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1. Deep learning-based phenotyping reclassifies combined hepatocellular-cholangiocarcinoma

Author: Julien Calderaro, Narmin Ghaffari Laleh, Qinghe Zeng, Pascale Maille, Loetitia Favre, Anaïs Pujals, Christophe Klein, Céline Bazille, Lara R. Heij, Arnaud Uguen, Tom Luedde, Luca Di Tommaso, Aurélie Beaufrère, Augustin Chatain, Delphine Gastineau, Cong Trung Nguyen, Hiep Nguyen-Canh, Khuyen Nguyen Thi, Viviane Gnemmi, Rondell P. Graham, Frédéric Charlotte, Dominique Wendum, Mukul Vij, Daniela S. Allende, Federico Aucejo, Alba Diaz, Benjamin Rivière, Astrid Herrero, Katja Evert, Diego Francesco Calvisi, Jérémy Augustin, Wei Qiang Leow, Howard Ho Wai Leung, Emmanuel Boleslawski, Mohamed Rela, Arnaud François, Anthony Wing-Hung Cha, Alejandro Forner, Maria Reig, Manon Allaire, Olivier Scatton, Denis Chatelain, Camille Boulagnon-Rombi, Nathalie Sturm, Benjamin Menahem, Eric Frouin, David Tougeron, Christophe Tournigand, Emmanuelle Kempf, Haeryoung Kim, Massih Ningarhari, Sophie Michalak-Provost, Purva Gopal, Raffaele Brustia, Eric Vibert, Kornelius Schulze, Darius F. Rüther, Sören A. Weidemann, Rami Rhaiem, Jean-Michel Pawlotsky, Xuchen Zhang, Alain Luciani, Sébastien Mulé, Alexis Laurent, Giuliana Amaddeo, Hélène Regnault, Eleonora De Martin, Christine Sempoux, Pooja Navale, Maria Westerhoff, Regina Cheuk-Lam Lo, Jan Bednarsch, Annette Gouw, Catherine Guettier, Marie Lequoy, Kenichi Harada, Pimsiri Sripongpun, Poowadon Wetwittayaklang, Nicolas Loménie, Jarukit Tantipisit, Apichat Kaewdech, Jeanne Shen, Valérie Paradis, Stefano Caruso, and Jakob Nikolas Kather
Subjects: Science
Abstract: Abstract Primary liver cancer arises either from hepatocytic or biliary lineage cells, giving rise to hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICCA). Combined hepatocellular- cholangiocarcinomas (cHCC-CCA) exhibit equivocal or mixed features of both, causing diagnostic uncertainty and difficulty in determining proper management. Here, we perform a comprehensive deep learning-based phenotyping of multiple cohorts of patients. We show that deep learning can reproduce the diagnosis of HCC vs. CCA with a high performance. We analyze a series of 405 cHCC-CCA patients and demonstrate that the model can reclassify the tumors as HCC or ICCA, and that the predictions are consistent with clinical outcomes, genetic alterations and in situ spatial gene expression profiling. This type of approach could improve treatment decisions and ultimately clinical outcome for patients with rare and biphenotypic cancers such as cHCC-CCA.
Published: 2023
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2. Should Hypervascular Incidentalomas Detected on Per-Interventional Cone Beam Computed Tomography during Intra-Arterial Therapies for Hepatocellular Carcinoma Impact the Treatment Plan in Patients Waiting for Liver Transplantation?

