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Article: Current Landscape of Immune Checkpoint Inhibitor Therapy for Hepatocellular Carcinoma.

Machairas, Nikolaos / Tsilimigras, Diamantis I / Pawlik, Timothy M

2022 Volume 14, Issue 8

Abstract: Hepatocellular carcinoma (HCC) is the most frequent primary liver tumor. As a result of advanced disease being often present at diagnosis, only a small percentage of patients are amenable to curative-intent treatment options such as surgical resection ... ...

Abstract	Hepatocellular carcinoma (HCC) is the most frequent primary liver tumor. As a result of advanced disease being often present at diagnosis, only a small percentage of patients are amenable to curative-intent treatment options such as surgical resection and liver transplantation. Systemic therapy consisting of tyrosine kinase inhibitors such as sorafenib had been used for over a decade with limited efficacy. More recently, treatment with immune checkpoint inhibitors has revolutionized the treatment landscape of various malignant tumors. With this shifting paradigm, recent data have demonstrated encouraging outcomes among patients with HCC. In particular, several trials have investigated the safety and efficacy of various immune checkpoint inhibitors (ICI) either as monotherapy or in the form of combined treatments. We sought to provide an overview of recent clinical trials among patients with advanced HCC as well as to highlight predictors of response and immune-related adverse events and to review the evidence on perioperative administration of ICI in patients with resectable HCC.
Language	English
Publishing date	2022-04-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14082018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Laparoscopic liver surgery: yesterday, today and tomorrow.

Machairas, Nikolaos / Sotiropoulos, Georgios C

Hepatobiliary surgery and nutrition

2019 Volume 8, Issue 3, Page(s) 324–326

Language	English
Publishing date	2019-06-11
Publishing country	China (Republic : 1949- )
Document type	Journal Article ; Comment
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn.2019.01.12
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Article ; Online: State-of-the-art surgery for hepatocellular carcinoma.

Machairas, Nikolaos / Tsilimigras, Diamantis I / Pawlik, Timothy M

Langenbeck's archives of surgery

2021 Volume 406, Issue 7, Page(s) 2151–2162

Abstract: Background: Hepatocellular carcinoma (HCC) is the most commonly diagnosed primary liver tumor with an increasing incidence worldwide. Management of patients with HCC is largely dictated by the presence of cirrhosis, disease stage, underlying liver ... ...

Abstract	Background: Hepatocellular carcinoma (HCC) is the most commonly diagnosed primary liver tumor with an increasing incidence worldwide. Management of patients with HCC is largely dictated by the presence of cirrhosis, disease stage, underlying liver function, and patient performance status. Purpose: We provide an update on key aspects of surgical treatment options for patients with HCC. RESULTS & CONCLUSIONS: Liver resection and transplantation remain cornerstone treatment options for patients with early-stage disease and constitute the only potentially curative options for HCC. Selection of patients for surgical treatment should include a thorough evaluation of tumor characteristics and biology, as well as evidence-based use of various available treatment options to achieve optimal long-term outcomes for patients with HCC.
MeSH term(s)	Carcinoma, Hepatocellular/surgery ; Hepatectomy ; Humans ; Liver Cirrhosis ; Liver Neoplasms/surgery ; Liver Transplantation
Language	English
Publishing date	2021-08-18
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/s00423-021-02298-3
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Article ; Online: Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: An individual participant data meta-analysis.

Mylonakis, Adam / Driva, Tatiana S / Lykoudis, Panagis / Frountzas, Maximos / Machairas, Nikolaos / Tsapralis, Dimitrios / Toutouzas, Konstantinos G / Schizas, Dimitrios

Annals of hepato-biliary-pancreatic surgery

2024

Abstract: Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGCs) of the pancreas is a rare neoplasm that accounts for less than 1% of all pancreatic malignancies. The aim of this study was to review the literature regarding UC-OGC, and to highlight ... ...

