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  1. Article ; Online: Complexity of trials on pain management in acute pancreatitis: an ongoing challenge.

    Kamarajah, Sivesh K / MacLennan, Graeme / Pandanaboyana, Sanjay

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2024  

    Language English
    Publishing date 2024-04-15
    Publishing country United States
    Document type Letter
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2024.03.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Predictors of textbook outcome following oesophagogastric cancer surgery.

    Velayudham, Ganesh K / Dermanis, Alexander / Kamarajah, Sivesh K / Griffiths, Ewen A

    Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

    2024  

    Abstract: Textbook outcome (TO) is a composite measure representing an ideal perioperative course, which has been utilized to assess the quality of care in oesophagogastric cancer (OGC) surgery. We aim to determine TO rates among OGC patients in a UK tertiary ... ...

    Abstract Textbook outcome (TO) is a composite measure representing an ideal perioperative course, which has been utilized to assess the quality of care in oesophagogastric cancer (OGC) surgery. We aim to determine TO rates among OGC patients in a UK tertiary center, investigate predictors of TO attainment, and evaluate the relationship between TO and survival. A retrospective analysis of a prospectively collected departmental database between 2006 and 2021 was conducted. Patients that underwent radical OGC surgery with curative intent were included. TO attainment required margin-negative resection, adequate lymphadenectomy, uncomplicated postoperative course, and no hospital readmission. Predictors of TO were investigated using multivariable logistic regression. The association between TO and survival was evaluated using Kaplan-Meier analysis and Cox regression modeling. In sum, 667 esophageal cancer and 312 gastric cancer patients were included. TO was achieved in 35.1% of esophagectomy patients and 51.3% of gastrectomy patients. Several factors were independently associated with a low likelihood of TO attainment: T3 stage (odds ratio (OR): 0.41, 95% confidence interval (CI) [0.22-0.79], p = 0.008) and T4 stage (OR:0.26, 95% CI [0.08-0.72], p = 0.013) in the esophagectomy cohort and high BMI (OR:0.93, 95% CI [0.88-0.98], p = 0.011) in the gastrectomy cohort. TO attainment was associated with greater overall survival and recurrence-free survival in esophagectomy and gastrectomy cohorts. TO is a relevant quality metric that can be utilized to compare surgical performance between centers and investigate patients at risk of TO failure. Enhancement of preoperative care measures can improve TO rates and, subsequently, long-term survival.
    Language English
    Publishing date 2024-03-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639470-x
    ISSN 1442-2050 ; 1120-8694
    ISSN (online) 1442-2050
    ISSN 1120-8694
    DOI 10.1093/dote/doae023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: The Evolution of Neo-Adjuvant Therapy in the Treatment of Oesophageal and Gastro-Oesophageal Junction Adenocarcinomas.

    Dermanis, Alexander A / Kamarajah, Sivesh K / Tan, Benjamin

    Cancers

    2023  Volume 15, Issue 19

    Abstract: Historically, oesophageal and gastro-oesophageal junction adenocarcinomas were associated with a poor prognosis. The advent of neoadjuvant therapy has transformed the management of oesophageal and gastro-oesophageal junction adenocarcinomas further and ... ...

    Abstract Historically, oesophageal and gastro-oesophageal junction adenocarcinomas were associated with a poor prognosis. The advent of neoadjuvant therapy has transformed the management of oesophageal and gastro-oesophageal junction adenocarcinomas further and offers the possibility to reverse disease progression, eliminate micrometastasis, and offer potentially better outcomes for these patients. This review provides an overview of landmark clinical trials in this area, with different treatment regimens considered over the years as well as potential therapeutic agents on the horizon that may transform the management of oesophageal and gastro-oesophageal junction adenocarcinomas further.
    Language English
    Publishing date 2023-09-27
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15194741
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  4. Article ; Online: Evaluation of the AJCC 8th Edition Staging System for Pathologically Versus Clinically Staged Intrahepatic Cholangiocarcinoma (iCCA): a Time to Revisit a Dogma? A Surveillance, Epidemiology, and End Results (SEER) Analysis.

