Search

Your search keyword '"Fearnhead N.S."' showing total 19 results
Start Over Author "Fearnhead N.S."
19 results on '"Fearnhead N.S."'

4. P494 Multicentre cohort study to evaluate the need for re-intervention following multimodal treatment in Crohnʼs disease with perianal fistula

Author

Sebastian, S., Black, C., Pugliese, D., Armuzzi, A., Sahnan, K., Elkady, S.M., Katsanos, K.H., Christodoulou, D.K., Selinger, C., Maconi, G., Fiorino, G., Kopylov, U., Davidov, Y., Bosca-Watts, M.M., Ellul, P., Muscat, M., Karmiris, K., Fearnhead, N.S., Allgar, V., Hart, A.L., Ben-Horin, S., and Danese, S.

Published
2017
Full Text
View/download PDF

6. P240 Presentation and surgical interventions for Crohnʼs disease with perianal fistula in the biologics era: results from a multicentre study

Author

Black, C., Pugliese, D., Sahnan, K., Armuzzi, A., Elkady, S.M., Hart, A.L., Katsanos, K.H., Christodoulou, D.K., Selinger, C., Maconi, G., Fiorino, G., Davidov, Y., Kopylov, U., Ben-Horin, S., Navarro, P., Bosca-Watts, M.M., Muscat, M., Ellul, P., Karmiris, K., Allgar, V., Danese, S., Fearnhead, N.S., and Sebastian, S.

Published
2017
Full Text
View/download PDF

7. Developing a core outcome set for fistulising perianal Crohn's disease

Author

Sahnan, K., Tozer, P.J., Adegbola, S.O., Lee, M.J., Heywood, N., McNair, A.G.K., Hind, D., Yassin, N., Lobo, A.J., Brown, S.R., Sebastian, S., Phillips, R.K.S., Lung, P.F.C., Faiz, O.D., Crook, K., Blackwell, S., Verjee, A., Hart, A.L., Fearnhead, N.S., and ENiGMA collaborators, .

Abstract

OBJECTIVE: Lack of standardised outcomes hampers effective analysis and comparison of data when comparing treatments in fistulising perianal Crohn's disease (pCD). Development of a standardised set of outcomes would resolve these issues. This study provides the definitive core outcome set (COS) for fistulising pCD. DESIGN: Candidate outcomes were generated through a systematic review and patient interviews. Consensus was established via a three-round Delphi process using a 9-point Likert scale based on how important they felt it was in determining treatment success culminating in a final consensus meeting. Stakeholders were recruited nationally and grouped into three panels (surgeons and radiologists, gastroenterologists and IBD specialist nurses, and patients). Participants received feedback fromtheir panel(in the second round) andall participants(in the third round) to allow refinement of their scores. RESULTS: A total of 295 outcomes were identified from systematic reviews and interviews that were categorised into 92 domains. 187 stakeholders (response rate 78.5%) prioritised 49 outcomes through a three-round Delphi study.The final consensus meeting of 41 experts and patients generated agreement on an eight domain COS. The COS comprised three patient-reported outcome domains (quality of life, incontinence and a combined score of patient priorities) and five clinician-reported outcome domains (perianal disease activity, development of new perianal abscess/sepsis, new/recurrent fistula, unplanned surgery and faecal diversion). CONCLUSION: A fistulising pCD COS has been produced by all key stakeholders. Application of the COS will reduce heterogeneity in outcome reporting, thereby facilitating more meaningful comparisons between treatments, data synthesis and ultimately benefit patient care.

Published
2019

8. The colorectal surgeon's personality may influence the rectal anastomotic decision

Author

Moug, S.J., Henderson, N., Tiernan, J., Bisset, C.N., Ferguson, E., Harji, D., Maxwell-Armstrong, C., MacDermid, E., Acheson, A.G., Steele, R.J.C., and Fearnhead, N.S.

Abstract

Aim: \ud Colorectal surgeons regularly make the decision to anastomose, defunction or form an end colostomy when performing rectal surgery. This study aimed to define personality traits of colorectal surgeons and explore any influence of such traits on the decision to perform a rectal anastomosis.\ud \ud Method: \ud Fifty attendees of The Association of Coloproctology of Great Britain and Ireland 2016 Conference participated. After written consent, all underwent personality testing: alexithymia (inability to understand emotions), type of thinking process (intuitive versus rational) and personality traits (extraversion, agreeableness, openness, emotional stability, conscientiousness). Questions were answered regarding anastomotic decisions in various clinical scenarios and results analysed to reveal any influence of the surgeon's personality on anastomotic decision.\ud \ud Results: \ud Participants were: male (86%), consultants (84%) and based in England (68%). Alexithymia was low (4%) with 81% displaying intuitive thinking (reflex, fast). Participants scored higher in emotional stability (ability to remain calm) and conscientiousness (organized, methodical) compared with population norms. Personality traits influenced the next anastomotic decision if: surgeons had recently received criticism at a departmental audit meeting; were operating with an anaesthetist that was not their regular one; or there had been no anastomotic leaks in their patients for over 1 year.\ud \ud Conclusion: \ud Colorectal surgeons have speciality relevant personalities that potentially influence the important decision to anastomose and could explain the variation in surgical practice across the UK. Future work should explore these findings in other countries and any link of personality traits to patient‐related outcomes.