Abstract	Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGCs) of the pancreas is a rare neoplasm that accounts for less than 1% of all pancreatic malignancies. The aim of this study was to review the literature regarding UC-OGC, and to highlight its biological behavior, clinicopathologic characteristics, prognosis, and therapeutic options. A systematic review of the literature in PubMed/Medline and Scopus databases was performed (last search October 31st, 2023) for articles concerning pancreatic UC-OGC in the adult population. Fifty-seven studies met the inclusion criteria, involving 69 patients with a male-to-female ratio of 1.1:1 and a mean age of 62.96. Main symptoms included abdominal pain (33.3%), jaundice (14.5%), weight loss (8.7%), while fourteen patients (20.3%) were asymptomatic. Surgical resection was performed in 88.4% of cases. Survival rates at one, three, and five years were 58%, 44.7%, and 37.3% respectively. Sex, age, size (cut-off of 4 cm), location, and adjuvant treatment did not significantly affect patient survival. UC-OGC of the pancreas is a rare subtype of undifferentiated pancreatic carcinoma with a better prognosis than conventional pancreatic ductal adenocarcinoma or undifferentiated carcinoma without giant cells. The establishment of a dedicated patient registry is imperative to further delineate the optimal treatment for this uncommon clinical entity.
Language	English
Publishing date	2024-02-23
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	3012179-6
ISSN	2508-5859 ; 2508-5778
ISSN (online)	2508-5859
ISSN	2508-5778
DOI	10.14701/ahbps.23-161
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Article ; Online: The EPH/Ephrin System in Pancreatic Ductal Adenocarcinoma (PDAC): From Pathogenesis to Treatment.

Papadakos, Stavros P / Dedes, Nikolaos / Gkolemi, Nikolina / Machairas, Nikolaos / Theocharis, Stamatios

International journal of molecular sciences

2023 Volume 24, Issue 3

Abstract: Pancreatic ductal adenocarcinoma (PDAC) is a major concern for health care systems worldwide, since its mortality remains unaltered despite the surge in cutting-edge science. The EPH/ephrin signaling system was first investigated in the 1980s. EPH/ ... ...

Abstract	Pancreatic ductal adenocarcinoma (PDAC) is a major concern for health care systems worldwide, since its mortality remains unaltered despite the surge in cutting-edge science. The EPH/ephrin signaling system was first investigated in the 1980s. EPH/ephrins have been shown to exert bidirectional signaling and cell-to-cell communication, influencing cellular morphology, adhesion, migration and invasion. Recent studies have highlighted the critical role of the EPH/ephrin system in various physiologic processes, including cellular proliferation, survival, synaptic plasticity and angiogenesis. Thus, it has become evident that the EPH/ephrin signaling system may have compelling effects on cell homeostasis that contribute to carcinogenesis. In particular, the EPH/ephrins have an impact on pancreatic morphogenesis and development, whereas several EPHs and ephrins are altered in PDAC. Several clinical and preclinical studies have attempted to elucidate the effects of the EPH/ephrin pathway, with multilayered effects on PDAC development. These studies have highlighted its highly promising role in the diagnosis, prognosis and therapeutic management of PDAC. The aim of this review is to explore the obscure aspects of the EPH/ephrin system concerning the development, physiology and homeostasis of the pancreas.
MeSH term(s)	Humans ; Ephrins/metabolism ; Receptors, Eph Family/metabolism ; Signal Transduction/physiology ; Pancreas/metabolism ; Adenocarcinoma
Chemical Substances	Ephrins ; Receptors, Eph Family (EC 2.7.10.1)
Language	English
Publishing date	2023-02-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24033015
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Article: Simultaneous resection of synchronous colorectal liver metastases: a promising alternative to staged resections.

