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385 results on '"MEHDORN, MATTHIAS"'

10. Kolonkarzinom

Author

Mehdorn, Matthias, Kobitzsch, Benjamin, Rabe, Sebastian Murad, Gockel, Ines, and Stelzner, Sigmar

Published
2024
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35. Hyperspectral imaging in living and deceased donor kidney transplantation.

Author

Wrigge, Rasmus, Sucher, Robert, Haak, Fabian, Meyer, Hans-Jonas, Unruh, Julia, Hau, Hans-Michael, Mehdorn, Matthias, Tautenhahn, Hans-Michael, Seehofer, Daniel, and Scheuermann, Uwe

Subjects
RECEIVER operating characteristic curves, MEDICAL sciences, KIDNEY physiology, GLOMERULAR filtration rate, GRAFT survival, KIDNEY transplantation
Abstract

Objective and background: Hyperspectral imaging (HSI) is an innovative, noninvasive technique that assesses tissue and organ perfusion and oxygenation. This study aimed to evaluate HSI as a predictive tool for early postoperative graft function and long-term outcomes in living donor (LD) and deceased donor (DD) kidney transplantation (KT). Patients and methods: HSI of kidney allograft parenchyma from 19 LD and 51 DD kidneys was obtained intraoperatively 15 minutes after reperfusion. Using the dedicated HSI TIVITA Tissue System, indices of tissue oxygenation (StO2), perfusion (near-infrared [NIR]), organ hemoglobin (OHI), and tissue water (TWI) were calculated and then analyzed retrospectively. Results: LD kidneys had superior intraoperative HSI values of StO2 (0.78 ± 0.13 versus 0.63 ± 0.24; P = 0.001) and NIR (0.67 ± 0.10 versus 0.56 ± 0.27; P = 0.016) compared to DD kidneys. Delayed graft function (DGF) was observed in 18 cases (26%), in which intraoperative HSI showed significantly lower values of StO2 (0.78 ± 0.07 versus 0.35 ± 0.21; P < 0.001) and NIR (0.67 ± 0.11 versus 0.34 ± 0.32; P < 0.001). Receiver operating characteristic curve analysis demonstrated an excellent predictive value of HSI for the development of DGF, with an area under the curve of 0.967 for StO2 and 0.801 for NIR. Kidney grafts with low StO2 values (cut-off point 0.6) showed reduced renal function with a low glomerular filtration rate and elevated urea levels in the first two weeks after KT. Three years after KT, graft survival was also inferior in the group with initially low StO2 values. Conclusion: HSI is a useful tool for predicting DGF in living and deceased KT and may assist in estimating short-term allograft function. However, further studies with expanded cohorts are needed to evaluate the association between HSI and long-term graft outcomes. [ABSTRACT FROM AUTHOR]

Published
2025
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36. Diagnostic Accuracy and Reliability of CT-based Node-RADS for Esophageal Cancer.

Author

LEONHARDI, JAKOB, SCHNARKOWSKI, BENEDIKT, MEHDORN, MATTHIAS, HÖHN, ANNE-KATHRIN, NIEBISCH, STEFAN, PLUM, PATRICK, SEEHOFER, DANIEL, TIEPOLT, SOLVEIG, DENECKE, TIMM, and MEYER, HANS-JONAS

Subjects
LYMPH node cancer, COMPUTED tomography, LYMPH nodes, ESOPHAGEAL cancer, RECEIVER operating characteristic curves, COHEN'S kappa coefficient (Statistics)
Abstract

