11 results on '"Fredrik, Klevebro"'
Search Results
2. Influence of postoperative complications following esophagectomy for cancer on quality of life: A European multicenter study
- Author
-
N. Schuring, E. Jezerskyte, M.I. van Berge Henegouwen, M.A.G. Sprangers, P. Lagergren, A. Johar, S.R. Markar, S.S. Gisbertz, Sheraz R. Markar, Giovanni Zaninotto, Carlo Castoro, Asif Johar, Pernilla Lagergren, Jessie A. Elliott, Suzanne S. Gisbertz, Christophe Mariette, Rita Alfieri, Jeremy Huddy, Viknesh Sounderajah, Eleonora Pinto, Marco Scarpa, Fredrik Klevebro, Berit Sunde, Conor F. Murphy, Christine Greene, Narayanasamy Ravi, Guillaume Piessen, Hylke Brenkman, Jelle P. Ruurda, Richard Van Hillegersberg, Sjoerd Lagarde, Bas Wijnhoven, Manuel Pera, José Roig, Sandra Castro, Robert Matthijsen, John Findlay, Stefan Antonowicz, Nick Maynard, Orla McCormack, Arun Ariyarathenam, Grant Sanders, Edward Cheong, Shameen Jaunoo, William Allum, Jan Van Lanschot, Magnus Nilsson, John V. Reynolds, Mark I. van Berge Henegouwen, George B. Hanna, Surgery, Graduate School, CCA - Cancer Treatment and Quality of Life, Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Imaging and biomarkers, Medical Psychology, APH - Aging & Later Life, APH - Mental Health, CCA - Cancer biology and immunology, and CCA - Cancer Treatment and quality of life
- Subjects
Esophagectomy ,Quality of life ,Postoperative complications ,SDG 3 - Good Health and Well-being ,Oncology ,Esophageal neoplasms ,Surgery ,General Medicine - Abstract
Introduction: Postoperative complications following major surgery have been shown to be associated with reduced health-related quality of life (HRQL), and severe complications may have profound negative effects. This study aimed to examine whether long-term HRQL differs with the occurrence and severity of complications in a European multicenter prospective dataset of patients following esophagectomy for cancer. Methods: Disease-free patients following esophagectomy for cancer between 2010 and 2016 from the LASER study were included. Patients completed the LASER, EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires >1 year following treatment. Long-term HRQL was compared between patients with and without postoperative complications, subgroup analysis was performed for severity of complications (no, minor [Clavien-Dindo I-II], severe [Clavien-Dindo ≥ III]), using univariable and multivariable regression. Results: 645 patients were included: 283 patients with no, 207 with minor and 155 with severe complications. Significantly more dyspnea (QLQ-C30) was reported by patients with compared to patients without complications (differenceinmeans 6.3). In subgroup analysis, patients with severe complications reported more dyspnea (difference in means 8.3) than patients with no complications. None of the differences were clinically relevant (difference in means ≥ 10 points). LASER-based low mood (OR2.3) was statistically different for minor versus severe complications. Conclusion: Comparable HRQL was found in patients with and without postoperative complications following esophagectomy for cancer, after a mean follow-up of 4.4 years. Furthermore, patients with different levels of severity of complications had comparable HRQL. The level of HRQL in esophageal cancer patients are more likely explained by the impact of the complex procedure of the esophagectomy itself.
