82 results on '"Olthof, Pim"'
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2. Clinical features and prediction of long-term survival after surgery for perihilar cholangiocarcinoma
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Mantas, Anna, Otto, Carlos Constantin, Olthof, Pim B., Heise, Daniel, Hoyer, Dieter Paul, Bruners, Philipp, Dewulf, Maxim, Lang, Sven Arke, Ulmer, Tom Florian, Neumann, Ulf Peter, Bednarsch, Jan, Mantas, Anna, Otto, Carlos Constantin, Olthof, Pim B., Heise, Daniel, Hoyer, Dieter Paul, Bruners, Philipp, Dewulf, Maxim, Lang, Sven Arke, Ulmer, Tom Florian, Neumann, Ulf Peter, and Bednarsch, Jan more...
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Introduction:The treatment of perihilar Cholangiocarcinoma (pCCA) poses specific challenges not only due to its high perioperative complication rates but also due its dismal long-term prognosis with only a few long-term survivors (LTS) among the patients. Therefore, in this analysis characteristics and predictors of LTS in pCCA patients are investigated. Material and methods:In this single center analysis, patients undergoing curative-intent liver resection for pCCA between 2010 and 2022 were categorized into long-term and short-term survivors (STS) excluding perioperative mortality. Binary logistic regression was used to determine key differences between the groups and to develop a prognostic composite variable. This composite variable was subsequently tested in the whole cohort of surgically treated pCCA patients using Cox Regression analysis for cancer-specific survival (CSS). Results:Within a cohort of 209 individuals, 27 patients were identified as LTS (median CSS = 125 months) and 55 patients as STS (median CSS = 16 months). Multivariable analysis identified preoperative portal vein infiltration (OR = 5.85, p = 0.018) and intraoperative packed red blood cell (PRBC) transfusions (OR = 10.29, p = 0.002) as key differences between the groups. A prognostic composite variable based on these two features was created and transferred into a Cox regression model of the whole cohort. Here, the composite variable (HR = 0.35, p<0.001), lymph node metastases (HR = 2.15, p = 0.001) and postoperative complications (HR = 3.06, p<0.001) were identified as independent predictors of CSS. Conclusion: Long-term survival after surgery for pCCA is possible and is strongly negatively associated with preoperative portal vein infiltration and intraoperative PRBC transfusion. As these variables are part of preoperative staging or can be modulated by intraoperative technique, the proposed prognostic com more...
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- 2024
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3. The Influence of Hepatic Steatosis and Fibrosis on Postoperative Outcomes After Major Liver Resection of Perihilar Cholangiocarcinoma
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van Keulen, Anne Marleen, Olthof, Pim B., Buettner, Stefan, Bednarsch, Jan, Verheij, Joanne, Erdmann, Joris I., Nooijen, Lynn E., Porte, Robert J., Minnee, Robert C., Murad, Sarwa Darwish, Neumann, Ulf P., Heij, Lara, Groot Koerkamp, Bas, Doukas, Michail, van Keulen, Anne Marleen, Olthof, Pim B., Buettner, Stefan, Bednarsch, Jan, Verheij, Joanne, Erdmann, Joris I., Nooijen, Lynn E., Porte, Robert J., Minnee, Robert C., Murad, Sarwa Darwish, Neumann, Ulf P., Heij, Lara, Groot Koerkamp, Bas, and Doukas, Michail more...
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Background: Surgical resection for perihilar cholangiocarcinoma (pCCA) is associated with high operative risks. Impaired liver regeneration in patients with pre-existing liver disease may contribute to posthepatectomy liver failure (PHLF) and postoperative mortality. This study aimed to determine the incidence of hepatic steatosis and fibrosis and their association with PHLF and 90-day postoperative mortality in pCCA patients. Methods: Patients who underwent a major liver resection for pCCA were included in the study between 2000 and 2021 from three tertiary referral hospitals. Histopathologic assessment of hepatic steatosis and fibrosis was performed. The primary outcomes were PHLF and 90-day mortality. Results: Of the 401 included patients, steatosis was absent in 334 patients (83.3%), mild in 58 patients (14.5%) and moderate to severe in 9 patients (2.2%). There was no fibrosis in 92 patients (23.1%), periportal fibrosis in 150 patients (37.6%), septal fibrosis in 123 patients (30.8%), and biliary cirrhosis in 34 patients (8.5%). Steatosis (≥ 5%) was not associated with PHLF (odds ratio [OR] 1.36; 95% confidence interval [CI] 0.69–2.68) or 90-day mortality (OR 1.22; 95% CI 0.62–2.39). Neither was fibrosis (i.e., periportal, septal, or biliary cirrhosis) associated with PHLF (OR 0.76; 95% CI 0.41–1.41) or 90-day mortality (OR 0.60; 95% CI 0.33–1.06). The independent risk factors for PHLF were preoperative cholangitis (OR 2.38; 95% CI 1. 36–4.17) and future liver remnant smaller than 40% (OR 2.40; 95% CI 1.31–4.38). The independent risk factors for 90-day mortality were age of 65 years or older (OR 2.40; 95% CI 1.36–4.23) and preoperative cholangitis (OR 2.25; 95% CI 1.30–3.87). Conclusion: In this study, no association could be demonstrated between hepatic steatosis or fibrosis and postoperative outcomes after resection of pCCA. more...
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- 2024
4. Higher Postoperative Mortality and Inferior Survival After Right-Sided Liver Resection for Perihilar Cholangiocarcinoma:Left-Sided Resection is Preferred When Possible
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Olthof, Pim B, Erdmann, Joris I, Alikhanov, Ruslan, Charco, Ramón, Guglielmi, Alfredo, Hagendoorn, Jeroen, Hakeem, Abdul, Hoogwater, Frederik J H, Jarnagin, William R, Kazemier, Geert, Lang, Hauke, Maithel, Shishir K, Malago, Massimo, Malik, Hassan Z, Nadalin, Silvio, Neumann, Ulf, Olde Damink, Steven W M, Pratschke, Johann, Ratti, Francesca, Ravaioli, Matteo, Roberts, Keith J, Schadde, Erik, Schnitzbauer, Andreas A, Sparrelid, Ernesto, Topal, Baki, Troisi, Roberto I, Groot Koerkamp, Bas, Olthof, Pim B, Erdmann, Joris I, Alikhanov, Ruslan, Charco, Ramón, Guglielmi, Alfredo, Hagendoorn, Jeroen, Hakeem, Abdul, Hoogwater, Frederik J H, Jarnagin, William R, Kazemier, Geert, Lang, Hauke, Maithel, Shishir K, Malago, Massimo, Malik, Hassan Z, Nadalin, Silvio, Neumann, Ulf, Olde Damink, Steven W M, Pratschke, Johann, Ratti, Francesca, Ravaioli, Matteo, Roberts, Keith J, Schadde, Erik, Schnitzbauer, Andreas A, Sparrelid, Ernesto, Topal, Baki, Troisi, Roberto I, and Groot Koerkamp, Bas more...
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BACKGROUND: A right- or left-sided liver resection can be considered in about half of patients with perihilar cholangiocarcinoma (pCCA), depending on tumor location and vascular involvement. This study compared postoperative mortality and long-term survival of right- versus left-sided liver resections for pCCA.METHODS: Patients who underwent major liver resection for pCCA at 25 Western centers were stratified according to the type of hepatectomy-left, extended left, right, and extended right. The primary outcomes were 90-day mortality and overall survival (OS).RESULTS: Between 2000 and 2022, 1701 patients underwent major liver resection for pCCA. The 90-day mortality was 9% after left-sided and 18% after right-sided liver resection (p < 0.001). The 90-day mortality rates were 8% (44/540) after left, 11% (29/276) after extended left, 17% (51/309) after right, and 19% (108/576) after extended right hepatectomy (p < 0.001). Median OS was 30 months (95% confidence interval [CI] 27-34) after left and 23 months (95% CI 20-25) after right liver resection (p < 0.001), and 33 months (95% CI 28-38), 27 months (95% CI 23-32), 25 months (95% CI 21-30), and 21 months (95% CI 18-24) after left, extended left, right, and extended right hepatectomy, respectively (p < 0.001). A left-sided resection was an independent favorable prognostic factor for both 90-day mortality and OS compared with right-sided resection, with similar results after excluding 90-day fatalities.CONCLUSIONS: A left or extended left hepatectomy is associated with a lower 90-day mortality and superior OS compared with an (extended) right hepatectomy for pCCA. When both a left and right liver resection are feasible, a left-sided liver resection is preferred. more...
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- 2024
5. Effect of Sarcopenia on the Increase in Liver Volume and Function After Portal Vein Embolization
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Arntz, Pieter J.W., Olthof, Pim B., Korenblik, Remon, Heil, Jan, Kazemier, Geert, van Delden, Otto M., Bennink, Roelof J., Damink, Steven W.M.Olde, van Dam, Ronald M., Schadde, Erik, Erdmann, Joris I., Arntz, Pieter J.W., Olthof, Pim B., Korenblik, Remon, Heil, Jan, Kazemier, Geert, van Delden, Otto M., Bennink, Roelof J., Damink, Steven W.M.Olde, van Dam, Ronald M., Schadde, Erik, and Erdmann, Joris I. more...
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Purpose: Sarcopenia is associated with a decreased kinetic growth rate (KGR) of the future liver remnant (FLR) after portal vein embolization (PVE). However, little is known on the increase in FLR function (FLRF) after PVE. This study evaluated the effect of sarcopenia on the functional growth rate (FGR) after PVE measured with hepatobiliary scintigraphy (HBS). Methods: All patients who underwent PVE at the Amsterdam UMC between January 2005 and August 2017 were analyzed. Functional imaging by HBS was used to determine FGR. Liver volumetry was performed using multiphase contrast computed tomography (CT). Muscle area measurement to determine sarcopenia was taken at the third lumbar level (L3). Results: Out of the 95 included patients, 9 were excluded due to unavailable data. 70/86 (81%) patients were sarcopenic. In the multivariate logistic regression analysis, sarcopenia (p = 0.009) and FLR volume (FRLV) before PVE (p = 0.021) were the only factors correlated with KGR, while no correlation was found with FGR. 90-day mortality was similar across the sarcopenic and non-sarcopenic group (4/53 [8%] versus 1/11 [9%]; p = 1.000). The resection rates were also comparable (53/70 [75%] versus 11/16 [69%]; p = 0.542). Conclusion: FGR after PVE as measured by HBS appears to be preserved in sarcopenic patients. This is in contrast to KGR after PVE as measured by liver volumetry which is decreased in sarcopenic patients. Level of Evidence: Level 3b, cohort and case control studies. more...