Background/Aim: The recently published Node-Reporting and Data System (Node-RADS) can aid the characterization of lymph nodes in cross-sectional imaging. This study investigated the Node-RADS system in computed tomography (CT) to characterize lymph nodes in esophageal cancer. Patients and Methods: Overall, 126 patients (15 female, 11.9%) with a mean age of 62.1±10.4 years comprised the patient sample. All patients underwent resection with curative intent and the lymph nodes were histopathologically analyzed during clinical routine. For every patient, the locoregional lymph nodes were scored in accordance with the Node-RADS classification. For statistical analysis, receiver-operating characteristics (ROC) with area under the curve (AUC) were used to test for diagnostic accuracy; inter-reader variability was assessed with Cohen's kappa. Results: Overall, 54 patients were nodal positive (42.9%), 72 patients were nodal negative (57.1%). Inter-reader agreement was substantial for the overall Node-RADS scoring (ĸ=0.65, p<0.001). ROC curve analysis for lymph node discrimination (N0 versus N1-3) showed an AUC of 0.69 (95% confidence interval=0.59-0.79). A threshold score of more than 2 resulted in a sensitivity of 0.77 and a specificity of 0.55 for correctly predicting nodal positivity. Node-RADS 1 category had a malignancy rate of 30%, Node-RADS 2 of 14%, Node-RADS 3 of 81%, Node-RADS 4 of 90.1% and Node-RADS 5 of 86.5%. Conclusion: The Node-RADS score on staging CT is associated with the malignancy rate of lymph nodes in patients with EC with only moderate diagnostic accuracy. The inter-reader variability is moderate, which could pose difficulties for translation into clinical routine. [ABSTRACT FROM AUTHOR]

Published
2025
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48. Treatment Response After Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for Peritoneal Metastases of Colorectal Originf

Author

Martin Hübner, MD, S. P. Somashekhar, MD, Hugo Teixeira Farinha, MD, Julio Abba, MD, Ramya G. Rao, PhD, Mohammad Alyami, MD, Wouter Willaert, MD, PhD, on behalf of the PIPAC study group, Brigand Cecile, MD, Delhorme Jean-Baptiste, MD, PhD, Romain Benoit, MD, PhD, Charleux-Muller Diane, MD, Bertin Jean-Baptiste, MD, Rohr Serge, MD, Jager Tarkan, MD, Neureiter Daniel, MD, Schredl Philipp, MD, Weiss Lukas, MD, Klieser Eckhard, MD, Emmanuel Klaus, MD, Sgarbura Olivia, MD, PhD, Bouillin Alix, MD, Khellaf Lakhdar, MD, Nougaret Stephanie, MD, PhD, Samalin Emmanuelle, MD, Mazard Thibault, MD, PhD, Glehen Olivier, MD, PhD, Kepenekian Vahan, MD, PhD, Villeneuve Laurent, PhD, Hubner Martin, Demartines Nicolas, MD, Teixeira-Farinha Hugo, MD, Clerc Daniel, MD, Dromain Clarisse, MD, Sempoux Christine, MD, PhD, Robella Manuela, MD, Vaira Marco, MD, De Simone Michele, MD, Di Giorgio Andrea, MD, Ferracci Federica, MD, Rotolo Stefano, MD, Schena Carlo Alberto, MD, Inzani Frediano, MD, Bagala Cinzia, MD, Babucke Maximilian, MD, Piso Pompiliu, PhD, MD, Somashekhar s p, MD, Ashwin KR, DNB, Rohit Kumar, DNB, Susmita Rakshit, MBBS, MD, Amit Rauthan, DM, Bhatt Aditi, MS, MCh., Shaikh Sakina, BH,MS, MBA, Parikh Loma, MD, Sheth Sandeep, MD, Panchal Amee, MD, Thakkar Shweta, MD, Ezzano Anne-Cecile, MD, Aime Adeline, MD, Eveno Clarisse, MD, PhD, Noiret Barbara, MD, Khomiakov Vladimir, PhD, Ryabov Andrey, PhD, Utkina Anna, PhD, Aksenov Sergey, MD, Bolotina Larisa, PhD, Kaprin Andrey, PhD, Willaert Wouter, MD, PhD, Cosyns Sarah, PhD, MSc, Akhayad Soumaya, BSN, Ceelen Wim, MD, PhD, Gockel Ines, MD, Jansen-Winkeln Boris, MD, Thieme Rene, PhD, Schierle Katrin, MD, Moulla Yusef, MD, Mehdorn Matthias, MD, Abba Julio, MD, Trilling Bertrand, MD, PhD, Tidadini Fatah, MSc, Bonne Aline, MD, Arvieux Catherine, MD, PhD, Orry David, MD, Basso Valeria, MD, Ghiringhelli Francois, MD, PhD, Escayola Cecilia, MD, Torrent Juan Jose, MD, Alyami Mohammad, MD, Alqannas Mashhour, MD, Cortes Guiral Delia, MD, PhD, Alammari samer, MD, Bashanfer Galal, MD, Alshukami Anwar, MD, Reymond Marc A., MD, Solass Wiebke, MD, and Nadiradze Giorgi, MD