Author: Haytham Derbel, Athena Galletto Pregliasco, Sébastien Mulé, Julien Calderaro, Youssef Zaarour, Laetitia Saccenti, Mario Ghosn, Edouard Reizine, Maxime Blain, Alexis Laurent, Raffaele Brustia, Vincent Leroy, Giuliana Amaddeo, Alain Luciani, Vania Tacher, and Hicham Kobeiter
Subjects: hepatocellular carcinoma, liver neoplasms, neoplasm recurrence, magnetic resonance imaging, prognosis, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Background: Current guidelines do not indicate any comprehensive management of hepatic hypervascular incidentalomas (HVIs) discovered in hepatocellular carcinoma (HCC) patients during intra-arterial therapies (IATs). This study aims to evaluate the prognostic value of HVIs detected on per-interventional cone beam computed tomography (CBCT) during IAT for HCC in patients waiting for liver transplantation (LT). Material and methods: In this retrospective single-institutional study, all liver-transplanted HCC patients between January 2014 and December 2018 who received transarterial chemoembolization (TACE) or radioembolization (TARE) before LT were included. The number of ≥10 mm HCCs diagnosed on contrast-enhanced pre-interventional imaging (PII) was compared with that detected on per-interventional CBCT with a nonparametric Wilcoxon test. The correlation between the presence of an HVI and histopathological criteria associated with poor prognosis (HPP) on liver explants was investigated using the chi-square test. Tumor recurrence (TR) and TR-related mortality were investigated using the chi-square test. Recurrence-free survival (RFS), TR-related survival (TRRS), and overall survival (OS) were assessed according to the presence of HVI using Kaplan–Meier analysis. Results: Among 63 included patients (average age: 59 ± 7 years, H/F = 50/13), 36 presented HVIs on per-interventional CBCT. The overall nodule detection rate of per-interventional CBCT was superior to that of PII (median at 3 [Q1:2, Q3:5] vs. 2 [Q1:1, Q3:3], respectively, p < 0.001). No significant correlation was shown between the presence of HVI and HPP (p = 0.34), TR (p = 0.095), and TR-related mortality (0.22). Kaplan–Meier analysis did not show a significant impact of the presence of HVI on RFS (p = 0.07), TRRS (0.48), or OS (p = 0.14). Conclusions: These results may indicate that the treatment plan during IAT should not be impacted or modified in response to HVI detection.
Published: 2024
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3. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area: What's new 12 months later?

Author: Raffaele Brustia, Mohamed Bouattour, Manon Allaire, Marie Lequoy, Clémence Hollande, Hélène Regnault, Lorraine Blaise, Nathalie Ganne-Carrié, Valérie Vilgrain, Edouard Larrey, Chetana Lim, Olivier Scatton, Sanaa El Mouhadi, Violaine Ozenne, François Paye, Pierre Balladur, Anthony Dohan, Pierre-Philippe Massault, Stanislas Pol, Marco Dioguardi Burgio, Ailton Sepulveda, Francois Cauchy, Alain Luciani, Daniele Sommacale, Vincent Leroy, Julien Calderaro, Francoise Roudot-Thoraval, Jean-Charles Nault, and Giuliana Amaddeo
Subjects: 2019-nCoV, COVID-19, Management, Hepatocellular carcinoma, cirrhosis, Specialties of internal medicine, RC581-951
Abstract: Introduction and Objectives: The lockdown policy introduced in 2020 to minimize the spread of the COVID-19 pandemic, significantly affected the management and care of patients affected by hepatocellular carcinoma (HCC). The aim of this follow-up study was to determine the 12 months impact of the COVID-19 pandemic on the cohort of patients affected by HCC during the lockdown, within six French academic referral centers in the metropolitan area of Paris. Materials and Methods: We performed a 12 months follow-up of the cross-sectional study cohort included in 2020 on the management of patients affected by HCC during the first six weeks of the COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed). Overall survival were compared between the groups. Predictors of mortality were analysed with Cox regression. Results: From the initial cohort, 575 patients were included (n = 263 Exposed_COVID, n = 312 Unexposed_COVID). Overall and disease free survival at 12 months were 59.9 ± 3.2% vs. 74.3 ± 2.5% (p
Published: 2023
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4. Prognostic factors influencing outcomes in hepatocellular carcinoma patients undergoing selective internal radiation therapy

