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المؤلفون: Ian D. McGilvray, Carol-Anne Moulton, Gonzalo Sapisochin, Carla F. Murillo Perez, Steve Gallinger, Tommy Ivanics, Anand Ghanekar, Luckshi Rajendran, Hala Muaddi, Madhukar S. Patel, Nathanael Raschzok, Bettina E. Hansen, Chaya Shwaartz, Marco P. A. W. Claasen, Sean P. Cleary, Trevor Reichman, Peter Yoon
المساهمون: Surgery
المصدر: Surgery (United States), 171(4), 982-991. Mosby Inc.
مصطلحات موضوعية: medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, Malignancy, Disease-Free Survival, Liver disease, Hepatectomy, Humans, Medicine, Cumulative incidence, Propensity Score, Retrospective Studies, business.industry, Proportional hazards model, Liver Neoplasms, Length of Stay, medicine.disease, Surgery, Treatment Outcome, Hepatocellular carcinoma, Propensity score matching, Laparoscopy, Liver function, business
الوصف: Background Laparoscopic liver resections for malignancy are increasing worldwide, and yet data from North America are lacking. We aimed to assess the long-term outcomes of patients undergoing laparoscopic liver resection and open liver resection as a treatment for hepatocellular carcinoma. Methods Patients undergoing liver resection for hepatocellular carcinoma between January 2008 and December 2019 were retrospectively studied. A propensity score matching was performed using patient demographics, laboratory parameters, etiology of liver disease, liver function, and tumor characteristics. Primary outcomes included overall survival and cumulative incidence of recurrence. Kaplan-Meier and competing risk cumulative incidence were used for survival analyses. Multivariable Cox regression and Fine-Gray proportional hazard regression were performed to determine hazard for death and recurrence, respectively. Results Three hundred and ninety-one patients were identified (laparoscopic liver resection: 110; open liver resection: 281). After propensity score matching, 149 patients remained (laparoscopic liver resection: 57; open liver resection: 92). There were no significant differences between groups with regard to extent of hepatectomy performed and tumor characteristics. The laparoscopic liver resection group experienced a lower proportion of ≥Clavien-Dindo grade III complications (14% vs 29%; P = .01). In the matched cohort, the 1-, 3-, and 5-year overall survival rate in the laparoscopic liver resection versus open liver resection group was 90.9%, 79.3%, 70.5% vs 91.3%, 88.5%, 83.1% (P = .26), and the cumulative incidence of recurrence 31.1%, 59.7%, 62.9% vs 18.9%, 40.6%, 49.2% (P = .06), respectively. Conclusion This study represents the largest single institutional study from North America comparing long-term oncologic outcomes of laparoscopic liver resection and open liver resection as a treatment for primary hepatocellular carcinoma. The combination of reduced short-term complications and equivalent long-term oncologic outcomes favor the laparoscopic approach when feasible.