Published
2018

9. Palliative pelvic exenteration: A systematic review of patient-centered outcomes

Author

Kroon, Hidde M., primary, Dudi-Venkata, N.N., additional, Bedrikovetski, S., additional, Thomas, M.L., additional, Kelly, M.E., additional, Aalbers, A.G.J., additional, Abdul Aziz, N., additional, Abraham-Nordling, M., additional, Akiyoshi, T., additional, Alberda, W., additional, Andric, M., additional, Antoniou, A., additional, Austin, K.K., additional, Baker, R.P., additional, Bali, M., additional, Baseckas, G., additional, Bednarski, B.K., additional, Beets, G.L., additional, Berg, P.L., additional, Beynon, J., additional, Biondo, S., additional, Bordeianou, L., additional, Brunner, M., additional, Buchwald, P., additional, Burger, J.W.A., additional, Burling, D., additional, Campain, N., additional, Chan, K.K.L., additional, Chang, G.J., additional, Chew, M.H., additional, C Chong, P., additional, Christensen, H.K., additional, Codd, M., additional, Colquhoun, A.J., additional, Corr, A., additional, Coscia, M., additional, Coyne, P.E., additional, Creavin, B., additional, Damjanovic, L., additional, Daniels, I.R., additional, Davies, M., additional, Davies, R.J., additional, de Wilt, J.H.W., additional, Denost, Q., additional, Dietz, D., additional, Dozois, E.J., additional, Duff, M., additional, Eglinton, T., additional, Enriquez-Navascues, J.M., additional, Evans, M.D., additional, Fearnhead, N.S., additional, Frizelle, F.A., additional, Garcia-Granero, E., additional, Garcia-Sabrido, J.L., additional, Gentilini, L., additional, George, M.L., additional, Glynn, R., additional, Golda, T., additional, Griffiths, B., additional, Harris, D.A., additional, Evans, M., additional, Hagemans, J.A.W., additional, Harji, D.P., additional, Heriot, A.G., additional, Hohenberger, W., additional, Holm, T., additional, Jenkins, J.T., additional, Kapur, S., additional, Kanemitsu, Y., additional, Kelley, S.R., additional, Keller, D.S., additional, Kim, H., additional, Koh, C.E., additional, Kok, N.F.M., additional, Kokelaar, R., additional, Kontovounisios, C., additional, Kusters, M., additional, Larson, D.W., additional, Law, W.L., additional, Laurberg, S., additional, Lee, P., additional, Lydrup, M.L., additional, Lynch, A.C., additional, Mantyh, C., additional, Mathis, K.L., additional, Martling, A., additional, Meijerink, W.J.H.J., additional, Merkel, S., additional, Mehta, A.M., additional, McDermott, F.D., additional, McGrath, J.S., additional, Mirnezami, A., additional, Morton, J.R., additional, Mullaney, T.G., additional, Mesquita-Neto, J.W., additional, Nielsen, M.B., additional, Nieuwenhuijzen, G.A.P., additional, Nilsson, P.J., additional, O'Connell, P.R., additional, Palmer, G., additional, Patsouras, D., additional, Pellino, G., additional, Poggioli, G., additional, Quinn, M., additional, Quyn, A., additional, Radwan, R.W., additional, Rasheed, S., additional, Rasmussen, P.C., additional, Regenbogen, S.E., additional, Rocha, R., additional, Rothbarth, J., additional, Roxburgh, C., additional, Rutten, H.J.T., additional, Ryan, É., additional, Sagar, P.M., additional, Saklani, A., additional, Schizas, A.M.P., additional, Schwarzkopf, E., additional, Scripcariu, V., additional, Shaikh, I., additional, Shida, D., additional, Simpson, A., additional, Smart, N.J., additional, Smith, J.J., additional, Solomon, M.J., additional, Sørensen, M.M., additional, Steele, S.R., additional, Steffens, D., additional, Stocchi, L., additional, Stylianides, N.A., additional, Tekkis, P.P., additional, Taylor, C., additional, Tsarkov, P., additional, Tsukamoto, S., additional, Turner, W.H., additional, Tuynman, J.B., additional, van Ramshorst, G.H., additional, van Zoggel, D., additional, Vasquez-Jimenez, W., additional, Verhoef, C., additional, Verstegen, M., additional, Wakeman, C., additional, Warrier, S., additional, Wasmuth, H.H., additional, Weiser, M.R., additional, Wheeler, J.M.D., additional, Wild, J., additional, Yip, J., additional, Winter, D.C., additional, and Sammour, T., additional

Published
2019
Full Text
View/download PDF

10. Making an IMPACT: A priority setting consultation exercise to improve outcomes in patients with locally advanced, recurrent and metastatic colorectal cancer

Author

Vallance, A.E., primary, Harji, D., additional, Fearnhead, N.S., additional, Acheson, A., additional, Adams, K., additional, Adams, R., additional, Alsina, D., additional, Antoniou, A., additional, Arnott, R., additional, Bach, S., additional, Battersby, N., additional, Bedford, M., additional, Beggs, A., additional, Belcher, E., additional, Boulstridge, L., additional, Boyle, K., additional, Bradbury, J., additional, Braun, M., additional, Brown, E., additional, Brown, G., additional, Burling, D., additional, Cameron, I., additional, Campbell, K., additional, Carney, K., additional, Cecil, T., additional, Chapman, M., additional, Chapman, S., additional, Chong, P., additional, Coyne, P., additional, Clark, S., additional, Crane, S., additional, Daniels, I., additional, Davies, J., additional, Davies, L., additional, Davies, M., additional, Dawson, C., additional, Dawson, P., additional, Duff, M., additional, Demick, A., additional, Elavia, K., additional, Gardner, R., additional, Evans, M., additional, Fenwick, S., additional, Galbraith, S., additional, Good, J., additional, Gilbert, D., additional, Griffiths, B., additional, Hargest, R., additional, Hill, J., additional, Hompes, R., additional, Huguet, E., additional, Jenkins, J., additional, Kapur, S., additional, Karandikar, S., additional, Katte, C., additional, Kumar, N., additional, Langman, G., additional, Lim, M., additional, Lopes de Azevedo-Gilbert, R., additional, Macdonald, A., additional, Machesney, M., additional, Mathur, P., additional, Maxwell-Armstrong, C., additional, McArthur, D., additional, McDermott, F., additional, McDermott, U., additional, Mirnezami, A., additional, Mitchell, P., additional, Mohamed, F., additional, Moran, B., additional, Morris, M., additional, Murphy, J., additional, Nakas, A., additional, Norris, C., additional, O'Dwyer, S., additional, Panagiotopoulou, I., additional, Pellino, G., additional, Polignano, F., additional, Powell, C., additional, Renehan, A., additional, Rowbottom, P., additional, Sagar, P., additional, Samuel, L., additional, Seligmann, J., additional, Shaikh, I., additional, Simpson, A., additional, Skaife, P., additional, Skarrot, P., additional, Speake, W., additional, Stearns, A., additional, Stylianides, N.A., additional, Sutton, P., additional, Swarnkar, K., additional, Taylor, C., additional, Tebala, G., additional, Thorpe, G., additional, Tiernan, J., additional, Toogood, G., additional, Vimalchandran, D., additional, Walker, K., additional, Walsh, C., additional, Warren, O., additional, Wasan, H., additional, Welsh, F., additional, Wheeler, J., additional, Whitley, S., additional, Wilson, M., additional, Winter, D., additional, and Youssef, H., additional

Published
2019
Full Text
View/download PDF

11. UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol

Author

Lee, M.J., Sayers, A.E., Drake, T.M., Hollyman, M., Bradburn, M., Hind, D., Wilson, T.R., and Fearnhead, N.S.

