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  1. Article ; Online: Critical appraisal of surgical margins according to KRAS status in liver resection for colorectal liver metastases: Should surgical strategy be influenced by tumor biology?

    Rhaiem, Rami / Duramé, Adrien / Primavesi, Florian / Dorcaratto, Dimitri / Syn, Nicholas / Rodríguez, Ángela de la Hoz / Dupré, Aurélien / Piardi, Tullio / Fernández, Gerardo Blanco / Villaverde, Arancha Prada / Rodríguez Sanjuán, Juan C / Santiago, Roberto Fernández / Fernández-Moreno, María-Carmen / Ferret, Georgina / Ben, Santiago López / Suárez Muñoz, Miguel Á / Perez-Alonso, Alejandro J / Koh, Ye-Xin / Jones, Robert /
    Martín-Pérez, Elena / Kianmanesh, Reza / Di Martino, Marcello

    Surgery

    2024  

    Abstract: Background: KRAS mutation is a negative prognostic factor for colorectal liver metastases. Several studies have investigated the resection margins according to KRAS status, with conflicting results. The aim of the study was to assess the oncologic ... ...

    Abstract Background: KRAS mutation is a negative prognostic factor for colorectal liver metastases. Several studies have investigated the resection margins according to KRAS status, with conflicting results. The aim of the study was to assess the oncologic outcomes of R0 and R1 resections for colorectal liver metastases according to KRAS status.
    Methods: All patients who underwent resection for colorectal liver metastases between 2010 and 2015 with available KRAS status were enrolled in this multicentric international cohort study. Logistic regression models were used to investigate the outcomes of R0 and R1 colorectal liver metastases resections according to KRAS status: wild type versus mutated. The primary outcomes were overall survival and disease-free survival.
    Results: The analysis included 593 patients. KRAS mutation was associated with shorter overall survival (40 vs 60 months; P = .0012) and disease-free survival (15 vs 21 months; P = .003). In KRAS-mutated tumors, the resection margin did not influence oncologic outcomes. In multivariable analysis, the only predictor of disease-free survival and overall survival was primary tumor location (P = .03 and P = .03, respectively). In KRAS wild-type tumors, R0 resection was associated with prolonged overall survival (74 vs 45 months, P < .001) and disease-free survival (30 vs 17 months, P < .001). The multivariable model confirmed that R0 resection margin was associated with prolonged overall survival (hazard ratio = 1.43, 95% confidence interval: 1.01-2.03) and disease-free survival (hazard ratio = 1.42; 95% confidence interval: 1.06-1.91).
    Conclusions: KRAS-mutated colorectal liver metastases showed more aggressive tumor biology with inferior overall survival and disease-free survival after liver resection. Although R0 resection was not associated with improved oncologic outcomes in the KRAS-mutated tumors group, it seems to be of paramount importance for achieving prolonged long-term survival in KRAS wild-type tumors.
    Language English
    Publishing date 2024-03-21
    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.2024.02.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Perioperative chemotherapy versus surgery alone for resectable colorectal liver metastases: an international multicentre propensity score matched analysis on long-term outcomes according to established prognostic risk scores.

    Di Martino, Marcello / Primavesi, Florian / Syn, Nicholas / Dorcaratto, Dimitri / de la Hoz Rodríguez, Ángela / Dupré, Aurélien / Piardi, Tullio / Rhaiem, Rami / Blanco Fernández, Gerardo / Prada Villaverde, Arancha / Rodríguez Sanjuán, Juan C / Fernández Santiago, Roberto / Fernández-Moreno, María-Carmen / Ferret, Georgina / López Ben, Santiago / Suárez Muñoz, Miguel Á / Perez-Alonso, Alejandro J / Koh, Ye-Xin / Jones, Robert /
    Martín-Pérez, Elena

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

    2021  Volume 23, Issue 12, Page(s) 1873–1885

    Abstract: Background: There is still uncertainty regarding the role of perioperative chemotherapy (CTx) in patients with resectable colorectal liver metastases (CRLM), especially in those with a low-risk of recurrence.: Methods: Multicentre retrospective ... ...