    Kamarajah, Sivesh K

    Journal of gastrointestinal cancer

    2018  Volume 50, Issue 3, Page(s) 392–399

    Abstract: Background: Recently, the AJCC has released its 8th edition changes to the staging system for intrahepatic cholangiocarcinoma (iCCA). This study sought to validate the proposed changes to the 8th edition of AJCC system for T and N classification of iCCA ...

    Abstract Background: Recently, the AJCC has released its 8th edition changes to the staging system for intrahepatic cholangiocarcinoma (iCCA). This study sought to validate the proposed changes to the 8th edition of AJCC system for T and N classification of iCCA using a population-based data set.
    Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database (1998-2013), patients undergoing resection or non-surgical management for non-metastatic iCCA were identified. Overall survival was estimated using the Kaplan-Meier method and compared using log-rank tests. Concordance indices (c-indices) calculated from Cox proportional hazards models were calculated to evaluate discriminatory power.
    Results: The study included 2630 patients resected (37%) or non-surgically managed (63%) for iCCA. Nodal staging was performed in 56%, of whom 31% had positive nodes. For all patients with iCCA, the median 5-year survival by AJCC T classification for T1a, T1b, T2, T3, and T4 was 32, 21, 14, 10, and 10 months, respectively (p < 0.001). The concordance index for the staging system was 0.57 for all patients, 0.62 for those who underwent resection, and 0.54 for patients who did not undergo resection.
    Conclusion: In summary, the new AJCC 8th edition staging system is comparable to the 7th edition and valid in stratifying patients with iCCA. However, the performance of the staging system is better in patients undergoing surgical resection than those undergoing non-surgical management. These findings further highlight the need for improved accuracy of radiological imaging in clinically staging patients to guide prognosis.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/classification ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/surgery ; Cholangiocarcinoma/classification ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging/standards ; Prospective Studies ; SEER Program ; Survival Rate ; Young Adult
    Language English
    Publishing date 2018-03-12
    Publishing country United States
    Document type Comparative Study ; Journal Article
    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/s12029-018-0084-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Fibrosis score impacts survival following resection for hepatocellular carcinoma (HCC): A Surveillance, End Results and Epidemiology (SEER) database analysis.

    Kamarajah, Sivesh K

    Asian journal of surgery

    2018  Volume 41, Issue 6, Page(s) 551–561

    Abstract: Background/objectives: Surgical extirpation for hepatocellular carcinoma (HCC) with background fibrosis remains a challenge. This study evaluated impact of fibrosis score on long term outcomes of patients undergoing surgical resection for HCC.: ... ...

    Abstract Background/objectives: Surgical extirpation for hepatocellular carcinoma (HCC) with background fibrosis remains a challenge. This study evaluated impact of fibrosis score on long term outcomes of patients undergoing surgical resection for HCC.
    Methods: Using the Surveillance, Epidemiology and End Results (SEER) database (2004-2013), complete data on 1433 patients undergoing surgical resection for non-metastatic HCC were identified. Overall survival (OS) was estimated using the Kaplan-Meier method. Cox proportional hazards model were used to produce adjusted hazard ratios (HR).
    Results: In this study, 54% (650/1433) patients had F5-6 fibrosis at the time for surgical resection of HCC. In adjusted models, F5/6 fibrosis significantly reduces overall survival (HR: 1.62, 95% CI: 1.34-1.94; p < 0.001). Median survival was significantly longer for patients with F0-4 fibrosis for T1a, T1b and T2 tumours as compared to F5-6 fibrosis, not for T3 and T4 tumours, even when stratified by extent of hepatectomy. There were no significant differences in 90-day post-operative mortality between fibrosis groups when stratified by T-classifications.
    Conclusion: Liver resection in patients with advanced fibrosis has significantly lower survival as compared to patients with F0-4 fibrosis in early stage (T1 and T2), not advanced tumours (T3 and T4). Improvement in patient selection and perioperative care for liver resection may offer consistent and clinically meaningful long-term survival in HCC.
    MeSH term(s) Aged ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Female ; Fibrosis ; Hepatectomy/mortality ; Humans ; Liver/pathology ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Staging ; Survival Rate ; Treatment Outcome
    Language English
    Publishing date 2018-02-14
    Publishing country China
    Document type Journal Article
    ZDB-ID 1068461-x
    ISSN 0219-3108 ; 1015-9584
    ISSN (online) 0219-3108
    ISSN 1015-9584
    DOI 10.1016/j.asjsur.2018.01.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Esophagectomy or Total Gastrectomy for Siewert 2 Gastroesophageal Junction (GEJ) Adenocarcinoma: An Ongoing Debate.

