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المصدر: European journal of surgical oncology, vol. 48, no. 4, pp. 822-833
مصطلحات موضوعية: Male, medicine.medical_specialty, Skin Neoplasms, MEDLINE, Rectum, Malignancy, Metastasis, Prostate, Internal medicine, medicine, Humans, Melanoma, business.industry, Stomach, Cancer, General Medicine, Prognosis, medicine.disease, Primary tumor, medicine.anatomical_structure, Oncology, Secondary tumor, Surgery, business
الوصف: Background Metastatic spread to the rectum is a rare finding, and management of rectal metastases (RM) is not standardized. The aim of the present study was to review the evidence on diagnosis, management and outcomes of RM. Methods A computerized literature search through MEDLINE/PubMed, Embase and the Cochrane databases was performed, applying a combination of terms related to RM. Articles and abstracts were screened and final selection was done after cross-referencing and by use of predefined eligibility criteria. Results Final analysis was based on 99 publications totaling 162 patients with RM from 16 different primary tumors. Most common origins of RM were breast (42 patients), stomach (38 patients), and prostate (16 patients). RM occurred metachronously in the majority of patients (77%). The main treatment was surgical resection (n = 32), followed by chemotherapy (n = 16). Median overall survival for breast RM, stomach RM, and prostate RM were 24 months (95% CI 9-39 months), 7 months (95% CI 0-14 months), and 24 months (95% CI 7-41 months), respectively. Conclusion RM is a rare and highly heterogeneous condition. Surgical treatment appears to be a valuable treatment option in selected patients, while overall prognosis depends mainly on the primary tumor.
وصف الملف: application/pdf
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المؤلفون: Pierre Allemann, Jakob R. Izbicki, Markus Schäfer, Ismail Labgaa, Julie Perinel, Alessandro Zerbi, Mustapha Adham, Nicolas Demartines, Michael F. Nentwich, Dionisios Vrochides, Gaëtan-Romain Joliat, Gennaro Nappo, Jesse K Sulzer
المصدر: HPB, vol. 23, no. 3, pp. 379-386
مصطلحات موضوعية: medicine.medical_specialty, Pancreatic ductal adenocarcinoma, Hepatology, Tumor size, business.industry, Gastroenterology, Margins of Excision, Prognosis, Pancreatic head, Pancreatic Neoplasms, medicine.anatomical_structure, Internal medicine, Cohort, medicine, Resection margin, Humans, In patient, Lymph Nodes, Ductal adenocarcinoma, business, Lymph node, Carcinoma, Pancreatic Ductal, Retrospective Studies
الوصف: Background Resection margin status and lymph node (LN) involvement are known prognostic factors for patients who undergo pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC). This study aimed to compare overall survival (OS) and disease-free survival (DFS) by resection margin status in patients with PDAC and LN involvement. Methods A retrospective international multicentric study was performed including four Western centers. Multivariable Cox analysis was performed to identify prognostic factors of OS and DFS. Median OS and DFS were calculated using Kaplan–Meier curves and compared using log-rank tests. Results A cohort of 814 PDAC patients with pancreatoduodenectomy were analyzed. A total of 651 patients had LN involvement (80%). On multivariable analysis R1 resection was not an independent factor of worse OS and DFS in patients with LN involvement (HR 1.1, p = 0.565; HR 1.2, p = 0.174). Only tumor size, grade, and adjuvant chemotherapy were associated with OS and DFS. Median OS and DFS were similar between patients with R0 and R1 resections (23 vs. 20 months, p = 0.196; 15 vs. 14 months, p = 0.080). Conclusion Resection status was not identified as predictor of OS or DFS in PDAC patients with LN involvement. Extensive surgery to achieve R0 resection in such patients might not influence the disease course.
