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Book: Manual of interventional radiology

Coldwell, Douglas M. / Kennedy, Andrew S. / Martin, Robert CG / Sharma, Vivek R.

2018

Author's details	Douglas M. Coldwell, Professor and Vice Chair of Radiology, Professor of Bioengineering and Director of Vacular and Interventional Radiology, University of Louisville, Kentucky, USA ; [Contributors Douglas M. Coldwell, Andrew S. Kennedy, Robert C. G. Martin, Vivek R. Sharma]
Keywords	Neoplasms / radiotherapy ; Combined Modality Therapy / methods ; Radiology, Interventional / organization & administration ; Radiology, Interventional / methods
Language	English
Size	xi, 217 Seiten, Illustrationen
Publisher	Thieme
Publishing place	New York
Publishing country	United States
Document type	Book
HBZ-ID	HT019560012
ISBN	978-1-62623-138-2 ; 9781626231962 ; 1-62623-138-9 ; 1626231966
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Developing sarcopenia during neoadjuvant therapy is associated with worse survival in esophageal adenocarcinoma patients.

Pierce, Katherine / Philips, Prejesh / Egger, Michael E / Scoggins, Charles R / Martin, Robert Cg

Surgery

2023 Volume 175, Issue 3, Page(s) 718–725

Abstract: Background: Sarcopenia in cancer patients has been associated with mixed postoperative outcomes. The aim of this study was to evaluate whether the development of sarcopenia during the neoadjuvant period is predictive of postoperative mortality in ... ...

Abstract	Background: Sarcopenia in cancer patients has been associated with mixed postoperative outcomes. The aim of this study was to evaluate whether the development of sarcopenia during the neoadjuvant period is predictive of postoperative mortality in esophageal adenocarcinoma patients. Methods: We queried a prospective database to retrieve the sarcopenic status of patients with esophageal adenocarcinoma who underwent cross-sectional imaging of the third lumbar vertebra at diagnosis and within 2 months of undergoing an esophagogastrectomy between 2014 and 2022. Results: Of the 71 patients included in the study, 36 (50.7%) presented with sarcopenia at diagnosis. Of the 35 non-sarcopenic patients, 14 (40%) developed sarcopenia during the neo-adjuvant period. Patients who were not sarcopenic at diagnosis but developed sarcopenia preoperatively had significantly worse overall survival than patients sarcopenic at diagnosis and not sarcopenic preoperatively and patients experiencing no change in sarcopenic status (median 18 vs 47 vs 31 months; P = .02). Diagnostic and preoperative sarcopenic status alone were not significantly associated with overall survival (P = .48 and P = .56, respectively). Although 37 (52.1%) patients died, the cause of death was often not cancer-related (54.1%) and included acute respiratory failure, pneumonia, and cardiac arrest. No significant survival difference was observed when stratified by >10% weight loss (P = .9) or large loss in body mass index (P = .8). Conclusion: Developing sarcopenia during the neo-adjuvant period may be associated with worse overall survival in patients requiring esophagogastrectomy.
MeSH term(s)	Humans ; Sarcopenia/diagnosis ; Sarcopenia/diagnostic imaging ; Neoadjuvant Therapy/adverse effects ; Esophageal Neoplasms/complications ; Esophageal Neoplasms/surgery ; Adenocarcinoma/complications ; Adenocarcinoma/surgery ; Retrospective Studies ; Prognosis
Language	English
Publishing date	2023-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2023.09.017
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Article ; Online: Hepatic Arterial Therapy for First-Line Treatment of Unresectable Colorectal Liver Metastases: What We Know in the Wake of Two Recent Randomized Control Trials.

Akinwande, Olaguoke / Martin, Robert Cg

Cardiovascular and interventional radiology

2017 Volume 40, Issue 2, Page(s) 315–317

MeSH term(s)	Aged ; Antineoplastic Agents/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemoembolization, Therapeutic/methods ; Colorectal Neoplasms/pathology ; Female ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/secondary ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Survival Analysis ; Treatment Outcome
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2017-02
Publishing country	United States
Document type	Letter ; Randomized Controlled Trial
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-016-1469-0
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Article ; Online: Laparoscopic microwave ablation versus percutaneous microwave ablation of hepatic malignancies: Efficacy and recurrence-free survival outcomes in patients.

