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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 509-511页

作者： Paschalis Gavriilidis timothy m.pawlik Department of Surgery Colchester General HospitalColchesterUK Department of Surgery The Ohio State University Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA

As the fifth most common gastrointestinal cancer worldwide,hepatocellular carcinoma(HCC)often presents at advanced stages of *** the subset of patients who present with tumor and liver-related features amenable to surgery,hepatic resection—in addition to transplantation—offers the best chance at curative-intent *** can be associated,however,with risk of complications and perioperative death especially among individuals with concomitant portal hypertension,liver fibrosis,cirrhosis,and portal vein thrombosis(1-3).Post-resection liver failure is also a major concern and can be a devasting complication following hepatic resection(4,5).Overall survival following hepatic resection of HCC ranges from only 30–50%,and recurrence can be common depending on the stage of *** turn,there is considerable interest in identifying markers to help stratify patients relative to risk of recurrence and prognosis to define which groups of patients may benefit the most from hepatic resection of HCC(1-5).

关键词： Hepatocellular carcinoma(HCC) systemic immune inflammation index(SIII) systemic inflammatory index neutrophil-to-lymphocyte ratio(NLR) platelet-to-lymphocyte ratio(PLR)

Liver transplantation for colorectal liver metastasis:the exception,not the rule

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 857-860页

作者： Diamantis I.Tsilimigras Anargyros Bakopoulos timothy m.pawlik1 timothy m.pawlik Department of Surgery Division of Surgical OncologyThe Ohio State UniversityWexner Medical Center and James Comprehensive Cancer CenterColumbusOHUSA Department of Surgery Laiko University HospitalNational and Kapodistrian University of AthensAthensGreece Department of Surgery Attikon University HospitalNational and Kapodistrian University of AthensAthensGreece

Approximately half of individuals diagnosed with colorectal cancer(CRC)will develop colorectal liver metastasis(CRLm)during the course of their disease(1,2).Liver resection is the only potentially curative treatment for patients with CRLm,yet less than 20%of individuals are candidates for resection due to the extent or location of liver disease,underlying liver function and/or presence of extrahepatic metastases(1,2).In addition,the oncologic benefit of liver resection for CRLm is limited by recurrence rates than can be as high as 70%(3).Liver transplantation(LT)for CRLm was initially proposed as an alternative treatment strategy in the early 1990s but was abandoned due to the initial poor outcomes(3,4).The concept of transplantation for CRLm was later revisited in the 2000s by a group in Oslo,Norway that reported promising results in the SECA-I pilot study(5).Since the completion of the SECA-I study,the Norwegian group has also published other promising data from the SECA-II study(6).In addition,other notable outcomes have been reported in the RAPID study(7),as well as another study from specialized centers in North America(8),both of which have revitalized the concept of LT for CRLm.

关键词： Liver transplantation(LT) colorectal cancer(CRC) liver metastasis colorectal liver metastasis(CRLm)

Association of Pringle maneuver with postoperative recurrence and survival following hepatectomy for hepatocellular carcinoma: a multicenter propensity score and competing-risks regression analysis

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 412-424,I0003-I0010页

作者： Shi-Chuan Tang Yong-Kang Diao Kong-Ying Lin Chao Li Xiao Xu Lei Liang Jie Kong Qing-Jing Chen Xian-ming Wang Fu-Bao Liu Wei-min Gu Ya-Hao Zhou Ying-Jian Liang Hong-Zhi Liu ming-Da Wang Lan-Qing Yao timothy m.pawlik Feng Shen Wan Yee Lau Tian Yang Yong-Yi Zeng Department of Hepatobiliary Surgery Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina Department of Hepatobiliary Surgery Eastern Hepatobiliary Surgery HospitalNavy Medical University(Second Military Medical University)ShanghaiChina Department of Hepatobiliary Surgery Affiliated Hospital of Nantong UniversityNantongChina Department of Hepatobiliary Surgery People’s Hospital of Zhejiang ProvincialPeople’s Hospital of Hangzhou Medical CollegeHangzhouChina Department of Hepatobiliary Heze Municiple HospitalHezeChina Department of General Surgery First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan HospitalJinanChina Department of Hepatobiliary Surgery First Affiliated Hospital of Anhui Medical UniversityHefeiChina The First Department of General Surgery Fourth Hospital of HarbinHarbinChina Department of Hepatobiliary Surgery Pu’er People’s HospitalPu’erChina Department of Hepatobiliary Surgery First Affiliated Hospital of Harbin Medical UniversityHarbinChina Department of Surgery Ohio State UniversityWexner Medical CenterColumbusOHUSA Faculty of medicine The Chinese University of Hong KongHong KongChina Department of Hepatopancreatobiliary Surgery First Affiliated Hospital of Fujian Medical UniversityFuzhouChina The Liver Disease Research Center of Fujian Province FuzhouChina