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- 2024
6. ASO Author Reflections:Surgical Strategy for Perihilar Cholangiocarcinoma
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Olthof, Pim B., Koerkamp, Bas Groot, Olthof, Pim B., and Koerkamp, Bas Groot
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- 2024
7. Prognostic value of Mandard score and nodal status for recurrence patterns and survival after multimodal treatment of oesophageal adenocarcinoma
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Henckens, Sofie P.G., Liu, Dajia, Gisbertz, Suzanne S., Kalff, Marianne C., Anderegg, Maarten C.J., Crull, David, Daams, Freek, van Dalsen, Annette D., Dekker, Jan Willem T., van Det, Marc J., van Duijvendijk, Peter, Eshuis, Wietse J., Groenendijk, Richard P.R., Haveman, Jan Willem, van Hillegersberg, Richard, Luyer, Misha D.P., Olthof, Pim B., Pierie, Jean Pierre E.N., Plat, Victor D., Rosman, Camiel, Ruurda, Jelle P., van Sandick, Johanna W., Sosef, Meindert N., Voeten, Daan M., Vijgen, Guy H.E.J., Bijlsma, Maarten F., Meijer, Sybren L., Hulshof, Maarten C.C.M., Oyarce, Cesar, Lagarde, Sjoerd M., van Laarhoven, Hanneke W.M., van Berge Henegouwen, Mark I., Henckens, Sofie P.G., Liu, Dajia, Gisbertz, Suzanne S., Kalff, Marianne C., Anderegg, Maarten C.J., Crull, David, Daams, Freek, van Dalsen, Annette D., Dekker, Jan Willem T., van Det, Marc J., van Duijvendijk, Peter, Eshuis, Wietse J., Groenendijk, Richard P.R., Haveman, Jan Willem, van Hillegersberg, Richard, Luyer, Misha D.P., Olthof, Pim B., Pierie, Jean Pierre E.N., Plat, Victor D., Rosman, Camiel, Ruurda, Jelle P., van Sandick, Johanna W., Sosef, Meindert N., Voeten, Daan M., Vijgen, Guy H.E.J., Bijlsma, Maarten F., Meijer, Sybren L., Hulshof, Maarten C.C.M., Oyarce, Cesar, Lagarde, Sjoerd M., van Laarhoven, Hanneke W.M., and van Berge Henegouwen, Mark I. more...
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BACKGROUND: This study evaluated the association of pathological tumour response (tumour regression grade, TRG) and a novel scoring system, combining both TRG and nodal status (TRG-ypN score; TRG1-ypN0, TRG>1-ypN0, TRG1-ypN+ and TRG>1-ypN+), with recurrence patterns and survival after multimodal treatment of oesophageal adenocarcinoma. METHODS: This Dutch nationwide cohort study included patients treated with neoadjuvant chemoradiotherapy followed by oesophagectomy for distal oesophageal or gastro-oesophageal junctional adenocarcinoma between 2007 and 2016. The primary endpoint was the association of Mandard score and TRG-ypN score with recurrence patterns (rate, location, and time to recurrence). The secondary endpoint was overall survival. RESULTS: Among 2746 inclusions, recurrence rates increased with higher Mandard scores (TRG1 30.6%, TRG2 44.9%, TRG3 52.9%, TRG4 61.4%, TRG5 58.2%; P < 0.001). Among patients with recurrent disease, the distribution (locoregional versus distant) was the same for the different TRG groups. Patients with TRG1 developed more brain recurrences (17.7 versus 9.8%; P = 0.001) and had a longer mean overall survival (44 versus 35 months; P < 0.001) than those with TRG>1. The TRG>1-ypN+ group had the highest recurrence rate (64.9%) and worst overall survival (mean 27 months). Compared with the TRG>1-ypN0 group, patients with TRG1-ypN+ had a higher risk of recurrence (51.9 versus 39.6%; P < 0.001) and worse mean overall survival (33 versus 41 months; P < 0.001). CONCLUSION: Improved tumour response to neoadjuvant therapy was associated with lower recurrence rates and higher overall survival rates. Among patients with recurrent disease, TRG1 was associated with a higher incidence of brain recurrence than TRG>1. Residual nodal disease influenced prognosis more negatively than residual disease at the primary tumour site. more...
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- 2024
8. Nationwide treatment and outcomes of intrahepatic cholangiocarcinoma
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Olthof, Pim B., Franssen, Stijn, Keulen, A.M. van, Geest, Lydia G.M. van der, Hoogwater, Frederik J.H., Coenraad, M., Tjwa, E.T., Verheij, J., Koerkamp, Bas Groot, Olthof, Pim B., Franssen, Stijn, Keulen, A.M. van, Geest, Lydia G.M. van der, Hoogwater, Frederik J.H., Coenraad, M., Tjwa, E.T., Verheij, J., and Koerkamp, Bas Groot more...
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- 2023
9. ASO Visual Abstract:The Influence of Hepatic Steatosis and Fibrosis on Postoperative Outcomes After Major Liver Resection of Perihilar Cholangiocarcinoma
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van Keulen, Anne Marleen, Olthof, Pim B., Buettner, Stefan, Bednarsch, Jan, Verheij, Joanne, Erdmann, Joris I., Nooijen, Lynn E., Porte, Robert J., Minnee, Robert C., Darwish Murad, Sarwa, Neumann, Ulf P., Heij, Lara, Groot Koerkamp, Bas, Doukas, Michail, van Keulen, Anne Marleen, Olthof, Pim B., Buettner, Stefan, Bednarsch, Jan, Verheij, Joanne, Erdmann, Joris I., Nooijen, Lynn E., Porte, Robert J., Minnee, Robert C., Darwish Murad, Sarwa, Neumann, Ulf P., Heij, Lara, Groot Koerkamp, Bas, and Doukas, Michail more...
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- 2023
10. Nationwide treatment and outcomes of intrahepatic cholangiocarcinoma
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Olthof, Pim B., Franssen, Stijn, van Keulen, Anne Marleen, van der Geest, Lydia G., Hoogwater, Frederik J.H., Coenraad, Minneke, van Driel, Lydi M.J.W., Erdmann, Joris I., Mohammad, Nadia H., Heij, Lara, Klümpen, Heinz Josef, Tjwa, Eric, Valkenburg-van Iersel, Liselot, Verheij, Joanne, Groot Koerkamp, Bas, Olthof, Pim B., Franssen, Stijn, van Keulen, Anne Marleen, van der Geest, Lydia G., Hoogwater, Frederik J.H., Coenraad, Minneke, van Driel, Lydi M.J.W., Erdmann, Joris I., Mohammad, Nadia H., Heij, Lara, Klümpen, Heinz Josef, Tjwa, Eric, Valkenburg-van Iersel, Liselot, Verheij, Joanne, and Groot Koerkamp, Bas more...
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Background:Most data on the treatment and outcomes of intrahepatic cholangiocarcinoma (iCCA) derives from expert centers. This study aimed to investigate the treatment and outcomes of all patients diagnosed with iCCA in a nationwide cohort. Methods: Data on all patients diagnosed with iCCA between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Results: In total, 1747 patients diagnosed with iCCA were included. Resection was performed in 292 patients (17%), 548 patients (31%) underwent palliative systemic treatment, and 867 patients (50%) best supportive care (BSC). The OS median and 1-, and 3-year OS were after resection: 37.5 months (31.0–44.0), 79.2%, and 51.6%,; with systemic therapy, 10.0 months (9.2–10.8), 38.4%, and 5.1%, and with BSC 2.2 months (2.0–2.5), 10.4%, and 1.3% respectively. The resection rate for patients who first presented in academic centers was 33% (96/292) compared to 13% (195/1454) in non-academic centers (P < 0.001). Discussion: Half of almost 1750 patients with iCCA over an 8 year period did not receive any treatment with a 1-year OS of 10.4%. Three-year survival was about 50% after resection, while long-term survival was rare after palliative treatment. The resection rate was higher in academic centers compared to non-academic centers. more...
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- 2023
11. Hepatobiliary scintigraphy to predict postoperative liver failure after major liver resection; a multicenter cohort study in 547 patients
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Olthof, Pim B., Arntz, Pieter, Truant, Stéphanie, El Amrani, Mehdi, Dasari, Bobby V.M., Tomassini, Federico, Troisi, Roberto I., Bennink, Roel J., Grunhagen, Dirk, Chapelle, Thiery, Op de Beeck, Bart, Zanoni, Lucia, Serenari, Matteo, Erdmann, Joris I., Olthof, Pim B., Arntz, Pieter, Truant, Stéphanie, El Amrani, Mehdi, Dasari, Bobby V.M., Tomassini, Federico, Troisi, Roberto I., Bennink, Roel J., Grunhagen, Dirk, Chapelle, Thiery, Op de Beeck, Bart, Zanoni, Lucia, Serenari, Matteo, and Erdmann, Joris I. more...
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Background: This study aimed to analyze the predictive value of Hepatobiliary scintigraphy (HBS) for posthepatectomy liver failure (PHLF) after major liver resection with a comparison to assessment of liver volume in a multicenter cohort. Methods: Patients who underwent liver resection after HBS were included from six centers. Remnant liver volume was calculated from CT images. PHLF was scored and graded according to the grade B/C ISGLS criteria. Results: In 547 patients PHLF incidence was 10% (56/547) and 90-day mortality rate 8% (42/547). Overall predictive value of remnant liver function was 0.66 (0.58–0.74) and similar to that of remnant volume (0.63 (0.72). For biliary tumors, a function cut-off of 2.7%/min/m2 and 30% volume cut-off resulted in a PHLF rate 12% and 13%, respectively. While an 8.5%/min (4.5%/min/m2) function cut-off resulted in 7% PHLF for those with a function above the cutoff while a 40% volume cutoff still resulted in 14% PHLF rate. In the multivariable analyses for PHLF, liver function was predictive but liver volume was not. Conclusion: The current study shows that preoperative liver function assessment using HBS is at least as predictive for PHLF as liver volume assessment, and likely has several advantages, particularly in the high-risk sub-group of biliary tumors. more...
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- 2023
12. E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy
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Primavesi, Florian, Maglione, Manuel, Cipriani, Federica, Denecke, Timm, Oberkofler, Christian E., Starlinger, Patrick, Dasari, Bobby V.M., Heil, Jan, Sgarbura, Olivia, Søreide, Kjetil, Diaz-Nieto, Rafael, Fondevila, Constantino, Frampton, Adam E., Geisel, Dominik, Henninger, Benjamin, Hessheimer, Amelia J., Lesurtel, Mickaël, Mole, Damian, Öllinger, Robert, Olthof, Pim, Reiberger, Thomas, Schnitzbauer, Andreas A., Schwarz, Christoph, Sparrelid, Ernesto, Stockmann, Martin, Truant, Stéphanie, Aldrighetti, Luca, Braunwarth, Eva, D'Hondt, Mathieu, DeOliveira, Michelle L., Erdmann, Joris, Fuks, David, Gruenberger, Thomas, Kaczirek, Klaus, Malik, Hassan, Öfner, Dietmar, Rahbari, Nuh N., Göbel, Georg, Siriwardena, Ajith K., Stättner, Stefan, Primavesi, Florian, Maglione, Manuel, Cipriani, Federica, Denecke, Timm, Oberkofler, Christian E., Starlinger, Patrick, Dasari, Bobby V.M., Heil, Jan, Sgarbura, Olivia, Søreide, Kjetil, Diaz-Nieto, Rafael, Fondevila, Constantino, Frampton, Adam E., Geisel, Dominik, Henninger, Benjamin, Hessheimer, Amelia J., Lesurtel, Mickaël, Mole, Damian, Öllinger, Robert, Olthof, Pim, Reiberger, Thomas, Schnitzbauer, Andreas A., Schwarz, Christoph, Sparrelid, Ernesto, Stockmann, Martin, Truant, Stéphanie, Aldrighetti, Luca, Braunwarth, Eva, D'Hondt, Mathieu, DeOliveira, Michelle L., Erdmann, Joris, Fuks, David, Gruenberger, Thomas, Kaczirek, Klaus, Malik, Hassan, Öfner, Dietmar, Rahbari, Nuh N., Göbel, Georg, Siriwardena, Ajith K., and Stättner, Stefan more...