    Abstract Background: There is still uncertainty regarding the role of perioperative chemotherapy (CTx) in patients with resectable colorectal liver metastases (CRLM), especially in those with a low-risk of recurrence.
    Methods: Multicentre retrospective analysis of patients with CRLM undergoing liver resection between 2010-2015. Patients were divided into two groups according to whether they received perioperative CTx or not and were compared using propensity score matching (PSM) analysis. Then, they were stratified according to prognostic risk scores, including: Clinical Risk Score (CRS), Tumour Burden Score (TBS) and Genetic And Morphological Evaluation (GAME) score.
    Results: The study included 967 patients with a median follow-up of 68 months. After PSM analysis, patients with perioperative CTx presented prolonged overall survival (OS) in comparison with the surgery alone group (82.8 vs 52.5 months, p = 0.017). On multivariable analysis perioperative CTx was an independent predictor of increased OS (HR 0.705, 95%CI 0.705-0.516, p = 0.029). The benefits of perioperative CTx on survival were confirmed in patients with CRS and TBS scores ≤2 (p = 0.022 and p = 0.020, respectively) and in patients with a GAME score ≤1 (p = 0.006).
    Conclusion: Perioperative CTx demonstrated an increase in OS in patients with CRLM. Patients with a low-risk of recurrence seem to benefit from systemic treatment.
    MeSH term(s) Colorectal Neoplasms/surgery ; Hepatectomy/adverse effects ; Humans ; Liver Neoplasms/surgery ; Neoplasm Recurrence, Local/surgery ; Prognosis ; Propensity Score ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2021-05-15
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2131251-5
    ISSN 1477-2574 ; 1365-182X
    ISSN (online) 1477-2574
    ISSN 1365-182X
    DOI 10.1016/j.hpb.2021.04.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6326: Show issues Location:
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  3. Article: Ectopic pancreas in gallbladder. Clinical significance, diagnostic and therapeutic implications.

    Sanchiz Cárdenas, Elena Margarita / Soler Humanes, Rocío / Lavado Fernández, Ana I / Díaz Nieto, Rafael / Suárez Muñoz, Miguel A

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

    2015  Volume 107, Issue 11, Page(s) 701–703

    Abstract: Ectopic or heterotopic pancreas is defined as the presence of pancreatic tissue in an anatomical place not related to the pancreas, being it most frequent locations the stomach and small bowel. Its finding in the gallbladder is exceptional. Since the ... ...

    Abstract Ectopic or heterotopic pancreas is defined as the presence of pancreatic tissue in an anatomical place not related to the pancreas, being it most frequent locations the stomach and small bowel. Its finding in the gallbladder is exceptional. Since the first case was reported by Otschkin in 1916, about 30 cases have been described in literature. We report the case of a 43 years-old male patient who had an urgent laparoscopic cholecystectomy with the diagnosis of acute cholecystitis, which pathological study showed the existence of chronic cholecystitis with heterotopic pancreatic tissue in the gallbladder wall.
    MeSH term(s) Adult ; Cholecystectomy, Laparoscopic ; Cholecystitis/etiology ; Cholecystitis/surgery ; Choristoma/pathology ; Choristoma/surgery ; Gallbladder Diseases/pathology ; Gallbladder Diseases/surgery ; Humans ; Male ; Pancreas
    Language English
    Publishing date 2015-11
    Publishing country Spain
    Document type Case Reports ; Journal Article
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2015.3627/2014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 199: Show issues Location:
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  4. Article: Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project).