Background:The application of Pringle maneuver(Pm)during hepatectomy reduces intraoperative blood loss and the need for perioperative transfusion,but its effect on long-term recurrence and survival for patients with hepatocellular carcinoma(HCC)remains *** sought to determine the association between the application of Pm and post-hepatectomy oncologic outcomes for patients with ***:Patients who underwent curative hepatectomy for HCC at 9 Chinese hospitals from January 2010 to December 2018 were *** two propensity score methods[propensity score matching(PSm)and inverse probability of treatment weight(IPTW)],cumulative recurrence rate and cancer-specific mortality(CSm)were compared between the patients in the Pm and non-Pm *** competing-risks regression models were performed to adjust for the effect of non-cancer-specific mortality and other prognostic risk ***:Of the 2,798 included patients,2,404 and 394 did and did not adopt Pm(the Pm and non-Pm groups),*** rates of intraoperative blood transfusion,postoperative 30-day mortality and morbidity were comparable between the two groups(all P>0.05).In the PSm cohort by the 1:3 ratio,compared to 382 patients in the non-Pm group,1,146 patients in the Pm group also had the higher cumulative 5-year recurrence rate and CSm(63.9%and 39.1%vs.55.3%and 31.6%,both Pmilar results were also yielded in the entire cohort and the IPTW *** competing-risks regression analyses demonstrated that no application of the Pm was independently associated with lower recurrence rate and CSm based on various analytical cohorts[hazard ratio(HR),0.82 and 0.77 in the adjusted entire cohort,HR 0.80 and 0.73 in the PSm cohort,and HR 0.80 and 0.76 in the IPTW cohort,respectively].Conclusions:The findings suggested that no application of Pm during hepatectomy for patients with HCC reduced the risk of postoperative recurrence and cancer-specific death by appr

关键词： Hepatocellular carcinoma(HCC) Pringle maneuver(Pm) recurrence survival hepatectomy

Trends in the use of adjuvant therapy for resected intrahepatic cholangiocarcinoma: getting ahead of the data

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Hepatobiliary Surgery and Nutrition 2021年第4期10卷 515-517页

作者： Jordan m.Cloyd timothy m.pawlik Department of Surgery Division of Surgical OncologyThe Ohio State University Wexner Medical CenterColumbusOHUSA

Intrahepatic cholangiocarcinoma(ICC),the second most common primary liver malignancy,is an aggressive cancer occurring with increasing global *** advances in our understanding of its pathogenesis and molecular underpinnings,diagnostic and staging capabilities,and locoregional and systemic treatment options have occurred over the past several decades(1).

关键词： hepatic adjuvant pathogenesis

more accurate reporting of surgical techniques would be SUPER

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 628-630页

作者： Samantha m.Ruff timothy m.pawlik Division of Surgical Oncology Department of SurgeryThe Ohio State UniversityWexner Medical CenterColumbusOHUSA

Surgical education entails learning to care for patients in and out of the operating ***,this encompasses everything from the preoperative work-up to managing potential postoperative *** the operating room,surgical technique includes common,widely applicable skills,like how to square a knot,but also the more nuanced anatomical considerations of each operation,intra-operative decision-making,and ways to adapt when faced with the ***,surgical technique was taught through the apprenticeship model with knowledge passed down from attending to trainee and through textbooks written by surgical *** mode of learning/teaching is still the enduring structure of most residency programs.