Abstract

Introduction Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. Methods and analysis UK hospitals providing emergency general surgery are eligible to participate. This study has three components: (1) a clinical preference questionnaire to be completed by consultants providing emergency general surgical care to assesses preferences in diagnostics and therapeutic approaches, including laparoscopy and nutritional interventions; (2) site resource profile questionnaire to indicate ease of access to diagnostic services, operating theatres, nutritional support teams and postoperative support including intensive care; (3) prospective cohort study of all cases of SBO admitted during an 8-week period at participating trusts. Data on diagnostics, operative and nutritional interventions, and in-hospital mortality and morbidity will be captured, followed by data validation. Ethics and dissemination This will be conducted as a national audit of practice in conjunction with trainee research collaboratives, with support from patient representatives, surgeons, anaesthetists, gastroenterologists and a clinical trials unit. Site-specific reports will be provided to each participant site as well as an overall report to be disseminated through specialist societies. Results will be published in a formal project report endorsed by stakeholders, and in peer-reviewed scientific reports. Key findings will be debated at a focused national meeting with a view to quality improvement initiatives.

Published
2017

13. Surgical Management of Fistulating Perianal Crohn's Disease - A UK Survey

Author

Lee, M.J., Heywood, N., Sagar, P.M., Brown, S.R., Fearnhead, N.S., and pCD Collaborators

Abstract

AIM: Around one-third of patients with Crohn's disease are affected by Crohn's fistula-in-ano (pCD). It typically follows a chronic course and patients undergo long-term medical and surgical therapy. We set out to describe current surgical practice in the management of pCD in the UK. METHODS: A survey of surgical management of pCD was designed by an expert group of colorectal surgeons and gastroenterologists. This assessed acute, elective, multidisciplinary and definitive surgical management. A pilot of the questionnaire was undertaken at the Digestive Disease Federation 2015 meeting. The survey was refined and distributed nationally through the trainee collaborative networks. RESULTS: National rollout obtained responses from 133 surgeons of 179 approached (response rate 74.3%). At first operation, 32% surgeons would always consider drainage of sepsis and 31.1% would place a draining seton. At first elective operation, 66.6% would routinely insert of draining seton, and 84.4% would avoid cutting seton. The IBD multidisciplinary team was available to 87.6% respondents, although only 25.1% routinely discussed pCD patients. Anti-TNF-α therapy was routinely considered by 64.2%, although 44.2% left medical management to gastroenterology. Common definitive procedures were removal of seton only (70.7%), fistulotomy (57.1%), advancement flap (38.9%), fistula plug (36.4%) and ligation of intersphincteric track (LIFT) procedure (31.8%). Indications for diverting stoma or proctectomy were intractable sepsis, incontinence, and poor quality of life. DISCUSSION: This survey has demonstrated areas of common practice, but has also highlighted divergent practice including choices of definitive surgery and multimodal management. Practical guidelines are required to support colorectal surgeons in the UK. This article is protected by copyright. All rights reserved.

Published
2016

14. GSTM1 and GSTT1 polymorphisms as modifiers of age at diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC) in a homogeneous cohort of individuals carrying a single predisposing mutation

Author

Felix, R., Bodmer, W., Fearnhead, N.S., van der Merwe, L., Goldberg, P., and Ramesar, R.S.

Abstract

The variability in phenotype that occurs for so-called 'single-gene disorders' may be because of germline alterations in numerous primary and ''modifier'' genes. Within HNPCC families harbouring the same primary predisposing mutation, differences exist in the site of cancer, age of onset of disease symptoms and, consequently, survival until diagnosis of disease. The current study investigated a cohort of 129 individuals, from 13 different families, who harbour the identical nonsense mutation (C1528T) in the hMLH1 gene, predisposing them primarily to Lynch I syndrome. This cohort was screened for previously described polymorphisms in the glutathione-S-transferase genes, viz. GSTT1 and GSTM1. Male null carriers for both GSTT1 and GSTM1 were approximately three times more at risk of developing cancer at an earlier age when compared to non-null males. This work, particularly because of the relatively large ''homogeneous'' primary mutation cohort, provides evidence that genotypic changes distinct from the primary 'HNPCC-causing' mutation, influence the survival period until diagnosis of disease. It provides an impetus for expanding the study to include a wider range of candidate modifier genes. Such work may potentially lead to the development of individualised interval screening regimens for individuals with varying modifier genotypes-an attractive option in a resource-poor country.

Published
2006
Full Text
View/download PDF

15. The colorectal surgeon’s personality may influence the rectal anastomotic decision

Author

Moug, Susan, Henderson, N., Tiernan, J., Bisset, C.N., Ferguson, Eamonn, Harji, D., Maxwell-Armstrong, C., MacDermid, E., Acheson, A.G., Steele, R.J.C., Fearnhead, N.S., Moug, Susan, Henderson, N., Tiernan, J., Bisset, C.N., Ferguson, Eamonn, Harji, D., Maxwell-Armstrong, C., MacDermid, E., Acheson, A.G., Steele, R.J.C., and Fearnhead, N.S.

Abstract

Aim. Colorectal surgeons regularly make the decision to anastomose, defunction or form an end colostomy when performing rectal surgery. This study aimed to define personality traits of colorectal surgeons and explore any influence of such traits on the decision to perform a rectal anastomosis. Method. 50 attendees of The Association of Coloproctology of Great Britain and Ireland 2016 conference participated. After written consent, all underwent personality testing: alexithymia (inability to understand emotions); type of thinking process (intuitive versus rational) and personality traits (extraversion; agreeableness; openness; emotional stability; conscientiousness). Questions were answered regarding anastomotic decisions in various clinical scenarios and results analysed to reveal any influence of the surgeon’s personality on anastomotic decision. Results. Participants were: male (86%); consultants (84%); England based (68%). Alexithymia was low (4%) with 81% displaying intuitive thinking (reflex, fast). Participants scored higher in emotional stability (ability to remain calm) and conscientiousness (organised, methodical) compared to population norms. Personality traits influenced the next anastomotic decision if: surgeons had recently received criticism at a departmental audit meeting; operating with an anaesthetist that is not your regular one; or there had been no anastomotic leaks in their patients for >1 year. Conclusion. Colorectal surgeons have speciality relevant personalities that potentially influence the important decision to anastomose and could explain the variation in surgical practice across the U.K. Future work should explore these findings in other countries and any link of personality traits to patient related outcomes.