Author: Maria Stella Franzè, Paul Vigneron, Anna Sessa, Carlo Saitta, Julia Chalaye, Vania Tacher, Alain Luciani, Hélène Regnault, Ancuta Bejan, Rami Rhaiem, Daniele Sommacale, Vincent Leroy, Raffaele Brustia, Giovanni Raimondo, and Giuliana Amaddeo
Subjects: Hepatocellular carcinoma, Selective internal radiation therapy, Radioembolization, Yttrium-90, Prognostic factors, Specialties of internal medicine, RC581-951
Abstract: Selective internal radiation therapy (SIRT) has emerged as a viable endovascular treatment strategy for hepatocellular carcinoma (HCC). According to the Barcelona Clinic Liver Cancer (BCLC) classification, SIRT is currently recommended for early- and intermediate-stage HCC that is unsuitable for alternative locoregional therapies. Additionally, SIRT remains a recommended treatment for patients with advanced-stage HCC and portal vein thrombosis (PVT) without extrahepatic metastasis. Several studies have shown that SIRT is a versatile and promising treatment with a wide range of applications. Consequently, given its favourable characteristics in various scenarios, SIRT could be an encouraging treatment option for patients with HCC across different BCLC stages. Over the past decade, an increasing number of studies have focused on better understanding the prognostic factors associated with SIRT to identify patients who derive the most benefit from this treatment or to refine the optimal technical procedures of SIRT. Several variables can influence treatment decisions, with a growing emphasis on a personalised approach. This review, based on the literature, will focus on the prognostic factors associated with the effectiveness of radioembolization and related complications. By comprehensively analysing these factors, we aimed to provide a clearer understanding of how to optimise the use of SIRT in managing HCC patients, thereby enhancing outcomes across various clinical scenarios.
Published: 2025
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5. Liver resection for single large hepatocellular carcinoma: a prognostic factors study

