scholarly journals Predicting the Risk of Postoperative Complications in Patients Undergoing Minimally Invasive Resection of Primary Liver Tumors

2021 ◽  
Vol 10 (4) ◽  
pp. 685
Author(s):  
Philipp K. Haber ◽  
Christoph Maier ◽  
Anika Kästner ◽  
Linda Feldbrügge ◽  
Santiago Andres Ortiz Galindo ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Characteristic Curve ◽  
Minimal Invasive ◽  
Internal Validation ◽  
Primary Liver Tumors ◽  
Relative Contribution ◽  
Major Complications ◽  
Patient Health ◽  
Performance Area ◽  
Minimal Invasive Techniques

Minimal-invasive techniques are increasingly applied in clinical practice and have contributed towards improving postoperative outcomes. While comparing favorably with open surgery in terms of safety, the occurrence of severe complications remains a grave concern. To date, no objective predictive system has been established to guide clinicians in estimating complication risks as the relative contribution of general patient health, liver function and surgical parameters remain unclear. Here, we perform a single-center analysis of all consecutive patients undergoing laparoscopic liver resection for primary hepatic malignancies since 2010. Among the 210 patients identified, 32 developed major complications. Several independent predictors were identified through a multivariate analysis, defining a preoperative model: diabetes, history of previous hepatectomy, surgical approach, alanine aminotransferase levels and lesion entity. The addition of operative time and whether conversion was required significantly improved predictions and were thus incorporated into the postoperative model. Both models were able to identify patients with major complications with acceptable performance (area under the receiver-operating characteristic curve (AUC) for a preoperative model = 0.77 vs. postoperative model = 0.80). Internal validation was performed and confirmed the discriminatory ability of the models. An easily accessible online tool was deployed in order to estimate probabilities of severe complication without the need for manual calculation.

Ablation in Primary Liver Tumors

2019 ◽  
Vol 03 (02) ◽  
pp. 107-116
Author(s):  
D. Putzer ◽  
P. Schullian ◽  
R. Bale
Keyword(s):  
Thermal Ablation ◽  
Liver Tumors ◽  
Large Diameter ◽  
Three Dimensional ◽  
Safety Margin ◽  
Minimal Invasive ◽  
R0 Resection ◽  
Recurrence Rates ◽  
Stereotactic Techniques ◽  
Primary Liver Tumors

Minimal invasive thermal ablation techniques have a key role in the treatment regimen of primary liver tumors. These relatively low-risk procedures are established in nonresectable liver tumors and even challenge the surgical approach, which is regarded as first-line treatment in eligible patients.The location and size of the liver tumor, the applied ablation, and guidance technique are crucial for treatment outcome. The confirmation of an adequate ablation zone including sufficient tumor overlap and a safety margin (A0 ablation analogous to R0 resection) is crucial to minimize local recurrence rates and improve survival. A variety of different ablation devices is available. The outcome of conventional computed tomography- or ultrasound-guided thermal ablation in small lesions is well comparable to surgery. However, in liver lesions with large diameter overlapping ablation zones are required to ensure an adequate ablation margin. Therefore, stereotactic techniques in combination with a multiple needle approach, three-dimensional trajectory planning, and image fusion for intraoperative treatment evaluation have been successfully introduced.

Eight years after introducing liver resection at the Oncology Institute of Vojvodina

2013 ◽  
Vol 21 (3-4) ◽  
pp. 101-104
Author(s):  
Ivan Majdevac ◽  
Nikola Budisin ◽  
Milan Ranisavljevic ◽  
Dejan Lukic ◽  
Imre Lovas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Liver Tumors ◽  
Liver Parenchyma ◽  
Malignant Neoplasms ◽  
Chemotherapy Treatment ◽  
Primary Liver Tumors ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases ◽  
Medical Histories

Background: Hepatectomies are mostly performed for the treatment of hepatic benign or malignant neoplasms, intrahepatic gallstones, or parasitic cysts of the liver. The most common malignant neoplasms of the liver are metastases from colorectal cancer. Anatomic liver resection involves two or more hepatic segments, while non-anatomic liver resection involves resection of the metastases with a margin of uninvolved tissue. The aim of this manuscript was to show results of hepatectomies performed at the Oncology Institute of Vojvodina. Methods: We performed 133 liver resections from January 1997 to December 2013. Clinical and histopathological data were obtained from operative protocols, histopathological reports, and patients? medical histories. Results: We did 80 metastasectomies, 51 segmentectomies, and 18 radiofrequent ablations (RFA). Average number of colorectal cancer metastases was 1.67 per patient. We also made 10 left hepatectomies. In all cases, we made non-anatomic resections. Conclusion: Decision about anatomic versus non-anatomic resections for colorectal metastasis and primary liver tumors should be made before surgical exploration. Preservation of liver parenchyma is important with respect to liver failure and postoperative chemotherapy treatment.

Rearrangement of a common cellular DNA domain on chromosome 4 in human primary liver tumors.