Full Text
View/download PDF

16. Contemporary management of locally advanced and recurrent rectal cancer: views from the PelvEx collaborative

Author

Kelly M. E., O’Sullivan N. J., Fahy M. R., Aalbers A. G. J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Abu Saadeh F., Akiyoshi T., Alberda W., Albert M., Andric M., Angeles M. A., Angenete E., Antoniou A., Auer R., Austin K. K., Aytac E., Aziz O., Bacalbasa N., Baker R. P., Bali M., Baransi S., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Bergzoll C., Beynon J., Biondo S., Boyle K., Bordeianou L., Brecelj E., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J. W. A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Ceelen W., Chan K. K. L., Chang G. J., Chang M., Chew M. H., Chok A. Y., Chong P., Clouston H., Codd M., Collins D., Colquhoun A. J., Constantinides J., Corr A., Coscia M., Cosimelli M., Cotsoglou C., Coyne P. E., Croner R. S., Damjanovich L., Daniels I. R., Davies M., Delaney C. P., de Wilt J. H. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Drozdov E., Duff M., Eglinton T., Enriquez-Navascues J. M., Espín-Basany E., Evans M. D., Eyjólfsdóttir B., Fearnhead N. S., Ferron G., Fichtner-Feigl S., Flatmark K., Fleming F. J., Flor B., Folkesson J., Frizelle F. A., Funder J., Gallego M. A., Gargiulo M., García-Granero E., García-Sabrido J. L., Gava V. G., Gentilini L., George M. L., George V., Georgiou P., Ghosh A., Ghouti L., Gil-Moreno A., Giner F., Ginther D. N., Glyn T., Glynn R., Golda T., Griffiths B., Harris D. A., Hanchanale V., Harji D. P., Harris C., Helewa R. M., Hellawell G., Heriot A. G., Hochman D., HohenbergerW., Holm T., Hompes R., Hornung B., Hurton S., Hyun E., Ito M., Iversen L. H., Jenkins J. T., Jourand K., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kazi M., Kelley S. R., Keller D. S., Ketelaers S. H. J., Khan M. S., Kiran R. P., Kim H., Kim H. J., Koh C. E., Kok N. F. M., Kokelaar R., Kontovounisios C., Kose F., Koutra M., Kristensen H. Ø., Kroon H. M., Kumar S., Kusters M., Lago V., Lampe B., Lakkis Z., Larach J. T., Larkin J. O., Larsen S. G., Larson D. W., Law W. L., Lee P. J., Limbert M., Loria A., Lydrup ML., Lyons A., Lynch A. C., Maciel J., Manfredelli S., Mann C., Mantyh C., Mathis K. L., Marques C. F. S., Martinez A., Martling A., Mehigan B. J., MeijerinkW. J. H. J., Merchea A., Merkel S., Mehta A. M., Mikalauskas S., McArthur D. R., McCormick J. J., McCormick P., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Monson J. R. T., Navarro A. S., Neeff H., Negoi I., Neto J. W. M., Ng J. L., Nguyen B., Nielsen M. B., Nieuwenhuijzen G. A. P., Nilsson P. J., Nordkamp S., Nugent T., Oliver A., O’Dwyer S. T., Paarnio K., Palmer G., Pappou E., Park J., Patsouras D., Peacock O., Pellino G., Peterson A. C., Pfeffer F., Pinson J., Poggioli G., Proud D., Quinn M., Quyn A., Rajendran N., Radwan R. W., Rao C., Rasheed S., Rausa E., Regenbogen S. E., Reims H. M., Renehan A., Rintala J., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H. J. T., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A. M. P., Schwarzkopf E., Scripcariu D., Scripcariu V., Selvasekar C., Shaikh I., Simpson A., Skeie-Jensen T., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sørensen M. M., Sorrentino L., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Spasojevic M., Sumrien H., Sutton P. A., Swartking T., Takala H., Tan E. J., Taylor C., Taylor D., Tekin A., Tekkis P. P., Teras J., Thaysen H. V., Thurairaja R., Thorgersen E. B., Tiernan J., Toh E. L., Tolenaar J., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., Valente M., van Ramshorst G. H., van Rees J., van Zoggel D., Vasquez-JimenezW., Vather R., Verhoef C., Vierimaa M., Vizzielli G., Voogt E. L. K., Uehara K., Urrejola G., Wakeman C., Warrier S. K., Wasmuth H. H., Waters P. S., Weber K., Weiser M. R., Wheeler J. M. D., Wild J., Williams A., Wilson M., Wolthuis A., Yano H., Yip B., Yoo R. N., Zappa M. A., Winter D. C., and Kelly M.E., O’Sullivan N.J., Fahy M.R., Aalbers A.G.J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Abu Saadeh F., Akiyoshi T., Alberda W., Albert M., Andric M., Angeles M.A., Angenete E., Antoniou A., Auer R., Austin K.K., Aytac E., Aziz O., Bacalbasa N., Baker R.P., Bali M., Baransi S., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Bergzoll C., Beynon J., Biondo S., Boyle K., Bordeianou L., Brecelj E., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J.W.A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Ceelen W., Chan K.K.L., Chang G.J., Chang M., Chew M.H., Chok A.Y., Chong P., Clouston H., Codd M., Collins D., Colquhoun A.J., Constantinides J., Corr A., Coscia M., Cosimelli M., Cotsoglou C., Coyne P.E., Croner R.S., Damjanovich L., Daniels I.R., Davies M., Delaney C.P., de Wilt J.H.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Drozdov E., Duff M., Eglinton T., Enriquez-Navascues J.M., Espín-Basany E., Evans M.D., Eyjólfsdóttir B., Fearnhead N.S., Ferron G., Fichtner-Feigl S., Flatmark K., Fleming F.J., Flor B., Folkesson J., Frizelle F.A., Funder J., Gallego M.A., Gargiulo M., García-Granero E., García-Sabrido J.L., Gargiulo M., Gava V.G., Gentilini L., George M.L., George V., Georgiou P., Ghosh A., Ghouti L., Gil-Moreno A., Giner F., Ginther D.N., Glyn T., Glynn R., Golda T., Griffiths B., Harris D.A., Hanchanale V., Harji D.P., Harris C., Helewa R.M., Hellawell G., Heriot A.G., Hochman D., HohenbergerW., Holm T., Hompes R., Hornung B., Hurton S., Hyun E., Ito M., Iversen L.H., Jenkins J.T., Jourand K., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kazi M., Kelley S.R., Keller D.S., Ketelaers S.H.J., Khan M.S., Kiran R.P., Kim H., Kim H.J., Koh C.E., Kok N.F.M., Kokelaar R., Kontovounisios C., Kose F., Koutra M., Kristensen H.Ø., Kroon H.M., Kumar S., Kusters M., Lago V., Lampe B., Lakkis Z., Larach J.T., Larkin J.O., Larsen S.G., Larson D.W., Law W.L., Lee P.J., Limbert M., Loria A., Lydrup ML., Lyons A., Lynch A.C., Maciel J., Manfredelli S., Mann C., Mantyh C., Mathis K.L., Marques C.F.S., Martinez A., Martling A., Mehigan B.J., MeijerinkW.J.H.J., Merchea A., Merkel S., Mehta A.M., Mikalauskas S., McArthur D.R., McCormick J.J., McCormick P., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Monson J.R.T., Navarro A.S., Neeff H., Negoi I., Neto J.W.M., Ng J.L., Nguyen B., Nielsen M.B., Nieuwenhuijzen G.A.P., Nilsson P.J., Nordkamp S., Nugent T., Oliver A., O’Dwyer S.T., Paarnio K., Palmer G., Pappou E., Park J., Patsouras D., Peacock O., Pellino G., Peterson A.C., Pfeffer F., Pinson J., Poggioli G., Proud D., Quinn M., Quyn A., Rajendran N., Radwan R.W., Rajendran N., Rao C., Rasheed S., Rausa E., Regenbogen S.E., Reims H.M., Renehan A., Rintala J., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H.J.T., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A.M.P., Schwarzkopf E., Scripcariu D., Scripcariu V., Selvasekar C., Shaikh I., Simpson A., Skeie-Jensen T., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sørensen M.M., Sorrentino L., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Spasojevic M., Sumrien H., Sutton P.A., Swartking T., Takala H., Tan E.J., Taylor C., Taylor D., Tekin A., Tekkis P.P., Teras J., Thaysen H.V., Thurairaja R., Thorgersen E.B., Tiernan J., Toh E.L., Tolenaar J., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., Valente M., van Ramshorst G.H., van Rees J., van Zoggel D., Vasquez-JimenezW., Vather R., Verhoef C., Vierimaa M., Vizzielli G., Voogt E.L.K., Uehara K., Urrejola G., Wakeman C., Warrier S.K.,Wasmuth H.H.,Waters P.S.,Weber K.,Weiser M.R., Wheeler J.M.D.,Wild J., Williams A., Wilson M., Wolthuis A., Yano H., Yip B., Yoo R.N., Zappa M.A., Winter D.C.