    Serradilla-Martín, Mario / Villodre, Celia / Falgueras-Verdaguer, Laia / Zambudio-Carroll, Natalia / Castell-Gómez, José T / Blas-Laina, Juan L / Borrego-Estella, Vicente / Domingo-Del-Pozo, Carlos / García-Plaza, Gabriel / González-Rodríguez, Francisco J / Montalvá-Orón, Eva M / Moya-Herraiz, Ángel / Paterna-López, Sandra / Suárez-Muñoz, Miguel A / Alkorta-Zuloaga, Maialen / Blanco-Fernández, Gerardo / Dabán-Collado, Enrique / Gómez-Bravo, Miguel A / Miota-de-Llamas, José I /
    Rotellar, Fernando / Sánchez-Pérez, Belinda / Sánchez-Cabús, Santiago / Pacheco-Sánchez, David / Rodríguez-Sanjuan, Juan C / Varona-Bosque, María A / Carrión-Álvarez, Lucía / de la Serna-Esteban, Sofía / Dopazo, Cristina / Martín-Pérez, Elena / Martínez-Cecilia, David / Castro-Santiago, María J / Dorcaratto, Dimitri / Gutiérrez-Díaz, Marta L / Asencio-Pascual, José M / Burdío-Pinilla, Fernando / Carracedo-Iglesias, Roberto / Escartín-Arias, Alfredo / Ielpo, Benedetto / Rodríguez-Laiz, Gonzalo / Valdivieso-López, Andrés / De-Vicente-López, Emilio / Alonso-Orduña, Vicente / Ramia, José M

    Cancers

    2024  Volume 16, Issue 9

    Abstract: 1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present ... ...

    Abstract (1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%;
    Language English
    Publishing date 2024-04-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16091676
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Use and outcome of minimally invasive pancreatic surgery in the European E-MIPS registry.

    van der Heijde, Nicky / Vissers, Frederique L / Manzoni, Alberto / Zimmitti, Giuseppe / Balsells, Joaquim / Berrevoet, Frederik / Bjornsson, Bergthor / van den Boezem, Peter / Boggi, Ugo / Bratlie, Svein O / Burdio, Fernando / Coratti, Andrea / D'Hondt, Mathieu / Del Pozo, Carlos D / Dokmak, Safi / Fara, Regis / Can, Mehmet F / Festen, Sebastiaan / Forgione, Antonello /
    Fristrup, Claus / Gaujoux, Sebastien / Groot Koerkamp, Bas / Hackert, Thilo / Khatkov, Igor E / Keck, Tobias / Seppänen, Hanna / Lips, Daan / Luyer, Misha / Pittau, Gabriella / Maglione, Manuel / Molenaar, I Quintus / Pessaux, Patrick / Roeyen, Geert / Saint-Marc, Olivier / Cabus, Santiago S / van Santvoort, Hjalmar / van der Schelling, George / Serradilla-Martin, Mario / Souche, Francois-Regis / Suarez Muñoz, Miguel Á / Marino, Marco V / Besselink, Marc G / Abu Hilal, Mohammed

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

    2022  Volume 25, Issue 4, Page(s) 400–408

    Abstract: Background: The European registry for minimally invasive pancreatic surgery (E-MIPS) collects data on laparoscopic and robotic MIPS in low- and high-volume centers across Europe.: Methods: Analysis of the first year (2019) of the E-MIPS registry, ... ...