- Published
- 2023
3. Partial stomach-partitioning gastrojejunostomy for gastric outlet obstruction: A cohort study based on consecutive case series from a single center
- Author
-
Magnus Nilsson, Mats Lindblad, Fredrik Klevebro, Andrianos Tsekrekos, B. Sunde, Masaru Hayami, Ioannis Rouvelas, and Biying Huang
- Subjects
medicine.medical_specialty ,RD1-811 ,Upper gastrointestinal cancer ,Gastric Bypass ,Subgroup analysis ,Single Center ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Stomach Neoplasms ,Humans ,Medicine ,Gastrointestinal Neoplasms ,Retrospective Studies ,Partial stomach-partitioning gastrojejunostomy ,Gastric emptying ,Gastric Outlet Obstruction ,business.industry ,Stomach ,Palliative Care ,Modified Devine exclusion ,Retrospective cohort study ,Gastric outlet obstruction ,medicine.disease ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Quality of Life ,030211 gastroenterology & hepatology ,business ,Cohort study - Abstract
Summary Background/objective Gastric outlet obstruction can have a large impact on quality of life for patients with upper gastrointestinal cancer or benign obstruction. Partial stomach-partitioning gastrojejunostomy has previously shown promising outcomes compared to conventional gastrojejunostomy in terms of reduced delayed gastric emptying. The objective of the current study was to present outcomes of partial stomach-partitioning gastrojejunostomy in a single high-volume center for upper gastrointestinal cancer. Methods A retrospective cohort study including all consecutive patients who underwent partial stomach-partitioning gastrojejunostomy from 2013 to 2020. The primary outcome was oral intake tolerance. A subgroup analysis was performed in all patients with manifest gastric outlet obstruction comparing partial stomach-partitioning gastrojejunostomy to conventional gastrojejunostomy. Results Partial stomach-partitioning gastrojejunostomy was performed in 32 patients and laparoscopic technique was used in 19 patients (59%). The procedure improved oral intake tolerance defined by gastric outlet obstruction scoring system by 0.63 points on average (P = 0.041). No postoperative complications related to the procedure were observed. Recurrence of gastric outlet obstruction developed in six patients (19%), four patients (13%) required endoscopic reintervention but no patient required surgical reintervention. A comparison between partial stomach-partitioning gastrojejunostomy and conventional gastrojejunostomy showed no statistically significant differences regarding postoperative nutritional status, length of hospital stay, recurrence or reintervention. Conclusion The results of the study show that partial stomach-partitioning gastrojejunostomy can be an effective surgical treatment for patients suffering from gastric outlet obstruction and that the procedure can be safely performed with laparoscopic technique.
- Published
- 2022
4. Postoperative complications after esophagectomy for cancer, neoadjuvant chemoradiotherapy compared to neoadjuvant chemotherapy: A single institutional cohort study
- Author
-
Halla Sif Ólafsdóttir, Emmy Dalqvist, Eva Onjukka, Fredrik Klevebro, Magnus Nilsson, Giovanna Gagliardi, and Gabriella Alexandersson von Döbeln
- Subjects
Oncology ,Radiology, Nuclear Medicine and imaging - Published
- 2023
5. Laparoscopic Versus Open Gastrectomy for Cancer: A Western Center Cohort Study
- Author
-
Lars Lundell, Mats Lindblad, Magnus Nilsson, Andrianos Tsekrekos, Satoshi Kamiya, Masaru Hayami, Fredrik Klevebro, and Ioannis Rouvelas
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Blood Loss, Surgical ,Anastomosis ,Severity of Illness Index ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Blood loss ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,Hospital Mortality ,Leak rate ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Surgical outcomes ,Cancer ,Laparoscopic gastrectomy ,Length of Stay ,Middle Aged ,medicine.disease ,Conversion to Open Surgery ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,Cohort ,Lymph Node Excision ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,Gastric cancer ,business ,Cohort study - Abstract
Background Laparoscopic gastrectomy (LG) for cancer has been introduced in institutions worldwide in an effort to minimize surgical trauma, while aiming to provide comparable oncological outcomes to conventional open gastrectomy (OG). The aim of this study was to present our results during the period of implementation of the laparoscopic technique. Materials and methods In 2012, LG for the treatment of gastric cancer was introduced at our institution. The results presented are based on a retrospective analysis of data from a cohort of all patients treated with curative intent over the period 2010-2018. Results During the study period, 206 patients underwent surgery for gastric cancer: 129 patients (62.6%) had an OG and 77 patients (37.4%) an LG. The conversion rate due to technical reasons was 2.6%. LG was associated with significantly less intraoperative blood loss [mean (mL), OG 544 versus LG 176] and shorter hospital stay than OG [mean (d), OG 12 versus LG 8], fewer severe complications (Clavien-Dindo grade ≥ IIIb) [OG 29 (22.5%) versus LG 9 (11.7%), P = 0.081], significantly lower anastomotic leak rate [OG 18 (14.0%) versus LG 1 (1.3%)] and no 90-day mortality. The percentage of R0 resections was similar between the two groups (OG 82.2% versus LG 85.7%, P = 0.507), while the mean number of resected lymph nodes was significantly higher in the laparoscopic group [OG 34 versus LG 39, P = 0.030]. Conclusions Our data suggest that similar and, in some aspects, better short-term outcomes can be achieved with LG with maintained oncological quality.