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BACKGROUND: Posthepatectomy liver failure (PHLF) contributes significantly to morbidity and mortality after liver surgery. Standardized assessment of preoperative liver function is crucial to identify patients at risk. These European consensus guidelines provide guidance for preoperative patient assessment. METHODS: A modified Delphi approach was used to achieve consensus. The expert panel consisted of hepatobiliary surgeons, radiologists, nuclear medicine specialists, and hepatologists. The guideline process was supervised by a methodologist and reviewed by a patient representative. A systematic literature search was performed in PubMed/MEDLINE, the Cochrane library, and the WHO International Clinical Trials Registry. Evidence assessment and statement development followed Scottish Intercollegiate Guidelines Network methodology. RESULTS: Based on 271 publications covering 4 key areas, 21 statements (at least 85 per cent agreement) were produced (median level of evidence 2- to 2+). Only a few systematic reviews (2++) and one RCT (1+) were identified. Preoperative liver function assessment should be considered before complex resections, and in patients with suspected or known underlying liver disease, or chemotherapy-associated or drug-induced liver injury. Clinical assessment and blood-based scores reflecting liver function or portal hypertension (for example albumin/bilirubin, platelet count) aid in identifying risk of PHLF. Volumetry of the future liver remnant represents the foundation for assessment, and can be combined with indocyanine green clearance or LiMAx® according to local expertise and availability. Functional MRI and liver scintigraphy are alternatives, combining FLR volume and function in one examination. CONCLUSION: These guidelines reflect established methods to assess preoperative liver function and PHLF risk, and have uncovered evidence gaps of interest for future resea more...
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- 2023
13. Evaluation of National Surgical Practice for Lateral Lymph Nodes in Rectal Cancer in an Untrained Setting
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Sluckin, Tania C., Hazen, Sanne Marije J.A., Horsthuis, Karin, Beets-Tan, Regina G.H., Aalbers, Arend G.J., Beets, Geerard L., Boerma, Evert Jan G., Borstlap, Jaap, van Breest Smallenburg, Vivian, Burger, Jacobus W.A., Crolla, Rogier M.P.H., Daniëls-Gooszen, Alette W., Davids, Paul H.P., Dunker, Michalda S., van Gils, Renza A.H., van Koeverden, Sebastiaan, Oosterling, Steven J., Rothbarth, Joost, Talsma, Aaldert K., Vanhooymissen, Inge J.S., Verdaasdonk, Emiel G.G., Vermaas, Maarten, de Vries, Marianne, Tanis, Pieter J., van Aalten, Susanna M., Antonisse, Imogeen E., Cate, David W.G.ten, Curutchet, Sam, Dekker, Emmelie N., Demirkiran, Ahmet, van Egdom, Laurentine S.E., El-Massoudi, Youssef, van Elderen, Saskia, van den Hoek, Sjoerd, Hoff, Christiaan, Imani, Farshad, Kok, Sylvia, Koster, Ingrid M., Kroese, Leonard F., Muller, Karin, Noordman, Bo J., Olthof, Pim B., van Rees, Jan M., Roosen, Lodewijk J., Spillenaar-Bilgen, Ernst J., van der Valk, Maxime J.M., Velema, Laura A., Verhagen, Tim, van Westerveld, Paul P., Zheng, Kang J., Sluckin, Tania C., Hazen, Sanne Marije J.A., Horsthuis, Karin, Beets-Tan, Regina G.H., Aalbers, Arend G.J., Beets, Geerard L., Boerma, Evert Jan G., Borstlap, Jaap, van Breest Smallenburg, Vivian, Burger, Jacobus W.A., Crolla, Rogier M.P.H., Daniëls-Gooszen, Alette W., Davids, Paul H.P., Dunker, Michalda S., van Gils, Renza A.H., van Koeverden, Sebastiaan, Oosterling, Steven J., Rothbarth, Joost, Talsma, Aaldert K., Vanhooymissen, Inge J.S., Verdaasdonk, Emiel G.G., Vermaas, Maarten, de Vries, Marianne, Tanis, Pieter J., van Aalten, Susanna M., Antonisse, Imogeen E., Cate, David W.G.ten, Curutchet, Sam, Dekker, Emmelie N., Demirkiran, Ahmet, van Egdom, Laurentine S.E., El-Massoudi, Youssef, van Elderen, Saskia, van den Hoek, Sjoerd, Hoff, Christiaan, Imani, Farshad, Kok, Sylvia, Koster, Ingrid M., Kroese, Leonard F., Muller, Karin, Noordman, Bo J., Olthof, Pim B., van Rees, Jan M., Roosen, Lodewijk J., Spillenaar-Bilgen, Ernst J., van der Valk, Maxime J.M., Velema, Laura A., Verhagen, Tim, van Westerveld, Paul P., and Zheng, Kang J. more...
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Background: Involved lateral lymph nodes (LLNs) have been associated with increased local recurrence (LR) and ipsi-lateral LR (LLR) rates. However, consensus regarding the indication and type of surgical treatment for suspicious LLNs is lacking. This study evaluated the surgical treatment of LLNs in an untrained setting at a national level. Methods: Patients who underwent additional LLN surgery were selected from a national cross-sectional cohort study regarding patients undergoing rectal cancer surgery in 69 Dutch hospitals in 2016. LLN surgery consisted of either ‘node-picking’ (the removal of an individual LLN) or ‘partial regional node dissection’ (PRND; an incomplete resection of the LLN area). For all patients with primarily enlarged (≥7 mm) LLNs, those undergoing rectal surgery with an additional LLN procedure were compared to those undergoing only rectal resection. Results: Out of 3057 patients, 64 underwent additional LLN surgery, with 4-year LR and LLR rates of 26% and 15%, respectively. Forty-eight patients (75%) had enlarged LLNs, with corresponding recurrence rates of 26% and 19%, respectively. Node-picking (n = 40) resulted in a 20% 4-year LLR, and a 14% LLR after PRND (n = 8; p = 0.677). Multivariable analysis of 158 patients with enlarged LLNs undergoing additional LLN surgery (n = 48) or rectal resection alone (n = 110) showed no significant association of LLN surgery with 4-year LR or LLR, but suggested higher recurrence risks after LLN surgery (LR: hazard ratio [HR] 1.5, 95% confidence interval [CI] 0.7–3.2, p = 0.264; LLR: HR 1.9, 95% CI 0.2–2.5, p = 0.874). Conclusion: Evaluation of Dutch practice in 2016 revealed that approximately one-third of patients with primarily enlarged LLNs underwent surgical treatment, mostly consisting of node-picking. Recurrence rates were not significantly affected by LLN surgery, but did suggest worse outcomes. Outcomes of LLN surgery after adequate training requires further research. more...
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- 2023
14. Uptake of robot-assisted colon cancer surgery in the Netherlands
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Sterk, Marlou F.M., Crolla, Rogier M.P.H., Verseveld, Mareille, Dekker, Jan Willem T., van der Schelling, George P., Verhoef, Cornelis, Olthof, Pim B., Sterk, Marlou F.M., Crolla, Rogier M.P.H., Verseveld, Mareille, Dekker, Jan Willem T., van der Schelling, George P., Verhoef, Cornelis, and Olthof, Pim B. more...
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Background:The robot-assisted approach is now often used for rectal cancer surgery, but its use in colon cancer surgery is less well defined. This study aims to compare the outcomes of robotic-assisted colon cancer surgery to conventional laparoscopy in the Netherlands. Methods: Data on all patients who underwent surgery for colon cancer from 2018 to 2020 were collected from the Dutch Colorectal Audit. All complications, readmissions, and deaths within 90 days after surgery were recorded along with conversion rate, margin and harvested nodes. Groups were stratified according to the robot-assisted and laparoscopic approach. Results:In total, 18,886 patients were included in the analyses. The operative approach was open in 15.2%, laparoscopic in 78.9% and robot-assisted in 5.9%. The proportion of robot-assisted surgery increased from 4.7% in 2018 to 6.9% in 2020. There were no notable differences in outcomes between the robot-assisted and laparoscopic approach for Elective cT1-3M0 right, left, and sigmoid colectomy. Only conversion rate was consistently lower in the robotic group. (4.6% versus 8.8%, 4.6% versus 11.6%, and 1.6 versus 5.9%, respectively).Conclusions: This nationwide study on surgery for colon cancer shows there is a gradual but slow adoption of robotic surgery for colon cancer up to 6.9% in 2020. When comparing the outcomes of right, left, and sigmoid colectomy, clinical outcomes were similar between the robotic and laparoscopic approach. However, conversion rate is consistently lower in the robotic procedures. more...
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- 2023
15. Author response to:Comment on: Multivariable prediction model for both 90-day mortality and long-term survival for individual patients with perihilar cholangiocarcinoma: does the predicted survival justify the surgical risk?
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Buettner, Stefan, van Keulen, Anne-Marleen, Groot Koerkamp, Bas, Olthof, Pim B, Buettner, Stefan, van Keulen, Anne-Marleen, Groot Koerkamp, Bas, and Olthof, Pim B
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- 2023
16. Multivariable prediction model for both 90-day mortality and long-term survival for individual patients with perihilar cholangiocarcinoma:does the predicted survival justify the surgical risk?
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van Keulen, Anne-Marleen, Buettner, Stefan, Erdmann, Joris I, Pratschke, Johann, Ratti, Francesca, Jarnagin, William R, Schnitzbauer, Andreas A, Lang, Hauke, Ruzzenente, Andrea, Nadalin, Silvio, Cescon, Matteo, Topal, Baki, Olthof, Pim B, Groot Koerkamp, Bas, van Keulen, Anne-Marleen, Buettner, Stefan, Erdmann, Joris I, Pratschke, Johann, Ratti, Francesca, Jarnagin, William R, Schnitzbauer, Andreas A, Lang, Hauke, Ruzzenente, Andrea, Nadalin, Silvio, Cescon, Matteo, Topal, Baki, Olthof, Pim B, and Groot Koerkamp, Bas more...
