42 research outputs found
A multi-institution analysis of outcomes of liver-directed surgery for metastatic renal cell cancer
No full textObjectives: Management of liver metastasis (LM) from a non-colorectal, non-neuroendocrine primary carcinoma remains controversial. Few data exist on the management of hepatic metastasis from primary renal cell carcinoma (RCC). This study sought to determine the safety and efficacy of surgery for RCC LM. Methods: A total of 43 patients who underwent surgery for RCC hepatic metastasis between 1994 and 2011 were identified in a multi-institution hepatobiliary database. Clinicopathologic, operative and outcome data were collected and analysed. Results: Mean patient age was 62.4 years and most patients (67.4%) were male. The mean tumour size of the primary RCC was 6.9 cm and most tumours (72.1%) were designated as clear cell carcinoma. Nine patients (20.9%) presented with synchronous LM. Among the patients with metachronous disease, the median time from diagnosis of the primary RCC to treatment of LM was 17.2 months (range: 2.1189.3 months). The mean size of the RCC LM was 4.0 cm and most patients (55.8%) had a solitary metastasis. Most patients (86.0%) underwent a minor resection (up to three segments). Final pathology showed margin status to be negative (R0) in 95.3% of patients. Postoperative morbidity was 23.3% and there was one perioperative death. A total of 69.8% of patients received perioperative chemotherapy. Overall 3-year survival was 62.1%. Three-year recurrence-free survival was 27.3% and the median length of recurrence-free survival was 15.5 months. Conclusions: Resection of RCC hepatic metastasis is safe and is associated with low morbidity and near-zero mortality. Although recurrence occurs in up to 50% of patients, resection can be associated with long-term survival in a well-selected subset of patients
Comparing neoadjuvant chemotherapy with or without radiation therapy for pancreatic ductal adenocarcinoma: National Cancer Database cohort analysis
No full textBackground: Neoadjuvant treatment is important for improving the rate of R0 surgical resection and overall survival outcome in treating patients with pancreatic ductal adenocarcinoma (PDAC). However, the true efficacy of radiotherapy (RT) for neoadjuvant treatment of PDAC is uncertain. This retrospective study evaluated the treatment outcome of neoadjuvant RT in the treatment of PDAC. Methods: Collected from the National Cancer Database, information on patients with PDAC who underwent neoadjuvant chemotherapy (NAC) and pancreatectomy between 2010 to 2016 was used in this study. Short- and long-term outcomes were compared between patients who received neoadjuvant chemoradiotherapy (NACRT) and NAC. Results: The study included 6936 patients, of whom 3185 received NACRT and 3751 NAC. The groups showed no difference in overall survival (NACRT 16.1 months versus NAC 17.4 months; P = 0.054). NACRT is associated with more frequent margin negative resection (86.1 versus 80.0 per cent; P < 0.001) but a more unfavourable 90-day mortality than NAC (6.4 versus 3.6 per cent; P < 0.001). The odds of 90-day mortality were higher in the radiotherapy group (odds ratio 1.81; P < 0.001), even after adjusting for significant covariates. Patients who received NACRT received single-agent chemotherapy more often than those who received NAC (31.5 versus 10.7 per cent; P < 0.001). Conclusion: This study failed to show a survival benefit for NACRT over NAC alone, despite its association with negative margin resection. The significantly higher mortality in NACRT warrants further investigation into its efficacy in the treatment of pancreatic cancer
Renal Dysfunction in Liver Transplant Candidates: Evaluation, Classification and Management in Contemporary Practice
No full text
Time-related changes in the prognostic significance of the total number of examined lymph nodes in node-negative pancreatic head cancer
No full textModel for the end-stage liver disease and death prediction in a cohort of Brazilian patients on the waiting list for liver transplantation
No full textDevelopment and validation of the albumin-bilirubin gamma-glutamyl transferase score for enhanced prognostic accuracy after hepatocellular carcinoma resection