وصف الملف: application/pdf
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المصدر: Pancreas. 50:104-110
مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Pancreatic ductal adenocarcinoma, Databases, Factual, Endocrinology, Diabetes and Metabolism, Risk Assessment, Pancreaticoduodenectomy, Time-to-Treatment, Lesion, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Interquartile range, Internal Medicine, medicine, Time to surgery, Humans, In patient, Lymph node, Aged, Retrospective Studies, Hepatology, Proportional hazards model, business.industry, Hazard ratio, Middle Aged, Pancreatic Neoplasms, Treatment Outcome, medicine.anatomical_structure, Chemotherapy, Adjuvant, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Radiology, Neoplasm Recurrence, Local, medicine.symptom, Tomography, X-Ray Computed, business, Carcinoma, Pancreatic Ductal
الوصف: OBJECTIVES Some studies suggested the importance of performing pancreatoduodenectomy expeditiously in resectable pancreatic ductal adenocarcinoma (PDAC). This study aimed to assess the prognostic value of time to surgery in patients undergoing pancreatoduodenectomy for PDAC. METHODS All PDAC patients who underwent upfront pancreatoduodenectomy were collected (2000-2015). Diagnosis date was the computed tomography scan date where a suspicious pancreatic head lesion was observed. Survival analyses were performed using Kaplan-Meier method. Cox model was used to find predictive factors of survival. RESULTS A total of 192 patients underwent pancreatoduodenectomy. The median time to surgery was 27 days (interquartile range, 17-40 days). The best dichotomous threshold for 24-month overall survival (OS) was 30 days. The median OS was similar between groups with time to surgery of fewer than 30 days and time to surgery of 30 days or more (25 vs 21 months, P = 0.609). Similar results were found for median recurrence-free survivals (19 vs 15 months, P = 0.561). On Cox regressions, time to surgery was not associated with shorter OS. Only lymph node invasion and adjuvant chemotherapy were independent OS predictors (hazard ratio, 2.610, P = 0.006, and hazard ratio, 2.042, P = 0.001). CONCLUSIONS Delaying surgery 30 days or more after diagnostic computed tomography scan was not associated with poorer OS and recurrence-free survival. Moreover, time to surgery was not prognostic of OS.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6da320c483566e47fb010270728f4bd8
https://doi.org/10.1097/mpa.0000000000001719 -
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المؤلفون: Pascal St-Amour, Nicolas Demartines, Ismail Labgaa, Gaëtan-Romain Joliat, Didier Roulin, Aude Eckert, Pénélope St-Amour, Emmanuel Melloul
المصدر: Langenbeck's Archives of Surgery
Langenbeck's archives of surgery, vol. 405, no. 7, pp. 959-966مصطلحات موضوعية: medicine.medical_specialty, medicine.medical_treatment, Pancreatic surgery, Surgery, Adjuvant chemotherapy, ERAS, Liver surgery, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Pancreatic cancer, medicine, Humans, Prospective Studies, Prospective cohort study, Aged, Retrospective Studies, Chemotherapy, business.industry, Recovery of Function, Vascular surgery, Length of Stay, medicine.disease, Cardiac surgery, Pancreatic Neoplasms, medicine.anatomical_structure, Cardiothoracic surgery, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Original Article, Female, Guideline Adherence, Pancreas, business, Enhanced Recovery After Surgery, Abdominal surgery
الوصف: Background Multidisciplinary approach with adjuvant chemotherapy is the key element to provide optimal outcomes in pancreas and liver malignancies. However, post-operative complications may increase the interval between surgery and chemotherapy with negative oncologic effects. Hypothesis and study aim The aim of the study was to analyse whether compliance to Enhanced Recovery After Surgery (ERAS) pathway was associated with decreased interval to adjuvant chemotherapy. Methods Retrospective analysis of all consecutive ERAS patients with surgery for hepatobiliary or pancreatic malignancies at the University Hospital of Lausanne between 2012 and 2016. Multivariate analysis was performed to assess the impact of ERAS compliance on time to chemotherapy. Results A total of 133 patients with adjuvant chemotherapy were included (n = 44 liver and n = 89 pancreatic cancer). Median compliance to ERAS was 61% (IQR 55–67) for the study population, and median delay to chemotherapy was 49 days (IQR 39-61). Overall, compliance ≥ 67% to ERAS induced a significant reduction in the interval between surgery and chemotherapy for young patients (< 65 years old) with or without severe comorbidities (reduction of 22 and 10 days, respectively). High compliance in young ASA3 patients with liver colorectal metastases was associated with an increase of 481 days of DFS. Conclusions ERAS compliance ≥ 67% tends to be associated with a reduction in the delay to adjuvant chemotherapy for young patients with hepatobiliary and pancreatic malignancies. More prospective studies with strict adhesion to the ERAS protocol are needed to confirm these results.