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المؤلفون: Jennifer Croke, Meredith Giuliani, Caro, Ross Halperin, Cody Harper, Amanda Caissie, Gabrielle Robin, Michael Brundage, Erika Brown, Carol-Anne Davis, Lianne Wilson, Louise Bird
المصدر: Journal of Cancer Education. 37:1834-1841
مصطلحات موضوعية: medicine.medical_specialty, business.industry, Best practice, medicine.medical_treatment, Public Health, Environmental and Occupational Health, Charter, Patient engagement, Radiation therapy, Oncology, General partnership, Family medicine, Radiation oncology, Medicine, business, Accreditation, Patient education
الوصف: Patient engagement and education have been mandated across Canadian radiation oncology programs (ROP). Guidance documents include the 2014 Canadian Association of Radiation Oncology (CARO) Radiation Therapy Patient Charter, the 2016 Canadian Partnership for Quality Radiotherapy (CPQR) Patient Engagement Guidelines (PEG) for Canadian Radiation Treatment Programs, and Accreditation Canada’s 2017 refresh of Cancer Care Standards. Since little is known regarding uptake of these guidance statements, Canadian ROP were surveyed to assess current patient engagement and education practices. An e-survey was sent to Canadian ROP (n = 44). The survey focused on awareness and uptake of the CARO Patient Charter, CPQR PEG, and patient education practices. Survey development was guided by these documents and expert consensus, including CARO’s Quality and Standards Patient Education/Engagement working group. Many (71%) responding ROP were familiar with the CARO Patient Charter, while 24% reported use. More than half (53%) of ROP were aware of the CPQR PEG, but approximately third (37%) had previously completed a self-audit. Most (88%) ROP view a pan-Canadian, evidence-based approach to educational materials beneficial and feasible (80%), with the majority (89%) willing to share their best practices across the radiotherapy community. Patient engagement and education are nationally mandated and supported by guidance documents. However, gaps have been identified across ROP for awareness and use of available tools, as well as uptake of their processes critical to quality of care. Understanding current practices will inform CPQR/CARO-supported pan-Canadian initiatives to optimize uptake, including development of CPQR Patient Education Guidance for Canadian Radiation Treatment Programs.
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المؤلفون: Karla T. Foster, Stephanie Kile, Regan Tyler, Carol Anne Kennedy, Olivia Strain
المصدر: Journal of the American Pharmacists Association. 61:S12-S16
مصطلحات موضوعية: medicine.medical_specialty, Pharmacist, Pharmacology (nursing), Pharmacy, Pharmacists, Herpes Zoster, 030226 pharmacology & pharmacy, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), medicine, Herpes Zoster Vaccine, Humans, 030212 general & internal medicine, health care economics and organizations, Retrospective Studies, Pharmacies, Pharmacology, business.industry, Retrospective cohort study, Odds ratio, medicine.disease, Vaccination, Emergency medicine, Zoster vaccine, business, medicine.drug, Shingles
الوصف: The objectives of this study were to analyze the impact a pharmacist phone call has played on patients completing the 2-dose shingles vaccine series and to explore the effect that patient cost has on the second dose administration.A retrospective cohort study design was used to evaluate whether patients who had a pharmacist phone call intervention were more likely to return for their second recombinant zoster vaccine (RZV) dose than patients who did not have a pharmacist phone call intervention. In addition, the impact of immunization cost on series completion was analyzed. The study evaluated the SHINGRIX call lists from 10 randomly selected pharmacies within a large pharmacy chain. The percentage of patients who received the call intervention and their second RZV dose was compared with the percentage of patients who did not receive the intervention yet returned for their second dose of RZV. A chi-square test of independence analyzed the relationship between the 2 variables. An odds ratio (OR) was calculated to determine the relationship between payment data and second dose return status.The relationship between pharmacists' phone calls and patients' return for the second dose vaccination was statistically significant (P0.05). Based on payment data, the relationship between the cost of the first dose to the patient and the second dose vaccination was not statistically significant (OR 0.6703; 95% CI 0.4153-1.082).A higher percentage of patients received their second RZV dose if they spoke with a pharmacist. Based on the results of this study, a pharmacist's intervention may affect completion rates of the RZV series more than cost.