Author: Vincent Nguyen-Khac, Raffaele Brustia, Rami Rhaiem, Hélène Regnault, Anna Sessa, Sebastien Mule, Christophe Duvoux, Alexis Laurent, Vincent Leroy, Julien Calderaro, Alain Luciani, Francoise Roudot-Thoraval, Giuliana Amaddeo, and Daniele Sommacale
Subjects: Large hepatocellular carcinoma, Liver resection, Prognostic score, Alpha-fetoprotein, Tumour portal invasion, Cirrhosis, Specialties of internal medicine, RC581-951
Abstract: Introduction and objectives: Liver resection is the only curative therapeutic option for large hepatocellular carcinoma (> 5 cm), but survival is worse than in smaller tumours, mostly due to the high recurrence rate. There is currently no proper tool for stratifying relapse risk. Herein, we investigated prognostic factors before hepatectomy in patients with a single large hepatocellular carcinoma (HCC). Material and methods: We retrospectively identified 119 patients who underwent liver resection for a single large HCC in 2 tertiary academic French centres and collected pre- and post-operative clinical, biological and radiological features. The primary outcome was overall survival at five years. Secondary outcomes were recurrence-free survival at five years and prognostic factors for recurrence. Results: A total of 84% of the patients were male, and the median age was 66 years old (IQR 58–74). Thirty-nine (33%) had Child–Pugh A cirrhosis, and the mean Model for End-Stage Liver Disease (MELD) score was 6 (6–6). The aetiology of liver disease was predominantly alcohol-related (48%), followed by nonalcoholic steatohepatitis (22%), hepatitis B (18%) and hepatitis C (10%). The mean tumour size was 70 mm (55–110). The median overall survival was 72.5 months (IC 95%: 56.2-88.7), and the five-year overall survival was 55.1 ± 5.5%. The median recurrence-free survival was 26.6 months (95% CI: 16.0-37.1), and the five-year recurrence-free survival rate was 37.8 ± 5%. In multivariate analysis, preoperative prognostic factors for recurrence were baseline alpha-fetoprotein (AFP) > 7 ng/mL (p
Published: 2022
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6. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author: Nicola de’Angelis, Fausto Catena, Riccardo Memeo, Federico Coccolini, Aleix Martínez-Pérez, Oreste M. Romeo, Belinda De Simone, Salomone Di Saverio, Raffaele Brustia, Rami Rhaiem, Tullio Piardi, Maria Conticchio, Francesco Marchegiani, Nassiba Beghdadi, Fikri M. Abu-Zidan, Ruslan Alikhanov, Marc-Antoine Allard, Niccolò Allievi, Giuliana Amaddeo, Luca Ansaloni, Roland Andersson, Enrico Andolfi, Mohammad Azfar, Miklosh Bala, Amine Benkabbou, Offir Ben-Ishay, Giorgio Bianchi, Walter L. Biffl, Francesco Brunetti, Maria Clotilde Carra, Daniel Casanova, Valerio Celentano, Marco Ceresoli, Osvaldo Chiara, Stefania Cimbanassi, Roberto Bini, Raul Coimbra, Gian Luigi de’Angelis, Francesco Decembrino, Andrea De Palma, Philip R. de Reuver, Carlos Domingo, Christian Cotsoglou, Alessandro Ferrero, Gustavo P. Fraga, Federica Gaiani, Federico Gheza, Angela Gurrado, Ewen Harrison, Angel Henriquez, Stefan Hofmeyr, Roberta Iadarola, Jeffry L. Kashuk, Reza Kianmanesh, Andrew W. Kirkpatrick, Yoram Kluger, Filippo Landi, Serena Langella, Real Lapointe, Bertrand Le Roy, Alain Luciani, Fernando Machado, Umberto Maggi, Ronald V. Maier, Alain Chichom Mefire, Kazuhiro Hiramatsu, Carlos Ordoñez, Franca Patrizi, Manuel Planells, Andrew B. Peitzman, Juan Pekolj, Fabiano Perdigao, Bruno M. Pereira, Patrick Pessaux, Michele Pisano, Juan Carlos Puyana, Sandro Rizoli, Luca Portigliotti, Raffaele Romito, Boris Sakakushev, Behnam Sanei, Olivier Scatton, Mario Serradilla-Martin, Anne-Sophie Schneck, Mohammed Lamine Sissoko, Iradj Sobhani, Richard P. ten Broek, Mario Testini, Roberto Valinas, Giorgos Veloudis, Giulio Cesare Vitali, Dieter Weber, Luigi Zorcolo, Felice Giuliante, Paschalis Gavriilidis, David Fuks, and Daniele Sommacale
Subjects: Laparoscopic cholecystectomy, Biliary duct injury, Magnetic resonance imaging, Antibiotic therapy, Computed tomography, Guidelines, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.
Published: 2021
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7. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area

Author: Giuliana Amaddeo, Raffaele Brustia, Manon Allaire, Marie Lequoy, Clémence Hollande, Hélène Regnault, Lorraine Blaise, Nathalie Ganne-Carrié, Olivier Séror, Edouard Larrey, Chetana Lim, Olivier Scatton, Sanaa El Mouhadi, Violaine Ozenne, François Paye, Pierre Balladur, Anthony Dohan, Pierre-Philippe Massault, Stanislas Pol, Marco Dioguardi Burgio, Valérie Vilgrain, Ailton Sepulveda, Francois Cauchy, Alain Luciani, Daniele Sommacale, Vincent Leroy, Francoise Roudot-Thoraval, Mohamed Bouattour, and Jean-Charles Nault
Subjects: 2019-nCoV, COVID-19, Management, Hepatocellular carcinoma, Cirrhosis, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract: Background & Aims: Patients affected by hepatocellular carcinoma (HCC) represent a vulnerable population during the COVID-19 pandemic and may suffer from altered allocation of healthcare resources. The aim of this study was to determine the impact of the COVID-19 pandemic on the management of patients with HCC within 6 referral centres in the metropolitan area of Paris, France. Methods: We performed a multicentre, retrospective, cross-sectional study on the management of patients with HCC during the first 6 weeks of the COVID-19 pandemic (exposed group), compared with the same period in 2019 (unexposed group). We included all patients discussed in multidisciplinary tumour board (MTB) meetings and/or patients undergoing a radiological or surgical programmed procedure during the study period, with curative or palliative intent. Endpoints were the number of patients with a modification in the treatment strategy, or a delay in decision-to-treat. Results: After screening, n = 670 patients were included (n = 293 exposed to COVID, n = 377 unexposed to COVID). Fewer patients with HCC presented to the MTB in 2020 (p = 0.034) and fewer had a first diagnosis of HCC (n = 104 exposed to COVID, n = 143 unexposed to COVID, p = 0.083). Treatment strategy was modified in 13.1% of patients, with no differences between the 2 periods. Nevertheless, 21.5% vs. 9.5% of patients experienced a treatment delay longer than 1 month in 2020 compared with 2019 (p
Published: 2021
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8. Correction: Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis.