Subjects
Cancer Research, perioperative care, ENHANCED RECOVERY, diagnostic, EXENTERATION, surgical management, surgical outcomes, recurrent rectal cancer, SDG 3 - Good Health and Well-being, locally advanced rectal cancer, QUALITY-OF-LIFE, Medicine and Health Sciences, diagnostics, 1112 Oncology and Carcinogenesis, PATHOLOGICAL COMPLETE RESPONSE, rectal cancer, SURGICAL TECHNIQUES, OUTCOMES, Science & Technology, HYPERTHERMIC INTRAPERITONEAL, PelvEx Collaborative, CHEMOTHERAPY, WHOLE-BODY MRI, NEOADJUVANT CHEMORADIOTHERAPY, Oncology, quality of life, CYTOREDUCTIVE SURGERY, HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY, Life Sciences & Biomedicine
Abstract

Pelvic exenteration is a complex operation performed for locally advanced and recurrent pelvic cancers. The goal of surgery is to achieve clear margins, therefore identifying adjacent or involved organs, bone, muscle, nerves and/or vascular structures that may need resection. While these extensive resections are potentially curative, they can be associated with substantial morbidity. Recently, there has been a move to centralize care to specialized units, as this facilitates better multidisciplinary care input. Advancements in pelvic oncology and surgical innovation have redefined the boundaries of pelvic exenterative surgery. Combined with improved neoadjuvant therapies, advances in diagnostics, and better reconstructive techniques have provided quicker recovery and better quality of life outcomes, with improved survival This article provides highlights of the current management of advanced pelvic cancers in terms of surgical strategy and potential future developments.