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المؤلفون: Chu-Shu Gu, Steven Gallinger, Pablo E. Serrano, Carol-Anne Moulton
المساهمون: Surgery
المصدر: The American Surgeon. 87:1431-1437
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Disease free survival, Colorectal cancer, Computed tomography, Disease, Neoplasms, Multiple Primary, 03 medical and health sciences, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, Overall survival, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Liver Neoplasms, General Medicine, Middle Aged, medicine.disease, Survival Rate, Positron emission tomography, 030220 oncology & carcinogenesis, Female, Radiology, Colorectal Neoplasms, Tomography, X-Ray Computed, business
الوصف: Introduction Selected patients with colorectal cancer liver metastases (CRLM) and synchronous extrahepatic disease (EHD) are considered for surgery. Objectives To evaluate the change in surgical management and long-term survival (disease-free survival [DFS] and overall survival [OS]) for patients with CRLM and EHD who undergo positron emission tomography combined with computed tomography (PET-CT) vs no PET-CT. Methods Patients with CRLM were enrolled in a trial evaluating the effect of PET-CT (vs no PET-CT) on surgical management, DFS, and OS. This is a sub-study of the trial, including only patients with synchronous EHD. Cox proportional hazard models were used to calculate risks for recurrence and death. Survival were described by Kaplan-Meier method and compared with log-rank test. Results Of 25 patients with EHD (PET-CT arm: 14/270 (5%) and no PET-CT arm: 11/134 (8%)), PET-CT changed surgical management in 14%, all of which avoided liver resection due to more extensive disease. Complete metastasectomy was achieved in 36% (5/14) and 72% (8/11), respectively. Respectively, PET-CT vs no PET-CT had statistically similar median DFS, 5.6 months (95% confidence interval (CI) 3.6-18) vs 7.6 months (95% CI 2.9-15) and median OS, 42 months (95% CI 25-48) vs 29 months (95% CI 17-41). EHD was associated with worse DFS (hazard ratio HR = 1.89, 95% CI 1.41-2.52) and OS (HR = 2.47, 95% CI 1.6-3.83). Conclusions Preoperative PET-CT for the management of resectable CRLM did not improve long-term outcomes among patients who had synchronous EHD; however, it changed surgical management in a relatively significant proportion of patients.
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المؤلفون: Soon, Jan Mei, Brazier, Anna Kate may, Wallace, Carol Anne
المصدر: Trends in Food Science & Technology. 97:76-87
مصطلحات موضوعية: 0301 basic medicine, medicine.medical_specialty, Food poisoning, Food industry, business.industry, Public health, digestive, oral, and skin physiology, 030106 microbiology, D620, Outbreak, D630, 04 agricultural and veterinary sciences, Near miss, medicine.disease, Food safety, 040401 food science, Product (business), 03 medical and health sciences, 0404 agricultural biotechnology, Environmental health, Economic cost, medicine, business, Food Science, Biotechnology
الوصف: Background Global food safety incidents are frequently reported and are on the rise. Although the increase in number of food safety incidents is impacted by improved surveillance and reporting systems and increased awareness from consumers, nevertheless the increase in food safety issues is a threat to public health and the economic costs of countries and businesses. Hence, identifying the root causes of contamination or recall is critically needed to understand the source of contamination in foodborne outbreaks and product recalls, thus helping food businesses to develop risk mitigating strategies. Scope and approach This study aims to identify common contributory factors in food manufacturing incidents leading to potential food safety incidents (e.g. product withdrawals and recalls, food poisoning incidents and legal offences), and to near misses. This study reviews published food safety incidents and recalls collated from official websites (e.g. Center for Disease Control and Prevention, Rapid Alert System for Food and Feed, Food Standards Australia New Zealand) and journal databases (e.g. Science Direct, PubMed). Ishikawa cause and effect analysis was used along with published information to identify possible root causes. Key findings The total specific food safety incidents and/or recalls with known or suspected causes found over the period 2008–2018 is 2932. Where possible, the contributory and root causes of incidents were identified, or literature evidence was used to determine the suspected cause. Undeclared allergens and cross contamination were identified as the top two recorded causes of food safety incidents/recalls. This review has further proposed the primary and secondary causes for undeclared allergens and cross contamination. Conclusions This study offers key insights into global food safety incidents according to food and drink categories, hazards and common contributory factors. Food manufacturers could use the identified primary and secondary causes as guidance for continuous improvement programmes to prevent food safety incidents.