Author: Nicola de'Angelis, Capucine Baldini, Raffaele Brustia, Patrick Pessaux, Daniele Sommacale, Alexis Laurent, Bertrand Le Roy, Vania Tacher, Hicham Kobeiter, Alain Luciani, Elena Paillaud, Thomas Aparicio, Florence Canoui-Poitrine, and Evelyne Liuu
Subjects: Medicine, Science
Abstract: [This corrects the article DOI: 10.1371/journal.pone.0230914.].
Published: 2021
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9. Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis.

Author: Nicola de'Angelis, Capucine Baldini, Raffaele Brustia, Patrick Pessaux, Daniele Sommacale, Alexis Laurent, Bertrand Le Roy, Vania Tacher, Hicham Kobeiter, Alain Luciani, Elena Paillaud, Thomas Aparicio, Florence Canuï-Poitrine, and Evelyne Liuu
Subjects: Medicine, Science
Abstract: ObjectiveThe present study explored the existing literature to describe the outcomes of surgical and regional treatments for colorectal cancer metastases (mCRC) in older patients.MethodsA literature search was conducted in PubMed, EMBASE, Cochrane and ClinicalTrials.gov for studies published since 2000 that investigated the short- and long-term outcomes of regional treatments (surgical or non-surgical) for mCRC in patients aged ≥65 years. Pooled data analyses were conducted by calculating the risk ratio (RR), mean differences (MD) and hazard ratio (HR) between older and younger patients or between two different approaches in older patients.ResultsAfter screening 266 articles, 29 were included in this review. These studies reported the outcomes of surgery (n = 19) and non-surgical local ablation treatments (n = 3) for CRC metastases in older vs. younger patients or compared the outcomes of different interventions in older patients (n = 7). When comparing older vs. younger patients undergoing liver surgery for mCRC, pooled data analysis showed higher postoperative mortality [RR = 2.53 (95%CI: 2.00-3.21)] and shorter overall survival [HR = 1.17 (95%CI: 1.07-1.18)] in older patients, whereas no differences in operative outcomes, postoperative complications and disease-free survival were found. When comparing laparoscopy vs. open surgery for liver resection in older mCRC patients, laparoscopy was associated with fewer postoperative complications [RR = 0.27 (95%CI: 0.10-0.73)].ConclusionLiver resection for mCRC should not be disregarded a priori in older patients, who show similar operative and postoperative outcomes as younger patients. However, clinicians should consider that they are at increased risk of postoperative mortality and have a worse overall survival, which may reflect comorbidities and frailty.
Published: 2020
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10. P6.20 ROLE OF ALTERED VASCULAR REACTIVITY IN THE PATHOPHYSIOLOGY OF ACUTE MOUNTAIN SICKNESS