Published
2022
Full Text
View/download PDF

17. Palliative pelvic exenteration: A systematic review of patient-centered outcomes

Author

Hidde M. Kroon, N.N. Dudi-Venkata, S. Bedrikovetski, M.L. Thomas, M.E. Kelly, A.G.J. Aalbers, N. Abdul Aziz, M. Abraham-Nordling, T. Akiyoshi, W. Alberda, M. Andric, A. Antoniou, K.K. Austin, R.P. Baker, M. Bali, G. Baseckas, B.K. Bednarski, G.L. Beets, P.L. Berg, J. Beynon, S. Biondo, L. Bordeianou, M. Brunner, P. Buchwald, J.W.A. Burger, D. Burling, N. Campain, K.K.L. Chan, G.J. Chang, M.H. Chew, P. C Chong, H.K. Christensen, M. Codd, A.J. Colquhoun, A. Corr, M. Coscia, P.E. Coyne, B. Creavin, L. Damjanovic, I.R. Daniels, M. Davies, R.J. Davies, J.H.W. de Wilt, Q. Denost, D. Dietz, E.J. Dozois, M. Duff, T. Eglinton, J.M. Enriquez-Navascues, M.D. Evans, N.S. Fearnhead, F.A. Frizelle, E. Garcia-Granero, J.L. Garcia-Sabrido, L. Gentilini, M.L. George, R. Glynn, T. Golda, B. Griffiths, D.A. Harris, M. Evans, J.A.W. Hagemans, D.P. Harji, A.G. Heriot, W. Hohenberger, T. Holm, J.T. Jenkins, S. Kapur, Y. Kanemitsu, S.R. Kelley, D.S. Keller, H. Kim, C.E. Koh, N.F.M. Kok, R. Kokelaar, C. Kontovounisios, M. Kusters, D.W. Larson, W.L. Law, S. Laurberg, P. Lee, M.L. Lydrup, A.C. Lynch, C. Mantyh, K.L. Mathis, A. Martling, W.J.H.J. Meijerink, S. Merkel, A.M. Mehta, F.D. McDermott, J.S. McGrath, A. Mirnezami, J.R. Morton, T.G. Mullaney, J.W. Mesquita-Neto, M.B. Nielsen, G.A.P. Nieuwenhuijzen, P.J. Nilsson, P.R. O'Connell, G. Palmer, D. Patsouras, G. Pellino, G. Poggioli, M. Quinn, A. Quyn, R.W. Radwan, S. Rasheed, P.C. Rasmussen, S.E. Regenbogen, R. Rocha, J. Rothbarth, C. Roxburgh, H.J.T. Rutten, É. Ryan, P.M. Sagar, A. Saklani, A.M.P. Schizas, E. Schwarzkopf, V. Scripcariu, I. Shaikh, D. Shida, A. Simpson, N.J. Smart, J.J. Smith, M.J. Solomon, M.M. Sørensen, S.R. Steele, D. Steffens, L. Stocchi, N.A. Stylianides, P.P. Tekkis, C. Taylor, P. Tsarkov, S. Tsukamoto, W.H. Turner, J.B. Tuynman, G.H. van Ramshorst, D. van Zoggel, W. Vasquez-Jimenez, C. Verhoef, M. Verstegen, C. Wakeman, S. Warrier, H.H. Wasmuth, M.R. Weiser, J.M.D. Wheeler, J. Wild, J. Yip, D.C. Winter, T. Sammour, Kroon H.M., Dudi-Venkata N.N., Bedrikovetski S., Thomas M.L., Kelly M.E., Aalbers A.G.J., Abdul Aziz N., Abraham-Nordling M., Akiyoshi T., Alberda W., Andric M., Antoniou A., Austin K.K., Baker R.P., Bali M., Baseckas G., Bednarski B.K., Beets G.L., Berg P.L., Beynon J., Biondo S., Bordeianou L., Brunner M., Buchwald P., Burger J.W.A., Burling D., Campain N., Chan K.K.L., Chang G.J., Chew M.H., C Chong P., Christensen H.K., Codd M., Colquhoun A.J., Corr A., Coscia M., Coyne P.E., Creavin B., Damjanovic L., Daniels I.R., Davies M., Davies R.J., de Wilt J.H.W., Denost Q., Dietz D., Dozois E.J., Duff M., Eglinton T., Enriquez-Navascues J.M., Evans M.D., Fearnhead N.S., Frizelle F.A., Garcia-Granero E., Garcia-Sabrido J.L., Gentilini L., George M.L., Glynn R., Golda T., Griffiths B., Harris D.A., Evans M., Hagemans J.A.W., Harji D.P., Heriot A.G., Hohenberger W., Holm T., Jenkins J.T., Kapur S., Kanemitsu Y., Kelley S.R., Keller D.S., Kim H., Koh C.E., Kok N.F.M., Kokelaar R., Kontovounisios C., Kusters M., Larson D.W., Law W.L., Laurberg S., Lee P., Lydrup M.L., Lynch A.C., Mantyh C., Mathis K.L., Martling A., Meijerink W.J.H.J., Merkel S., Mehta A.M., McDermott F.D., McGrath J.S., Mirnezami A., Morton J.R., Mullaney T.G., Mesquita-Neto J.W., Nielsen M.B., Nieuwenhuijzen G.A.P., Nilsson P.J., O'Connell P.R., Palmer G., Patsouras D., Pellino G., Poggioli G., Quinn M., Quyn A., Radwan R.W., Rasheed S., Rasmussen P.C., Regenbogen S.E., Rocha R., Rothbarth J., Roxburgh C., Rutten H.J.T., Ryan E., Sagar P.M., Saklani A., Schizas A.M.P., Schwarzkopf E., Scripcariu V., Shaikh I., Shida D., Simpson A., Smart N.J., Smith J.J., Solomon M.J., Sorensen M.M., Steele S.R., Steffens D., Stocchi L., Stylianides N.A., Tekkis P.P., Taylor C., Tsarkov P., Tsukamoto S., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Verstegen M., Wakeman C., Warrier S., Wasmuth H.H., Weiser M.R., Wheeler J.M.D., Wild J., Yip J., Winter D.C., Sammour T., Kroon, Hm, Dudi-Venkata, Nn, Bedrikovetski, S, Thomas, Ml, Kelly, Me, Aalbers, Agj, Abdul Aziz, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Andric, M, Antoniou, A, Austin, Kk, Baker, Rp, Bali, M, Baseckas, G, Bednarski, Bk, Beets, Gl, Berg, Pl, Beynon, J, Biondo, S, Bordeianou, L, Brunner, M, Buchwald, P, Burger, Jwa, Burling, D, Campain, N, Chan, Kkl, Chang, Gj, Chew, Mh, C Chong, P, Christensen, Hk, Codd, M, Colquhoun, Aj, Corr, A, Coscia, M, Coyne, Pe, Creavin, B, Damjanovic, L, Daniels, Ir, Davies, M, Davies, Rj, de Wilt, Jhw, Denost, Q, Dietz, D, Dozois, Ej, Duff, M, Eglinton, T, Enriquez-Navascues, Jm, Evans, Md, Fearnhead, N, Frizelle, Fa, Garcia-Granero, E, Garcia- Sabrido, Jl, Gentilini, L, George, Ml, Glynn, R, Golda, T, Griffiths, B, Harris, Da, Evans, M, Hagemans, Jaw, Harji, Dp, Heriot, Ag, Hohenberger, W, Holm, T, Jenkins, Jt, Kapur, S, Kanemitsu, Y, Kelley, Sr, Keller, D, Kim, H, Koh, Ce, Kok, Nfm, Kokelaar, R, Kontovounisios, C, Kusters, M, Larson, Dw, Law, Wl, Laurberg, S, Lee, P, Lydrup, Ml, Lynch, Ac, Mantyh, C, Mathis, Kl, Martling, A, Meijerink, Wjhj, Merkel, S, Mehta, Am, Mcdermott, Fd, Mcgrath, J, Mirnezami, A, Morton, Jr, Mullaney, Tg, Mesquita-Neto, Jw, Nielsen, Mb, Nieuwenhuijzen, Gap, Nilsson, Pj, O’Connell, Pr, Palmer, G, Patsouras, D, Pellino, G, Poggioli, G, Quinn, M, Quyn, A, Radwan, Rw, Rasheed, S, Rasmussen, Pc, Regenbogen, Se, Rocha, R, Rothbarth, J, Roxburgh, C, Rutten, Hjt, Ryan, E, Sagar, Pm, Saklani, A, Schizas, Amp, Schwarzkopf, E, Scripcariu, V, Shaikh, I, Shida, D, Simpson, A, Smart, Nj, Smith, Jj, Solomon, Mj, Sørensen, Mm, Steele, Sr, Steffens, D, Stocchi, L, Stylianides, Na, Tekkis, Pp, Taylor, C, Tsarkov, P, Tsukamoto, S, Turner, Wh, Tuynman, Jb, van Ramshorst, Gh, van Zoggel, D, Vasquez- Jimenez, W, Verhoef, C, Verstegen, M, Wakeman, C, Warrier, S, Wasmuth, Hh, Weiser, Mr, Wheeler, Jmd, Wild, J, Yip, J, Winter, Dc, and Sammour, T.