وصف الملف: application/pdf
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المؤلفون: Matthew R. Orton, Ashton A. Connor, Kartik S Jhaveri, Steven Gallinger, Sandra Fischer, Joshua Shur, Dow-Mu Koh, Carol-Anne Moulton
المصدر: Journal of Surgical Oncology. 121:357-364
مصطلحات موضوعية: medicine.medical_specialty, Gadoxetic acid, medicine.diagnostic_test, business.industry, Proportional hazards model, Colorectal cancer, Hazard ratio, Computed tomography, Magnetic resonance imaging, Retrospective cohort study, General Medicine, medicine.disease, Resection, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, Surgery, Radiology, business, medicine.drug
الوصف: Background and objectives Colorectal cancer with liver metastases is potentially curable with surgical resection however clinical prognostic factors can insufficiently stratify patients. This study aims to assess whether radiomic features are prognostic and can inform clinical decision making. Methods This single-site retrospective study included 102 patients who underwent colorectal liver metastases resection with preoperative computed tomography (CT), magnetic resonance imaging (MRI) with gadoxetic acid (EOB) and clinical covariates. A lasso-regularized multivariate Cox proportional hazards model was applied to 114 features (10 clinical, 104 radiomic) to determine association with disease-free survival (DFS). A prognostic index was derived using the significant Cox regression coefficients and their corresponding input features and a threshold was determined to classify patients into high- and low-risk groups, and DFS compared using log-rank tests. Results Four covariates were significantly associated with DFS; bilobar disease (hazard ratio [HR]= 1.56; P = .0043), complete pathological response (HR= 0.67; P = .025), minimum pixel value (HR= 1.66; P = .00016), and small area emphasis (HR= 0.62; P = .0013) from the EOB-MRI data. Radiomic CT features were not prognostic. The prognostic index strongly stratified high- and low-risk prognostic groups (HR = 0.31; P = .00068). Conclusion Radiomic MRI features provided meaningful prognostic information above clinical covariates alone. This merits further validation for potential clinical implementation to inform management.
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المؤلفون: Anand Ghanekar, Arash Jaberi, Kong Teng Tan, Benjamin Loveday, Gonazolo Sapisochin, Carol-Anne Moulton, Sean P. Cleary, R. Beecroft, Ian D. McGilvray, Paul D. Greig, Steven Gallinger, Sandra Fischer, Alice C. Wei
المصدر: HPB. 21:1072-1078
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Databases, Factual, medicine.medical_treatment, Operative Time, Kaplan-Meier Estimate, 030230 surgery, Risk Assessment, Disease-Free Survival, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Preoperative Care, Carcinoma, Humans, Medicine, Embolization, Survival analysis, Aged, Proportional Hazards Models, Retrospective Studies, Hepatology, Portal Vein, business.industry, Proportional hazards model, Liver Neoplasms, Gastroenterology, Retrospective cohort study, Length of Stay, Middle Aged, medicine.disease, Combined Modality Therapy, Embolization, Therapeutic, Magnetic Resonance Imaging, Survival Analysis, Logistic Models, Treatment Outcome, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Female, Radiology, Tomography, X-Ray Computed, business, Major hepatectomy, Cohort study
الوصف: Background Portal vein embolization (PVE) is used before major hepatectomy for hepatocellular carcinoma (HCC) to increase future liver remnant (FLR) volume. However, this may increase tumour growth rate, leading to more extensive resections. This study aimed to determine the effect of tumour growth, following PVE, on treatment plan. Method Retrospective cohort study conducted on patients treated from 2008 to 2015 with PVE before major hepatectomy for HCC. Liver and tumour volumetry was performed on pre- and post-PVE CT scans. Image-based and actioned plans were compared before and after PVE. Results Thirty-one patients received PVE. Non-tumour total liver volume decreased (median 1440 to 1394 cm3; p = 0.031), while tumour (median 161–240 cm3; p Conclusion Following PVE in the setting of HCC, tumour progression accounts for a change in treatment plan in approximately a quarter of patients. Further research is warranted to determine whether additional liver directed therapy should routinely be used to slow the growth of HCC post-PVE.