Musick, Joslin R / Philips, Prejesh / Scoggins, Charles R / Egger, Michael E / McMasters, Kelly M / Martin, Robert Cg

Surgery

2022 Volume 173, Issue 3, Page(s) 598–602

Abstract: Background: Hepatic thermal ablation has been found to be effective and equivalent to resection in certain liver histologies. Of the 16,000 annual liver ablations performed in the United States, only 13% (2,080 ablations) are performed laparoscopically. ...

Abstract	Background: Hepatic thermal ablation has been found to be effective and equivalent to resection in certain liver histologies. Of the 16,000 annual liver ablations performed in the United States, only 13% (2,080 ablations) are performed laparoscopically. The laparoscopic technique remains underused even with the benefits of improved staging and better access to tumors. The purpose of this study is to compare laparoscopic microwave ablation versus percutaneous microwave ablation in terms of efficacy and recurrence-free survival outcomes in patients with hepatic malignancies. Methods: A comparative analysis was performed on 275 patients (289 ablation procedures) who underwent laparoscopic microwave ablation or percutaneous microwave ablation between February 2011 and May 2021. Ablation success was confirmed postprocedure and recurrence was monitored at follow-up via contrast-enhanced computed tomography/magnetic resonance imaging and/or computed tomography/positron emission tomography. Results: The groups were similar for sex, age, body mass index, location of tumor, size of tumor, and number of tumors. Ablation success was 100% in both groups. Local recurrence was significant (5%: laparoscopic microwave ablation vs 22%: percutaneous microwave ablation, P = .002) and same-lobe recurrence (21%: laparoscopic microwave ablation vs 24%: percutaneous microwave ablation) was lower in the laparoscopic microwave ablation group. Median recurrence-free survival was 15.8 months for the laparoscopic microwave ablation group and 5.6 months for the percutaneous microwave ablation group (P = .0002). Overall, 90-day complications were lower in the laparoscopic microwave ablation group (11%) compared with the percutaneous microwave ablation group (21%) (P = .11). Conclusion: Laparoscopic surgical ablation is a critical surgical skill that must be taught in fellowship. Laparoscopic microwave ablation leads to better tumor specific outcomes and oncologic outcomes demonstrating clinical efficacy in the treatment of hepatic malignancies compared with percutaneous microwave ablation.
MeSH term(s)	Humans ; Microwaves/therapeutic use ; Liver Neoplasms ; Treatment Outcome ; Ablation Techniques/methods ; Laparoscopy ; Retrospective Studies ; Catheter Ablation/methods ; Carcinoma, Hepatocellular
Language	English
Publishing date	2022-10-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2022.06.054
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Article: Epigenetic modulation enhances immunotherapy for pancreatic ductal adenocarcinoma.

Li, Yan / Hong, Young K / Wang, Xingtong / Pandit, Harshul / Zheng, Qianqian / Yu, Youxi / Shi, Xiaoju / Chen, Yujia / Tan, Min / Pulliam, Zachary / Bhutiani, Neal / Lin, Andrew / Badach, Jeremy / Zhang, Ping / Martin, Robert Cg

Clinical & translational immunology

2022 Volume 11, Issue 12, Page(s) e1430

Abstract: Objectives: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with a poor prognosis. PDAC has poor response to immunotherapy because of its unique tumour microenvironment (TME). In an attempt to stimulate immunologically silent pancreatic ...

