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Patterns of cancer recurrence in localized resected hepatocellular carcinoma

Hepatobiliary & Pancreatic Diseases International 2015年第3期14卷 269-275页

作者： Aryavarta MS Kumar Elisha T Fredman christopher coppa Galal El-Gazzaz Federico N Aucejo May Abdel-Wahab Department of Radiation Oncology 9500 Euclid AveT28 Cleveland ClinicCleveland OH 44195 USA Department of Radiology 9500 Euclid Ave Hb6 Cleveland ClinicCleveland OH 44195 USA Department of Hepato-pancreato-biliary & Transplant Surgery 9500 Euclid Ave A100Cleveland OH 44195 USA

BACKGROUND： Tumor resection in non-metastatic hepato- cellular carcinoma （HCC） patients with adequate liver reserve offers a potential cure, but has a high 5-year recurrence rate. We analyzed the patterns of cancer... 详细信息

关键词： hepatocellular carcinoma patterns of failure partial hepatectomy

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Liver transplantation in patients with incidental hepatocellular carcinoma/cholangiocarcinoma and intrahepatic cholangiocarcinoma： a single-center experience

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Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 264-270页

作者： Mohammed Elshamy Naftali Presser Abdulrahman Y Hammad Daniel J Firl christopher coppa John Fung Federico N Aucejo Hepatobiliary and Transplant Surgery Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA Imaging Institute Cleveland Clinic Cleveland OH USA

BACKGROUND： Reports of fiver transplantation （LT） in patients with mixed hepatocellular carcinoma/cholangiocarcinoma （HCC/CC） and intrahepatic cholangiocarcinoma （ICC） are modest and have been mostly retrospective after pathological categorization in the setting of presumed HCC. Some studies suggest that patients undergoing LT with small and unifocal ICC or mixed HCC/CC can achieve about 40%-60% 5-year post-transplant survival. The study aimed to report our experience in patients undergoing LT with explant pathology revealing HCC/CC and ICC. METHODS： From a prospectively maintained database, we performed cohort analysis. We identified 13 patients who underwent LT with explant pathology revealing HCC/CC or ICC. RESULTS： The observed recurrence rate post-LT was 31% （4/13） and overall survival was 85%, 51%, and 51% at 1, 3 and 5 years, respectively. Disease-free survival was 68%, 51%, and 41% at 1, 3 and 5 years, respectively. In our cohort, four patients would have qualified for exception points based on updated HCC Organ Procurement and Transplantation Network imaging guidelines. CONCLUSIONS： Lesions which lack complete imaging characteristics of HCC may warrant pre-LT biopsy to fully elucidate their pathology. Identified patients with early HCC/CC or ICC may benefit from LT if unresectable. Additionally, incorporating adjunctive perioperative therapies such as in the case of patients undergoing LT with hilar cholangiocarcinoma may improve outcomes but this warrants further investigation.

关键词： mixed hepatocellular carcinoma/ cholangiocarcinoma liver transplantation survival outcomes

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Outcomes following operative vs. non-operative management of blunt traumatic pancreatic injuries: a retrospective multi-institutional study

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Burns & Trauma 2016年第4期4卷 316-322页

作者： Poppy Addison Toni Iurcotta Leo I.Amodu Geoffrey Crandall Meredith Akerman Daniel Galvin Annemarie Glazer Nathan christopherson Jose Prince Matthew Bank christopher Sorrentino Joaquin Cagliani Jeffrey Nicastro Gene coppa Ernesto P.Molmenti Horacio L.Rodriguez Rilo Department of Surgery Hofstra-Northwell School of MedicineHempsteadNYUSA Pancreas Disease Center Northwell HealthManhassetNYUSA Department of Surgery Hofstra-Northwell School of MedicineHempsteadNYUSA Department of Biostatistics Feinstein Institute for Medical ResearchManhassetNYUSA Pancreas Disease Center Northwell HealthManhassetNYUSA Department of Surgery Hofstra-Northwell School of MedicineHempsteadNYUSA Pancreas Disease Center Northwell HealthManhassetNYUSA Northwell Health 900 Northern BoulevardSuite 150Great NeckNY 11020USA

Background:Traumatic pancreatic injuries are rare,and guidelines specifying management are controversial and difficult to apply in the acute clinical *** to sparse data on these injuries,we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic *** hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated ***:We performed a retrospective review of data from four trauma centers in New York from 1990–2014,comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed *** compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher’s exact *** analysis was performed to determine the possible confounding factors associated with mortality in both treatment ***:Twenty nine patients were managed operatively and 32 *** was a significant difference between the operative and non-operative groups in median age(37.0 vs.16.2 years,P=0.016),grade of pancreatic injury(grade I;30.8 vs.85.2%,P value for all comparisons<0.0001),median injury severity score(ISS)(16.0 vs.4.0,P=0.002),blood transfusion(55.2 vs.15.6%,P=0.0012),other abdominal injuries(79.3 vs.38.7%,P=0.0014),pelvic fractures(17.2 vs.0.00%,P=0.020),intensive care unit(ICU)admission(86.2 vs.50.0%,P=0.003),median length of stay(LOS)(16.0 vs.4.0 days,P<0.0001),and mortality(27.6 vs.3.1%,P=0.010).Conclusions:Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated *** greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.

关键词： Injury Management Non-operative Operative Pancreas Trauma

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