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المؤلفون: Steven Gallinger, Sameer Parpia, Mark Levine, Pablo E. Serrano, Emilie P. Belley-Côté, Carol-Anne Moulton, Natalie Solis, Julian F. Daza
المصدر: European Journal of Surgical Oncology. 45:1341-1348
مصطلحات موضوعية: Male, Canada, medicine.medical_specialty, Colorectal cancer, Risk Assessment, Disease-Free Survival, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Cause of Death, Positron Emission Tomography Computed Tomography, Preoperative Care, medicine, Hepatectomy, Humans, Neoplasm Invasiveness, 030212 general & internal medicine, Colectomy, Neoplasm Staging, Randomized Controlled Trials as Topic, PET-CT, medicine.diagnostic_test, business.industry, Liver Neoplasms, Hazard ratio, Role, General Medicine, Odds ratio, Prognosis, medicine.disease, Survival Analysis, Treatment Outcome, Oncology, Positron emission tomography, Positron-Emission Tomography, 030220 oncology & carcinogenesis, Meta-analysis, Relative risk, Female, Surgery, Controlled Clinical Trials as Topic, Radiology, Colorectal Neoplasms, business
الوصف: Background Positron emission tomography (PET), alone or combined with computed tomography (CT), potentially enhances detection of occult metastatic colorectal cancer. Methods We compared the impact of PET/PET-CT with conventional imaging, versus conventional imaging alone, in patients with potentially resectable colorectal cancer liver metastases. MEDLINE, EMBASE, and CENTRAL were searched for studies investigating PET/PET-CT to determine resectability. Outcomes included overall (OS), disease-free survival (DFS), change in surgical management, and futile laparotomy. Evidence quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. A pre-specified protocol was registered in PROSPERO. Results Of 4034 articles, two randomized trials (n = 554), and 11 non-randomized studies (n = 2251) were included. PET/PET-CT did not improve OS (hazard ratio [HR] 0.94, 95% CI 0.69–1.26, moderate quality) or DFS (HR 1.01, 95% CI 0.82–1.26, moderate quality). In the two trials, PET/PET-CT changed surgical management in 8% of cases (95% CI 5–11%, high quality), and did not significantly reduce futile laparotomies (risk ratio 0.59, 95% CI 0.24–1.47, low quality). Among non-randomized studies, PET/PET-CT changed surgical management in 20% of cases (95% CI 17–22%, very low quality) and reduced futile laparotomies (odds ratio 0.51, 95% CI 0.32–0.81, very low quality). Conclusions Moderate-quality evidence suggests that preoperative PET/PET-CT does not improve OS or DFS in patients with colorectal cancer liver metastases. These results do not support routine use of PET/PET-CT in patients with potentially resectable disease. The main limitation of this study was the lack of randomized studies.