关键词： Surgical technique reporting guidelines education

Associating liver partition and portal vein ligation or combined transarterial chemo-embolisation and portal vein embolisation for staged hepatectomy for HBV-related hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 272-275页

作者： Paschalis Gavriilidis timothy m.pawlik Tomer meirson Daniel Azoulay Department of Surgery Colchester General HospitalColchesterUK Department of Surgery The Ohio State University Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Davidoff Cancer Center Rabin Medical Center-Bellinson HospitalPetah TikyaIsrael Department of Hepato-Biliary and Liver Transplantation Surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuifFrance

many patients with hepatocellular carcinoma are diagnosed with large tumours at an advanced *** addition,conditions such as liver fibrosis,cirrhosis,portal hypertension,viral load,and portal vein thrombosis due to either non-neoplastic or portal vein tumour thrombus limit the indications for surgical management to a select subset of individuals(1).

关键词： Associating liver partition and portal vein ligation(ALPPS) transarterial chemoembolization(TACE) portal vein embolisation(PVE)

Is there a role for resection of oligometastatic disease in pancreatic ductal adenocarcinoma?

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Journal of Cancer metastasis and Treatment 2020年第1期6卷 548-555页

作者： Yana Puckett mariam F.Eskander Christopher T.Aquina timothy m.pawlik Department of Surgery West Virginia University School of MedicineCharlestonWV 25340USA Department of Surgical Oncology The Ohio State UniversityColumbusOH 43210USA

It is estimated that approximately 80%-90%of pancreatic ductal adenocarcinoma(PDAC)will present with unresectable disease with about half of patients presenting with distant *** prognosis of these patients is generally poor with an average life expectancy of approximately 6 months and a median 5-year survival of 1%.The current standard of care for metastatic PDAC patients is palliative chemotherapy,as surgery in this setting does not lead to better *** recently,some centers have utilized very specific patient selection to perform resection of oligometastatic disease with reported improvement in survival-with many centers using response to systemic therapy as a sign of favorable *** performed a literature review investigating the role of surgical resection of oligometastatic disease of the lung and liver in PDAC.

关键词： Pancreatic cancer pancreatic ductal adenocarcinoma liver metastasis oligometastatic disease m1 surgery metastasectomy

Neuroendocrine liver metastases: a contemporary review of treatment strategies

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Hepatobiliary Surgery and Nutrition 2020年第4期9卷 440-451页

作者： Jordan m.Cloyd Aslam Ejaz Bhavana Konda mina S.makary timothy m.pawlik Departments of Surgery The Ohio State UniversityWexner Medical CenterColumbusOHUSA Departments of Internal medicine The Ohio State UniversityWexner Medical CenterColumbusOHUSA Departments of Radiology The Ohio State UniversityWexner Medical CenterColumbusOHUSA

Well-differentiated neuroendocrine tumors(NETs)are globally increasing in prevalence and the liver is the most common site of *** liver metastases(NELm)are heterogeneous in clinical presentation and ***,recent advances in diagnostic techniques and therapeutic strategies have improved the multidisciplinary management of this challenging *** feasible,surgical resection of NELm offers the best long-term *** indications for hepatic resection include performance status acceptable for major liver surgery,grade 1 or 2 tumors,absence of extrahepatic disease,adequate size and function of future liver remnant,and feasibility of resecting>90%of *** therapies including concomitant liver ablation are generally safe when used appropriately and may expand the number of patients eligible for *** patients with synchronous resectable NELm,resection of the primary either in a staged or combined fashion is *** patients who are not surgical candidates,liver-directed therapies such as transarterial embolization,chemoembolization,and radioembolization can provide locoregional control and improve symptoms of carcinoid *** systemic therapy options also exist for patients with advanced or progressive *** research efforts are needed to identify novel biomarkers that will define the optimal indications for and sequencing of treatments to be delivered in a personalized fashion.