- Published
- 2020
6. ENSURE: An International Multicentre Study Exploring Whether Surveillance after Oesophageal Cancer Surgery Impacts Oncological and Quality of Life Outcomes
- Author
-
Jessie A. Elliott, Sheraz R. Markar, Fredrik Klevebro, Asif Johar, Lucas Goense, Pernilla Lagergren, Giovanni Zaninotto, Richard van Hillegersberg, M Nilsson, George B. Hanna, John V. Reynolds, and ENSURE Study Group
- Published
- 2021
7. Current trends in multimodality treatment of esophageal and gastroesophageal junction cancer – Review article
- Author
-
Fredrik Klevebro, Simon Ekman, and Magnus Nilsson
- Subjects
Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Adenocarcinoma ,030230 surgery ,Perioperative Care ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Stomach Neoplasms ,law ,Internal medicine ,medicine ,Humans ,Esophagus ,Clinical Trials as Topic ,business.industry ,Thoracoscopy ,Cancer ,Chemoradiotherapy, Adjuvant ,Esophageal cancer ,medicine.disease ,Combined Modality Therapy ,Review article ,Surgery ,Esophagectomy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Esophagogastric Junction ,business ,Chemoradiotherapy - Abstract
Purpose Multimodality treatment has now been widely introduced in the curatively intended treatment of esophageal and gastroesophageal junction cancer. We aim to give an overview of the scientific evidence for the available treatment strategies and to describe which trends that are currently developing. Methods We conducted a review of the scientific evidence for the different curatively intended treatment strategies that are available today. Relevant articles of randomized controlled trials, cohort studies, and meta analyses were included. Results After a systematic search of relevant papers we have included 64 articles in the review. The results show that adenocarcinomas and squamous cell carcinomas of the esophagus and gastroesophageal junction are two separate entities and should be analysed and studied as two different diseases. Neoadjuvant treatment followed by surgical resection is the gold standard of the curatively intended treatment today. There is no scientific evidence to support the use of chemoradiotherapy over chemotherapy in the neoadjuvant setting for esophageal or junctional adenocarcinoma. There is reasonable evidence to support definitive chemoradiotherapy as a treatment option for squamous cell carcinoma of the esophagus. Conclusion The evidence base for curatively intended treatments of esophageal and gastroesophageal junction cancer is not very strong. Several on-going trials have the potential to change the gold standard treatments of today.
- Published
- 2017
8. A randomized clinical trial of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for cancer of the oesophagus or gastro-oesophageal junction
- Author
-
Magnus Nilsson, Anne-Birgitte Jacobsen, Fredrik Klevebro, Nils Glenjen, Lars Lundell, Gjermund Johnsen, Jon A. Tsai, Signe Friesland, Ingunn Hatlevoll, Pehr Lind, G. Alexandersson von Döbeln, and N. Wang
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Hematology ,Esophageal cancer ,medicine.disease ,Chemotherapy regimen ,Clinical trial ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Concomitant ,medicine ,030211 gastroenterology & hepatology ,Lymphadenectomy ,business ,Neoadjuvant therapy ,Chemoradiotherapy - Abstract
Background Neoadjuvant therapy improves long-term survival after oesophagectomy, treating oesophageal cancer, but the evidence to date is insufficient to determine which of the two main neoadjuvant therapy types, chemotherapy (nCT) or chemoradiotherapy (nCRT), is more beneficial. We aimed to compare the effects of nCT with those of nCRT. Patients and methods This multicentre trial, which was conducted in Sweden and Norway, recruited 181 patients with carcinoma of the oesophagus or the gastro-oesophageal junction who were candidates for curative-intended treatment. The primary end point was histological complete response after neoadjuvant treatment, which has been shown to be correlated with increased long-term survival. Study participants were randomized to nCT or nCRT, followed by surgery with two-field lymphadenectomy. Three cycles of platin/5-fluorouracil were administered in both arms, whereas 40 Gy of concomitant radiotherapy was added in the nCRT arm. Results The trial met the primary end point, histological complete response being achieved in 28% after nCRT versus 9% after nCT (P = 0.002). Lymph-node metastases were observed in 62% in the nCT group versus 35% in the nCRT group (P = 0.001). The R0 resection rate was 87% after nCRT and 74% after nCT (P = 0.04). There was no difference in overall survival between the treatment arms. Conclusion The addition of radiotherapy to neoadjuvant chemotherapy results in higher histological complete response rate, higher R0 resection rate, and a lower frequency of lymph-node metastases, without significantly affecting survival. clinicaltrials.gov NCT01362127 (https://clinicaltrials.gov; The full study protocol was registered in the Clinical Trials Database).