- Abstract
BACKGROUND: The risk of death after surgery for perihilar cholangiocarcinoma is high; nearly one in every five patients dies within 90 days after surgery. When the oncological benefit is limited, a high-risk resection may not be justified. This retrospective cohort study aimed to create two preoperative prognostic models to predict 90-day mortality and overall survival (OS) after major liver resection for perihilar cholangiocarcinoma.METHODS: Separate models were built with factors known before surgery using multivariable regression analysis for 90-day mortality and OS. Patients were categorized in three groups: favourable profile for surgical resection (90-day mortality rate below 10 per cent and predicted OS more than 3 years), unfavourable profile (90-day mortality rate above 25 per cent and/or predicted OS below 1.5 years), and an intermediate group.RESULTS: A total of 1673 patients were included. Independent risk factors for both 90-day mortality and OS included ASA grade III-IV, large tumour diameter, and right-sided hepatectomy. Additional risk factors for 90-day mortality were advanced age and preoperative cholangitis; those for long-term OS were high BMI, preoperative jaundice, Bismuth IV, and hepatic artery involvement. In total, 294 patients (17.6 per cent) had a favourable risk profile for surgery (90-day mortality rate 5.8 per cent and median OS 42 months), 271 patients (16.2 per cent) an unfavourable risk profile (90-day mortality rate 26.8 per cent and median OS 16 months), and 1108 patients (66.2 per cent) an intermediate risk profile (90-day mortality rate 12.5 per cent and median OS 27 months).CONCLUSION: Preoperative risk models for 90-day mortality and OS can help identify patients with resectable perihilar cholangiocarcinoma who are unlikely to benefit from surgical resection. Tailored shared decision-making is particularly essential for the large intermediate group. more...
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- 2023
17. Major complications and mortality after resection of intrahepatic cholangiocarcinoma:A systematic review and meta-analysis
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van Keulen, Anne Marleen, Büttner, Stefan, Erdmann, Joris I., Hagendoorn, Jeroen, Hoogwater, Frederik J.H., IJzermans, Jan N.M., Neumann, Ulf P., Polak, Wojciech G., De Jonge, Jeroen, Olthof, Pim B., Koerkamp, Bas Groot, van Keulen, Anne Marleen, Büttner, Stefan, Erdmann, Joris I., Hagendoorn, Jeroen, Hoogwater, Frederik J.H., IJzermans, Jan N.M., Neumann, Ulf P., Polak, Wojciech G., De Jonge, Jeroen, Olthof, Pim B., and Koerkamp, Bas Groot more...
- Abstract
Background: Evaluation of morbidity and mortality after hepatic resection often lacks stratification by extent of resection or diagnosis. Although a liver resection for different indications may have technical similarities, postoperative outcomes differ. The aim of this systematic review and meta-analysis was to determine the risk of major complications and mortality after resection of intrahepatic cholangiocarcinoma. Methods: Meta-analysis was performed to assess postoperative mortality (in-hospital, 30-, and 90-day) and major complications (Clavien-Dindo grade ≥III). Results: A total of 32 studies that reported on 19,503 patients were included. Pooled in-hospital, 30-day, and 90-day mortality were 5.9% (95% confidence interval 4.1–8.4); 4.6% (95% confidence interval 4.0–5.2); and 6.1% (95% confidence interval 5.0–7.3), respectively. Pooled proportion of major complications was 22.2% (95% confidence interval 17.7–27.5) for all resections. The pooled 90-day mortality was 3.1% (95% confidence interval 1.8–5.2) for a minor resection, 7.4% (95% confidence interval 5.9–9.3) for all major resections, and 11.4% (95% confidence interval 6.9–18.7) for extended resections (P = .001). Major complications were 38.8% (95% confidence interval 29.5–49) after a major hepatectomy compared to 11.3% (95% confidence interval 5.0–24.0) after a minor hepatectomy (P = .001). Asian studies had a pooled 90-day mortality of 4.4% (95% confidence interval 3.3–5.9) compared to 6.8% (95% confidence interval 5.6–8.2) for Western studies (P = .02). Cohorts with patients included before 2000 had a pooled 90-day mortality of 5.9% (95% confidence interval 4.8–7.3) compared to 6.8% (95% confidence interval 5.1–9.1) after 2000 (P = .44). Conclusion: When informing patients or comparing outcomes across hospitals, postoperative mortality rates after liver resection should be reported for 90-days with consideration of the diagnosis and the extent of liver resection. more...
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- 2023
18. Major complications and mortality after resection of intrahepatic cholangiocarcinoma: A systematic review and meta-analysis
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MCS-team, MS CGO, Cancer, van Keulen, Anne Marleen, Büttner, Stefan, Erdmann, Joris I., Hagendoorn, Jeroen, Hoogwater, Frederik J.H., IJzermans, Jan N.M., Neumann, Ulf P., Polak, Wojciech G., De Jonge, Jeroen, Olthof, Pim B., Koerkamp, Bas Groot, MCS-team, MS CGO, Cancer, van Keulen, Anne Marleen, Büttner, Stefan, Erdmann, Joris I., Hagendoorn, Jeroen, Hoogwater, Frederik J.H., IJzermans, Jan N.M., Neumann, Ulf P., Polak, Wojciech G., De Jonge, Jeroen, Olthof, Pim B., and Koerkamp, Bas Groot more...
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- 2023
19. Trends in Distal Esophageal and Gastroesophageal Junction Cancer Care: The Dutch Nationwide Ivory Study
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MS CGO, Cancer, Externen Med. Onco, Kalff, Marianne C, Henegouwen, Mark I van Berge, Baas, Peter C, Bahadoer, Renu R, Belt, Eric J T, Brattinga, Baukje, Claassen, Linda, Ćosović, Admira, Crull, David, Daams, Freek, van Dalsen, Annette D, Dekker, Jan Willem T, van Det, Marc J, Drost, Manon, van Duijvendijk, Peter, Eshuis, Wietse J, van Esser, Stijn, Gaspersz, Marcia P, Görgec, Burak, Groenendijk, Richard P R, Hartgrink, Henk H, van der Harst, Erwin, Haveman, Jan Willem, Heisterkamp, Joos, van Hillegersberg, Richard, Kelder, Wendy, Kingma, B Feike, Koemans, Willem J, Kouwenhoven, Ewout A, Lagarde, Sjoerd M, Lecot, Frederik, van der Linden, Philip P, Luyer, Misha D P, Nieuwenhuijzen, Grard A P, Olthof, Pim B, van der Peet, Donald L, Pierie, Jean-Pierre E N, Pierik, E G J M Robert, Plat, Victor D, Polat, Fatih, Rosman, Camiel, Ruurda, Jelle P, van Sandick, Johanna W, Scheer, Rene, Slootmans, Cettela A M, Sosef, Meindert N, Sosef, Odin V, de Steur, Wobbe O, Stockmann, Hein B A C, Stoop, Fanny J, Voeten, Daan M, Vugts, Guusje, Vijgen, Guy H E J, Weeda, Víola B, Wiezer, Marinus J, van Oijen, Martijn G H, Gisbertz, Suzanne S, MS CGO, Cancer, Externen Med. Onco, Kalff, Marianne C, Henegouwen, Mark I van Berge, Baas, Peter C, Bahadoer, Renu R, Belt, Eric J T, Brattinga, Baukje, Claassen, Linda, Ćosović, Admira, Crull, David, Daams, Freek, van Dalsen, Annette D, Dekker, Jan Willem T, van Det, Marc J, Drost, Manon, van Duijvendijk, Peter, Eshuis, Wietse J, van Esser, Stijn, Gaspersz, Marcia P, Görgec, Burak, Groenendijk, Richard P R, Hartgrink, Henk H, van der Harst, Erwin, Haveman, Jan Willem, Heisterkamp, Joos, van Hillegersberg, Richard, Kelder, Wendy, Kingma, B Feike, Koemans, Willem J, Kouwenhoven, Ewout A, Lagarde, Sjoerd M, Lecot, Frederik, van der Linden, Philip P, Luyer, Misha D P, Nieuwenhuijzen, Grard A P, Olthof, Pim B, van der Peet, Donald L, Pierie, Jean-Pierre E N, Pierik, E G J M Robert, Plat, Victor D, Polat, Fatih, Rosman, Camiel, Ruurda, Jelle P, van Sandick, Johanna W, Scheer, Rene, Slootmans, Cettela A M, Sosef, Meindert N, Sosef, Odin V, de Steur, Wobbe O, Stockmann, Hein B A C, Stoop, Fanny J, Voeten, Daan M, Vugts, Guusje, Vijgen, Guy H E J, Weeda, Víola B, Wiezer, Marinus J, van Oijen, Martijn G H, and Gisbertz, Suzanne S more...
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- 2023
20. Histopathological growth patterns of neuroendocrine tumor liver metastases
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Meyer, Yannick Y.M., Bohlok, Ali, Olthof, Pim P.B., Donckier De Donceel, Vincent, Doukas, Michail, Lucidi, Valerio, Vermeulen, Peter B., Grünhagen, Dirk Jan, Verhoef, Cornelis (Kees) C., Meyer, Yannick Y.M., Bohlok, Ali, Olthof, Pim P.B., Donckier De Donceel, Vincent, Doukas, Michail, Lucidi, Valerio, Vermeulen, Peter B., Grünhagen, Dirk Jan, and Verhoef, Cornelis (Kees) C. more...
- Abstract
Histopathological growth patterns (HGPs) of liver metastases represent a potential biomarker for prognosis after resection. They have never been studied in neuroendocrine tumor liver metastases (NETLM). This study evaluated if distinct HGPs can be observed in resected NETLM and if they have prognostic value. Sixty-three patients who underwent resection of NETLM between 01–01-2001 and 31–12-2021 were retrospectively included. HGPs were scored on Haematoxylin&Eosin slides using light microscopy, distinguishing desmoplastic- (dHGP), pushing- (pHGP) and replacement HGP (rHGP). Average HGP scores were calculated per patient. Each patient was classified according to predominant HGP. Overall and Disease-Free Survival (OS and DFS) were evaluated through Kaplan–Meier analysis and Cox regression. Eighteen patients had predominant dHGP (29%), 33 had predominant pHGP (52%) and 11 had predominant rHGP (17%). One patient had mixed HGP (2%). Five-year OS was 76% (95%CI: 66–87%) for the overall cohort. Five-year OS was 92% (95%CI: 77–100%) for dHGP, was 73% (95%CI: 59–91%) for pHGP, 50% (95%CI: 25–100%) for rHGP. Five-year DFS was 39% (95%CI: 19–83%) for dHGP, 44% (95%CI: 27–71%) for rHGP and 50% (95%CI: 23–100%) for pHGP. There was no significant association between HGP and OS or DFS in multivariable analysis. Distinct HGPs could be identified in NETLM. In patients who underwent resection of NETLM, no association was found between HGPs and postoperative survival. Half of the patients with NETLM have a predominant pushing growth pattern, which is a rare growth pattern in liver metastases from breast and colorectal cancer., SCOPUS: ar.j, info:eu-repo/semantics/published more...
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- 2023
21. Nationwide treatment and outcomes of intrahepatic cholangiocarcinoma.
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Olthof, Pim B. and Olthof, Pim B.
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- All institutes and research themes of the Radboud University Medical Center., Radboudumc 11: Renal disorders Gastroenterology.
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- 2023
22. Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score : is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS)?
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Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, Nadalin, Silvio, Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, and Nadalin, Silvio more...
