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Article ; Online: Survival analysis and identification of prognostic factors in colorectal liver metastasis after liver resection.

Plúa-Muñiz, Katherine / Bailón-Cuadrado, Martín / Pérez-Saborido, Baltasar / Pacheco-Sánchez, David / Pinto, Pilar / Asensio-Díaz, Enrique

Cirugia espanola

2022 Volume 101, Issue 3, Page(s) 160–169

Abstract: Introduction: Liver resection is the only curative treatment for colorectal liver metastasis. The identification of predictive factors leads to personalize patient management to enhance their long-term outcomes. This population-based study aimed to ... ...

Abstract	Introduction: Liver resection is the only curative treatment for colorectal liver metastasis. The identification of predictive factors leads to personalize patient management to enhance their long-term outcomes. This population-based study aimed to characterize factors associated with, and survival impact of patients who received hepatectomy for colorectal liver metastasis. Methods: A retrospective cohort study of all the hepatectomies for colorectal liver metastasis performed at third-level hospital of Spain (2010-2018) was conducted. The Kaplan-Meier method was used for survival analyses. Multivariable Cox and regression models were used to determine prognostic factors associated with overall survival. Results: The 5-year overall survival and disease-free survival were 42 and 33%, respectively. Survival analysis showed that metastasis features (number, largest size, distribution, and extrahepatic disease) and postsurgical factors (transfusion, major complications, and positive margin resection), as well as non-mutated KRAS, showed a significant association with survival. Otherwise, on multivariate analysis, only 5 independent risk factors were identified: major size metastasis >4 cm, RAS mutation, positive margin resection, intraoperative transfusion, and major complications. Conclusions: According to our findings, major size metastasis >4 cm, intraoperative transfusion, and major postoperative complications continue to be traditional prognostic factors. Meanwhile, the KRAS biomarker has a powerful impact as a survival prognostic factor.
MeSH term(s)	Humans ; Prognosis ; Hepatectomy/methods ; Retrospective Studies ; Proto-Oncogene Proteins p21(ras) ; Liver Neoplasms/secondary ; Survival Analysis ; Colorectal Neoplasms/surgery
Chemical Substances	Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2)
Language	English
Publishing date	2022-09-12
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.cireng.2022.09.023
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Article: A liver abscess secondary to a toothpick: a rare complication of accidental foreign body ingestion.

Pérez Saborido, Baltasar / Bailón Cuadrado, Martín / Velasco López, Rosalía

Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

2018 Volume 111, Issue 2, Page(s) 167–168

Abstract: Perforation of the gastrointestinal tract caused by the ingested foreign bodies and subsequent hepatic abscess formation is uncommon. Early diagnosis is difficult and the treatment is mainly surgical. ...

Abstract	Perforation of the gastrointestinal tract caused by the ingested foreign bodies and subsequent hepatic abscess formation is uncommon. Early diagnosis is difficult and the treatment is mainly surgical.
MeSH term(s)	Female ; Foreign Bodies/complications ; Foreign Bodies/diagnostic imaging ; Humans ; Liver Abscess/diagnostic imaging ; Liver Abscess/etiology ; Middle Aged ; Pyloric Antrum/diagnostic imaging ; Pyloric Antrum/injuries ; Tomography, X-Ray Computed
Language	English
Publishing date	2018-12-10
Publishing country	Spain
Document type	Case Reports ; Letter
ZDB-ID	1070381-0
ISSN	1130-0108 ; 0212-7512
ISSN	1130-0108 ; 0212-7512
DOI	10.17235/reed.2018.5860/2018
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Article: Impaired immune reaction and increased lactate and C-reactive protein for early prediction of severe morbidity and pancreatic fistula after pancreatoduodenectomy.

Rodriguez-Lopez, Mario / Tejero-Pintor, Francisco J / Bailon-Cuadrado, Martin / Barrera-Rebollo, Asterio / Perez-Saborido, Baltasar / Pacheco-Sanchez, David

Hepatobiliary & pancreatic diseases international : HBPD INT

2019 Volume 19, Issue 1, Page(s) 58–67

Abstract: Background: Prediction of complications after pancreatoduodenectomy (PD) remains of interest. Blood parameters and biomarkers during first and second postoperative days (POD1, POD2) may be early indicators of complications.: Methods: This case- ... ...