Subjects
medicine.medical_specialty, Pelvic Neoplasm, Palliative care, Fistula, medicine.medical_treatment, Disease, Locally advanced pelvic cancer, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Quality of life, Internal medicine, Patient-Centered Care, Outcome Assessment, Health Care, medicine, Palliative surgery, Humans, Pelvic Neoplasms, Pelvic exenteration, business.industry, Mortality rate, Patient-centered outcomes, Palliative Care, General Medicine, medicine.disease, Pelvic Exenteration, Oncology, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Surgery, business, Human
Abstract

Item does not contain fulltext OBJECTIVE: Palliative pelvic exenteration (PPE) is a technically complex operation with high morbidity and mortality rates, considered in patients with limited life expectancy. There is little evidence to guide practice. We performed a systematic review to evaluate the impact of PPE on symptom relief and quality of life (QoL). METHODS: A systematic review was conducted according to the PRISMA guidelines using Ovid MEDLINE, EMBASe, and PubMed databases for studies reporting on outcomes of PPE for symptom relief or QoL. Descriptive statistics were used on pooled patient cohorts. RESULTS: Twenty-three historical cohorts and case series were included, comprising 509 patients. No comparative studies were found. Most malignancies were of colorectal, gynaecological and urological origin. Common indications for PPE were pain, symptomatic fistula, bleeding, malodour, obstruction and pelvic sepsis. The pooled median postoperative morbidity rate was 53.6% (13-100%), the median in-hospital mortality was 6.3% (0-66.7%), and median OS was 14 months (4-40 months). Some symptom relief was reported in a median of 79% (50-100%) of the patients, although the magnitude of effect was poorly measured. Data for QoL measures were inconclusive. Five studies discouraged performing PPE in any patient, while 18 studies concluded that the procedure can be considered in highly selected patients. CONCLUSION: Available evidence on PPE is of low-quality. Morbidity and mortality rates are high with a short median OS interval. While some symptom relief may be afforded by this procedure, evidence for improvement in QoL is limited. A highly selective individualised approach is required to optimise the risk:benefit equation.

Published
2019
Full Text
View/download PDF

18. The impact of the COVID-19 pandemic on the Management of Locally Advanced Primary/Recurrent Rectal Cancer

Author

Chok A. Y., Kontovounisios C., Rasheed S., Kelly M. E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G. J., Chang M., Chew M. H., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Cosimelli M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., Jhw D. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Jaw H., Hanchanale V., Harji D. P., Helewa R. M., Hellawell G., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kim H., Kim H. J., Koh C. E., Nfm K., Kokelaar R., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Jrt M., Morton J. R., Mullaney T. G., Negoi I., Jwm N., Ng J. L., Nguyen B., Nielsen M. B., Gap N., Nilsson P. J., Oliver A., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasmussen P. C., Rausa E., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Sumrien H., Sutton P. A., Swartking T., Tan E. J., Taylor C., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G. H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Zappa M. A., Winter D. C., Tekkis P. P., Chok A.Y., Kontovounisios C., Rasheed S., Kelly M.E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K.K., Aziz O., Baker R.P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G.J., Chang M., Chew M.H., Chong P., Christensen H.K., Clouston H., Codd M., Collins D., Colquhoun A.J., Corr A., Coscia M., Cosimelli M., Coyne P.E., Creavin B., Croner R.S., Damjanovic L., Daniels I.R., Davies M., Davies R.J., Delaney C.P., Jhw D.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Duff M., Eglinton T., Enrique-Navascues J.M., Espin-Basany E., Evans M.D., Fearnhead N.S., Flatmark K., Fleming F., Frizelle F.A., Gallego M.A., Garcia-Granero E., Garcia-Sabrido J.L., Gentilini L., George M.L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D.A., Jaw H., Hanchanale V., Harji D.P., Helewa R.M., Hellawell G., Heriot A.G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J.T., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kelley S.R., Keller D.S., Khan M.S., Kim H., Kim H.J., Koh C.E., Nfm K., Kokelaar R., Kristensen H.O., Kroon H.M., Kusters M., Lago V., Larsen S.G., Larson D.W., Law W.L., Laurberg S., Lee P.J., Limbert M., Lydrup M.L., Lyons A., Lynch A.C., Mantyh C., Mathis K.L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A.M., McArthur D.R., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Jrt M., Morton J.R., Mullaney T.G., Negoi I., Jwm N., Ng J.L., Nguyen B., Nielsen M.B., Gap N., Nilsson P.J., Oliver A., O'Dwyer S.T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A.C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R.W., Rasmussen P.C., Rausa E., Regenbogen S.E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E.J., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shida D., Simpson A., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sorensen M.M., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Sumrien H., Sutton P.A., Swartking T., Tan E.J., Taylor C., Teras J., Thurairaja R., Toh E.L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H.H., Weber K., Weiser M.R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R.N., Zappa M.A., Winter D.C., Tekkis P.P., Chok, A. Y., Kontovounisios, C., Rasheed, S., Kelly, M. E., Agj, A., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bedford, M., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Jwa, B., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Kkl, C., Chang, G. J., Chang, M., Chew, M. H., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Cosimelli, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Jhw, D. W., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., George, V., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Jaw, H., Hanchanale, V., Harji, D. P., Helewa, R. M., Hellawell, G., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kim, H., Kim, H. J., Koh, C. E., Nfm, K., Kokelaar, R., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Cfs, M., Martling, A., Wjhj, M., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Jrt, M., Morton, J. R., Mullaney, T. G., Negoi, I., Jwm, N., Ng, J. L., Nguyen, B., Nielsen, M. B., Gap, N., Nilsson, P. J., Oliver, A., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasmussen, P. C., Rausa, E., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Hjt, R., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Amp, S., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Swartling, T., Sumrien, H., Sutton, P. A., Swartking, T., Tan, E. J., Taylor, C., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G. H., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Elk, V., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Jmd, W., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., Zappa, M. A., Winter, D. C., Tekkis, P. P., and Surgery

