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Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index

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World Journal of Gastroenterology 2008年第20期14卷 3224-3230页

作者： Mirna H Farhat ali i shamseddine Ayman N Tawil Ghina Berjawi Charif Sidani Wael Shamseddeen Kassem A Barada Division of Hematology-Oncology Department of Internal Medicine American University of Beirut Medical Center Department of Pathology American Universityof Beirut Medical Center Department of Radiology American University of Beirut Medical Center Department of Public health American University of Beirut Medical Center Division of Gastroenterology Departmentof Internal Medicine American University of Beirut MedicalCenter

AiM: To study the factors that may affect survival of cholangiocarcinoma in Lebanon. METHODS: A retrospective review of the medical records of 55 patients diagnosed with cholangio- carcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival. RESULTS: The median survival of all patients was 8.57 mo (0.03-105.2). Univariate analysis showed that low bilirubin level (ical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012, 0.038 and 0.038, respectively). in subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 mo, P = 0.001). Multivariate analysis identifiedonly low bilirubin level inistration as independent predictors associated with better survival (P iON: Our data show that palliative and postoperative chemotherapy as well as a bilirubin level independent predictors of a significant increase in survival in patients with cholangiocarcinoma.

关键词：胆红素胆管癌手术治疗化学疗法

Management Practices of Locally Advanced and Metastatic Urothelial Carcinoma: A Questionnaire-Based Survey among Lebanese Oncologists

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Open Journal of Urology 2024年第2期14卷 138-149页

作者： Joseph Kattan Sally Temraz Fadi Nasr Arafat Tfayli Christina Khater Anas Mugharbel Hady Ghanem Hampig Raphael Kourie Georges Hachem Sarah Masri Jamil Debs ali shamseddine Department of Hematology-Oncology H&#244tel-Dieu de France University Hospital Faculty of Medicine Saint-Joseph University of Beirut Beirut Lebanon Department of internal Medicine Hematology-Oncology Division American University of Beirut Medical Center Beirut Lebanon Hematology-Oncology Division American University of Beirut Medical Center Beirut Lebanon Department of Hematology-Oncology Saint Charles Hospital Beirut Lebanon Department of internal Medicine Makassed General Hospital Beirut Lebanon Hematology-Oncology Division Lebanese American University Medical Center - Rizk Hospital Beirut Lebanon Department of Hematology-Oncology Saint George Hospital University Medical Center Beirut Lebanon Pfizer Medical Affairs Beirut Lebanon

Background and Objective: The outcome of locally advanced and metastatic urothelial carcinoma LA/mUC has improved over the past years with a plethora of new treatments and the approval of immune checkpoint inhibitors (iCis), antibody-drug conjugates, and targeted agents, to identify locally advanced metastatic urothelial carcinoma’s current management practices in Lebanon and the implication of the ongoing economic crisis on the medical practice. Methods: An online questionnaire was used to survey ten Lebanese oncologists from six different hospitals, between July 5 and July 11, 2022, requesting information pertaining to their current clinical practice in the pharmacological treatment of locally advanced metastatic urothelial carcinoma. Key Findings: Cisplatin-based chemotherapy was the most frequently reported initial treatment of locally advanced metastatic urothelial carcinoma. Participants reported using immune checkpoint inhibitors in platinum-ineligible patients and those with PDL1 positive tumors. Also, they would not consider the concomitant use of immunotherapy and chemotherapy in the first-line setting. Participants believed that avelumab maintenance is effective in the absence of progression after first-line platinum-based chemotherapy;they would consider initiating it 2 - 10 weeks after completion of chemotherapy. Conclusions and Clinical implications: After comparing with current international guidelines, this study shows that Lebanese oncologists follow international guidelines and have deep knowledge of recent clinical trials for the management of locally advanced metastatic urothelial carcinoma, regardless of economic crisis challenges.

关键词： Clinical Practice Chemotherapy immune Checkpoint inhibitors PDL1 Urothelial Carcinoma

Sequencing of treatment in metastatic colorectal cancer:Where to fit the target?

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World Journal of Gastroenterology 2014年第8期20卷 1993-2004页

作者： Sally Temraz Deborah Mukherji ali shamseddine Division of Hematology/Oncology Department of Internal MedicineAmerican University of Beirut Medical Center (AUBMC)Riad El Solh 110 72020BeirutLebanon

Colorectal cancer is a lethal disease if not discovered *** though appropriate screening and preventive strategies are in place in many countries,a significant number of patients are still diagnosed at late stages of the *** management of metastatic colorectal cancer remains a significant clinical challenge to oncologists *** cytotoxic regimens constitute the main treatment of choice in this patient population,addition of the five biologics(bevacizumab,cetuximab,aflibercept,panitumumab and regorafenib)to these regimens has improved clinical *** most commonly used cytotoxic regimens include doublet combinations(FOLFOX/XELOX or FOLFiRi).Many clinical trials have been published and others are underway to compare the biologic agents with one another in order to prove the superiority of one regimen over *** colorectal cancer patients have many treatment options;however,the optimal use and sequence of targeted agents remain to be *** review entails concise and updated clinical data on the management of metastatic colorectal *** aim of the review is to determine where to fit the five biologic targets into the treatment algorithm of metastatic colorectal cancer patients and to derive treatment sequences that would achieve best clinical outcome based on the current available data.

关键词： Metastatic colorectal cancer Chemotherapy Anti-epi

Pancreaticoduodenectomy in the Middle East: Achieving optimal results through specialization and standardization

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Hepatobiliary & Pancreatic Diseases international 2019年第5期18卷 478-483页

作者： Walid Faraj Hussein Nassar Ahmad Zaghal Deborah Mukherji ali shamseddine Mariam Kanso Rola F. Jaafar Mohamad Khalife Liver Transplantation and Hepatopancreaticobiliary Surgery Department of General SurgeryAmerican University of Beirut Medical CenterBeirutLebanon Department of Oncology American University of Beirut Medical CenterBeirutLebanon

Background: Pancreaticoduodenectomy is a challenging surgical intervention that remains the cornerstone in the treatment of localized peri-ampullary pathologies. The concept of treatment standardization has been well-established in many high-volume centers in the world. Here, we present our experience in pancreaticoduodenectomy from 1994 to 2015. Methods: We performed a retrospective review of the medical charts of patients who underwent pancreaticoduodenectomy at our institution. Data was entered to SPSS statistical software and analyzed. The Mann-Whitney U and Fisher’s exact tests were used to report statistical differences between groups. Results: Of the 370 patients who underwent pacreaticoduodenectomy, 300 were analyzed. The 1-, 3-, 5- and 10-year survival rates were 85%, 35%, 15%, and 7%, respectively with a 30-day mortality rate of 5.0%(15 patients). The median age of the patients was 61 (13-84) years, with 193 (64.3%) males and 107 (35.7%) females. The median operative time was 300 (130-570) min. The median postoperative length of hospital stay was 12 (5-76) days. Thirty-two patients required re-laparotomies;10 for pancreatic leak, 7 for biliary leak and 15 for control of bleeding. Seventy-five (25.0%) patients developed pancreatic fistulae. Delayed gastric emptying was present in 31 (10.3%) patients. A significant improvement in surgical outcome was observed in cases done after 2008 which indicates the important role of specialized team in surgical management. Conclusions: The number of patients undergoing pancreaticoduodenectomy has been increasing annually over the past twenty-two years in our institution with results comparable to published series from high-volume centers. Through standardization of surgical techniques and perioperative management carried out by a specialist team, our results continue to improve despite the increasing complexity of cases referred to our unit.

关键词： Pancreatic cancer Pancreaticoduodenectomy Middle East