No full textBackground The albumin-bilirubin (ALBI) score, used for predicting outcomes after hepatocellular carcinoma (HCC) resection, does not directly capture liver cell damage or biliary obstruction. Gamma-glutamyl transferase (GGT), which reflects hepatic oxidative stress and inflammation, may complement the ALBI score. We sought to develop the ALBI-GGT score, a composite prognostic tool, and evaluate its performance to predict long-term outcomes among patients undergoing HCC resection. Methods Patients undergoing curative-intent HCC resection (2000-2023) were identified from an international, multi-institutional database. The cohort was divided into training (65%) and testing cohorts (35%). Multivariable Cox analysis examined the association of ALBI-GGT score with overall survival (OS). Results Among 759 patients, the median ALBI score was -2.78 (-3.02 to -2.48), and the median GGT was 55.0 U/L (31.0-93.0). On multivariable analysis, ALBI score (hazard ratio [HR], 1.473 [1.112-1.950]; P =.007) and GGT (HR, 1.007 [1.004-1.010]; P <.001) were predictors of overall mortality, alongside tumor burden score (HR, 1.051 [1.015-1.090]; P =.006) and American Society of Anesthesiologists class >2 (HR, 1.473 [1.005-2.161]; P =.047). There was a near-linear correlation between increasing ALBI scores and GGT and higher hazards of death. The ALBI-GGT score demonstrated the highest predictive accuracy in the testing set (concordance index, 0.68 [0.58-0.72]), outperforming the ALBI score (0.62 [0.56-0.69]) and GGT (0.65 [0.58-0.72]). The ALBI-GGT achieved the lowest Akaike and Bayesian information criteria. Time-dependent area under the curve (AUC) analysis demonstrated consistent superiority over 0 to 60 months. At 1-, 3-, and 5-years, the ALBI-GGT score had AUCs of 0.782, 0.725, and 0.688, respectively, outperforming ALBI score and GGT. The ALBI-GGT score was able to stratify patients into distinct prognostic groups (5-year OS, low ALBI-GGT [85.0%] vs intermediate ALBI-GGT [65.8%] vs high ALBI-GGT [56.8%]; P <.001). Conclusion ALBI score alone may be insufficient to prognostically stratify patients with HCC. Combining ALBI score with GGT was a superior tool to stratify patients relative to long-term survival. (c) 2025 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies
Non-Transplantable Recurrence After Initial Liver Resection of Hepatocellular Carcinoma: A Narrative Review
No full textEfecto de diversas cepas de levadura sobre caracteristicas analiticas y sensoriales de vinos Chardonnay y Sauvignon blanc, bajo condiciones de microvinificacion.
No full textResumen (Spanish, English)51 p.Se realizó un ensayo entre los meses de marzo-agosto de 2000, en el Centro Tecnológico de la Vid y el Vino (CTVV), perteneciente a la Universidad de Talca, con el objetivo de evaluar el comportamiento fermentativo y las características analíticas y sensoriales de tres cepas de levadura en vinos Chardonnay y tres cepas de levadura en vinos Sauvignon Blanc. El ensayo tuvo un diseño completamente al azar, con tres repeticiones. Los resultados obtenidos en los análisis químicos se evaluaron a través de un análisis de varianza y la separación de medias se realizó por medio del Test de LSD. Para la evaluación sensorial se utilizó el Test de Kruskall-Wallis. Para la microvinificación de cada cultivar se utilizó una pauta de microvinificación tradicional elaborada por el CTVV, para la producción de vinos blancos. Cada tratamiento correspondió a una de las siguientes cepas de levadura. Mosto Chardonnay: Collection Cepage Chardonnay, LVCB se 2- y LVCB ct 1 +. Mosto Sauvignon Blanc: Collection Cepage Sauvignon, Equinox 509 y 7105. Las cepas LVCB ct 1+ y Collection Cepage Chardonnay en mostos chardonnay, presentaron una cinética fermentativa regular, durante el transcurso de la fermentación alcohólica. En cambio, la cepa LVCB se 2- tuvo una relentización durante el último tercio de la fermentación. Además, ninguna de las cepas utilizadas dejó el vino completamente seco (menos de 2 g/L de azúcar residual). En mostos Sauvignon Blanc, la evolución de la fermentación presentó buenas características fermentativas mostrando un comportamiento similar entre las tres cepas utilizadas, sin embargo, ninguna de ellas fue capaz de dejar el vino con bajo contenido de azúcar residual. Analíticamente, tanto los vinos Chardonnay como Sauvignon Blanc, no mostraron diferencias significativas en ninguno de las variables estudiadas, a excepción del sulfuroso total. Sensorialmente, el panel calificador no mostró preferencias claras por ninguno de los vinos Sauvignon Blanc , en cambio, en la variedad Chardonnay, los vinos obtenidos por la cepa LVCB ct 1+, fueron calificados como los de mejor calidad