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URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d58319d0f44f93d685c0716fe200b69c
http://europepmc.org/articles/PMC7541355 -
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المؤلفون: Jesse V. Groen, Nicolas Demartines, Markus Schäfer, Stijn van Roessel, Ismail Labgaa, J. Sven D. Mieog, Dionisios Vrochides, Marc G. Besselink, Julie Perinel, Alessandro Zerbi, Gennaro Nappo, Jesse K Sulzer, Gaëtan-Romain Joliat, Mustapha Adham
المصدر: Joliat, Gaëtan-Romain; Labgaa, Ismail; Sulzer, Jesse; Vrochides, Dionisios; Zerbi, Alessandro; Nappo, Gennaro; Perinel, Julie; Adham, Mustapha; van Roessel, Stijn; Besselink, Marc G.; Mieog, J. Sven D.; Groen, Jesse V.; Demartines, Nicolas; Schäfer, Markus (2021). International assessment and validation of the prognostic role of lymph node ratio in patients with resected pancreatic head ductal adenocarcinoma. Hepatobiliary surgery and nutrition AME Publishing Company 10.21037/hbsn-21-99 <http://dx.doi.org/10.21037/hbsn-21-99>
Hepatobiliary surgery and nutrition, vol. 11, no. 6, pp. 822-833
Hepatobiliary Surgery and Nutrition. AME PUBL CO
Hepatobiliary Surgery and Nutritionمصطلحات موضوعية: medicine.medical_specialty, business.industry, lymphatic involvement, Pancreatic head, medicine.anatomical_structure, Pancreatectomy, cancer, medicine, General Earth and Planetary Sciences, In patient, Ductal adenocarcinoma, Radiology, business, Lymph node, General Environmental Science
الوصف: Lymph node ratio (LNR; positive/harvested lymph nodes) was identified as overall survival predictor in several cancers, including pancreatic adenocarcinoma. It remains unclear if LNR is predictive of overall survival in pancreatic adenocarcinoma patients staged pN2. This study assessed the prognostic overall survival role of LNR in pancreatic adenocarcinoma patients in relation with lymph node involvement. A retrospective international study in six different centers (Europe and United States) was performed. Pancreatic adenocarcinoma patients who underwent pancreatoduodenectomy from 2000 to 2017 were included. Patients with neoadjuvant treatment, metastases, R2 resections, or missing data regarding nodal status were excluded. Survival curves were calculated using Kaplan-Meier method and compared using log-rank test. Multivariable Cox regressions were performed to find independent overall survival predictors adjusted for potential confounders. A total of 1,327 patients were included. Lymph node involvement (pN+) was found in 1,026 patients (77%), 561 pN1 (55%) and 465 pN2 (45%). Median LNR in pN+ patients was 0.214 [interquartile range (IQR): 0.105-0.364]. On multivariable analysis, LNR was the strongest overall survival predictor in the entire cohort [hazard ratio (HR) =5.5; 95% confidence interval (CI): 3.1-9.9; P
وصف الملف: application/pdf
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::beb5c90740efd95782defbfa7b8e7341
https://pubmed.ncbi.nlm.nih.gov/36523941 -
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المؤلفون: Ismail Labgaa, S. Gonvers, Nicolas Demartines, Emmanuel Melloul, Nermin Halkic, Martin Hübner, Jonas Jurt, Gaëtan-Romain Joliat
المصدر: BJS Open
BJS Open, vol. 5, no. 2
BJS open, vol. 5, no. 2, pp. zraa015مصطلحات موضوعية: Liver surgery, Male, medicine.medical_specialty, Surgical stress, Subgroup analysis, Gastroenterology, 03 medical and health sciences, Leukocyte Count, 0302 clinical medicine, Stress, Physiological, White blood cell, Internal medicine, medicine, Humans, Laparoscopy, Enhanced recovery after surgery, Serum Albumin, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, General Medicine, Odds ratio, Perioperative, Middle Aged, medicine.anatomical_structure, C-Reactive Protein, Hematocrit, Liver, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Original Article, Female, business, Enhanced Recovery After Surgery, Biomarkers
الوصف: Background The clinical and economic impacts of enhanced recovery after surgery (ERAS) programmes have been demonstrated extensively. Whether ERAS protocols also have a biological effect remains unclear. This study aimed to investigate the biological impact of an ERAS programme in patients undergoing liver surgery. Methods A retrospective analysis of patients undergoing liver surgery (2010–2018) was undertaken. Patients operated before and after ERAS implementation in 2013 were compared. Surrogate markers of surgical stress were monitored: white blood cell count (WBC), C-reactive protein (CRP) level, albumin concentration, and haematocrit. Their perioperative fluctuations were defined as Δvalues, calculated on postoperative day (POD) 0 for Δalbumin and Δhaematocrit and POD 2 for ΔWBC and ΔCRP. Results A total of 541 patients were included, with 223 and 318 patients in non-ERAS and ERAS groups respectively. Groups were comparable, except for higher rates of laparoscopy (24.8 versus 11.2 per cent; P Conclusion Compared with conventional management, implementation of ERAS was associated with an attenuated stress response in patients undergoing liver surgery.