Subjects
Surgery, RD1-811
Abstract

Objective:. The objective of this study is to analyze oncological outcomes of patients with peritoneal metastases (PM) of colorectal origin treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC). Background:. PIPAC has been demonstrated to be a feasible and safe novel treatment for patients with PM of various origins. Only small series reports on survival after PIPAC by disease entity. Methods:. International retrospective cohort study of consecutive patients with PM of colorectal origin. Outcome measures were overall survival (OS), radiological response according to Response Evaluation Criteria in Solid Tumors (RECIST), histological response (peritoneal regression grading score [PRGS]: complete response: 1–4: no response), change of peritoneal cancer index (PCI), and symptom control. Results:. Seventeen eligible centers compiled 256 non-selected patients (mean age 61 [50.6–69.2], 43% female) and 606 procedures. Sixty-three percent were treated after 2 lines of chemotherapy, median PCI at PIPAC1 was 18 (interquartile range [IQR] = 10–27). Median OS was 19.00 months (IQR = 12.9–29.8) from diagnosis and 9.4 months (IQR = 4.5–16.8) from PIPAC1. One hundred and four of 256 patients (40.6%) had ≥3 procedures (per protocol [pp]) with the following outcomes at PIPAC3: RECIST: 59.3% partial response/stable, 40.7% progression; mean PRGS: 2.1 ± 0.9. Median PCI was 21 (IQR = 15–29) at baseline and 20 (IQR = 12–27) at PIPAC3 (P = 0.02). Fifty-six (54%) and 48 (46%) patients were symptomatic at baseline and PIPAC3, respectively (P = 0.267). Median OS for the pp cohort was 11.9 months (IQR = 10.7–15.0) from PIPAC1. Independent predictors for survival were radiological response (HR = 3.0; 95% CI = 1.6–5.7) and no symptoms (HR = 4.5, 95% CI = 2.2–9.1) at PIPAC3. Conclusions:. Objective treatment response and encouraging survival were demonstrated after PIPAC for colorectal PM. Prospective registry data and comparative studies are now needed in to confirm these data.

Published
2022
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50. Oncologic Surgery for Lower Gastrointestinal Tumors during Pregnancy: A Literature Review

Author

Plum, Patrick S., Chon, Seung-Hun, Alakus, Hakan, Mehdorn, Matthias, Stelzner, Sigmar, Thieme, René, Kreuser, Nicole, and Gockel, Ines

Abstract

Background:Colorectal cancer (CRC) during pregnancy can be a challenging situation due to the spatial confinement of the tumor with the growing uterus carrying the fetus. It is one of the more common tumor entities occurring in pregnant women, and therefore, it has to be taken into account if “patients describe suspicious” symptoms. Summary:Diagnosis and treatment are complex and require a specialized multidisciplinary team of visceral oncologists with expertise in colorectal surgery, gastrointestinal oncologists, gynecologists, obstetricians, and neonatologists to coordinate the optimal treatment plan with the patient. Multimodal treatment options depend on gestational age and tumor stage. Radical surgical oncologic therapy at the latest possible stage of pregnancy is often the only feasible, potentially curative treatment option. Chemotherapy and radiotherapy should be postponed to the postpartum period, if possible. Neonatological aspects, including the high risk of serious complications for the infant during and after anesthesia for oncologic surgery, such as cerebral hemorrhage, pulmonary hypoplasia, and necrotizing enterocolitis, must always be in the focus when considering the optimal timing of surgery, as well as the prognosis of the mother concerning her tumor. Key Message:Treatment of CRC during pregnancy is based on highly individualized therapeutic decisions rather than on standardized guideline recommendations. Surgical resection via partial colectomy, anterior rectal resections, and abdominoperineal extirpations are feasible. However, it has always to be considered if surgery has to be performed in elective situations or damage control procedures due to emergencies, such as mechanical ileus or perforations with intra-abdominal sepsis.

Published
2025
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