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Joost Huiskens Pim B. Olthof Eric P. van der Stok Thomas Bais Krijn P. van Lienden Adriaan Moelker Jan Krumeich Rudi M. Roumen Dirk J. Grünhagen Cornelis J.A. Punt Martin van Amerongen Johannes H.W. de Wilt Cornelis Verhoef Thomas M. Van Gulik 《European journal of surgical oncology》2018,44(1):108-114
Introduction
There is an ongoing controversy surrounding portal vein embolization (PVE) regarding the short-term safety of PVE and long-term oncological benefit. This study aims to compare survival outcomes of patients subjected to major liver resection for colorectal liver metastases (CRLM) with or without PVE.Methods
All consecutive patients who underwent major liver resection for CRLM in four high volume liver centres between January 2000 and December 2015 were included. Major liver resection was defined as resection of at least three Couinaud liver segments. To reduce selection bias, propensity score matching was performed for PVE and non-PVE patients with overall and disease-free survival as primary endpoints. For matching, all patients who underwent PVE followed by a major liver resection were selected. Patients were matched to patients who had undergone major liver resection without PVE.Results
Of 745 patients undergoing major liver resection for CRLM, 53 patients (7%) underwent PVE before liver resection. In the overall cohorts, PVE patients had inferior DFS and a trend towards inferior OS. A total of 46 PVE patients were matched to 46 non-PVE patients to create comparable cohorts and between these two matched cohorts no differences in DFS (3-year DFS 16% vs 9%, p = 0.776) or OS (5-year OS 14% vs 14%, p = 0.866) were found.Conclusions
This retrospective, matched analysis does not suggest a negative impact of PVE on long-term outcomes after liver resection in patients with CRLM. 相似文献2.
P.B. Olthof J. Huiskens N.R. Schulte D.A. Wicherts M.G. Besselink O.R.C. Busch P.J. Tanis T.M. van Gulik 《European journal of surgical oncology》2017,43(1):100-106
Background
Hepatic vascular inflow occlusion (VIO) can be applied during resection of colorectal liver metastases (CRLM) to control intra-operative blood loss, but has been linked to accelerated growth of micrometastases in experimental models. This study aimed to investigate the effects of hepatic VIO on disease-free and overall survival (DFS and OS) in patients following resection for CRLM.Methods
All patients who underwent liver resection for CRLM between January 2006 and September 2015 at our center were analyzed. Hepatic VIO was performed if deemed indicated by the operating surgeon and severe ischemia was defined as ≥20 min continuous or ≥45 min cumulative intermittent VIO. Cox regression analysis was performed to identify predictive factors for DFS and OS.Results
A total of 208 patients underwent liver resection for CRLM. VIO was performed in 64 procedures (31%), and fulfilled the definition of severe ischemia in 40 patients. Patients with severe ischemia had inferior DFS (5-year DFS 32% vs. 11%, P < 0.01), and inferior OS (5-year OS 37% vs. 64%, P < 0.01). At multivariate analysis, a high clinical risk score (Hazard ratio (HR) 1.60 (1.08–2.36)) and severe ischemia (HR 1.89 (1.21–2.97)) were independent predictors of worse DFS. Severe ischemia was not an independent predictor of OS.Conclusion
The present cohort study suggests that prolonged hepatic VIO during liver resection for CRLM was associated with reduced DFS. A patient-tailored approach seems advisable although larger studies should confirm these findings. 相似文献3.
Irene Jacobi Lisette van der Molen Hermelinde Huiskens Maya A. van Rossum Frans J. M. Hilgers 《European archives of oto-rhino-laryngology》2010,267(10):1495-1505
Purpose of this review is to systematically assess the effects on voice and speech of advanced head and neck cancer and its
treatment by means of chemoradiotherapy (CRT). The databases Medline, Embase and Cochrane were searched (1991–2009) for terms
head and neck cancer, chemoradiation, voice and speech rehabilitation. Twenty articles met the inclusion criteria, whereof
14 reported on voice outcomes and 10 on speech. Within the selected 20 studies, 18 different tools were used for speech or
voice evaluation. Most studies assessed their data by means of patient questionnaires. Four studies presented outcome measures
in more than one dimension. Most studies summarised the outcomes of posttreatment data that were assessed at various points
in time after treatment. Except for four studies, pre-treatment measurements were lacking. This and the fact that most studies
combined the outcomes of patients with radiated laryngeal cancers with outcome data of non-laryngeal cancer patients impedes
an interpretation in terms of the effects of radiation versus the effects of the disease itself on voice or speech. Overall,
the studies indicated that voice and speech degenerated during CRT, improved again 1–2 months after treatment and exceeded
pre-treatment levels after 1 year or longer. However, voice and speech measures do not show normal values before or after
treatment. Given the large-ranged posttreatment data, missing baseline assessment and the lacking separation of tumour/radiation
sites, there is an urgent need for structured standardised multi-dimensional speech and voice assessment protocols in patients
with advanced head and neck cancer treated with CRT. 相似文献
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Jansen Swetta A. Huiskens Bas Trompet Stella Jukema JWouter Mooijaart Simon P. Willems van Dijk Ko van Heemst Diana Noordam Raymond 《Age (Dordrecht, Netherlands)》2022,44(3):1703-1713
GeroScience - The significance of classical risk factors in coronary artery disease (CAD) remains unclear in older age due to possible changes in underlying disease pathologies. Therefore, we... 相似文献
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Snoeren N Huiskens J Rijken AM van Hillegersberg R van Erkel AR Slooter GD Klaase JM van den Tol PM Ten Kate FJ Jansen MC van Gulik TM 《Annals of surgical oncology》2011,18(13):3702-3710
Background
Local tumor progression (LTP) is a serious complication after local ablation of malignant liver tumors, negatively influencing patient survival. LTP may be the result of incomplete ablation of the treated tumor. In this study, we determined whether viable tumor cells attached to the needle applicator after ablation was associated with LTP and disease-free survival.Methods
In this prospective study, tissue was collected of 96 consecutive patients who underwent local liver ablations for 130 liver malignancies. Cells and tissue attached to the needle applicators were analyzed for viability using glucose-6-phosphate-dehydrogenase staining and autofluorescence intensity levels of H&;E stained sections. Patients were followed-up until disease progression.Results
Viable tumor cells were found on the needle applicators after local ablation in 26.7% of patients. The type of needle applicator used, an open approach, and the omission of track ablation were significantly correlated with viable tumor tissue adherent to the needle applicator. The presence of viable cells was an independent predictor of LTP. The attachment of viable cells to the needle applicators was associated with a shorter time to LTP.Conclusions
Viable tumor cells adherent to the needle applicators were found after ablation of 26.7% of patients. An independent risk factor for viable cells adherent to the needle applicators is the omission of track ablation. We recommend using only RFA devices that have track ablation functionality. Adherence of viable tumor cells to the needle applicator after local ablation was an independent risk factor for LTP. 相似文献
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