Subjects
Oncology, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Locally advanced, MEDLINE, Comorbidity, COVID-19 - advanced - recurrent - primary - rectal cancer, SDG 3 - Good Health and Well-being, Internal medicine, Pandemic, Correspondence, medicine, Combined Modality Therapy, Humans, General, Pandemics, Recurrent Rectal Cancer, Neoplasm Staging, business.industry, Rectal Neoplasms, SARS-CoV-2, COVID-19, medicine.disease, Neoplasm staging, Surgery, Neoplasm Recurrence, Local, business
Published
2020

19. Predicting outcomes of pelvic exenteration using machine learning

Author

Dudurych I., Kelly M. E., Aalbers A. G. J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J. W. A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Chan K. K. L., Chang G. J., Chew M. H., Chok A. K., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., Wilt J. H. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Hagemans J. A. W., Hanchanale V., Harji D. P., Helewa R. M., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kiran R. P., Kim H., Kim H. J., Koh C. E., Kok N. F. M., Kokelaar R., Kontovounisios C., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Margues C. F. S., Martling A., Meijerink W. J. H. J., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Monson J. R. T., Morton J. R., Mullaney T. G., Negoi I., Neto J. W. M., Nguyen B., Nielsen M. B., Nieuwenhuijzen G. A. P., Nilsson P. J., Oliver A., O'Connell P. R., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasheed S., Rasmussen P. C., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H. J. T., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A. M. P., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Sumrien H., Sutton P. A., Swartking T., Tan E. J., Taylor C., Tekkis P. P., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G. H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Voogt E. L. K., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Wheeler J. M. D., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Winter D. C., Dudurych I., Kelly M.E., Aalbers A.G.J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K.K., Aziz O., Baker R.P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J.W.A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Chan K.K.L., Chang G.J., Chew M.H., Chok A.K., Chong P., Christensen H.K., Clouston H., Codd M., Collins D., Colquhoun A.J., Corr A., Coscia M., Coyne P.E., Creavin B., Croner R.S., Damjanovic L., Daniels I.R., Davies M., Davies R.J., Delaney C.P., Wilt J.H.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Duff M., Eglinton T., Enrique-Navascues J.M., Espin-Basany E., Evans M.D., Fearnhead N.S., Flatmark K., Fleming F., Frizelle F.A., Gallego M.A., Garcia-Granero E., Garcia-Sabrido J.L., Gentilini L., George M.L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D.A., Hagemans J.A.W., Hanchanale V., Harji D.P., Helewa R.M., Heriot A.G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J.T., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kelley S.R., Keller D.S., Khan M.S., Kiran R.P., Kim H., Kim H.J., Koh C.E., Kok N.F.M., Kokelaar R., Kontovounisios C., Kristensen H.O., Kroon H.M., Kusters M., Lago V., Larsen S.G., Larson D.W., Law W.L., Laurberg S., Lee P.J., Limbert M., Lydrup M.L., Lyons A., Lynch A.C., Mantyh C., Mathis K.L., Margues C.F.S., Martling A., Meijerink W.J.H.J., Merkel S., Mehta A.M., McArthur D.R., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Monson J.R.T., Morton J.R., Mullaney T.G., Negoi I., Neto J.W.M., Nguyen B., Nielsen M.B., Nieuwenhuijzen G.A.P., Nilsson P.J., Oliver A., O'Connell P.R., O'Dwyer S.T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A.C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R.W., Rasheed S., Rasmussen P.C., Regenbogen S.E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H.J.T., Ryan E.J., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A.M.P., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sorensen M.M., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Sumrien H., Sutton P.A., Swartking T., Tan E.J., Taylor C., Tekkis P.P., Teras J., Thurairaja R., Toh E.L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Voogt E.L.K., Uehara K., Wakeman C., Warrier S., Wasmuth H.H., Weber K., Weiser M.R., Wheeler J.M.D., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R.N., Winter D.C., Surgery, Dudurych, I., Kelly, M. E., Aalbers, A. G. J., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bedford, M., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Burger, J. W. A., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Chan, K. K. L., Chang, G. J., Chew, M. H., Chok, A. K., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Wilt, J. H. W., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., George, V., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Hagemans, J. A. W., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Margues, C. F. S., Martling, A., Meijerink, W. J. H. J., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Monson, J. R. T., Morton, J. R., Mullaney, T. G., Negoi, I., Neto, J. W. M., Nguyen, B., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., Oliver, A., O'Connell, P. R., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Rutten, H. J. T., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Swartling, T., Sumrien, H., Sutton, P. A., Swartking, T., Tan, E. J., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G. H., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Voogt, E. L. K., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Wheeler, J. M. D., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., and Winter, D. C.

Subjects
Artificial intelligence, medicine.medical_treatment, Machine learning, computer.software_genre, Logistic regression, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], SDG 3 - Good Health and Well-being, Medicine, Humans, Pelvic exenteration, Receiver operating characteristic, Artificial neural network, business.industry, Rectal Neoplasms, Deep learning, Gastroenterology, Prognosis, pelvic exenteration, Support vector machine, machine learning, Test set, colorectal surgery, Neoplasm Recurrence, Local, business, computer, Predictive modelling, artificial neural network
Abstract

Aim: We aim to compare machine learning with neural network performance in predicting R0 resection (R0), length of stay >14days (LOS), major complication rates at 30days postoperatively (COMP) and survival greater than 1 year (SURV) for patients having pelvic exenteration for locally advanced and recurrent rectal cancer. Method: A deep learning computer was built and the programming environment was established. The PelvEx Collaborative database was used which contains anonymized data on patients who underwent pelvic exenteration for locally advanced or locally recurrent colorectal cancer between 2004 and 2014. Logistic regression, a support vector machine and an artificial neural network (ANN) were trained. Twenty per cent of the data were used as a test set for calculating prediction accuracy for R0, LOS, COMP and SURV. Model performance was measured by plotting receiver operating characteristic (ROC) curves and calculating the area under the ROC curve (AUROC). Results: Machine learning models and ANNs were trained on 1147 cases. The AUROC for all outcome predictions ranged from 0.608 to 0.793 indicating modest to moderate predictive ability. The models performed best at predicting LOS >14days with an AUROC of 0.793 using preoperative and operative data. Visualized logistic regression model weights indicate a varying impact of variables on the outcome in question. Conclusion: This paper highlights the potential for predictive modelling of large international databases. Current data allow moderate predictive ability of both complex ANNs and more classic methods.

Published
2020

Catalog

Books, media, physical & digital resources
See catalog results