Machairas, Nikolaos / de Santibañes, Martin / Dorovinis, Panagiotis / Frampton, Adam Enver

Hepatobiliary surgery and nutrition

2021 Volume 10, Issue 5, Page(s) 720–723

Language	English
Publishing date	2021-10-25
Publishing country	China (Republic : 1949- )
Document type	Editorial ; Comment
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn-21-210
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Article ; Online: Management of Bilateral Metachronous Adrenal Metastases from Hepatocellular Carcinoma.

Dorovinis, Panagiotis / Machairas, Nikolaos / Keramida, Myrto D / Kykalos, Stylianos / Dimitroulis, Dimitrios / Sotiropoulos, Georgios C

Journal of gastrointestinal cancer

2022 Volume 54, Issue 3, Page(s) 979–981

MeSH term(s)	Humans ; Carcinoma, Hepatocellular/therapy ; Carcinoma, Hepatocellular/secondary ; Liver Neoplasms/therapy ; Liver Neoplasms/pathology ; Adrenal Gland Neoplasms/surgery ; Adrenal Gland Neoplasms/secondary ; Tomography, X-Ray Computed ; alpha-Fetoproteins
Chemical Substances	alpha-Fetoproteins
Language	English
Publishing date	2022-08-02
Publishing country	United States
Document type	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/s12029-022-00854-8
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Article ; Online: Contamination of the Preservation Solution in Solid Organ Transplantation.

Sotiropoulos, G C / Kostakis, I D / Prodromidou, A / Garoufalia, Z / Stamopoulos, P / Machairas, N

Transplantation proceedings

2019 Volume 51, Issue 2, Page(s) 392–395

Abstract: Introduction: Preservation solutions (PS), in which grafts for patients undergoing liver transplantation are stored, represent a medium suitable for microorganism growth and a potential source for transmission of pathogenic germs to the transplant ... ...

Abstract	Introduction: Preservation solutions (PS), in which grafts for patients undergoing liver transplantation are stored, represent a medium suitable for microorganism growth and a potential source for transmission of pathogenic germs to the transplant recipients. The aim of the present study was to review the relevant literature for the incidence and predictors of positive microbiological findings in the PS. Patients and methods: We performed a literature review of publications on bacterial and fungal contamination of PS during cold organ storage focusing on its impact on bacteremia and/or nosocomial infection of the recipient. Results: Overall 19 studies were reviewed, published between the years 2000 and 2016, that encompassed a total of 5647 patients. Positive cultures were identified in 1428 patients (25%). The documentation of bacteremia showed a wide deviation with documented ranges between 0% and 69%. Data on the identification of same species or of related nosocomial infections were only sparsely available; same species were found in a rate of 0% to 8%, and nosocomial infections were attributed to them in an incidence of 0% to 19%. Conclusions: Our study underlines both the limited published data and the contradictory available information on contamination of preservation solution in solid organ transplantation, not allowing for any recommendations. The necessity for prospective, multicentric studies on this topic is mandatory.
MeSH term(s)	Adult ; Cross Infection/epidemiology ; Cross Infection/etiology ; Drug Contamination/statistics & numerical data ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Organ Preservation/adverse effects ; Organ Preservation/methods ; Organ Preservation Solutions/adverse effects ; Organ Transplantation/adverse effects ; Prospective Studies ; Transplant Recipients
Chemical Substances	Organ Preservation Solutions
Language	English
Publishing date	2019-01-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2019.01.070
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Article ; Online: Prediction of Microvascular Tumor Invasion in Liver Transplant Candidates With Hepatocellular Carcinoma: A Feasible Concept or a Misleading Illusion?

Sotiropoulos, G C / Machairas, N / Fouzas, I / Vernadakis, S / Paul, A / Wohlschlaeger, J

Transplantation proceedings

2019 Volume 51, Issue 2, Page(s) 421–423

Abstract: Introduction: Hepatocellular carcinoma (HCC) in cirrhosis is a widely accepted indication for liver transplantation (LT). Many scoring systems have been proposed intending to an extension of the established Milan criteria. Bridging treatments are ... ...

