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排序方式: 共有94条查询结果,搜索用时 15 毫秒
1.
Giuliante Felice Viganò Luca De Rose Agostino M. Mirza Darius F. Lapointe Réal Kaiser Gernot Barroso Eduardo Ferrero Alessandro Isoniemi Helena Lopez-Ben Santiago Popescu Irinel Ouellet Jean-Francois Hubert Catherine Regimbeau Jean-Marc Lin Jen-Kou Skipenko Oleg G. Ardito Francesco Adam René 《Annals of surgical oncology》2021,28(13):8198-8208
Annals of Surgical Oncology - The liver-first approach in patients with synchronous colorectal liver metastases (CRLM) has gained wide consensus but its role is still to be clarified. We aimed to... 相似文献
2.
Living donor liver transplantation and hepatitis C 总被引:1,自引:0,他引:1
Preliminary results indicate that living donor liver transplantation (LDLT) recipients infected with HCV develop earlier and more severe recurrence than their cadaveric counterparts. The mechanisms underlying this observation are unknown, but could include hepatic regeneration, differences in LDLT recipient demographics, immune homology between donor and recipient, or other factors not previously considered. The optimum clinical approach is to consider LDLT in HCV-infected recipients only as a life-saving procedure and to attempt to eradicate HCV before LT to prevent recurrent infection. 相似文献
3.
Dumitrascu T Barbu ST Purnichescu-Purtan R Ionescu M Popescu I 《Hepato-gastroenterology》2012,59(114):592-598
Background/Aims: Central pancreatectomy is a pancreas- sparing alternative to standard pancreatic resections in selected cases. Although associated with high morbidity, the risk factors for surgical complications of this procedure are not yet defined. Methodology: The clinicopathological and perioperative data of 24 patients who underwent central pancreatectomies (2002-2010) were correlated with surgical complications. Results: The overall morbidity rate was 54% (pancreatic fistula, 40%). In a univariate analysis, age over 40 years, body mass index ≥30kg/m2, smoking and American Society of Anesthesiologists III scores were significantly correlated with increased morbidity. In a multivariate analysis, a significant correlation with the development of complications was found for body mass index ≥30kg/m2 and age over 40 years. Conclusions: Certain patient-related factors (older age, obesity and smoking) appear to have a negative impact on early postoperative outcome after central pancreatectomy. For patients with these factors, an alternative distal pancreatectomy should be considered. Central pancreatectomy should be tailored not only to the pathology but also to the patient profile. 相似文献
4.
5.
Andrew X. Zhu MD Darrell R. Borger MD Yuhree Kim MD David Cosgrove MD Aslam Ejaz MD Sorin Alexandrescu MD Ryan Thomas Groeschl MD Vikram Deshpande MD James M. Lindberg MD Cristina Ferrone MD Christine Sempoux MD Thomas Yau MD Ronnie Poon MD Irinel Popescu MD Todd W. Bauer MD T. Clark Gamblin MD Jean Francois Gigot MD Robert A. Anders MD Timothy M. Pawlik MD MPH PhD 《Annals of surgical oncology》2014,21(12):3827-3834
Background
The molecular alterations that drive tumorigenesis in intrahepatic cholangiocarcinoma (ICC) remain poorly defined. We sought to determine the incidence and prognostic significance of mutations associated with ICC among patients undergoing surgical resection.Methods
Multiplexed mutational profiling was performed using nucleic acids that were extracted from 200 resected ICC tumor specimens from 7 centers. The frequency of mutations was ascertained and the effect on outcome was determined.Results
The majority of patients (61.5 %) had no genetic mutation identified. Among the 77 patients (38.5 %) with a genetic mutation, only a small number of gene mutations were identified with a frequency of >5 %: IDH1 (15.5 %) and KRAS (8.6 %). Other genetic mutations were identified in very low frequency: BRAF (4.9 %), IDH2 (4.5 %), PIK3CA (4.3 %), NRAS (3.1 %), TP53 (2.5 %), MAP2K1 (1.9 %), CTNNB1 (0.6 %), and PTEN (0.6 %). Among patients with an IDH1-mutant tumor, approximately 7 % were associated with a concurrent PIK3CA gene mutation or a mutation in MAP2K1 (4 %). No concurrent mutations in IDH1 and KRAS were noted. Compared with ICC tumors that had no identified mutation, IDH1-mutant tumors were more often bilateral (odds ratio 2.75), while KRAS-mutant tumors were more likely to be associated with R1 margin (odds ratio 6.51) (both P < 0.05). Although clinicopathological features such as tumor number and nodal status were associated with survival, no specific mutation was associated with prognosis.Conclusions
Most somatic mutations in resected ICC tissue are found at low frequency, supporting a need for broad-based mutational profiling in these patients. IDH1 and KRAS were the most common mutations noted. Although certain mutations were associated with ICC clinicopathological features, mutational status did not seemingly affect long-term prognosis. 相似文献6.