Author: Rosa Maria Bruno, Guido Giardini, Sandro Malacrida, Bruna Catuzzo, Sabina Armenia, Lorenzo Ghiadoni, Raffaele Brustia, Paolo Laveder, Paolo Salvi, Emmanuel Cauchy, and Lorenza Pratali
Subjects: Specialties of internal medicine, RC581-951, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Purpose: The aim of this study is to explore the physiological vascular adaptation to exposure to high altitude and to test the hypothesis that its impairment might play a role in the pathophysiology of acute mountain sickness (AMS). Methods: 34 healthy volunteers (age 38±11years, 13 women) were studied at the sea-level and after passive ascent to 3842 m (Aguille du Midi, France). Blood pressure (BP), O2 saturation (SO2), endothelial function (flow-mediated dilation, FMD), carotid distensibility coefficient (DC), carotid-femoral pulse wave velocity (PWV), peak systolic velocity in the middle cerebral artery (MCA-PSV) were performed at sea level (T0) and after 4-h hypobaric hypoxia (T1). AMS was defined as a Lake-Louise Score>5 after 24-h hypobaric hypoxia (T2). Results: At T2 12 individuals developed AMS (AMS+). AMS+ had a greater SO2 worsening at T1 as compared to AMS- (AMS+: 97.2±1.2 to 79.3±5.8%; AMS-: 97.3±1.2 to 83.1 ± 5.7%, p=0.03), with similar heart rate increase and unchanged BP. FMD was significantly reduced in AMS+ (5.75±3.01 to 3.27±1.87%, p=0.04), but not in AMS- (4.74±2.47 to 4.02±2.36%). Mean carotid diameter was increased at T1 in both groups. DC tended to be increased in AMS- but not in AMS+, while PWV was unchanged. MCA-PSV was increased in AMS-, but not in AMS+. Conclusions: In healthy asymptomatic individuals exposed to high altitude, conduit artery endothelial function is preserved in the cerebral district vasodilatation, increased elasticity and blood flow occurs. This compensatory response is early blunted in AMS+, before symptoms onset, thus suggesting a pathogenetic role.
Published: 2015
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11. THU-494 Selective internal radiation therapy for unresectable hepatocellular carcinoma in a tertiary center in France, update and final analysis

Author: Regnault, Hélène, primary, Chalaye, Julia, additional, Galletto, Athena, additional, Perrin, Clara, additional, Amaddeo, Giuliana, additional, Lequoy, Marie, additional, Kobeiter, Hicham, additional, Mule, Sebastien, additional, Reizine, Edouard, additional, Itti, Emmanuel, additional, Duvoux, Christophe, additional, Laurent, Alexis, additional, Sommacale, Daniele, additional, Leroy, Vincent, additional, Luciani, Alain, additional, Derbel, Haytham, additional, Calderaro, Julien, additional, Tacher, Vania, additional, and Raffaele, Brustia, additional
Published: 2024
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12. FRI-456 Characterization of the intratumoral immune microenvironment of hepatocellular carcinoma before selective intrahepatic radiation therapy (SIRT) and study of its prognostic value on response to treatment

Author: Franzè, Maria Stella, primary, Vigneron, Paul, additional, Caruso, Stefano, additional, Regnault, Hélène, additional, Sessa, Anna, additional, Maille, Pascale, additional, Bouda, Yasmine, additional, Iavarone, Massimo, additional, Canova, Lorenzo, additional, Maggioni, Marco, additional, Khac, Eric Nguyen, additional, Sarba, Ruxandra, additional, Yzet, Thierry, additional, Heurgue-berlot, Alexandra, additional, Kianmanesh, Reza, additional, Rhaiem, Rami, additional, Nault, Jean Charles, additional, Soussan, Michael, additional, Sutter, Olivier, additional, Allaire, Manon, additional, Lequoy, Marie, additional, Bouattour, Mohamed, additional, Beaufrère, Aurélie, additional, Burgio, Marco Dioguardi, additional, Raffaele, Brustia, additional, Sommacale, Daniele, additional, Luciani, Alain, additional, Tacher, Vania, additional, Pawlotsky, Jean-Michel, additional, Leroy, Vincent, additional, Calderaro, Julien, additional, and Amaddeo, Giuliana, additional
Published: 2024
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13. Paradigm shift: should preoperative 3D reconstruction models become mandatory before hepatectomy for hepatocellular carcinoma (HCC)? Results of a multicenter prospective trial