    Kamarajah, Sivesh K / Markar, Sheraz R

    Annals of surgical oncology

    2021  Volume 29, Issue 1, Page(s) 750

    MeSH term(s) Adenocarcinoma/surgery ; Esophageal Neoplasms/surgery ; Esophagectomy ; Esophagogastric Junction/surgery ; Gastrectomy ; Humans ; Registries ; Surgical Oncology
    Language English
    Publishing date 2021-10-11
    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/s10434-021-10916-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: ASO Author Reflections: Is Neoadjuvant Chemotherapy Associated with Acceptable Short-Term Outcomes for Pancreatic Cancer?

    Kamarajah, Sivesh K / Dahdaleh, Fadi

    Annals of surgical oncology

    2021  Volume 28, Issue 4, Page(s) 1906–1907

    MeSH term(s) Humans ; Neoadjuvant Therapy ; Pancreatic Neoplasms/drug therapy
    Language English
    Publishing date 2021-01-02
    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/s10434-020-09472-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: ASO Author Reflections: Smoking Status Impact on Perioperative Morbidity and Long-Term Survival of Patients Undergoing Esophagectomy for Cancer.

    Kamarajah, Sivesh K / Phillips, Alexander W

    Annals of surgical oncology

    2021  Volume 28, Issue 9, Page(s) 4916–4917

    MeSH term(s) Esophageal Neoplasms/surgery ; Esophagectomy ; Humans ; Morbidity ; Smoking
    Language English
    Publishing date 2021-03-05
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-021-09765-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: ASO Author Reflections: Postoperative Chemotherapy After Neoadjuvant Therapy and Pancreatectomy for Pancreatic Cancer: Balancing Patient Physiology and Disease Biology.

    Kamarajah, Sivesh K / Dahdaleh, Fadi

    Annals of surgical oncology

    2021  Volume 28, Issue 11, Page(s) 6803–6804

    MeSH term(s) Biology ; Humans ; Neoadjuvant Therapy ; Pancreatectomy ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/surgery
    Language English
    Publishing date 2021-03-27
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-021-09896-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Strengths and Limitations of Registries in Surgical Oncology Research.

    Kamarajah, Sivesh K / Nathan, Hari

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

    2021  Volume 25, Issue 11, Page(s) 2989–2996

    Abstract: Over the past two decades, there has been a dramatic increase in studies based on large multi-institutional tumor registries. Applications of such databases span various research themes including epidemiology, oncology, surgical techniques, perioperative ...

    Abstract Over the past two decades, there has been a dramatic increase in studies based on large multi-institutional tumor registries. Applications of such databases span various research themes including epidemiology, oncology, surgical techniques, perioperative outcomes, and prognosis. Although these databases are acquired relatively easily, offer larger sample sizes and improved generalizability compared with institutional data, acknowledging limitations within analysis and cautious interpretation of data is important. Questionable conclusions can result when insufficient attention is paid to issues such as data quality and depth, potential sources of bias and missing data. This article reviews research themes and important limitations of these databases. The contemporary reporting of these issues in the literature and an increased awareness among surgical oncologists of potential applications and limitations will ensure that studies in the surgical oncology literature achieve high standards of methodological quality and clinical utility.
    MeSH term(s) Databases, Factual ; Humans ; Medical Oncology ; Registries ; Surgical Oncology
    Language English
    Publishing date 2021-09-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-021-05094-y
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