Abstract	Introduction: Hepatocellular carcinoma (HCC) in cirrhosis is a widely accepted indication for liver transplantation (LT). Many scoring systems have been proposed intending to an extension of the established Milan criteria. Bridging treatments are systematically applied in order to maintain or to downstage such patients to the listing criteria. The objective of our study was to estimate the feasibility of the prediction of microvascular tumor invasion in transplant candidates. Patients and methods: Data corresponding to transplanted HCC patients were reviewed for the purposes of this study. All tumor slices were blindly re-evaluated by a single pathologist in order to score for tumor necrosis and microvascular invasion. Recipients of pediatric or split LT were excluded. Results: Eighty patients (30 women and 50 men) were included in the study. Tumor necrosis was absent in 29 of 80 liver explants (36.25%). In the majority of instances (63.75%) tumor necrosis was evident in proportions between 5% and 100%. In 58 liver explants showing 0%-60% tumor necrosis and 22 liver explants showing > 60% tumor necrosis, microvascular tumor invasion was detectable in 11 and 0 cases, respectively (P = .0385). Conclusion: In about one-fourth of the cases (27.5%) microvascular tumor invasion could not be detected due to extended areas of tumor necrosis. Preoperative detection of microvascular invasion is misleading.
MeSH term(s)	Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular/pathology ; Female ; Humans ; Liver Cirrhosis/complications ; Liver Neoplasms/pathology ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Invasiveness/pathology ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2019-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2019.01.016
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Article ; Online: Laparoscopic parastomal hernia repair: keyhole, Sugarbaker, sandwich, or hybrid technique with 3D mesh? An updated systematic review and meta-analysis.

Kritharides, Nicos / Papaconstantinou, Dimitrios / Kykalos, Stylianos / Machairas, Nikolaos / Schizas, Dimitrios / Nikiteas, Nikolaos I / Dimitroulis, Dimitrios

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 448

Abstract: Purpose: Parastomal hernia is the most common complication after stoma formation with an incidence that approaches 50% at 2 years postoperatively. In the last decade, different approaches of minimally invasive procedures have been proposed for the ... ...

Abstract	Purpose: Parastomal hernia is the most common complication after stoma formation with an incidence that approaches 50% at 2 years postoperatively. In the last decade, different approaches of minimally invasive procedures have been proposed for the treatment of parastomal hernia. Nevertheless, the superiority of one technique over the others remains still unclear. Our objective was to update and systematically analyze current state of research concerning the postoperative outcomes of the four most prevalent minimally invasive techniques. Methods: A systematic literature search of three databases (Medline, Scopus, Google Scholar) was undertaken for articles published from January 2015 to November 2022. Fifteen studies from a previous meta-analysis on the topic were included. Results: Thirty-three studies incorporating 1289 total patients were deemed eligible for inclusion in the final analysis. The keyhole technique was associated with the highest incidence of postoperative complications and recurrences (31.3% and 24.1%, respectively), followed by the Sugarbaker technique (27.6% and 9%, respectively). Operative time was among the lowest in patients operated with the 3D mesh technique, while patients undergoing the keyhole technique experienced the shortest cumulative length of hospital stay (6 days). Conclusion: Each technique demonstrates a unique profile of effectiveness offset by the propensity towards developing postoperative complications. While no conclusive evidence on the optimal technique exist to date, newer minimally invasive techniques show promising results, albeit based on limited data. The future of parastomal hernia repair seems to rely on a highly individualized approach, tailored to the distinctive characteristics of both the hernia and the patient.
MeSH term(s)	Humans ; Herniorrhaphy/adverse effects ; Surgical Mesh/adverse effects ; Incisional Hernia/etiology ; Incisional Hernia/surgery ; Surgical Stomas/adverse effects ; Hernia/complications ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Hernia, Ventral/etiology ; Hernia, Ventral/surgery
Language	English
Publishing date	2023-11-29
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-03177-9
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