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Aggressive surgical approach in patients with adrenal-only metastases from hepatocellular carcinoma enables higher survival rates than standard systemic therapy

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 28-33页

作者： Sorin T Alexandrescu Adina E Croitoru razvan T Grigorie dana r tomescu Gabriela Droc Mugur C Grasu Irinel Popescu Dan Setlacec Centre of General Surgery and Liver Transplantation Fundeni Clinical InstituteBucharest 022328Romania Carol Davila University of Medicine and Pharmacy Bucharest 020021Romania Department of Oncology Fundeni Clinical InstituteBucharest 022328Romania Faculty of Medicine Titu Maiorescu UniversityBucharest 031593Romania Dan Tulbure Centre of Anesteziology and Intensive Care Fundeni Clinical InstituteBucharest 022328Romania Department of radiology Fundeni Clinical InstituteBucharest 022328Romania

Background:Although guidelines recommend systemic therapy even in patients with limited extrahepatic metastases from hepatocellular carcinoma(HCC),a few recent studies suggested a potential benefit for resection of extrahepatic ***,the benefit of adrenal resection(Ar)for adrenal-only metastases(AOM)from HCC was not proved *** is the first study to compare long-term outcomes of Ar to those of sorafenib in patients with AOM from ***:The patients with adrenal metastases(AM)from HCC were identified from the electronic records of the institution between January 2002 and December *** who presented AM and other sites of extrahepatic disease were ***,the patients with AOM who received other therapies than Ar or sorafenib were ***:A total of 34 patients with AM from HCC were *** of these,22 patients had AOM,6 receiving other treatment than Ar or ***,8 patients with AOM underwent Ar(Ar group),while 8 patients were treated with sorafenib(SOr group).The baseline characteristics of the two groups were not significantly different in terms of age,sex,number and size of the primary tumor,timing of AM diagnosis,Child-Pugh and ECOG *** a median follow-up of 15.5 months,in the Ar group,the 1-,3-,and 5-year overall survival rates(85.7%,42.9%,and 0%,respectively)were significantly higher than those achieved in the SOr group(62.5%,0%and 0%at 1-,3-and 5-year,respectively)(P=0.009).The median progression-free survival after Ar(14 months)was significantly longer than that after sorafenib therapy(6 months,P=0.002).Conclusions:In patients with AOM from HCC,Ar was associated with significantly higher overall and progression-free survival rates than systemic therapy with *** results could represent a starting-point for future phase II/III clinical trials.

关键词： Adrenal metastases Hepatocellular carcinoma Adrenal resection Sorafenib Survival

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Accessory renal arteries-a source of hypertension:A case report

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World Journal of Clinical Cases 2023年第7期11卷 1506-1512页

作者： Amalia Calinoiu Elena-Cristina Guluta Adina rusu Alexandra Minca Dragos Minca Luminita tomescu Valeriu Gheorghita dana Galieta Minca Lucian Negreanu Department of Internal Medicine Prof.Dr.Agrippa Ionescu Emergency Clinical HospitalBucuresti 011356BucureștiRomania Department of Gastroenterology Bucharest University Emergency HospitalBucharest 050098Romania Department of Internal Medicine Clinic Bucharest University Emergency HospitalBucharest 050098Romania Department of rheumatology Clinic Center of Rheumatic Disease"Dr.Ion Stoia"Bucharest 030167Romania Department of radiology Clinic Prof.Dr.Agrippa Ionescu Clinical Emergency HospitalBucharest 011356Romania Department of Infectious Disease Clinic Prof Dr.Agrippa Ionescu Clinical Emergency HospitalBucharest 011356Romania Department of Public Health and Management Carol Davila University of Medicine and PharmacyBucharest 020021Romania Department of Gastroenterology Carol Davila University of Medicine and PharmacyBucharest 020021Romania

BACKGrOUND Secondary hypertension is a relatively rare condition most commonly caused by renovascular disease due to atherosclerotic vascular disease or fibromuscular *** accessory renal arteries are frequent,to date,only six cases of secondary hypertension determined by their existence have been *** SUMMArY We describe a case of a 39-year-old female who came to the emergency department with an urgent hypertensive crisis and hypertensive *** normal renal arteries,the computed tomography angiography revealed an inferior polar artery with 50%stenosis of its *** treatment with amlodipine,indapamide and perindopril was adopted,leading to blood pressure control within one *** To the best of our knowledge,there are controversies regarding accessory renal arteries as a potential etiology for secondary hypertension,but the seven similar cases already described,along with the current case,could reinforce the necessity of more studies concerning this subject.

关键词： Accessory artery Secondary hypertension renal artery stenosis renovascular disease risk factor Young patients Case report

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High perioperative lactate levels and decreased lactate clearance are associated with increased incidence of posthepatectomy liver failure

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Hepatobiliary & Pancreatic Diseases International 2021年第6期20卷 592-594页

作者： Mihai Popescu Simona Dima Vladislav Brasoveanu Andrada Tudor Mihai Simionescu dana tomescu “Carol Davila”University of Medicine and Pharmacy Bucharest 020021Romania Department of Anesthesia and Intensive Care Fundeni Clinical InstituteBucharest 022328Romania “Dan Setlacec”Center for General Surgery and Liver Transplantation Fundeni Clinical InstituteBucharest 022328Romania

To the Editor:Extensive liver resection represents a life-saving intervention in patients with primary or secondary liver *** advances made in the field of chemotherapy and surgical techniques have translated into a greater number of patients who are older and with more complex comorbidities presenting for major liver surgery[1]and thus having an increased risk of perioperative mortality.

关键词： chemotherapy liver mortality

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