- Published
- 2016
9. Morbidity and mortality after surgery for cancer of the oesophagus and gastro-oesophageal junction: A randomized clinical trial of neoadjuvant chemotherapy vs. neoadjuvant chemoradiation
- Author
-
Anne-Birgitte Jacobsen, Gjermund Johnsen, Jon A. Tsai, Egil Johnson, T. Myrnas, Magnus Nilsson, Mats Lindblad, Fredrik Klevebro, Signe Friesland, Lars Lundell, Saga Persson, Asgaut Viste, and Eva Szabo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Adenocarcinoma ,Severity of Illness Index ,law.invention ,Postoperative Complications ,Randomized controlled trial ,law ,Multicenter trial ,Antineoplastic Combined Chemotherapy Protocols ,parasitic diseases ,medicine ,Carcinoma ,Humans ,Neoadjuvant therapy ,Aged ,Neoplasm Staging ,Sweden ,Norway ,business.industry ,Incidence ,Chemoradiotherapy, Adjuvant ,General Medicine ,Middle Aged ,medicine.disease ,Neoadjuvant Therapy ,Surgery ,Esophagectomy ,Radiation therapy ,Clinical trial ,Treatment Outcome ,Oncology ,Chemotherapy, Adjuvant ,Concomitant ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Female ,Lymphadenectomy ,Esophagogastric Junction ,Fluorouracil ,Cisplatin ,Morbidity ,business ,Follow-Up Studies - Abstract
Objective To compare the incidence and severity of postoperative complications after oesophagectomy for carcinoma of the oesophagus and gastro-oesophageal junction (GOJ) after randomized accrual to neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT). Background Neoadjuvant therapy improves long-term survival after oesophagectomy. To date, evidence is insufficient to determine whether combined nCT, or nCRT alone, is the most beneficial. Methods Patients with carcinoma of the oesophagus or GOJ, resectable with a curative intention, were enrolled in this multicenter trial conducted at seven centres in Sweden and Norway. Study participants were randomized to nCT or nCRT followed by surgery with two-field lymphadenectomy. Three cycles of cisplatin/5-fluorouracil was administered in all patients, while 40 Gy of concomitant radiotherapy was administered in the nCRT group. Results Of the randomized 181 patients, 91 were assigned to nCT and 90 to nCRT. One-hundred-and-fifty-five patients, 78 nCT and 77 nCRT, underwent resection. There was no statistically significant difference between the groups in the incidence of surgical or nonsurgical complications (P-value = 0.69 and 0.13, respectively). There was no 30-day mortality, while the 90-day mortality was 3% (2/78) in the nCT group and 6% (5/77) in the nCRT group (P = 0.24). The median Clavien-Dindo complication severity grade was significantly higher in the nCRT group (P = 0.001). Conclusion There was no significant difference in the incidence of complications between patients randomized to nCT and nCRT. However, complications were significantly more severe after nCRT. Registration trial database The trial was registered in the Clinical Trials Database (registration number NCT01362127 ).
- Published
- 2015
10. Mo1240 – Pneumatic Balloon Dilation for Recurrence of Symptoms After Heller Myotomy
- Author
-
Michael Gluck, Nadav Sahar, Donald E. Low, Richard A. Kozarek, Andrew S. Ross, Fredrik Klevebro, Michael V. Chiorean, and Shayan Irani
- Subjects
Heller myotomy ,medicine.medical_specialty ,Pneumatic balloon ,Hepatology ,business.industry ,Gastroenterology ,Dilation (morphology) ,Medicine ,business ,Surgery - Published
- 2019
11. 219 – Assessment of Health Related Quality of Life and Digestive Symptoms in Long Term, Disease Free Survivors Following Esophagectomy
- Author
-
Piers R. Boshier, Fredrik Klevebro, L. Hage, Donald E. Low, A Waller, K V Savva, and George B. Hanna
- Subjects
Health related quality of life ,medicine.medical_specialty ,Hepatology ,business.industry ,Esophagectomy ,medicine.medical_treatment ,Gastroenterology ,medicine ,Disease free ,Intensive care medicine ,business ,Term (time) - Published
- 2019
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.