- Abstract
Background: Preoperative patient selection in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is not always reliable with currently available scores, particularly in patients with primary liver tumor. This study aims to (I) to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and (II) to create a score predicting 90-day mortality preoperatively. Methods: Thirteen high-volume centers participated in this retrospective multicentric study. A risk analysis based on patient characteristics, underlying disease and procedure type was performed to identify risk factors and model the CAPRA score. A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index (CCI), the age-adjusted CCI (aCCI), the ALPPS risk score before Stage 1 (ALPPS-RS I) and Stage 2 (ALPPS-RS2). The model was internally validated applying bootstrapping. Results: A total of 451 patients were included. Mortality was 14.4%. The CAPRA score is calculated based on the following formula: (0.1*age) - (2*BSA) +1 (in the presence of primary liver tumor) +1 (in the presence of severe cardiovascular disease) +2 (in the presence of moderate or severe diabetes) +2 (in the presence of renal disease) +2 (if classic ALPPS is planned). The predictive ability was 0.837 for the CAPRA score, 0.443 for CCI, 0.519 for aCCI, 0.693 for ALPPS-RS I and 0.807 for ALPPS-RS2. After 1,000 cycles of bootstrapping the C statistic was 0.793. The accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of 4.70. Conclusions: Comorbidities play an important role in ALPPS and should be carefully considered when planning the procedure. By assessing the patients preoperative condition in relation to ALPPS, the CAPRA score has a very good ability to predict postoperative mortality. more...
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- 2022
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23. Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score : is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS)?
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Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, Nadalin, Silvio, Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, and Nadalin, Silvio more...
- Abstract
Background: Preoperative patient selection in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is not always reliable with currently available scores, particularly in patients with primary liver tumor. This study aims to (I) to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and (II) to create a score predicting 90-day mortality preoperatively. Methods: Thirteen high-volume centers participated in this retrospective multicentric study. A risk analysis based on patient characteristics, underlying disease and procedure type was performed to identify risk factors and model the CAPRA score. A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index (CCI), the age-adjusted CCI (aCCI), the ALPPS risk score before Stage 1 (ALPPS-RS I) and Stage 2 (ALPPS-RS2). The model was internally validated applying bootstrapping. Results: A total of 451 patients were included. Mortality was 14.4%. The CAPRA score is calculated based on the following formula: (0.1*age) - (2*BSA) +1 (in the presence of primary liver tumor) +1 (in the presence of severe cardiovascular disease) +2 (in the presence of moderate or severe diabetes) +2 (in the presence of renal disease) +2 (if classic ALPPS is planned). The predictive ability was 0.837 for the CAPRA score, 0.443 for CCI, 0.519 for aCCI, 0.693 for ALPPS-RS I and 0.807 for ALPPS-RS2. After 1,000 cycles of bootstrapping the C statistic was 0.793. The accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of 4.70. Conclusions: Comorbidities play an important role in ALPPS and should be carefully considered when planning the procedure. By assessing the patients preoperative condition in relation to ALPPS, the CAPRA score has a very good ability to predict postoperative mortality. more...
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- 2022
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24. Validation study of postoperative liver failure and mortality risk scores after liver resection for perihilar cholangiocarcinoma
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Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., Hirano, Satoshi, Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., and Hirano, Satoshi more...
- Abstract
Background: Surgery for perihilar cholangiocarcinoma (PHCC) remains a challenging procedure with high morbidity and mortality. The Academic Medical Center (Amsterdam UMC) and Memorial Sloan Kettering Cancer Center proposed a postoperative mortality risk score (POMRS) and post-hepatectomy liver failure score (PHLFS) to predict patient outcomes. This study aimed to validate the POMRS and PHLFS for PHCC patients at Hokkaido University. Methods: Medical records of 260 consecutive PHCC patients who had undergone major hepatectomy with extrahepatic bile duct resection without pancreaticoduodenectomy at Hokkaido University between March 2001 and November 2018 were evaluated to validate the PHLFS and POMRS. Results: The observed risks for PHLF were 13.7%, 24.5%, and 39.8% for the low-risk, intermediate risk, and high-risk groups, respectively, in the study cohort. A receiver-operator characteristic (ROC) analysis revealed that the PHLFS had moderate predictive value, with an analysis under the curve (AUC) value of 0.62. Mortality rates based on the POMRS were 1.7%, 5%, and 5.1% for the low-risk, intermediate-risk, and high-risk groups, respectively. The ROC analysis demonstrated an AUC value of 0.58. Conclusions: This external validation study showed that for PHLFS the threshold for discrimination in an Eastern cohort was reached (AUC >0.6), but it would require optimization of the model before use in clinical practice is acceptable. The POMRS were not applicable in the eastern cohort. Further external validation is recommended. more...
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- 2022
25. Validation study of postoperative liver failure and mortality risk scores after liver resection for perihilar cholangiocarcinoma
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1000010739296, Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., 1000050322813, Hirano, Satoshi, 1000010739296, Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., 1000050322813, and Hirano, Satoshi more...
- Abstract
Background: Surgery for perihilar cholangiocarcinoma (PHCC) remains a challenging procedure with high morbidity and mortality. The Academic Medical Center (Amsterdam UMC) and Memorial Sloan Kettering Cancer Center proposed a postoperative mortality risk score (POMRS) and post-hepatectomy liver failure score (PHLFS) to predict patient outcomes. This study aimed to validate the POMRS and PHLFS for PHCC patients at Hokkaido University. Methods: Medical records of 260 consecutive PHCC patients who had undergone major hepatectomy with extrahepatic bile duct resection without pancreaticoduodenectomy at Hokkaido University between March 2001 and November 2018 were evaluated to validate the PHLFS and POMRS. Results: The observed risks for PHLF were 13.7%, 24.5%, and 39.8% for the low-risk, intermediate risk, and high-risk groups, respectively, in the study cohort. A receiver-operator characteristic (ROC) analysis revealed that the PHLFS had moderate predictive value, with an analysis under the curve (AUC) value of 0.62. Mortality rates based on the POMRS were 1.7%, 5%, and 5.1% for the low-risk, intermediate-risk, and high-risk groups, respectively. The ROC analysis demonstrated an AUC value of 0.58. Conclusions: This external validation study showed that for PHLFS the threshold for discrimination in an Eastern cohort was reached (AUC >0.6), but it would require optimization of the model before use in clinical practice is acceptable. The POMRS were not applicable in the eastern cohort. Further external validation is recommended. more...
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- 2022
26. Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score : is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS)?
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Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, Nadalin, Silvio, Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, and Nadalin, Silvio more...
- Abstract
Background: Preoperative patient selection in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is not always reliable with currently available scores, particularly in patients with primary liver tumor. This study aims to (I) to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and (II) to create a score predicting 90-day mortality preoperatively. Methods: Thirteen high-volume centers participated in this retrospective multicentric study. A risk analysis based on patient characteristics, underlying disease and procedure type was performed to identify risk factors and model the CAPRA score. A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index (CCI), the age-adjusted CCI (aCCI), the ALPPS risk score before Stage 1 (ALPPS-RS I) and Stage 2 (ALPPS-RS2). The model was internally validated applying bootstrapping. Results: A total of 451 patients were included. Mortality was 14.4%. The CAPRA score is calculated based on the following formula: (0.1*age) - (2*BSA) +1 (in the presence of primary liver tumor) +1 (in the presence of severe cardiovascular disease) +2 (in the presence of moderate or severe diabetes) +2 (in the presence of renal disease) +2 (if classic ALPPS is planned). The predictive ability was 0.837 for the CAPRA score, 0.443 for CCI, 0.519 for aCCI, 0.693 for ALPPS-RS I and 0.807 for ALPPS-RS2. After 1,000 cycles of bootstrapping the C statistic was 0.793. The accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of 4.70. Conclusions: Comorbidities play an important role in ALPPS and should be carefully considered when planning the procedure. By assessing the patients preoperative condition in relation to ALPPS, the CAPRA score has a very good ability to predict postoperative mortality. more...
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- 2022
- Full Text
- View/download PDF
27. Validation study of postoperative liver failure and mortality risk scores after liver resection for perihilar cholangiocarcinoma
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1000010739296, Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., 1000050322813, Hirano, Satoshi, 1000010739296, Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., 1000050322813, and Hirano, Satoshi more...
- Abstract
Background: Surgery for perihilar cholangiocarcinoma (PHCC) remains a challenging procedure with high morbidity and mortality. The Academic Medical Center (Amsterdam UMC) and Memorial Sloan Kettering Cancer Center proposed a postoperative mortality risk score (POMRS) and post-hepatectomy liver failure score (PHLFS) to predict patient outcomes. This study aimed to validate the POMRS and PHLFS for PHCC patients at Hokkaido University. Methods: Medical records of 260 consecutive PHCC patients who had undergone major hepatectomy with extrahepatic bile duct resection without pancreaticoduodenectomy at Hokkaido University between March 2001 and November 2018 were evaluated to validate the PHLFS and POMRS. Results: The observed risks for PHLF were 13.7%, 24.5%, and 39.8% for the low-risk, intermediate risk, and high-risk groups, respectively, in the study cohort. A receiver-operator characteristic (ROC) analysis revealed that the PHLFS had moderate predictive value, with an analysis under the curve (AUC) value of 0.62. Mortality rates based on the POMRS were 1.7%, 5%, and 5.1% for the low-risk, intermediate-risk, and high-risk groups, respectively. The ROC analysis demonstrated an AUC value of 0.58. Conclusions: This external validation study showed that for PHLFS the threshold for discrimination in an Eastern cohort was reached (AUC >0.6), but it would require optimization of the model before use in clinical practice is acceptable. The POMRS were not applicable in the eastern cohort. Further external validation is recommended. more...
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- 2022
28. Validation study of postoperative liver failure and mortality risk scores after liver resection for perihilar cholangiocarcinoma
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Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., Hirano, Satoshi, Noji, Takehiro, Uemura, Satoko, Wiggers, Jimme K., Tanaka, Kimitaka, Nakanishi, Yoshitsugu, Asano, Toshimichi, Nakamura, Toru, Tsuchikawa, Takahiro, Okamura, Keisuke, Olthof, Pim B., Jarnagin, William R., van Gulik, Thomas M., and Hirano, Satoshi more...
- Abstract
Background: Surgery for perihilar cholangiocarcinoma (PHCC) remains a challenging procedure with high morbidity and mortality. The Academic Medical Center (Amsterdam UMC) and Memorial Sloan Kettering Cancer Center proposed a postoperative mortality risk score (POMRS) and post-hepatectomy liver failure score (PHLFS) to predict patient outcomes. This study aimed to validate the POMRS and PHLFS for PHCC patients at Hokkaido University. Methods: Medical records of 260 consecutive PHCC patients who had undergone major hepatectomy with extrahepatic bile duct resection without pancreaticoduodenectomy at Hokkaido University between March 2001 and November 2018 were evaluated to validate the PHLFS and POMRS. Results: The observed risks for PHLF were 13.7%, 24.5%, and 39.8% for the low-risk, intermediate risk, and high-risk groups, respectively, in the study cohort. A receiver-operator characteristic (ROC) analysis revealed that the PHLFS had moderate predictive value, with an analysis under the curve (AUC) value of 0.62. Mortality rates based on the POMRS were 1.7%, 5%, and 5.1% for the low-risk, intermediate-risk, and high-risk groups, respectively. The ROC analysis demonstrated an AUC value of 0.58. Conclusions: This external validation study showed that for PHLFS the threshold for discrimination in an Eastern cohort was reached (AUC >0.6), but it would require optimization of the model before use in clinical practice is acceptable. The POMRS were not applicable in the eastern cohort. Further external validation is recommended. more...