Abstract	Objectives: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with a poor prognosis. PDAC has poor response to immunotherapy because of its unique tumour microenvironment (TME). In an attempt to stimulate immunologically silent pancreatic cancer, we investigated the role of epigenetic therapy in modulating the TME to improve immunogenicity. Methods: In vitro Results: Drug treatments induced significant upregulation of gene expressions of Th1-attracting chemokines, Conclusion: We demonstrate that immunotherapy for PDAC can be potentiated with epigenetic therapy by increasing cancer-associated antigen expression and increased T-cell trafficking across the immunosuppressive tumour microenvironment via upregulation of the repressed chemokines and increased apoptosis with subsequent tumour regression.
Language	English
Publishing date	2022-11-28
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2694482-0
ISSN	2050-0068
ISSN	2050-0068
DOI	10.1002/cti2.1430
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Article ; Online: Enhanced recovery after surgery is safe for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

Martin, Robert Cg / Marshall, Bryce M / Philips, Prejesh / Egger, Michael / McMasters, Kelly M / Scoggins, Charles R

American journal of surgery

2020 Volume 220, Issue 6, Page(s) 1428–1432

Abstract: Introduction: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an effective, aggressive approach to treating intraperitoneal carcinomatosis. This study aimed to test the efficacy/safety of an enhanced recovery (ERAS) ... ...

Abstract	Introduction: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an effective, aggressive approach to treating intraperitoneal carcinomatosis. This study aimed to test the efficacy/safety of an enhanced recovery (ERAS) program after CRS-HIPEC surgery. Methods: Review of an IRB-approved prospectively maintained HIPEC database from 2003 to 2019. Adverse events and outcomes related to the primary operation were noted. Results: 125 HIPEC procedures performed met inclusion criteria, with 20 treated through ERAS. There was an improvement in LOS (ERAS: 9, 6.0-28.0; non-ERAS: 11.0, 6.0-45.1, P = 0.5), a significant reduction in opioid use during hospitalization (ERAS Total Morphine Equivalents 156 vs Non-ERAS of 856, p < 0.001), and a significant reduction in discharge opioid requirements (ERAS 55% of patients, non-ERAS 97%, p < 0.02). Conclusion: ERAS for CRS-HIPEC is safe, while maintaining quality outcomes, and leads to significant reductions in hospital opioid use and discharge narcotic usage. Our experience supports the full implementation of an ERAS protocol for HIPEC.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Analgesics, Opioid/therapeutic use ; Carcinoma/therapy ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Enhanced Recovery After Surgery ; Female ; Humans ; Hyperthermic Intraperitoneal Chemotherapy ; Male ; Middle Aged ; Pain Management ; Pain, Postoperative/drug therapy ; Peritoneal Neoplasms/therapy ; Prospective Studies
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2020-09-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2020.08.041
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Article ; Online: Should Sentinel Lymph Node Biopsy Be Performed for All T1b Melanomas in the New 8

Egger, Michael E / Stevenson, Megan / Bhutiani, Neal / Jordan, Adrienne C / Scoggins, Charles R / Philips, Prejesh / Martin, Robert Cg / McMasters, Kelly M

Journal of the American College of Surgeons

2019 Volume 228, Issue 4, Page(s) 466–472

Abstract: Background: In the 8: Study design: The National Cancer Database 2015 Melanoma Public Use File was used to select patients undergoing SLNB for thin T1 cutaneous melanoma from 2010 to 2015. Clinicopathologic risk factors for having a positive SLNB ... ...

Abstract	Background: In the 8 Study design: The National Cancer Database 2015 Melanoma Public Use File was used to select patients undergoing SLNB for thin T1 cutaneous melanoma from 2010 to 2015. Clinicopathologic risk factors for having a positive SLNB were evaluated. Univariable and multivariable logistic regression models and classification and regression tree analysis were performed to identify groups with high and low risk of positive SLNB. Results: We selected patients undergoing SLNB without ulceration with thickness 0.75 to 1.04 mm, staged T1b in the new 8 Conclusions: The new 8
MeSH term(s)	Adult ; Aged ; Databases, Factual ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; Male ; Melanoma/diagnosis ; Melanoma/pathology ; Middle Aged ; Neoplasm Staging ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/statistics & numerical data ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node Biopsy/standards ; Sentinel Lymph Node Biopsy/statistics & numerical data ; Skin Neoplasms/diagnosis ; Skin Neoplasms/pathology ; Unnecessary Procedures/statistics & numerical data
Language	English
Publishing date	2019-01-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1016/j.jamcollsurg.2018.12.030
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Article ; Online: Multigene Signature Panels and Breast Cancer Therapy: Patterns of Use and Impact on Clinical Decision Making.