وصف الملف: application/pdf
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7Lymph Node Ratio as Predictor of Survival in Patients with Resected Pancreatic Ductal Adenocarcinoma
المؤلفون: D. Vrochides, Jesse K Sulzer, Ismail Labgaa, Jesse V. Groen, Mustapha Adham, Nicolas Demartines, Alessandro Zerbi, J.S.D. Mieog, M.G. Besselink, Gaëtan-Romain Joliat, S. van Roessel, Markus Schäfer, Julie Perinel, Gennaro Nappo
المصدر: HPB. 23:S54-S55
مصطلحات موضوعية: Pathology, medicine.medical_specialty, medicine.anatomical_structure, Pancreatic ductal adenocarcinoma, Hepatology, business.industry, Gastroenterology, medicine, In patient, business, Lymph node
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المؤلفون: Ismail Labgaa, Paolo Boffetta, Kathryn Bambino, Nivetha Ganesan
المصدر: European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP). 29(2)
مصطلحات موضوعية: Male, Cancer Research, Epidemiology, Ecological Parameter Monitoring, Datasets as Topic, Disease, Malignancy, Arsenic, Global Burden of Disease, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Risk Factors, Environmental health, medicine, Humans, 030212 general & internal medicine, Gallbladder cancer, Groundwater, Carcinogen, Arsenic toxicity, Geography, Incidence (epidemiology), Gallbladder, Incidence, Public Health, Environmental and Occupational Health, Gallstones, medicine.disease, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Carcinogens, Female, Gallbladder Neoplasms, Water Pollutants, Chemical
الوصف: Gallbladder cancer (GBC) is an aggressive malignancy, associated with dismal outcomes. Although several risk factors including age, sex, and gallstones have been postulated, epidemiologic determinants of the disease remain largely uncovered. Moreover, the implication of environmental toxicants as possible risk factors is increasingly suspected. Arsenic (As), an established human carcinogen, is a natural contaminant of groundwater and has a geographic distribution similar to GBC incidence. This, combined with As metabolites being partially excreted in bile, raised the hypothesis that As may represent a carcinogenic hazard for the gallbladder. We conducted an analysis of the association between As concentration in groundwater and incidence rates of GBC worldwide in 52 countries. The USA, India, and Taiwan were selected on the basis of availability and quality of data for further investigation at a county-level. Relationships between As levels and GBC incidence were assessed using multivariable linear regression analyses. Analyses revealed significant associations between high As concentrations in groundwater and increased GBC incidences. Among women, correlations were observed worldwide (Spearman = 0.31, P = 0.028), in Taiwan (Spearman = 0.57, P = 0.005) and in India (R = 0.23, P = 0.006). In men, a correlation was observed in India (R = 0.26, P = 0.009) and a modest correlation was identified in the USA (Spearman = 0.14, P = 0.026). These results provide some support to the hypothesis of an association between high exposures to As-contaminated water on GBC, which appeared more prominent in women. Further observational and molecular studies, conducted at the individual level, are required to confirm this association and decipher its nature.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::86e6e3534d2a0d8d34ce764de885830f
https://pubmed.ncbi.nlm.nih.gov/31145133 -
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المؤلفون: Styliani Mantziari, Markus Schäfer, Nicolas Demartines, Martin Hübner, Gaëtan-Romain Joliat, Amaniel Kefleyesus, Ismail Labgaa
المصدر: BMJ open, vol. 7, no. 4, pp. e013966
BMJ Openمصطلحات موضوعية: Male, Procalcitonin, 0302 clinical medicine, Postoperative Complications, Abdomen, Abdomen/surgery, Adult, Aged, Biomarkers, C-Reactive Protein/metabolism, Calcitonin/metabolism, Elective Surgical Procedures/adverse effects, Female, Humans, Middle Aged, Postoperative Complications/metabolism, Postoperative Period, Predictive Value of Tests, Prospective Studies, Protein Precursors, Serum Albumin/metabolism, Switzerland/epidemiology, Biomarker, albumin, major surgery, postoperative complications, stress response, Prospective cohort study, biology, General Medicine, medicine.anatomical_structure, C-Reactive Protein, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Anesthesia, 030211 gastroenterology & hepatology, Switzerland, Calcitonin, medicine.medical_specialty, Surgical stress, Abdomen, Adult, Aged, albumin, Biomarker, Biomarkers, C-Reactive Protein, Calcitonin, Elective Surgical Procedures, Female, Humans, major surgery, Male, Middle Aged, postoperative complications, Postoperative Complications, Postoperative Period, Predictive Value of Tests, Prospective Studies, Protein Precursors, Serum Albumin, stress response, Switzerland, Serum albumin, 03 medical and health sciences, medicine, Serum Albumin, business.industry, Research, C-reactive protein, Surgery, biology.protein, Complication, business, Abdominal surgery