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المؤلفون: Shawn Hutchinson, Kartik S. Jhaveri, Ali Babaei Jandaghi, Trevor Reichman, Ian D. McGilvary, Osvaldo Espin-Garcia, Steven Gallinger, Carol-Anne Moulton, Anna Dodd, Seng Thipphavong
المصدر: Cancer Imaging, Vol 21, Iss 1, Pp 1-12 (2021)
Cancer Imagingمصطلحات موضوعية: Adult, Gadolinium DTPA, Male, CT scan, medicine.medical_specialty, Gadoxetic acid, Whipple procedure, R895-920, Liver mri, Surgical planning, 030218 nuclear medicine & medical imaging, Metastasis, Whipple Procedure, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, McNemar's test, Pancreatic cancer, Preoperative Care, medicine, Humans, Radiology, Nuclear Medicine and imaging, Liver metastasis, RC254-282, Aged, Retrospective Studies, Aged, 80 and over, Laparotomy, Radiological and Ultrasound Technology, business.industry, Gadoxetic acid-enhanced MRI, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Surgery, Pancreatic Neoplasms, Liver, Oncology, 030220 oncology & carcinogenesis, Female, Histopathology, business, Pancreatic adenocarcinoma, Research Article, medicine.drug
الوصف: Objectives To evaluate gadoxetic acid-enhanced liver MRI (EOB-MRI) versus contrast-enhanced computed tomography (CECT) for preoperative detection of liver metastasis (LM) and reduction of open-close laparotomies for pancreatic ductal adenocarcinoma (PDAC). Methods Sixty-six patients with PDAC had undergone preoperative EOB-MRI and CECT. LM detection by EOB-MRI and CECT and their impact on surgical planning, open-close laparotomies were compared by clinical and radiology reports and retrospective analysis of imaging by two blinded independent readers. Histopathology or imaging follow-up was the reference standard. Statistical analysis was performed at patient and lesion levels with two-sided McNemar tests. Results EOB-MRI showed higher sensitivity versus CECT (71.7% [62.1-80.0] vs. 34% [25.0-43.8]; p = 0.009), comparable specificity (98.6%, [96.9-99.5] vs. 100%, [99.1-100], and higher AUROC (85.1%, [80.4-89.9] vs. 66.9%, [60.9-73.1]) for LM detection. An incremental 7.6% of patients were excluded from surgery with a potential reduction of up to 13.6% in futile open-close laparotomies due to LM detected on EOB-MRI only. Conclusions Preoperative EOB-MRI has superior diagnostic performance in detecting LM from PDAC. This better informs surgical eligibility with potential reduction of futile open-close laparotomies from attempted curative intent pancreatic cancer surgery.
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المؤلفون: Stefano Partelli, John K. Ramage, Sara Massironi, Alessandro Zerbi, Hong Beom Kim, Patricia Niccoli, Francesco Panzuto, Luca Landoni, Ales Tomazic, Toni Ibrahim, Gregory Kaltsas, Emilio Bertani, Alain Sauvanet, Eva Segelov, Martyn Caplin, Jorgelina Coppa, Thomas Armstrong, Martin O. Weickert, Giovanni Butturini, Stefan Staettner, Florian Boesch, Mauro Cives, Carol Anne Moulton, Jin He, Andreas Selberherr, Orit Twito, Antonio Castaldi, Claudio Giovanni De Angelis, Sebastien Gaujoux, Hussein Almeamar, Andrea Frilling, Emanuel Vigia, Colin Wilson, Francesca Muffatti, Raj Srirajaskanthan, Pietro Invernizzi, Andrea Lania, Wooil Kwon, Jacques Ewald, Maria Rinzivillo, Chiara Nessi, Lojze M. Smid, Andrea Gardini, Marina Tsoli, Edgardo E. Picardi, Olivia Hentic, Daniel Croagh, Christos Toumpanakis, Davide Citterio, Emma Ramsey, Barbara Mosterman, Paolo Regi, Silvia Gasteiger, Roberta E. Rossi, Valeria Smiroldo, Jin-Young Jang, Massimo Falconi