Abstract	Background: Prediction of complications after pancreatoduodenectomy (PD) remains of interest. Blood parameters and biomarkers during first and second postoperative days (POD1, POD2) may be early indicators of complications. Methods: This case-control study included 50 patients. Baseline, POD1 and POD2 values of leukocytes, neutrophils, lymphocytes, platelets, hemoglobin, C-reactive protein (CRP), procalcitonin and arterial lactate were compared between individuals presenting Clavien ≥ III morbidity, pancreatic fistula (PF) or clinically relevant PF (CRPF) and those without these morbidities. Common variables reaching significance were further analyzed in order to calculate a predictive score. Results: Severe morbidity, PF and CRPF rates were 28.0%, 26.0% and 14.0%, respectively. Patients with severe morbidity had lower leukocytes on POD2 (P = 0.04). Patients with PF presented higher CRP on POD2 (P = 0.001), higher lactate on POD1 (P = 0.007) and POD2 (P = 0.008), and lower lymphocytes on POD1 (P = 0.007) and POD2 (P = 0.008). Patients with CRPF had lower leukocytes and neutrophils on POD1 (P = 0.048, P = 0.038), lower lymphocytes on POD1 (P = 0.001) and POD2 (P = 0.003), and higher CRP on POD2 (P = 0.001). Baseline parameters and procalcitonin obtained no statistical associations. Score was defined according to lymphocytes on POD1 < 650/µL and CRP on POD2 ≥ 250 mg/L allocating patients in 3 risk categories. PF and CRPF rates were statistically higher as risk category increased (P<0.001). Receiver operating characteristic curves and Hosmer-Lemeshow tests showed a good accuracy. Conclusions: Impaired immunological reaction during early postoperative period (lower leukocytes and, particularly, lymphocytes) in response to surgical aggression would favor complications after PD. Likewise, acidosis (higher arterial lactate) could behave as risk factor of PF. An elevated CRP on POD2 is also an early biomarker of PF. Our novel score based on postoperative lymphocyte count and CRP seems reliable for early prediction of PF.
MeSH term(s)	Aged ; C-Reactive Protein/analysis ; Case-Control Studies ; Female ; Humans ; Lactates/blood ; Male ; Middle Aged ; Morbidity ; Pancreatic Fistula/etiology ; Pancreatic Fistula/immunology ; Pancreaticoduodenectomy/adverse effects
Chemical Substances	Lactates ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2019-05-20
Publishing country	Singapore
Document type	Journal Article ; Observational Study
ZDB-ID	2241386-8
ISSN	1499-3872
ISSN	1499-3872
DOI	10.1016/j.hbpd.2019.05.003
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Article ; Online: A new dimensional-reducing variable obtained from original inflammatory scores is highly associated to morbidity after curative surgery for colorectal cancer.

Bailon-Cuadrado, Martin / Perez-Saborido, Baltasar / Sanchez-Gonzalez, Javier / Rodriguez-Lopez, Mario / Mayo-Iscar, Agustin / Pacheco-Sanchez, David

International journal of colorectal disease

2018 Volume 33, Issue 9, Page(s) 1225–1234

Abstract: Purpose: Several scores have been developed to define the inflammatory status of oncological patients. We suspect they share iterative information. Our hypothesis is that we may summarise their information into one or two new variables which will be ... ...

Abstract	Purpose: Several scores have been developed to define the inflammatory status of oncological patients. We suspect they share iterative information. Our hypothesis is that we may summarise their information into one or two new variables which will be independent. This will help us to predict, more accurately, which patients are at an increased risk of suffering postoperative complications after curative surgery for CRC. Methods: Observational prospective study with those patients undergoing curative surgery for CRC between September 2015 and February 2017. We analysed the influence of inflammatory scores (PNI, GPS, NLR, PLR) on postoperative morbidity (overall and severe complications, anastomotic leakage and reoperation). Results: Finally, 168 patients were analysed. We checked these four original scores are interrelated among them. Using a complex and innovative statistical method, we created two new independent variables (resultant A and resultant B) which resume the information coming from them. One of these two new variables (resultant A) was statistically associated to overall complications (OR, 2.239; 95% CI, 1.541-3.253; p = 0.0001), severe complications (OR, 1.773; 95% CI, 1.129-2.785; p = 0.013), anastomotic leakage (OR, 3.208; 95% CI, 1.416-7.268; p = 0.005) and reoperation (OR, 2.349; 95% CI, 1.281-4.305; p = 0.006). Conclusions: We evinced the four original scores we used share redundant information. We created two new independent new variables which resume their information. In our sample of patients, one of these variables turned out to be a great predictive factor for the four complications we analysed.
MeSH term(s)	Aged ; Anastomotic Leak/etiology ; Biomarkers/blood ; Blood Platelets ; C-Reactive Protein/metabolism ; Colectomy/adverse effects ; Colorectal Neoplasms/complications ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/surgery ; Decision Support Techniques ; Female ; Health Status ; Humans ; Inflammation/blood ; Inflammation/complications ; Inflammation/diagnosis ; Inflammation Mediators/blood ; Lymphocyte Count ; Lymphocytes ; Male ; Neutrophils ; Platelet Count ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Predictive Value of Tests ; Proctectomy/adverse effects ; Prospective Studies ; Reoperation ; Risk Assessment ; Risk Factors ; Serum Albumin, Human/metabolism ; Time Factors ; Treatment Outcome
Chemical Substances	Biomarkers ; Inflammation Mediators ; C-Reactive Protein (9007-41-4) ; Serum Albumin, Human (ZIF514RVZR)
Language	English
Publishing date	2018-06-20
Publishing country	Germany
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-018-3100-0
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Article: Severe morbidity after pancreatectomy is accurately predicted by preoperative pancreatic resection score (PREPARE): A prospective validation analysis from a medium-volume center.