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- 2022
29. Sarcopenia predicts reduced liver growth and reduced resectability in patients undergoing portal vein embolization before liver resection - A DRAGON collaborative analysis of 306 patients
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Heil, Jan, Heid, Franziska, Bechstein, Wolf O, Björnsson, Bergthor, Brismar, Torkel B, Carling, Ulrik, Erdmann, Joris, Fretland, Åsmund A, Grunhagen, Dirk, Hana, Renato A, Hohmann, Joachim, Linke, Richard, Meyer, Yannick, Nawawi, Abrar, Olthof, Pim B, Sandström, Per, Schnitzbauer, Andreas A, Sparrelid, Ernesto, Verhoef, Cornelis, Metrakos, Peter, Schadde, Erik, Heil, Jan, Heid, Franziska, Bechstein, Wolf O, Björnsson, Bergthor, Brismar, Torkel B, Carling, Ulrik, Erdmann, Joris, Fretland, Åsmund A, Grunhagen, Dirk, Hana, Renato A, Hohmann, Joachim, Linke, Richard, Meyer, Yannick, Nawawi, Abrar, Olthof, Pim B, Sandström, Per, Schnitzbauer, Andreas A, Sparrelid, Ernesto, Verhoef, Cornelis, Metrakos, Peter, and Schadde, Erik more...
- Abstract
Background: After portal vein embolization (PVE) 30% fail to achieve liver resection. Malnutrition is a modifiable risk factor and can be assessed by radiological indices. This study investigates, if sarcopenia affects resectability and kinetic growth rate (KGR) after PVE. Methods: A retrospective study was performed of the outcome of PVE at 8 centres of the DRAGON collaborative from 2010 to 2019. All malignant tumour types were included. Sarcopenia was defined using gender, body mass and skeletal muscle index. First imaging after PVE was used for liver volumetry. Primary and secondary endpoints were resectability and KGR. Risk factors impacting liver growth were assessed in a multivariable analysis. Results: Eight centres identified 368 patients undergoing PVE. 62 patients (17%) had to be excluded due to unavailability of data. Among the 306 included patients, 112 (37%) were non-sarcopenic and 194 (63%) were sarcopenic. Sarcopenic patients had a 21% lower resectability rate (87% vs. 66%, p < 0.001) and a 23% reduced KGR (p = 0.02) after PVE. In a multivariable model dichotomized for KGR ≥2.3% standardized FLR (sFLR)/week, only sarcopenia and sFLR before embolization correlated with KGR. Conclusion: In this largest study of risk factors, sarcopenia was associated with reduced resectability and KGR in patients undergoing PVE. more...
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- 2022
30. Increased Hepatic Microvascular Density, Oxygenation, and VEGF in the Hypertrophic Lobe following Portal Vein Embolization in Rabbits
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Uz, Zuhre, Ergin, Bulent, Shen, Lucinda, van Lienden, Krijn P., Rassam, Fadi, Olthof, Pim B., Bennink, Roel J., Ince, Can, van Gulik, Thomas M., Uz, Zuhre, Ergin, Bulent, Shen, Lucinda, van Lienden, Krijn P., Rassam, Fadi, Olthof, Pim B., Bennink, Roel J., Ince, Can, and van Gulik, Thomas M. more...
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Introduction: The microvascular events following portal vein embolization (PVE) are poorly understood despite the pivotal role of the microcirculation in liver regeneration and tumor progression. We aimed to assess the changes in hepatic microvascular perfusion and neo-angiogenesis after experimental PVE. Methods: PVE of the cranial liver lobes was performed in 12 New Zealand White rabbits divided into 2 groups of permanent (P-PVE) and reversible PVE (R-PVE), respectively. Hepatobiliary scintigraphy and CT were used to evaluate hepatic function and volume. Hepatic microcirculation was assessed using a handheld vital microscope (Cytocam) to measure microvascular density (total vessel density; TVD) before PVE, right after PVE, and 20 min after PVE, as well as at 14 days (D14 post-PVE) and 35 days (D35 post-PVE). Additionally, on D35, microvascular PO and liver parenchymal VEGF were assessed. Results: Eleven rabbits were included after PVE (R-PVE, n = 5; P-PVE, n = 6). TVD in the nonembo-lized (hypertrophic) lobes was higher than in the embolized (atrophic) lobes of the P-PVE group at D35 post-PVE (36.7 ± 7.2 vs. 23.4 ± 4.9 mm/mm p < 0.05). In the R-PVE group, TVD in the nonembolized lobes was not increased at D35. Function and volume were increased in the nonembolized lobes of the P-PVE group compared to the embolized lobes, but not in the R-PVE group. Likewise, the mmicrovascular PO2 and VEGF staining rate were higher in the nonembolized lobes of the P-PVE group at D35 post-PVE. Discussion/Conclusion: Successful volumetric and functional hypertrophy of the nonembolized lobe was accompanied by microvascular alterations featuring increased neo-angiogenesis, microvascular density, and microvascular oxygen pressure following P-PVE. more...
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- 2022
31. Current evidence on posthepatectomy liver failure:comprehensive review
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Sparrelid, Ernesto, Olthof, Pim B., Dasari, Bobby V.M., Erdmann, Joris I., Santol, Jonas, Starlinger, Patrick, Gilg, Stefan, Sparrelid, Ernesto, Olthof, Pim B., Dasari, Bobby V.M., Erdmann, Joris I., Santol, Jonas, Starlinger, Patrick, and Gilg, Stefan more...
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Introduction: Despite important advances in many areas of hepatobiliary surgical practice during the past decades, posthepatectomy liver failure (PHLF) still represents an important clinical challenge for the hepatobiliary surgeon. The aim of this review is to present the current body of evidence regarding different aspects of PHLF. Methods: A literature review was conducted to identify relevant articles for each topic of PHLF covered in this review. The literature search was performed using Medical Subject Heading terms on PubMed for articles on PHLF in English until May 2022. Results: Uniform reporting on PHLF is lacking due to the use of various definitions in the literature. There is no consensus on optimal preoperative assessment before major hepatectomy to avoid PHLF, although many try to estimate future liver remnant function. Once PHLF occurs, there is still no effective treatment, except liver transplantation, where the reported experience is limited. Discussion: Strict adherence to one definition is advised when reporting data on PHLF. The use of the International Study Group of Liver Surgery criteria of PHLF is recommended. There is still no widespread established method for future liver remnant function assessment. Liver transplantation is currently the only effective way to treat severe, intractable PHLF, but for many indications, this treatment is not available in most countries. more...
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- 2022
32. Minimally Invasive Liver Surgery:A Snapshot from a Major Dutch HPB and Transplant Center
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Marino, Rebecca, Olthof, Pim B., Shi, Hong J., Tran, Khe T. C., Ijzermans, Jan N. M., Terkivatan, Turkan, Marino, Rebecca, Olthof, Pim B., Shi, Hong J., Tran, Khe T. C., Ijzermans, Jan N. M., and Terkivatan, Turkan more...
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Background Minimally invasive liver surgery (MILS) has been progressively adopted on a nationwide scale. The aim of this study is to investigate MILS implementation in a high-volume Dutch hepato-pancreato-biliary and transplant center, which is considered a moderate to low-volume center from a European standpoint. Methods All patients who underwent MILS at Erasmus Medical Center between April 2010 and December 2021 were retrospectively reviewed. Patients' surgical outcomes were compared after stratification according to resections' difficulty and liver cirrhosis. Results A total of 212 cases were included. Major liver resections were performed in 24 patients (11%), while minor resections were performed in 188 patients (89%). Among those, 177 (94%) resections were classified as technically minor and 11 (6%) as technically major. Major morbidity was reported in 14/177 patients (8%) after technically minor resections and in 3/24 patients (13%) after major resections. Anatomically and technically major resections had higher intraoperative blood losses (425 (0-2100) vs. 240 (50-110) vs. 100 (0-2400) mL; p-value < 0.001) and longer hospital stay (6 (3-25) vs. 5 (2-9) vs. 3 (1-44); p-value < 0.001) when compared with the technically minor counterpart. Perioperative outcomes were similar when comparing cirrhotic MILS with the non-cirrhotic cohort. Conclusion MILS program implementation can lead to encouraging surgical outcomes even in low- to moderate-volume centers. Although low procedural volume might be predictive of impaired outcomes, long-standing experience in the HPB and liver transplant field could mitigate low-case volume effects on surgical outcomes. more...
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- 2022
33. The relevance of the liver volume increase after ALPPS
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Olthof, Pim B., Buettner, Stefan, Schadde, Erik, Olthof, Pim B., Buettner, Stefan, and Schadde, Erik
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- 2022
34. Sarcopenia and long-term survival outcomes after local therapy for colorectal liver metastasis:a meta-analysis
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Waalboer, Ruben B, Meyer, Yannick M, Galjart, Boris, Olthof, Pim B, van Vugt, Jeroen L A, Grünhagen, Dirk J, Verhoef, Cornelis, Waalboer, Ruben B, Meyer, Yannick M, Galjart, Boris, Olthof, Pim B, van Vugt, Jeroen L A, Grünhagen, Dirk J, and Verhoef, Cornelis more...
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BACKGROUND: Sarcopenia is defined as either low pre-operative muscle mass or low muscle density on abdominal CT imaging. It has been associated with worse short-term outcomes after surgery for colorectal liver metastases. This study aimed to evaluate whether sarcopenia also impacts long-term survival outcomes in these patients.METHODS: A random-effects meta-analysis was conducted following the PRISMA guidelines. Overall survival (OS) and disease-free survival (DFS) outcomes were evaluated.RESULTS: Eleven studies were included, ten reporting on the impact of low muscle mass and four on low muscle density. Sample sizes ranged between 47 and 539 (2124 patients in total). Altogether, 897 (42%) patients were considered sarcopenic, although definitions varied between studies. Median follow-up was 21-74 months. Low muscle mass (hazard ration (HR) 1.35, 95%CI 1.08-1.68) and low muscle density (HR 1.97, 95%CI 1.07-3.62) were associated with impaired OS. Low muscle mass (pooled HR 1.17, 95%CI 0.94-1.46) and low muscle density (pooled HR 1.13, 95%CI 0.85-1.50) were not associated with impaired RFS.DISCUSSION: Sarcopenia is associated with poorer OS, but not RFS, in patients with CRLM. Additional studies with standardized sarcopenia definitions are needed to better assess the impact of sarcopenia in patients with CRLM. more...
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- 2022
35. Interregional practice variations in the use of local therapy for synchronous colorectal liver metastases in the Netherlands
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Meyer, Yannick M., Olthof, Pim B., Grünhagen, Dirk J., Swijnenburg, Rutger Jan, Elferink, Marloes A.G., Verhoef, Cornelis, Meyer, Yannick M., Olthof, Pim B., Grünhagen, Dirk J., Swijnenburg, Rutger Jan, Elferink, Marloes A.G., and Verhoef, Cornelis more...
