comparisons.: Background: Despite ongoing efforts, postoperative mortality and morbidity ... ...

    Abstract Objective: The aim of this study was to define robust benchmark values for the surgical treatment of perihilar cholangiocarcinomas (PHC) to enable unbiased comparisons.
    Background: Despite ongoing efforts, postoperative mortality and morbidity remains high after complex liver surgery for PHC. Benchmark data of best achievable results in surgical PHC treatment are however still lacking.
    Methods: This study analyzed consecutive patients undergoing major liver surgery for PHC in 24 high-volume centers in 3 continents over the recent 5-year period (2014-2018) with a minimum follow-up of 1 year in each patient. Benchmark patients were those operated at high-volume centers (≥50 cases during the study period) without the need for vascular reconstruction due to tumor invasion, or the presence of significant co-morbidities such as severe obesity (body mass index ≥35), diabetes, or cardiovascular diseases. Benchmark cutoff values were derived from the 75th or 25th percentile of the median values of all benchmark centers.
    Results: Seven hundred eight (39%) of a total of 1829 consecutive patients qualified as benchmark cases. Benchmark cut-offs included: R0 resection ≥57%, postoperative liver failure (International Study Group of Liver Surgery): ≤35%; in-hospital and 3-month mortality rates ≤8% and ≤13%, respectively; 3-month grade 3 complications and the CCI: ≤70% and ≤30.5, respectively; bile leak-rate: ≤47% and 5-year overall survival of ≥39.7%. Centers operating mostly on complex cases disclosed better outcome including lower post-operative liver failure rates (4% vs 13%; P = 0.002). Centers from Asia disclosed better outcomes.
    Conclusion: Surgery for PHC remains associated with high morbidity and mortality with now the availability of benchmark values covering 21 outcome parameters, which may serve as key references for comparison in any future analyses of individuals, group of patients or centers.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Asia/epidemiology ; Benchmarking/standards ; Bile Duct Neoplasms/epidemiology ; Bile Duct Neoplasms/surgery ; Europe/epidemiology ; Female ; Follow-Up Studies ; Hepatectomy/standards ; Humans ; Klatskin Tumor/epidemiology ; Klatskin Tumor/surgery ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Retrospective Studies ; Time Factors ; United States/epidemiology
    Language English
    Publishing date 2021-07-27
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000005103
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective.

    D'Souza, Melroy A / Valdimarsson, Valentinus T / Campagnaro, Tommaso / Cauchy, Francois / Chatzizacharias, Nikolaos A / D'Hondt, Mathieu / Dasari, Bobby / Ferrero, Alessandro / Franken, Lotte C / Fusai, Giuseppe / Guglielmi, Alfredo / Hagendoorn, Jeroen / Hidalgo Salinas, Camila / Hoogwater, Frederik J H / Jorba, Rosa / Karanjia, Nariman / Knoefel, Wolfram T / Kron, Philipp / Lahiri, Rajiv /
    Langella, Serena / Le Roy, Bertrand / Lehwald-Tywuschik, Nadja / Lesurtel, Mickael / Li, Jun / Lodge, J Peter A / Martinou, Erini / Molenaar, Izaak Q / Nikov, Andrej / Poves, Ignasi / Rassam, Fadi / Russolillo, Nadia / Soubrane, Olivier / Stättner, Stefan / van Dam, Ronald M / van Gulik, Thomas M / Serrablo, Alejandro / Gallagher, Tom M / Sturesson, Christian

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

    2019  Volume 22, Issue 9, Page(s) 1339–1348

    Abstract: Background: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few ... ...

    Abstract Background: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers.
    Method: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed.
    Results: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival.
    Conclusion: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.
    MeSH term(s) Bile Duct Neoplasms/surgery ; Bile Ducts ; Bile Ducts, Intrahepatic ; Gallbladder Neoplasms/surgery ; Hepatectomy ; Humans ; Pancreaticoduodenectomy/adverse effects
    Language English
    Publishing date 2019-12-30
    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.2019.12.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    2020  

    Keywords covid19
    Language English
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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