الوصف: OBJECTIVE: To test postoperative serum albumin drop (ΔAlb) as a marker of surgical stress response and early predictor of clinical outcomes. DESIGN: Prospective cohort study (NCT02356484). Albumin was prospectively measured in 138 patients undergoing major abdominal surgery. Blood samples were collected before surgery and on postoperative days 0, 1 2 and 3. ΔAlb was compared to the modified estimation of physiologic ability and surgical stress (mE-PASS) score and correlated to the performances of C reactive protein (CRP), procalcitonin (PCT) and lactate (LCT). Postoperative outcomes were postoperative complications according to Clavien classification and Comprehensive Complication Index (CCI), and length of hospital stay (LoS). SETTING: Department of abdominal surgery in a European tertiary centre. PARTICIPANTS: Adult patients undergoing elective major abdominal surgery, with anticipated duration ≥2 hours. Patients on immunosuppressive or antibiotic treatments before surgery were excluded. RESULTS: The level of serum albumin rapidly dropped after surgery. ΔAlb correlated to the mE-PASS score (r=0.275, p=0.01) and to CRP increase (r=0.536, p{\textless}0.001). ΔAlb also correlated to overall complications (r=0.485, p{\textless}0.001), CCI (r=0.383, p{\textless}0.001) and LoS (r=0.468, p{\textless}0.001). A ΔAlb ≥10 g/L yielded a sensitivity of 77.1\% and a specificity of 67.2\% (AUC: 78.3\%) to predict complications. Patients with ΔAlb ≥10 g/L on POD 1 showed a threefold increased risk of overall postoperative complications. CONCLUSIONS: Early postoperative decrease of serum albumin correlated with the extent of surgery, its metabolic response and with adverse outcomes such as complications and length of stay. A decreased concentration of serum albumin ≥10 g/L on POD 1 was associated with a threefold increased risk of overall postoperative complications and may thus be used to identify patients at risk.
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URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::db57d0f5f042fd724b28b32a6fc639ed
https://serval.unil.ch/notice/serval:BIB_03EEEB1F3461 -
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المؤلفون: Massih Ningarhari, Carlos Villacorta-Martin, Amanda J. Craig, Augusto Villanueva, Ismail Labgaa
المصدر: Resistance to Targeted Anti-Cancer Therapeutics ISBN: 9783319561967
مصطلحات موضوعية: medicine.anatomical_structure, Cancer stem cell, Hepatocellular carcinoma, Cell, Cancer research, medicine, Disease, Drug resistance, Liquid biopsy, Biology, medicine.disease, Somatic evolution in cancer, Biomarker (cell)
الوصف: Hepatocellular carcinoma is a heterogeneous disease, both phenotypically and genetically. This heterogeneity can be observed over a spectrum ranging among tumors of different patients, multiple nodules of one patient and even within a single tumor nodule. As demonstrated in other tumor types, this diversity may contribute to the development of drug resistance. The mechanisms behind intra-tumoral heterogeneity are not yet fully understood, and potential theories include the clonal evolution or cancer stem cells differentiation hierarchy. In recent years, many technologies have helped assess clonal content of tumors, including multi-regional and single cell next generation sequencing. Changes in clonal content over time and during treatment can now be easily tracked, which will provide novel insights into cancer evolution and mechanisms of treatment resistance. This will be critical to provide novel therapeutic targets for second and third line therapies in hepatocellular carcinoma.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::de0189205273296d7f408dc6bf22a5b6
https://doi.org/10.1007/978-3-319-56197-4_1
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