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BACKGROUND: The aim of this study was to evaluate the Dutch regional practice variation in treatment of synchronous colorectal liver metastases (CRLM) over time and assess their impact on patients survival.METHODS: Two cohorts of patients with synchronous CRLM were selected from the Netherlands Cancer Registry (NCR). All patients diagnosed between 2014 and 2018 were selected to analyze interregional practice variations in local therapy (LT) with multivariable logistic regression. Overall survival (OS) was assessed for patients diagnosed from 2008 to 2013 using Kaplan Meier method and Cox regression analyses.RESULTS: The proportion of patients who underwent LT increased from 15.5% to 21.9%. Interregional use of LT varied from 19.1% to 25.0%. Multivariable logistic regression showed significant differences between regions in the use of LT (p = 0.001) in 2014-2018. There was no association between OS and region of diagnosis for patients who underwent LT after correction for confounders.The use of LT for CRLM increased from 15.5% in 2008-2013 to 21.9% in 2014-2018. Three-year OS increased from 16% to 19% respectively.CONCLUSION: Interregional practice variations have decreased. The remaining differences are not associated with OS. The use of local therapy and 3-year overall survival have increased over time. Local practice should be monitored to prevent undesirable variation in outcomes. more...
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- 2022
36. Absence of association between CT-assessed skeletal muscle mass and long-term oncological outcomes after curative therapy for colorectal liver metastasis
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Meyer, Yannick M., Galjart, Boris, Waalboer, Ruben B., Olthof, Pim B., van Vugt, Jeroen L.A., Grünhagen, Dirk J., Verhoef, Cornelis, Meyer, Yannick M., Galjart, Boris, Waalboer, Ruben B., Olthof, Pim B., van Vugt, Jeroen L.A., Grünhagen, Dirk J., and Verhoef, Cornelis more...
- Abstract
BACKGROUND: Sarcopenia is associated with impaired short- and long-term outcomes in gastrointestinal cancers. Whether sarcopenia is associated with impaired survival after local therapy of Colorectal Cancer Liver Metastases (CRLM) remains controversial. This study aimed to determine the influence of sarcopenia on long-term outcomes after curative-intent therapy for CRLM.METHODS: Patients undergoing local therapy for CRLM between 2003 and 2019 were retrospectively analyzed using the skeletal muscle index at the level of the third lumbar vertebra as an indicator of sarcopenia. Factors associated with overall (OS) and disease-free (DFS) survival were analyzed using univariable and multivariable cox regression.RESULTS: In total 213/465 patients (46%) were considered sarcopenic. Sarcopenic patients had no impaired 5-year OS or DFS compared to non-sarcopenic patients, 38% vs 44% (p = 0.153) and 19 vs 23% (p = 0.339) respectively. Sarcopenia was not associated with impaired OS (HR = 1.11, 95%CI = 0.85-1.46, p = 0.43) or DFS (HR = 0.99, 95%CI = 0.77-1.28, p = 0.96) in multivariable analysis. There were no significant differences in postoperative complications (p = 0.47), the incidence (p = 0.65) and treatment (p = 0.37) of recurrent metastases. Five-year OS after resection for recurrences was 14% (sarcopenic) and 22% (non-sarcopenic) p 0.716.CONCLUSION: Sarcopenia assessed by computed tomography was not associated with impaired survival outcomes in the group of CRLM patients overall. more...
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- 2022
37. Sarcopenia predicts reduced liver growth and reduced resectability in patients undergoing portal vein embolization before liver resection-A DRAGON collaborative analysis of 306 patients
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Heil, Jan, Heid, Franziska, Bechstein, Wolf O., Björnsson, Bergthor, Brismar, Torkel B., Carling, Ulrik, Erdmann, Joris, Fretland, Asmund A., Grunhagen, Dirk, Hana, Renato A., Hohmann, Joachim, Linke, Richard, Meyer, Yannick, Nawawi, Abrar, Olthof, Pim B., Sandström, Per, Schnitzbauer, Andreas A., Sparrelid, Ernesto, Verhoef, Cornelis, Metrakos, Peter, Schadde, Erik, Heil, Jan, Heid, Franziska, Bechstein, Wolf O., Björnsson, Bergthor, Brismar, Torkel B., Carling, Ulrik, Erdmann, Joris, Fretland, Asmund A., Grunhagen, Dirk, Hana, Renato A., Hohmann, Joachim, Linke, Richard, Meyer, Yannick, Nawawi, Abrar, Olthof, Pim B., Sandström, Per, Schnitzbauer, Andreas A., Sparrelid, Ernesto, Verhoef, Cornelis, Metrakos, Peter, and Schadde, Erik more...
- Abstract
Background: After portal vein embolization (PVE) 30% fail to achieve liver resection. Malnutrition is a modifiable risk factor and can be assessed by radiological indices. This study investigates, if sarcopenia affects resectability and kinetic growth rate (KGR) after PVE. Methods: A retrospective study was performed of the outcome of PVE at 8 centres of the DRAGON collaborative from 2010 to 2019. All malignant tumour types were included. Sarcopenia was defined using gender, body mass and skeletal muscle index. First imaging after PVE was used for liver volumetry. Primary and secondary endpoints were resectability and KGR. Risk factors impacting liver growth were assessed in a multivariable analysis. Results: Eight centres identified 368 patients undergoing PVE. 62 patients (17%) had to be excluded due to unavailability of data. Among the 306 included patients, 112 (37%) were non-sarcopenic and 194 (63%) were sarcopenic. Sarcopenic patients had a 21% lower resectability rate (87% vs. 66%, p < 0.001) and a 23% reduced KGR (p = 0.02) after PVE. In a multivariable model dichotomized for KGR >2.3% standardized FLR (sFLR)/week, only sarcopenia and sFLR before embolization correlated with KGR. Conclusion: In this largest study of risk factors, sarcopenia was associated with reduced resectability and KGR in patients undergoing PVE. more...
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- 2022
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38. Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score : is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS)?
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Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, Nadalin, Silvio, Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, and Nadalin, Silvio more...
- Abstract
Background: Preoperative patient selection in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is not always reliable with currently available scores, particularly in patients with primary liver tumor. This study aims to (I) to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and (II) to create a score predicting 90-day mortality preoperatively. Methods: Thirteen high-volume centers participated in this retrospective multicentric study. A risk analysis based on patient characteristics, underlying disease and procedure type was performed to identify risk factors and model the CAPRA score. A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index (CCI), the age-adjusted CCI (aCCI), the ALPPS risk score before Stage 1 (ALPPS-RS I) and Stage 2 (ALPPS-RS2). The model was internally validated applying bootstrapping. Results: A total of 451 patients were included. Mortality was 14.4%. The CAPRA score is calculated based on the following formula: (0.1*age) - (2*BSA) +1 (in the presence of primary liver tumor) +1 (in the presence of severe cardiovascular disease) +2 (in the presence of moderate or severe diabetes) +2 (in the presence of renal disease) +2 (if classic ALPPS is planned). The predictive ability was 0.837 for the CAPRA score, 0.443 for CCI, 0.519 for aCCI, 0.693 for ALPPS-RS I and 0.807 for ALPPS-RS2. After 1,000 cycles of bootstrapping the C statistic was 0.793. The accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of 4.70. Conclusions: Comorbidities play an important role in ALPPS and should be carefully considered when planning the procedure. By assessing the patients preoperative condition in relation to ALPPS, the CAPRA score has a very good ability to predict postoperative mortality. more...
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- 2022
- Full Text
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39. Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score : is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS)?
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Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, Nadalin, Silvio, Capobianco, Ivan, Oldhafer, Karl J., Fard-Aghaie, Mohammed-Hossein, Robles-Campos, Ricardo, Brusadin, Roberto, Petrowsky, Henrik, Linecker, Michael, Mehrabi, Arianeb, Hoffmann, Katrin, Li, Jun, Heumann, Asmus, Hernandez-Alejandro, Roberto, Tun-Abraham, Mauro Enrique, Jovine, Elio, Serenari, Matteo, Björnsson, Bergthor, Sandström, Per, Alikhanov, Ruslan, Efanov, Mikhail, Muiesan, Paolo, Schlegel, Andrea, Gulik, Thomas M. van, Olthof, Pim B., Stavrou, Gregor Alexander, Serna-Higulta, Lina Maria, Königsrainer, Alfred, and Nadalin, Silvio more...
- Abstract
Background: Preoperative patient selection in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is not always reliable with currently available scores, particularly in patients with primary liver tumor. This study aims to (I) to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and (II) to create a score predicting 90-day mortality preoperatively. Methods: Thirteen high-volume centers participated in this retrospective multicentric study. A risk analysis based on patient characteristics, underlying disease and procedure type was performed to identify risk factors and model the CAPRA score. A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index (CCI), the age-adjusted CCI (aCCI), the ALPPS risk score before Stage 1 (ALPPS-RS I) and Stage 2 (ALPPS-RS2). The model was internally validated applying bootstrapping. Results: A total of 451 patients were included. Mortality was 14.4%. The CAPRA score is calculated based on the following formula: (0.1*age) - (2*BSA) +1 (in the presence of primary liver tumor) +1 (in the presence of severe cardiovascular disease) +2 (in the presence of moderate or severe diabetes) +2 (in the presence of renal disease) +2 (if classic ALPPS is planned). The predictive ability was 0.837 for the CAPRA score, 0.443 for CCI, 0.519 for aCCI, 0.693 for ALPPS-RS I and 0.807 for ALPPS-RS2. After 1,000 cycles of bootstrapping the C statistic was 0.793. The accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of 4.70. Conclusions: Comorbidities play an important role in ALPPS and should be carefully considered when planning the procedure. By assessing the patients preoperative condition in relation to ALPPS, the CAPRA score has a very good ability to predict postoperative mortality. more...