المساهمون: Partelli, S, Ramage, J, Massironi, S, Zerbi, A, Kim, H, Niccoli, P, Panzuto, F, Landoni, L, Tomazic, A, Ibrahim, T, Kaltsas, G, Bertani, E, Sauvanet, A, Segelov, E, Caplin, M, Coppa, J, Armstrong, T, Weickert, M, Butturini, G, Staettner, S, Boesch, F, Cives, M, Moulton, C, He, J, Selberherr, A, Twito, O, Castaldi, A, De Angelis, C, Gaujoux, S, Almeamar, H, Frilling, A, Vigia, E, Wilson, C, Muffatti, F, Srirajaskanthan, R, Invernizzi, P, Lania, A, Kwon, W, Ewald, J, Rinzivillo, M, Nessi, C, Smid, L, Gardini, A, Tsoli, M, Picardi, E, Hentic, O, Croagh, D, Toumpanakis, C, Citterio, D, Ramsey, E, Mosterman, B, Regi, P, Gasteiger, S, Rossi, R, Smiroldo, V, Jang, J, Falconi, M, Partelli, Stefano, Ramage, John K, Massironi, Sara, Zerbi, Alessandro, Kim, Hong Beom, Niccoli, Patricia, Panzuto, Francesco, Landoni, Luca, Tomazic, Ale, Ibrahim, Toni, Kaltsas, Gregory, Bertani, Emilio, Sauvanet, Alain, Segelov, Eva, Caplin, Martyn, Coppa, Jorgelina, Armstrong, Thoma, Weickert, Martin O, Butturini, Giovanni, Staettner, Stefan, Boesch, Florian, Cives, Mauro, Moulton, Carol Anne, He, Jin, Selberherr, Andrea, Twito, Orit, Castaldi, Antonio, De Angelis, Claudio Giovanni, Gaujoux, Sebastien, Almeamar, Hussein, Frilling, Andrea, Vigia, Emanuel, Wilson, Colin, Muffatti, Francesca, Srirajaskanthan, Raj, Invernizzi, Pietro, Lania, Andrea, Kwon, Wooil, Ewald, Jacque, Rinzivillo, Maria, Nessi, Chiara, Smid, Lojze M, Gardini, Andrea, Tsoli, Marina, Picardi, Edgardo E, Hentic, Olivia, Croagh, Daniel, Toumpanakis, Christo, Citterio, Davide, Ramsey, Emma, Mosterman, Barbara, Regi, Paolo, Gasteiger, Silvia, Rossi, Roberta E, Smiroldo, Valeria, Jang, Jin-Young, Falconi, Massimo
المصدر: Frontiers in Medicine
Frontiers in Medicine, Vol 7 (2020)
Repositório Científico de Acesso Aberto de Portugal
Repositório Científico de Acesso Aberto de Portugal (RCAAP)
instacron:RCAAPمصطلحات موضوعية: lcsh:R5-920, medicine.medical_specialty, Surgical approach, business.industry, Optimal treatment, Nodule (medicine), General Medicine, small nonfunctioning pancreatic neuroendocrine neoplasm, Asymptomatic, NF-PanNEN_2 cm, HCC CHBPT, ASPEN study, surgery, Study Protocol, aspen study, follow-up, management, nf-pannen_2 cm, surveillance, medicine, Medicine, Observational study, Radiology, medicine.symptom, lcsh:Medicine (General), business
الوصف: Introduction: The optimal treatment for small, asymptomatic, nonfunctioning pancreatic neuroendocrine neoplasms (NF-PanNEN) is still controversial. European Neuroendocrine Tumor Society (ENETS) guidelines recommend a watchful strategy for asymptomatic NF-PanNEN Methods: ASPEN is a prospective international observational multicentric cohort study supported by ENETS. The study is registered in ClinicalTrials.gov with the identification code NCT03084770. Based on the incidence of NF-PanNEN the number of expected patients to be enrolled in the ASPEN study is 1,000 during the study period (2017–2022). Primary endpoint is disease/progression-free survival, defined as the time from study enrolment to the first evidence of progression (active surveillance group) or recurrence of disease (surgery group) or death from disease. Inclusion criteria are: age >18 years, the presence of asymptomatic sporadic NF-PanNEN ≤2 cm proven by a positive fine-needle aspiration (FNA) or by the presence of a measurable nodule on high-quality imaging techniques that is positive at 68Gallium DOTATOC-PET scan.Conclusion: The ASPEN study is designed to investigate if an active surveillance of asymptomatic NF-PanNEN ≤2 cm is safe as compared to surgical approach.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6da57c9998ebaeb2654596b89223d578
http://hdl.handle.net/10281/336891
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