Rodriguez-Lopez, Mario / Tejero-Pintor, Francisco J / Perez-Saborido, Baltasar / Barrera-Rebollo, Asterio / Bailon-Cuadrado, Martin / Pacheco-Sanchez, David

Hepatobiliary & pancreatic diseases international : HBPD INT

2018 Volume 17, Issue 6, Page(s) 559–565

Abstract: Background: Major morbidity in pancreatic surgery remains high. Different scores for predicting complications have been described. Preoperative pancreatic resection (PREPARE) score is based on objective preoperative variables and offers good predictive ... ...

Abstract	Background: Major morbidity in pancreatic surgery remains high. Different scores for predicting complications have been described. Preoperative pancreatic resection (PREPARE) score is based on objective preoperative variables and offers good predictive accuracy for Clavien ≥ III complications. This study aimed to validate this score and analyze other preoperative variables in a prospective study performed in a medium-volume center. Methods: A total of 50 pancreatic resections were included. Preoperative variables were registered and PREPARE was calculated. The main outcome was severe morbidity (Clavien ≥ III) up to 30 days after discharge. The secondary outcomes were length of stay (LOS) and readmission. Statistical validation was performed to compare severe morbidity rate among the scores categories. Association with other preoperative variables (not included in PREPARE) was also tested. Results: Of the 50 pancreatic resections, the severe morbidity was 34.0%, with median LOS of 11 days. Readmission rate was 25.5%. Severe morbidity rates according to PREPARE categories were 18.5% in low-risk group, 41.7% in intermediate-risk group, and 63.6% in high-risk group, respectively (P = 0.023). The accuracy was 72% (Hosmer-Lemeshow, P = 0.86). ROC curve was obtained both for PREPARE score expressed as incremental values and categorized as the three risk groups, showing an area under curve (AUC) of 0.736 (95% CI: 0.586-0.887; P = 0.007) and 0.712 (95% CI: 0.555-0.869; P = 0.015), respectively. PREPARE was significant in multivariate analysis. Median LOS was statistically higher as PREPARE category increases (9, 11 and 15 days in low-, intermediate- and high-risk groups, respectively; P = 0.009). Readmission was not associated with any variables. Conclusions: PREPARE behaves as an independent risk factor for severe morbidity after pancreatic surgery. Score validation shows good accuracy prediction. Increasing PREPARE category is also associated with longer LOS.
MeSH term(s)	Adult ; Aged ; Body Mass Index ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Morbidity ; Pancreatectomy/adverse effects ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Patient Readmission ; Prospective Studies ; ROC Curve
Language	English
Publishing date	2018-09-26
Publishing country	Singapore
Document type	Journal Article ; Observational Study ; Validation Studies
ZDB-ID	2241386-8
ISSN	1499-3872
ISSN	1499-3872
DOI	10.1016/j.hbpd.2018.09.017
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Article ; Online: Embolismo pulmonar por fistulización de quiste hidatídico hepático a vena cava inferior.

Bailón-Cuadrado, Martín / Barrera-Rebollo, Asterio / Pérez-Saborido, Baltasar / Asensio-Díaz, Enrique