关键词： Gastroenteropancreatic neuroendocrine tumors(GEP-NETs) liver-directed therapies carcinoid hepatic resection targeted therapy

Current state of the art imaging approaches for colorectal liver metastasis

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Hepatobiliary Surgery and Nutrition 2020年第1期9卷 35-48页

作者： Bita Hazhirkarzar Pegah Khoshpouri mohammadreza Shaghaghi mounes Aliyari Ghasabeh timothy m.pawlik Ihab R.Kamel Russell H.morgan Department of Radiology and Radiological Sciences Johns Hopkins University School of MedicineBaltimoreMDUSA Department of Surgery The Ohio State UniversityWexner Medical CenterColumbusOHUSA

One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in CRC treatments have provided patients with primary and metastatic CRC a better long-term prognosis. The presence of synchronous or metachronous metastasis has been associated, however, with worse survival. The most common site of metastatic disease is the liver. A variety of treatment modalities aimed at targeting colorectal liver metastases (CRLm) has been demonstrated to improve the prognosis of these patients. Loco-regional approaches such as surgical resection and tumor ablation (operative and percutaneous) can provide patients with a chance at long-term disease control and even cure in select populations. Patient selection is important in defining the most suitable treatment option for CRLm in order to provide the best possible survival benefit while avoiding unnecessary interventions and adverse events. medical imaging plays a crucial role in evaluating the characteristics of CRLms and disease resectability. Size of tumors, proximity to adjacent anatomical structures, and volume of the unaffected liver are among the most important imaging parameters to determine the suitability of patients for surgical management or other appropriate treatment approaches. We herein provide a comprehensive overview of current-state-of-the-art imaging in the management of CRLm, including staging, treatment planning, response and survival assessment, and post-treatment surveillance. Computed tomography (CT) scan and magnetic resonance imaging (mRI) are two most commonly used techniques, which can be used solely or in combination with functional imaging modalities such as positron emission tomography (PET) and diffusion weighted imaging (DWI). Providing up-to-date evidence on advantages and disadvantages of imaging modalities and tumor assessment criteria, the current

关键词： Colorectal metastasis liver imaging tumor response

Cohort contributions to trends in the incidence and mortality of intrahepatic cholangiocarcinoma

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Hepatobiliary Surgery and Nutrition 2018年第4期7卷 270-276页

作者： Eliza W.Beal Dmitry Tumin Dimitrios moris Xu-Feng Zhang Jeffery Chakedis mary Dilhoff Carl m.Schmidt timothy m.pawlik Department of Surgery Division of Surgical OncologyThe Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research InstituteColumbusOHUSA Department of Anesthesiology and Pain medicine Nationwide Children’s HospitalColumbusOHUSA Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710000China

Background: The incidence and mortality of intrahepatic cholangiocarcinoma (ICC) are increasing worldwide. We used age-period-cohort (APC) modeling to evaluate the contribution of cohort effects to trends in ICC incidence and mortality in the US. methods: Incidence data were acquired from the Surveillance, Epidemiology and End-Results (SEER) program. mortality data were obtained from the Centers for Disease Control and Prevention WONDER Database. APC models using restricted cubic splines were fitted to estimate change in incidence and mortality risk over age, and modification of incidence and mortality risks according to birth cohort and period of diagnosis or death. Likelihood ratio tests were used to summarize improvement in model fit with APC modeling. Results: There were 4,053 cases of ICC at SEER registry sites between 1973–2012. ICC incidence increased with older age and across all birth cohorts examined. Inclusion of cohort effects tended to improve model fit relative to an age-period model (likelihood ratio test P=0.082). The national crude ICC-related mortality rate increased from 2.9 to 5.0 per 100,000 among males and 2.7 to 4.6 per 100,000 among females. Among males, ICC mortality risk varied across birth cohorts, and inclusion of cohort effects in a model predicting ICC mortality risk improved model fit (likelihood ratio test P=0.001), but cohort effects did not alter model fit among females (P=0.223). Conclusions: ICC incidence and mortality have increased over time in the United States. Birth cohort effects influenced increased ICC incidence and ICC mortality among males, but were not evident in the trend of ICC mortality among females.

关键词： Intrahepatic cholangiocarcinoma (ICC) incidence mortality cohort effect age-period-cohort model (APC model)