Dean J. Arnaoutakis MD Michael N. Mavros MD Feng Shen MD Sorin Alexandrescu MD Amin Firoozmand MD Irinel Popescu MD Matthew Weiss MD Christopher L. Wolfgang MD Michael A. Choti MD Timothy M. Pawlik MD MPH PhD 《Annals of surgical oncology》2014,21(1):147-154
Background
Hepatocellular carcinoma (HCC) primarily affects patients with a cirrhotic liver. Reports on the characteristics of patients with HCC in noncirrhotic liver, as well as predictors of recurrence and survival, are scarce.Methods
Between 1992 and 2011, 334 patients treated for HCC in noncirrhotic liver were identified from three major hepatobiliary centers. Clinicopathological characteristics were analyzed and independent predictors of recurrence and overall survival were identified using Cox proportional hazards models.Results
Median patient age was 58 years and 77 % were male. Most patients had a solitary (81 %) and poorly or undifferentiated tumor (56 %); median size was 6.5 cm. The majority of patients (96 %) underwent liver resection (microscopically negative margins in 94 %), whereas a few had transarterial chemoembolization or transplantation (4 %). Median recurrence-free survival (RFS) was 2.5 years, and 1- and 5-year RFS was 71.1, and 35 %, respectively. Elevated alkaline phosphatase levels [hazards ratio (HR) = 1.82], poor tumor differentiation (HR = 1.4), macrovascular invasion (HR = 2.18), and the presence of satellite lesions (HR = 1.9), or intrahepatic metastases (HR = 2.59) were independently associated with shorter RFS; in contrast, an intact tumor capsule independently prolonged RFS (HR = 0.46). Median overall survival was 5.9 years, and 1- and 5-year overall survival was 86.9, and 54.5 %, respectively. Tumor size ≥5 cm (HR = 2.27), macrovascular (HR = 2.72) or adjacent organ invasion (HR = 3.34), and satellite lesions (HR = 2.18) were independently associated with shorter overall survival, whereas an intact tumor capsule showed a protective effect (HR = 0.51).Conclusions
Following resection of HCC in the setting of no cirrhosis, more than one-half of patients were alive after 5 years. However, even among patients with no cirrhosis, recurrence was common. Factors associated with RFS and overall survival included tumor characteristics, such as tumor capsule, satellite lesions, and vascular invasion. 相似文献7.
Gaya Spolverato Aslam Ejaz Yuhree Kim Georgios C. Sotiropoulos Andreas Pau Sorin Alexandrescu Hugo Marques Carlo Pulitano Eduardo Barroso Bryan M. Clary Luca Aldrighetti Todd W. Bauer Dustin M. Walters Ryan Groeschl T. Clark Gamblin Wallis Marsh Kevin T. Nguyen Ryan Turley Irinel Popescu Catherine Hubert Stephanie Meyer Jean-Francois Gigot Gilles Mentha Timothy M. Pawlik 《Journal of gastrointestinal surgery》2014,18(7):1284-1291
The association between tumor size and survival in patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection is controversial. We sought to define the incidence of major and microscopic vascular invasion relative to ICC tumor size, and identify predictors of microscopic vascular invasion in patients with ICC ≥5 cm. A total of 443 patients undergoing surgical resection for ICC between 1973 and 2011 at one of 11 participating institutions were identified. Clinical and pathologic data were evaluated using uni- and multivariate analyses. As tumor sized increased, the incidence of microscopic vascular invasion increased: <3 cm, 3.6 %; 3–5 cm, 24.7 %; 5–7 cm, 38.3 %; 7–15 cm, 32.9 %, ≥15 cm, 55.6 %; (p?<?0.001). Increasing tumor size was also found to be associated with worsening tumor grade. The incidence of poorly differentiated tumors increased with increasing ICC tumor size: <3 cm, 9.7 %; 3–5 cm, 19.8 %; 5–7 cm, 24.2 %; 7–15 cm, 21.1 %; >15 cm, 31.6 % (p?=?0.04). The presence of perineural invasion (odds ratio [OR]?=?2.98) and regional lymph node metastasis (OR?=?4.43) were independently associated with an increased risk of microscopic vascular invasion in tumors ≥5 cm (both p?<?0.05). Risk of microscopic vascular invasion and worse tumor grade increased with tumor size. Large tumors likely harbor worse pathologic features; this information should be considered when determining therapy and prognosis of patients with large ICC. 相似文献
8.
Badea I Moja D Tudose A Stoicescu D 《Journal of pharmaceutical and biomedical analysis》2002,30(4):1371-1378
A first derivative spectrometric method has been developed for the determination of the 5-fluorouracil and N1(2'-furanidyl)uracil related substances and degradation products of tegafur. The wavelengths selected for the determination of 5-fluorouracil and N1(2'-furanidyl)uracil were 298 and 288 nm, respectively. At this wavelength, the calibration graphs between the amplitude of the signals and the concentration of each compound were linear up to 24.75 mg l(-1) for 5-fluorouracil and up to 20.20 mg l(-1) for N1(2'-furanidyl)uracil. The detection limits were 0.40 and 0.050 mg l(-1) for 5-fluorouracil and N1(2'-furanidyl)uracil, respectively. The method is simple and rapid and does not require any preliminary treatment of the sample. The method was validated. 相似文献
9.
10.
Xu-Feng Zhang Fabio Bagante Qinyu Chen Eliza W. Beal Yi Lv Matthew Weiss Irinel Popescu Hugo P. Marques Luca Aldrighetti Shishir K. Maithel Carlo Pulitano Todd W. Bauer Feng Shen George A. Poultsides Olivier Soubrane Guillaume Martel B. Groot Koerkamp Alfredo Guglielmi Timothy M. Pawlik 《Surgery》2018,163(5):1114-1120