Enfermedades infecciosas y microbiologia clinica

2015 Volume 33, Issue 8, Page(s) 572

Title translation	Pulmonary embolism due to a liver hydatid cyst fistulized into the inferior cava vein.
MeSH term(s)	Albendazole/therapeutic use ; Anaphylaxis/etiology ; Anthelmintics/therapeutic use ; Blood Vessel Prosthesis Implantation ; Combined Modality Therapy ; Digestive System Fistula/etiology ; Digestive System Fistula/surgery ; Echinococcosis, Hepatic/complications ; Echinococcosis, Hepatic/diagnostic imaging ; Echinococcosis, Hepatic/drug therapy ; Echinococcosis, Hepatic/surgery ; Emergencies ; Humans ; Male ; Middle Aged ; Pulmonary Embolism/etiology ; Rupture, Spontaneous ; Vascular Fistula/etiology ; Vascular Fistula/surgery ; Vena Cava, Inferior/pathology ; Vena Cava, Inferior/surgery
Chemical Substances	Anthelmintics ; Albendazole (F4216019LN)
Language	Spanish
Publishing date	2015-10
Publishing country	Spain
Document type	Case Reports ; Letter
ZDB-ID	1070941-1
ISSN	1578-1852 ; 0213-005X
ISSN (online)	1578-1852
ISSN	0213-005X
DOI	10.1016/j.eimc.2015.02.009
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Article: Intraductal papillary neoplasia of the bile duct with malignancy: a differentiated entity of cholangiocarcinoma with a better prognosis. A review of three new cases.

Pérez Saborido, Baltasar / Bailón Cuadrado, Martín / Rodríguez López, Mario / Asensio Díaz, Enrique / Madrigal Rubiales, Beatriz / Barrera Rebollo, Asterio

Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

2017 Volume 109, Issue 8, Page(s) 592–595

Abstract: Introduction: Intraductal papillary neoplasms of the bile duct have been recognized as a differentiated entity to other biliary tumors since 2001. They are characterized by intraductal growth, with or without mucus production, and have malignant ... ...

Abstract	Introduction: Intraductal papillary neoplasms of the bile duct have been recognized as a differentiated entity to other biliary tumors since 2001. They are characterized by intraductal growth, with or without mucus production, and have malignant potential, although they have a better prognosis than other types of cholangiocarcinoma. Case reports: From January 2010 to August 2015, we included three patients with a confirmed diagnosis of bile duct intraductal papillary neoplasia with malignancy that were treated at our center. Two cases were male and one female with a mean age of 67.3 years. All three patients presented malignancy at the time of diagnosis. One patient was asymptomatic and the diagnosis was reported in the hepatectomy specimen after a liver transplant due to autoimmune hepatitis. The other two patients presented with cholestasis and acute cholangitis and the diagnosis was made based on imaging tests (computed tomography [CT] and magnetic resonance imaging [MRI]) and endoscopic retrograde cholangiopancreatography (ERCP) with brushing and a biopsy. The treatment in both cases was surgical with a left hepatectomy, and resection of the left bile duct and segment I. They did not receive adjuvant treatment. None of the cases had recurrence of the disease. Discussion: Malignant intraductal papillary neoplasias of the biliary tract represent a different entity of cholangiocarcinoma with a better prognosis. Its diagnosis is based on imaging tests and histology by ERCP. The treatment is surgical, achieving a high rate of success with a low relapse rate.
Language	English
Publishing date	2017-08
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1070381-0
ISSN	1130-0108 ; 0212-7512
ISSN	1130-0108 ; 0212-7512
DOI	10.17235/reed.2017.4835/2016
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Article ; Online: Recent outcomes of liver transplantation for Budd-Chiari syndrome: A study of the European Liver Transplant Registry (ELTR) and affiliated centers.

Dongelmans, Edo / Erler, Nicole / Adam, Rene / Nadalin, Silvio / Karam, Vincent / Yilmaz, Sezai / Kelly, Claire / Pirenne, Jacques / Acarli, Koray / Allison, Michael / Hakeem, Abdul / Dhakshinamoorthy, Vijayanand / Fedaruk, Dzmitry / Rummo, Oleg / Kilic, Murat / Nordin, Arno / Fischer, Lutz / Parente, Alessandro / Mirza, Darius /

Bennet, William / Tokat, Yaman / Faitot, Francois / Antonelli, Barbara B / Berlakovich, Gabriela / Patch, David / Berrevoet, Frederik / Ribnikar, Marija / Gerster, Theophile / Savier, Eric / Gruttadauria, Salvatore / Ericzon, Bo-Göran / Valdivieso, Andrés / Cuervas-Mons, Valentin / Perez Saborido, Baltasar / Croner, Roland S / De Carlis, Luciano / Magini, Giulia / Rossi, Roberta / Popescu, Irinel / Razvan, Laze / Schneeberger, Stefan / Blokzijl, Hans / Llado, Laura / Gomez Bravo, Miguel Angel / Duvoux, Christophe / Mezjlík, Vladimír / Oniscu, Gabriel C / Pearson, Kelsey / Dayangac, Murat / Lucidi, Valerio / Detry, Olivier / Rotellar, Fernando / den Hoed, Caroline / Polak, Wojciech G / Darwish Murad, Sarwa

Hepatology (Baltimore, Md.)