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- 2022
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40. Recurrent Disease after Esophageal Cancer Surgery: A Substudy of The Dutch Nationwide Ivory Study
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MS CGO, Cancer, Heelkunde Opleiding, Externen Med. Onco, Kalff, Marianne C, Henckens, Sofie P G, Voeten, Daan M, Heineman, David J, Hulshof, Maarten C C M, van Laarhoven, Hanneke W M, Eshuis, Wietse J, Baas, Peter C, Bahadoer, Renu R, Belt, Eric J T, Brattinga, Baukje, Claassen, Linda, Ćosović, Admira, Crull, David, Daams, Freek, van Dalsen, Annette D, Dekker, Jan Willem T, van Det, Marc J, Drost, Manon, Duijvendijk, Peter van, Esser, Stijn van, Gaspersz, Marcia P, Görgec, Burak, Groenendijk, Richard P R, Hartgrink, Henk H, Harst, Erwin van der, Haveman, Jan Willem, Heisterkamp, Joos, Hillegersberg, Richard van, Kelder, Wendy, Kingma, B Feike, Koemans, Willem J, Kouwenhoven, Ewout A, Lagarde, Sjoerd M, Lecot, Frederik, van der Linden, Philip P, Luyer, Misha D P, Nieuwenhuijzen, Grard A P, Olthof, Pim B, van der Peet, Donald L, Pierie, Jean-Pierre En, Pierik, E G J M Robert, Plat, Victor D, Polat, Fatih, Rosman, Camiel, Ruurda, Jelle P, van Sandick, Johanna W, Scheer, Rene, Slootmans, Cettela AM, Sosef, Meindert N, Sosef, Odin V, de Steur, Wobbe O, Stockmann, Hein B A C, Stoop, Fanny J, Vugts, Guusje, Vijgen, Guy H E J, Weeda, Víola B, Wiezer, Marinus J, van Oijen, Martijn G H, van Berge Henegouwen, Mark I, Gisbertz, Suzanne S, MS CGO, Cancer, Heelkunde Opleiding, Externen Med. Onco, Kalff, Marianne C, Henckens, Sofie P G, Voeten, Daan M, Heineman, David J, Hulshof, Maarten C C M, van Laarhoven, Hanneke W M, Eshuis, Wietse J, Baas, Peter C, Bahadoer, Renu R, Belt, Eric J T, Brattinga, Baukje, Claassen, Linda, Ćosović, Admira, Crull, David, Daams, Freek, van Dalsen, Annette D, Dekker, Jan Willem T, van Det, Marc J, Drost, Manon, Duijvendijk, Peter van, Esser, Stijn van, Gaspersz, Marcia P, Görgec, Burak, Groenendijk, Richard P R, Hartgrink, Henk H, Harst, Erwin van der, Haveman, Jan Willem, Heisterkamp, Joos, Hillegersberg, Richard van, Kelder, Wendy, Kingma, B Feike, Koemans, Willem J, Kouwenhoven, Ewout A, Lagarde, Sjoerd M, Lecot, Frederik, van der Linden, Philip P, Luyer, Misha D P, Nieuwenhuijzen, Grard A P, Olthof, Pim B, van der Peet, Donald L, Pierie, Jean-Pierre En, Pierik, E G J M Robert, Plat, Victor D, Polat, Fatih, Rosman, Camiel, Ruurda, Jelle P, van Sandick, Johanna W, Scheer, Rene, Slootmans, Cettela AM, Sosef, Meindert N, Sosef, Odin V, de Steur, Wobbe O, Stockmann, Hein B A C, Stoop, Fanny J, Vugts, Guusje, Vijgen, Guy H E J, Weeda, Víola B, Wiezer, Marinus J, van Oijen, Martijn G H, van Berge Henegouwen, Mark I, and Gisbertz, Suzanne S more...
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- 2022
41. Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid
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de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, Olthof, Pim B, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, and Olthof, Pim B more...
- Abstract
In a previous study, obeticholic acid (OCA) increased liver growth before partial hepatectomy (PHx) in rats through the bile acid receptor farnesoid X-receptor (FXR). In that model, OCA was administered during obstructive cholestasis. However, patients normally undergo PHx several days after biliary drainage. The effects of OCA on liver regeneration were therefore studied in post-cholestatic Wistar rats. Rats underwent sham surgery or reversible bile duct ligation (rBDL), which was relieved after 7 days. PHx was performed one day after restoration of bile flow. Rats received 10 mg/kg OCA per day or were fed vehicle from restoration of bile flow until sacrifice 5 days after PHx. Liver regeneration was comparable between cholestatic and non-cholestatic livers in PHx-subjected rats, which paralleled liver regeneration a human validation cohort. OCA treatment induced ileal Fgf15 mRNA expression but did not enhance post-PHx hepatocyte proliferation through FXR/SHP signaling. OCA treatment neither increased mitosis rates nor recovery of liver weight after PHx but accelerated liver regrowth in rats that had not been subjected to rBDL. OCA did not increase biliary injury. Conclusively, OCA does not induce liver regeneration in post-cholestatic rats and does not exacerbate biliary damage that results from cholestasis. This study challenges the previously reported beneficial effects of OCA in liver regeneration in cholestatic rats. more...
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- 2021
42. Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid
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Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, Olthof, Pim B, Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, and Olthof, Pim B more...
- Published
- 2021
43. Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid
- Author
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Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, Olthof, Pim B, Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, and Olthof, Pim B more...
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- 2021
44. Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid
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Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, Olthof, Pim B, Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, and Olthof, Pim B more...
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- 2021
45. Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid
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Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, Olthof, Pim B, Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, and Olthof, Pim B more...
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- 2021
46. Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid
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Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, Olthof, Pim B, Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, and Olthof, Pim B more...
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- 2021
47. Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid
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Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, Olthof, Pim B, Sub Membrane Biochemistry & Biophysics, Afd Pharmaceutics, Pharmaceutics, de Haan, Lianne R, Verheij, Joanne, van Golen, Rowan F, Horneffer-van der Sluis, Verena, Lewis, Matthew R, Beuers, Ulrich H W, van Gulik, Thomas M, Olde Damink, Steven W M, Schaap, Frank G, Heger, Michal, and Olthof, Pim B more...
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- 2021
48. Actual 10-Year Survival after Resection of Perihilar Cholangiocarcinoma:What Factors Preclude a Chance for Cure?
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van Keulen, Anne-Marleen, Olthof, Pim B., Cescon, Matteo, Guglielmi, Alfredo, Jarnagin, William R., Nadalin, Silvio, Pratschke, Johann, Ratti, Francesca, Troisi, Roberto I., Groot Koerkamp, Bas, Buettner, Stefan, Erdmann, Joris I., van Keulen, Anne-Marleen, Olthof, Pim B., Cescon, Matteo, Guglielmi, Alfredo, Jarnagin, William R., Nadalin, Silvio, Pratschke, Johann, Ratti, Francesca, Troisi, Roberto I., Groot Koerkamp, Bas, Buettner, Stefan, and Erdmann, Joris I. more...
- Abstract
Simple Summary Long-term survival for patients with perihilar cholangiocarcinoma (pCCA) is rare. The median overall survival of patients undergoing curative-intent surgery for pCCA is 19 to 39 months. This multicenter study aimed to determine the cure rate and to identify clinicopathological factors that may preclude cure. Four hundred and sixty patients were included with a median follow-up of 10 years. Median OS was 29.9 months. Twenty-nine (6%) patients reached 10-year OS. The observed cure rate was 5%. Factors that virtually precluded cure (i.e., below 1%) according to the mixture cure model included age above 70, Bismuth-Corlette type IV tumors, hepatic artery reconstruction, and positive resection margins. Cure was unlikely (i.e., below 3%) in patients with positive lymph nodes or poor tumor differentiation. These factors need to be considered in patient counseling and long-term follow-up after surgery. Complete resection of perihilar cholangiocarcinoma (pCCA) is the only potentially curative treatment. Long-term survival data is rare and prognostic analyses are hindered by the rarity of the disease. This study aimed to determine the cure rate and to identify clinicopathological factors that may preclude cure. All consecutive resections for pathologically confirmed pCCA between 2000 and 2009 in 22 centers worldwide were included in a retrospective cohort study. Each center included its retrospective data series. A total of 460 patients were included with a median follow-up of 10 years for patients alive at last follow-up. Median overall survival (OS) was 29.9 months and 10-year OS was 12.8%. Twenty-nine (6%) patients reached 10-year OS. The observed cure rate was 5%. Factors that virtually precluded cure (i.e., below 1%) according to the mixture cure model included age above 70, Bismuth-Corlette type IV tumors, hepatic artery reconstruction, and positive resection margins. Cure was unlikely (i.e., below 3%) in patients with positive lymph nodes or poor tumor d more...
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- 2021
49. Eligibility for Liver Transplantation in Patients with Perihilar Cholangiocarcinoma (vol 28, pg 1483, 2021)
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Vugts, Jaynee J. A., Gaspersz, Marcia P., Roos, Eva, Franken, Lotte C., Olthof, Pim B., Coelen, Robert J. S., van Vugt, Jeroen L. A., Labeur, Tim A., Brouwer, Lieke, Besselink, Marc G. H., IJzermans, Jan N. M., Murad, Sarwa Darwish, van Gulik, Thomas M., de Jonge, Jeroen, Polak, Wojciech G., Busch, Olivier R. C., Erdmann, Joris L., Koerkamp, Bas Groot, Buettner, Stefan, Vugts, Jaynee J. A., Gaspersz, Marcia P., Roos, Eva, Franken, Lotte C., Olthof, Pim B., Coelen, Robert J. S., van Vugt, Jeroen L. A., Labeur, Tim A., Brouwer, Lieke, Besselink, Marc G. H., IJzermans, Jan N. M., Murad, Sarwa Darwish, van Gulik, Thomas M., de Jonge, Jeroen, Polak, Wojciech G., Busch, Olivier R. C., Erdmann, Joris L., Koerkamp, Bas Groot, and Buettner, Stefan more...
- Published
- 2021
50. Nationwide treatment and outcomes of perihilar cholangiocarcinoma
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van Keulen, Anne Marleen, Franssen, Stijn, van der Geest, Lydia G., de Boer, Marieke T., Coenraad, Minneke, van Driel, Lydi M.J.W., Erdmann, Joris, Haj Mohammad, Nadia, Heij, Lara, Klümpen, Heinz Josef, Tjwa, Eric, Valkenburg-van Iersel, Liselot, Verheij, Joanne, Groot Koerkamp, Bas, Olthof, Pim, van Keulen, Anne Marleen, Franssen, Stijn, van der Geest, Lydia G., de Boer, Marieke T., Coenraad, Minneke, van Driel, Lydi M.J.W., Erdmann, Joris, Haj Mohammad, Nadia, Heij, Lara, Klümpen, Heinz Josef, Tjwa, Eric, Valkenburg-van Iersel, Liselot, Verheij, Joanne, Groot Koerkamp, Bas, and Olthof, Pim more...
- Abstract
Background: Perihilar cholangiocarcinoma (pCCA) is a rare tumour that requires complex multidisciplinary management. All known data are almost exclusively derived from expert centres. This study aimed to analyse the outcomes of patients with pCCA in a nationwide cohort. Methods: Data on all patients diagnosed with pCCA in the Netherlands between 2010 and 2018 were obtained from the Netherlands Cancer Registry. Data included type of hospital of diagnosis and the received treatment. Outcomes included the type of treatment and overall survival. Results: A total of 2031 patients were included and the median overall survival for the overall cohort was 5.2 (95% CI 4.7-5.7) months. Three-hundred-ten (15%) patients underwent surgical resection, 271 (13%) underwent palliative systemic treatment, 21 (1%) palliative local anti-cancer treatment and 1429 (70%) underwent best supportive care. These treatments resulted in a median overall survival of 29.6 (95% CI 25.2-34.0), 12.2 (95% CI 11.0-13.3), 14.5 (95%CI 8.2-20.8) and 2.9 (95% CI 2.6-3.2) months respectively. Resection rate was 13% in patients who were diagnosed in non-academic and 32% in academic centres (P <.001), which resulted in a survival difference in favour of academic centres. Median overall survival was 9.7 (95% CI 7.7-11.7) months in academic centres compared to 4.9 (95% CI 4.3-5.4) months in non-academic centres (P <.001). Conclusions: In patients with pCCA, resection rate and overall survival were higher for patients who were diagnosed in academic centres. These results show population-based outcomes of pCCA and highlight the importance of regional collaboration in the treatment of these patients. more...
- Published
- 2021
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