Bhutiani, Neal / Egger, Michael E / Ajkay, Nicolás / Scoggins, Charles R / Martin, Robert Cg / McMasters, Kelly M

Journal of the American College of Surgeons

2018 Volume 226, Issue 4, Page(s) 406–412.e1

Abstract: Background: A growing body of evidence supports the use of multigene signature panels (MSPs) in predicting recurrence risk in patients with invasive breast cancer. This study aimed to evaluate trends in MSP use over time and the effect of MSPs on ... ...

Abstract	Background: A growing body of evidence supports the use of multigene signature panels (MSPs) in predicting recurrence risk in patients with invasive breast cancer. This study aimed to evaluate trends in MSP use over time and the effect of MSPs on administration of postoperative chemotherapy. Study design: The National Cancer Database was queried for all women with invasive breast cancer who underwent resection between 2011 and 2014 and had information about performance of an MSP, hormone receptor status, and receipt of chemotherapy. Multigene signature panel use over time was evaluated, and patterns of use of Oncotype DX (ODX) and MammaPrint (MP) were compared. Results: In a total of 476,128 patients, an MSP was obtained in 153,782 (30.2%). Multigene signature panel use increased over time and was associated with a decreased rate of chemotherapy administration (24.6% MSP vs 37.2% no MSP; p < 0.001). Oncotype DX remained the most common MSP used throughout the study period. Oncotype DX was used more commonly in stage I disease than MP, and MP was used more commonly in stage II and III disease. MammaPrint was more commonly used in hormone receptor-negative patients, human epidermal growth factor receptor 2-positive patients, and patients with positive lymph nodes. Postoperative chemotherapy was administered to a higher proportion of patients assessed with MP than with ODX (41.3% vs 23.4%, respectively; p < 0.001). Conclusions: Use of MSPs among patients with breast cancer has increased over time and is associated with a decreased use of adjuvant chemotherapy. Oncotype DX continues to be the most widely used MSP, although MP use has increased over time. Future studies are warranted to determine the optimal use of these MSPs in risk assessment and postoperative decision making.
MeSH term(s)	Aged ; Breast Neoplasms/genetics ; Breast Neoplasms/pathology ; Breast Neoplasms/therapy ; Chemotherapy, Adjuvant ; Clinical Decision-Making ; Female ; Gene Expression Profiling ; Humans ; Mastectomy ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Retrospective Studies ; Transcriptome
Language	English
Publishing date	2018-01-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1016/j.jamcollsurg.2017.12.043
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Article ; Online: Transarterial Chemoembolization vs Radioembolization for Neuroendocrine Liver Metastases: A Multi-Institutional Analysis.

Egger, Michael E / Armstrong, Emily / Martin, Robert Cg / Scoggins, Charles R / Philips, Prejesh / Shah, Manisha / Konda, Bhavana / Dillhoff, Mary / Pawlik, Timothy M / Cloyd, Jordan M

Journal of the American College of Surgeons

2020 Volume 230, Issue 4, Page(s) 363–370

Abstract: Background: Liver-directed hepatic arterial therapies are associated with improved survival and effective symptom control for patients with unresectable neuroendocrine liver metastases (NELM). Whether transarterial chemoembolization (TACE) or ... ...