2024

Abstract: Background and aims: Management of Budd-Chiari syndrome (BCS) has improved over the last decades. The main aim was to evaluate the contemporary post-liver transplantant (post-LT) outcomes in Europe.: Approach and results: Data from all patients who ... ...

Abstract	Background and aims: Management of Budd-Chiari syndrome (BCS) has improved over the last decades. The main aim was to evaluate the contemporary post-liver transplantant (post-LT) outcomes in Europe. Approach and results: Data from all patients who underwent transplantation from 1976 to 2020 was obtained from the European Liver Transplant Registry (ELTR). Patients < 16 years with secondary BCS or HCC were excluded. Patient survival (PS) and graft survival (GS) before and after 2000 were compared. Multivariate Cox regression analysis identified predictors of PS and GS after 2000. Supplemental data was requested from all ELTR-affiliated centers and received from 44. In all, 808 patients underwent transplantation between 2000 and 2020. One-, 5- and 10-year PS was 84%, 77%, and 68%, and GS was 79%, 70%, and 62%, respectively. Both significantly improved compared to outcomes before 2000 ( p < 0.001). Median follow-up was 50 months and retransplantation rate was 12%. Recipient age (aHR:1.04,95%CI:1.02-1.06) and MELD score (aHR:1.04,95%CI:1.01-1.06), especially above 30, were associated with worse PS, while male sex had better outcomes (aHR:0.63,95%CI:0.41-0.96). Donor age was associated with worse PS (aHR:1.01,95%CI:1.00-1.03) and GS (aHR:1.02,95%CI:1.01-1.03). In 353 patients (44%) with supplemental data, 33% had myeloproliferative neoplasm, 20% underwent TIPS pre-LT, and 85% used anticoagulation post-LT. Post-LT anticoagulation was associated with improved PS (aHR:0.29,95%CI:0.16-0.54) and GS (aHR:0.48,95%CI:0.29-0.81). Hepatic artery thrombosis and portal vein thrombosis (PVT) occurred in 9% and 7%, while recurrent BCS was rare (3%). Conclusions: LT for BCS results in excellent patient- and graft-survival. Older recipient or donor age and higher MELD are associated with poorer outcomes, while long-term anticoagulation improves both patient and graft outcomes.
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000778
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Article ; Online: Incarcerated Recurrent Amyand's Hernia: Inguinal Herniorraphy and Laparoscopic Inspection.

Bailon-Cuadrado, Martin / Perez-Saborido, Baltasar / Asensio-Diaz, Enrique / Blanco-Alvarez, Jose I / Rodriguez-Lopez, Mario

Surgical infections

2016 Volume 17, Issue 2, Page(s) 264–265

MeSH term(s)	Aged, 80 and over ; Appendicitis/diagnosis ; Appendicitis/surgery ; Hernia/complications ; Hernia/diagnosis ; Hernia/therapy ; Herniorrhaphy/methods ; Humans ; Laparoscopy/methods ; Male ; Recurrence
Language	English
Publishing date	2016-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1440120-4
ISSN	1557-8674 ; 1096-2964
ISSN (online)	1557-8674
ISSN	1096-2964
DOI	10.1089/sur.2015.157
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Article: Preoperative pancreatic resection score: a preliminary prospective validation from Spain.

Rodriguez-Lopez, Mario / Bailon-Cuadrado, Martin / Tejero-Pintor, Francisco J / Perez-Saborido, Baltasar / Asensio-Diaz, Enrique / Barrera-Rebollo, Asterio

Hepatobiliary & pancreatic diseases international : HBPD INT

2016 Volume 15, Issue 6, Page(s) 667–668

MeSH term(s)	Aged ; Biliary Tract Diseases/diagnosis ; Biliary Tract Diseases/mortality ; Biliary Tract Diseases/surgery ; Decision Support Techniques ; Female ; Humans ; Male ; Middle Aged ; Pancreatectomy/adverse effects ; Pancreatectomy/mortality ; Pancreatic Diseases/diagnosis ; Pancreatic Diseases/mortality ; Pancreatic Diseases/surgery ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Risk Assessment ; Risk Factors ; Spain ; Treatment Outcome
Language	English
Publishing date	2016-12-01
Publishing country	Singapore
Document type	Letter ; Observational Study ; Validation Studies
ZDB-ID	2241386-8
ISSN	1499-3872
ISSN	1499-3872
DOI	10.1016/s1499-3872(16)60151-0
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