    Abstract Background: The European registry for minimally invasive pancreatic surgery (E-MIPS) collects data on laparoscopic and robotic MIPS in low- and high-volume centers across Europe.
    Methods: Analysis of the first year (2019) of the E-MIPS registry, including minimally invasive distal pancreatectomy (MIDP) and minimally invasive pancreatoduodenectomy (MIPD). Primary outcome was 90-day mortality.
    Results: Overall, 959 patients from 54 centers in 15 countries were included, 558 patients underwent MIDP and 401 patients MIPD. Median volume of MIDP was 10 (7-20) and 9 (2-20) for MIPD. Median use of MIDP was 56.0% (IQR 39.0-77.3%) and median use of MIPD 27.7% (IQR 9.7-45.3%). MIDP was mostly performed laparoscopic (401/558, 71.9%) and MIPD mostly robotic (234/401, 58.3%). MIPD was performed in 50/54 (89.3%) centers, of which 15/50 (30.0%) performed ≥20 MIPD annually. This was 30/54 (55.6%) centers and 13/30 (43%) centers for MIPD respectively. Conversion rate was 10.9% for MIDP and 8.4% for MIPD. Overall 90 day mortality was 1.1% (n = 6) for MIDP and 3.7% (n = 15) for MIPD.
    Conclusion: Within the E-MIPS registry, MIDP is performed in about half of all patients, mostly using laparoscopy. MIPD is performed in about a quarter of patients, slightly more often using the robotic approach. A minority of centers met the Miami guideline volume criteria for MIPD.
    MeSH term(s) Humans ; Pancreatic Neoplasms/surgery ; Robotic Surgical Procedures/adverse effects ; Pancreas/surgery ; Pancreatectomy/adverse effects ; Pancreaticoduodenectomy/adverse effects ; Minimally Invasive Surgical Procedures ; Laparoscopy/adverse effects ; Registries ; Postoperative Complications/etiology ; Treatment Outcome
    Language English
    Publishing date 2022-08-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2131251-5
    ISSN 1477-2574 ; 1365-182X
    ISSN (online) 1477-2574
    ISSN 1365-182X
    DOI 10.1016/j.hpb.2022.07.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Carcinoma suprarrenal: supervivencia a 7 años libre de enfermedad tras resección completa del tumor primario y resecciones repetidas de recidivas locorregional y a distancia. Revisión a raiz de un caso con una pobre esperanza de vida inicial.

    Ramírez Plaza, César P / Santoyo Santoyo, Julio / Domínguez López, Marta E / Eloy-García Carrasco, Carmen / Cobo Dols, Manuel / Suárez Muñoz, Miguel A / Fernández Aguilar, José L / de la Fuente Perucho, Agustín

    Archivos espanoles de urologia

    2005  Volume 58, Issue 2, Page(s) 115–119

    Abstract: Objectives: We report the case of a female patient with adrenal carcinoma who had undergone surgery and presented with local-regional and distant recurrences, emphasizing the importance of the aggressive surgical treatment to achieve long-term survival ... ...

    Title translation Adrenal carcinoma: 7 year disease free survival after complete primary tumor resection and repeated resection of local-regional and distant recurrences. Review after one case with poor initial life expectancy.
    Abstract Objectives: We report the case of a female patient with adrenal carcinoma who had undergone surgery and presented with local-regional and distant recurrences, emphasizing the importance of the aggressive surgical treatment to achieve long-term survival which is unexpected sometimes. Currently, it represents the gold standard and all cases should be reported to stimulate other groups to work in this line.
    Methods/results: We report the case of a 29-year-old female patient who consulted for left flank pain, being diagnosed of an adrenal tumor by radiological tests; she underwent surgical excision of a left adrenal carcinoma (stage II). Later on she presented with local-regional recurrences (2 times) and distant metastases (liver) undergoing excision in three procedures. Currently, the patient is alive and free of disease 7 years after diagnosis.
    Conclusions: Adrenal cancer recurrences have been considered lethal in the short-term. Nevertheless, an aggressive surgical approach of local recurrences and metastasic disease may significantly prolong patient's survival and, sometimes, leave the patient disease free several years after the diagnosis of the primary tumor.
    MeSH term(s) Adrenal Gland Neoplasms/mortality ; Adrenal Gland Neoplasms/surgery ; Adult ; Carcinoma/mortality ; Carcinoma/surgery ; Disease-Free Survival ; Female ; Humans ; Reoperation ; Time Factors
    Language Spanish
    Publishing date 2005-03-07
    Publishing country Spain
    Document type Case Reports ; English Abstract ; Journal Article
    ZDB-ID 211673-x
    ISSN 0004-0614
    ISSN 0004-0614
    DOI 10.4321/s0004-06142005000200004
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