Abstract	Background: Liver-directed hepatic arterial therapies are associated with improved survival and effective symptom control for patients with unresectable neuroendocrine liver metastases (NELM). Whether transarterial chemoembolization (TACE) or transarterial radioembolization (TARE) with yttrium-90 (y-90) are associated with improved short- or long-term outcomes is unknown. Study design: A retrospective review was performed of all patients with NELM undergoing transarterial therapies, from 2000 to 2018, at 2 academic medical centers. Postoperative morbidity, radiographic response according to response evaluation criteria in solid tumors (RECIST) criteria, and long-term outcomes were compared between patients who underwent TACE vs TARE. Results: Among 248 patients with NELM, 197 (79%) received TACE and 51 (21%) received TARE. While patients who underwent TACE were more likely to have carcinoid syndrome, larger tumors, and higher chromogranin A levels, there was no difference in tumor differentiation, primary site, bilobar disease, or synchronous presentation. Nearly all TARE treatments (92%) were performed as outpatient procedures, while 99% of TACE patients spent at least 1 night in the hospital. There were no differences in overall morbidity (TARE 13.7% vs TACE 22.6%, p = 0.17), grade III/IV complication (5.9% vs 9.2%, p = 0.58), or 90-day mortality. The disease control rate (DCR) on first post-treatment imaging (RECIST partial/complete response or stable disease) was greater for TACE compared with TARE (96% vs 83%, p < 0.01). However, there was no difference in median overall survival (OS, 35.9 months vs 50.1 months, p = 0.3) or progression-free survival (PFS, 15.9 months vs 19.9 months, p = 0.37). Conclusions: In this retrospective multi-institutional analysis, both TACE and TARE with Y-90 were safe and effective liver-directed therapies for unresectable NELM. Although TARE was associated with a shorter length of hospital stay, TACE demonstrated improved short-term DCR, and both resulted in comparable long term outcomes.
MeSH term(s)	Aged ; Chemoembolization, Therapeutic/methods ; Embolization, Therapeutic/methods ; Female ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/secondary ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Neuroendocrine Tumors/secondary ; Neuroendocrine Tumors/therapy ; Retrospective Studies ; Treatment Outcome ; Yttrium Radioisotopes/administration & dosage
Chemical Substances	Yttrium Radioisotopes ; Yttrium-90 (1K8M7UR6O1)
Language	English
Publishing date	2020-02-04
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Multicenter Study
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1016/j.jamcollsurg.2019.12.026
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Article: Intra - operative Anesthesia Management in Patients Undergoing Surgical Irreversible Electroporation of the Pancreas, Liver, Kidney, and Retroperitoneal Tumors.

Martin, Robert Cg / Schwartz, Eric / Adams, JoAnn / Farah, Ian / Derhake, Brian M

Anesthesiology and pain medicine

2015 Volume 5, Issue 3, Page(s) e22786

Abstract: Background: Irreversible electroporation (IRE) is a relatively new approach to the management of multiple types of locally advanced soft tissue tumors. Unique peri-procedural anesthetic management is needed in the safe and effective delivery of this ... ...

Abstract	Background: Irreversible electroporation (IRE) is a relatively new approach to the management of multiple types of locally advanced soft tissue tumors. Unique peri-procedural anesthetic management is needed in the safe and effective delivery of this therapy. Objectives: This study analyzed IRE therapy in relation to anesthetic management for our initial cohort and then established and validated a set of best practical guidelines for general anesthesia in patients undergoing IRE for abdominal tumors. Patients and methods: An IRB-approved prospective data collection outcome protocol was utilized. This study was broken up into two cohorts as follows: the initial 38 patients (pts) undergoing IRE in which anesthetic management was not defined or optimized and then a 40-pt validation cohort to establish the most efficacious anesthetic protocols. Results: During IRE delivery, a deeper neuromuscular blockade is required to ensure that all retroperitoneal muscle excitation was minimized. In the initial 38-pt cohort, attempts to treat hypertension (median SBP 190, range 185-215 and median diastolic 98, range 91-115) were made with various types of anti-hypertensives with minimal-to-insufficient effects. The established inhalation was sevoflurane with an approximate median dose of 8.0 volume percentage. Analgesic management of continuous remifentanil was utilized with epidural management, which optimized HTN and tolerance to IRE therapy. Conclusions: Anesthetic management for IRE of soft tissue deviates from standard anesthetic medical therapy in regards to depth of neuromuscular blockade and analgesic management during IRE energy delivery. However, minor modifications in anesthesia management allow for a safe and efficient patient procedure.
Language	English
Publishing date	2015-04-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3018888-X
ISSN	2228-7531 ; 2228-7523
ISSN (online)	2228-7531
ISSN	2228-7523
DOI	10.5812/aapm.22786
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