1988 ◽  
Vol 62 (2) ◽  
pp. 629-632 ◽  
Author(s):  
C Pasquinelli ◽  
F Garreau ◽  
L Bougueleret ◽  
E Cariani ◽  
K H Grzeschik ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Chromosome 4 ◽  
Primary Liver Tumors ◽  
Cellular Dna

Orthotopic liver transplantation in primary liver tumors

1993 ◽  
Vol 53 (S3) ◽  
pp. 74-77 ◽  
Author(s):  
Enrique Moreno-González ◽  
Carmelo Loinaz ◽  
Ramon Gómez ◽  
Ignacio Garclá ◽  
Ignacio González-Pinto ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Liver Tumors ◽  
Primary Liver Tumors

scholarly journals Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies

2019 ◽  
Vol 57 (1) ◽  
pp. 37-46
Author(s):  
Adela Turcanu ◽  
Ecaterina Pitel ◽  
Vlada-Tatiana Dumbrava ◽  
Eugen Tcaciuc ◽  
Ana Donscaia ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Tumors ◽  
Hepatitis Virus ◽  
Primary Liver Cancer ◽  
Virus Surface ◽  
Primary Liver Tumors ◽  
B Virus ◽  
Tertiary Healthcare ◽  
Serum Alpha Fetoprotein ◽  
The Republic

Abstract Introduction. Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital. Methods. A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation. Results. The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases. Conclusions. The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.

scholarly journals Differentiating COVID-19 and dengue from other febrile illnesses in co-epidemics: Development and internal validation of COVIDENGUE scores

2021 ◽  
Author(s):  
Patrick Gerardin ◽  
Olivier Maillard ◽  
Lea Bruneau ◽  
Frederic Accot ◽  
Florian Legrand ◽  
...  
Keyword(s):  
Goodness Of Fit ◽  
Multinomial Logistic Regression ◽  
Characteristic Curve ◽  
Severe Dengue ◽  
Delayed Presentation ◽  
Upper Respiratory Tract ◽  
Discriminative Ability ◽  
Internal Validation ◽  
Logistic Regression Models ◽  
Testing Center

Background. In a retrospective cohort study, we previously distinguished the factors associated with coronavirus 2019 (COVID-19) or dengue from those associated with other febrile illnesses (OFIs). In this study, we developed a scoring system to discriminate both infectious diseases. Methods. Predictors of both infections were sought using multinomial logistic regression models (OFIs as controls) in all subjects suspected of COVID-19 who attended the SARS-CoV-2 testing center of Saint-Pierre teaching hospital, Reunion Island, between March 23 and May 10, 2020. Two COVIDENGUE scores were developed and internally validated by bootstrapping for predicting each infection after weighting the odd ratios according to a predefined rule. The discriminative ability of each score was assessed using the area under the receiver operating characteristic curve (AUC). Their calibration was assessed using goodness-of-fit statistics. Results. Over 49 days, 80 COVID-19, 60 non-severe dengue and 872 OFI cases were diagnosed. The translation of the best fit model yielded two COVIDENGUE scores composed of 11 criteria: contact with a COVID-19 positive case (+3 points for COVID-19; 0 point for dengue), return from travel abroad within 15 days (+3/-1), previous individual episode of dengue (+1/+3), active smoking (-3/0), body ache (0/+5), cough (0/-2), upper respiratory tract infection symptoms (-1/-1), anosmia (+7/-1), headache (0/+5), retro-orbital pain (-1/+5), and delayed presentation (>3 days) to hospital (+1/0). The AUC was of 0.79 (95%CI 0.76-0.82) for COVID-19 score and of 0.88 (95%CI 0.85-0.90) for dengue score. Calibration was satisfactory for COVID-19 score and excellent for dengue score. For predicting COVID-19, sensitivity was of 97% at the 0-point cut-off and specificity approximated 99% at the 10-point cut-off. For predicting dengue, sensitivity approximated 97% at the 3-point cut-off and specificity 98% at the 11-point cut-off. Conclusions. In conclusion, the COVIDENGUE scores proved discriminant to differentiate COVID-19 and dengue from other febrile illnesses in the context of SARS-CoV-2 testing center during a co-epidemic. Further studies are needed to validate or refine these scores in other settings.

scholarly journals Horizons of development of immunotherapy for malignant liver tumors

2021 ◽  
pp. 81-89
Author(s):  
V. E. Mukhin ◽  
Yu. S. Konstantinova ◽  
R. R. Gimadiev ◽  
N. V. Mazurchik
Keyword(s):  
Liver Tumors ◽  
Surgical Excision ◽  
Malignant Neoplasms ◽  
Therapeutic Approaches ◽  
Liver Malignancies ◽  
Primary Liver Tumors ◽  
Malignant Liver Tumors ◽  
Malignant Liver ◽  
Methods Of Treatment ◽  
New Strategies

Primary liver tumors are one of the most common types of malignant neoplasms. Surgical excision is still the most effective treatment in the early stages of the disease, however in most cases early diagnosis is difficult. Moreover, even if the treatment is carried out according to a radical program, the risk of relapse remains extremely high. In this regard, the search for new strategies for the treatment of liver malignancies that differ from traditional methods of treatment is not terminated. One of such promising approaches is immunotherapy. The present review is devoted to the current understanding of the mechanisms of action and the available clinical experience in the use of immunotherapy approaches in the treatment of liver malignancies. Combining different types of immunotherapy or combining immunotherapy with traditional therapeutic approaches can facilitate a synergistic effect and contribute to the development of personalized medicine.

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