Author: Emanuele Felli, Emmanuel Boleslawski, Daniele Sommacale, Olivier Scatton, Raffaele Brustia, Lilian Schwarz, Daniel Cherqui, Thomas Zacharias, Alexis Laurent, Jean-Yves Mabrut, Catherine Schuster, Benoit Gallix, and Patrick Pessaux
Subjects: Hepatology, Gastroenterology
Published: 2023

14. Liver Transplantation Using Allografts With Recent Liver Blunt Trauma: A Nationwide Audit From the French CRISTAL Biomedicine Agency Registry

Author: Florian, Seckler, Célia, Turco, Kayvan, Mohkam, Pietro, Addeo, Fabien, Robin, François, Cauchy, Charlotte, Maulat, Raffaele, Brustia, Brice, Paquette, François, Faitot, Delphine, Weil Verhoeven, Anne, Minello, Zaher, Lakkis, Vincent, Di Martino, Marianne, Latournerie, Laurence, Chiche, Mehdi, El Amrani, Petru, Bucur, Francis, Navarro, Sophie, Chopinet, Mircea, Chirica, Johan, Gagnière, Antonio, Iannelli, Gaëlle, Cheisson, Christophe, Chardot, Daniele, Sommacale, Fabrice, Muscari, Federica, Dondero, Laurent, Sulpice, Philippe, Bachellier, Olivier, Scatton, Jean Yves, Mabrut, Bruno, Heyd, and Alexandre, Doussot
Subjects: Transplantation
Abstract: In the current setting of organ shortage, brain-dead liver donors with recent liver trauma (RLT) represent a potential pool of donors. Yet, data on feasibility and safety of liver transplantation (LT) using grafts with RLT are lacking.All liver grafts from brain-dead donors with RLT proposed for LT between 2010 and 2018 were identified from the nationwide CRISTAL registry of the Biomedicine Agency. The current study aimed at evaluating 1-y survival as the primary endpoint.Among 11 073 LTs, 142 LTs (1.3%) using grafts with RLT were performed. These 142 LTs, including 23 split LTs, were performed from 131 donors (46.1%) of 284 donors with RLT proposed for LT. Transplanted grafts were procured from donors with lower liver enzymes levels (P 0.001) and less advanced liver trauma according to the American Association for the Surgery of Trauma liver grading system (P 0.001) compared with not transplanted grafts. Before allocation procedures, 20 (7%) of 284 donors underwent damage control intervention. During transplantation, specific liver trauma management was needed in 19 patients (13%), consisting of local hemostatic control (n = 15), partial hepatic resection on back-table (n = 3), or perihepatic packing (n = 1). Ninety-day mortality and severe morbidity rates were 8.5% (n = 12) and 29.5% (n = 42), respectively. One-year overall and graft survival rates were 85% and 81%, and corresponding 5-y rates were 77% and 72%, respectively.Using liver grafts from donors with RLT seems safe with acceptable long-term outcomes. All brain-dead patients with multiorgan trauma, including liver injury, should be considered for organ allocation.
Published: 2022

15. Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022

Author: Gaëtan-Romain Joliat, Kosuke Kobayashi, Kiyoshi Hasegawa, John-Edwin Thomson, Robert Padbury, Michael Scott, Raffaele Brustia, Olivier Scatton, Hop S. Tran Cao, Jean-Nicolas Vauthey, Selim Dincler, Pierre-Alain Clavien, Stephen J. Wigmore, Nicolas Demartines, and Emmanuel Melloul
Subjects: Liver, Teaching Rounds, Humans, Preoperative Exercise, Surgery, Enhanced Recovery After Surgery
Abstract: Background Enhanced Recovery After Surgery (ERAS) has been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016. The aim of the present article was to update the ERAS guidelines in liver surgery using a modified Delphi method based on a systematic review of the literature. Methods A systematic literature review was performed using MEDLINE/PubMed, Embase, and the Cochrane Library. A modified Delphi method including 15 international experts was used. Consensus was judged to be reached when >80% of the experts agreed on the recommended items. Recommendations were based on the Grading of Recommendations, Assessment, Development and Evaluations system. Results A total of 7541 manuscripts were screened, and 240 articles were finally included. Twenty-five recommendation items were elaborated. All of them obtained consensus (>80% agreement) after 3 Delphi rounds. Nine items (36%) had a high level of evidence and 16 (64%) a strong recommendation grade. Compared to the first ERAS guidelines published, 3 novel items were introduced: prehabilitation in high-risk patients, preoperative biliary drainage in cholestatic liver, and preoperative smoking and alcohol cessation at least 4 weeks before hepatectomy. Conclusions These guidelines based on the best available evidence allow standardization of the perioperative management of patients undergoing liver surgery. Specific studies on hepatectomy in cirrhotic patients following an ERAS program are still needed.
Published: 2022

16. Artificial intelligence predicts immune and inflammatory gene signatures directly from hepatocellular carcinoma histology

Author: Qinghe Zeng, Christophe Klein, Stefano Caruso, Pascale Maille, Narmin Ghaffari Laleh, Daniele Sommacale, Alexis Laurent, Giuliana Amaddeo, David Gentien, Audrey Rapinat, Hélène Regnault, Cécile Charpy, Cong Trung Nguyen, Christophe Tournigand, Raffaele Brustia, Jean Michel Pawlotsky, Jakob Nikolas Kather, Maria Chiara Maiuri, Nicolas Loménie, and Julien Calderaro
Subjects: Carcinoma, Hepatocellular, ROC Curve, Hepatology, Artificial Intelligence, Liver Neoplasms, Humans
Abstract: Patients with hepatocellular carcinoma (HCC) displaying overexpression of immune gene signatures are likely to be more sensitive to immunotherapy, however, the use of such signatures in clinical settings remains challenging. We thus aimed, using artificial intelligence (AI) on whole-slide digital histological images, to develop models able to predict the activation of 6 immune gene signatures.AI models were trained and validated in 2 different series of patients with HCC treated by surgical resection. Gene expression was investigated using RNA sequencing or NanoString technology. Three deep learning approaches were investigated: patch-based, classic MIL and CLAM. Pathological reviewing of the most predictive tissue areas was performed for all gene signatures.The CLAM model showed the best overall performance in the discovery series. Its best-fold areas under the receiver operating characteristic curves (AUCs) for the prediction of tumors with upregulation of the immune gene signatures ranged from 0.78 to 0.91. The different models generalized well in the validation dataset with AUCs ranging from 0.81 to 0.92. Pathological analysis of highly predictive tissue areas showed enrichment in lymphocytes, plasma cells, and neutrophils.We have developed and validated AI-based pathology models able to predict the activation of several immune and inflammatory gene signatures. Our approach also provides insights into the morphological features that impact the model predictions. This proof-of-concept study shows that AI-based pathology could represent a novel type of biomarker that will ease the translation of our biological knowledge of HCC into clinical practice.Immune and inflammatory gene signatures may be associated with increased sensitivity to immunotherapy in patients with advanced hepatocellular carcinoma. In the present study, the use of artificial intelligence-based pathology enabled us to predict the activation of these signatures directly from histology.
Published: 2022

17. Macrotrabecular-Massive Hepatocellular Carcinoma: Light and Shadow in Current Knowledge

Author: Anna Sessa, Sébastien Mulé, Raffaele Brustia, Hélène Regnault, Athena Galletto Pregliasco, Rami Rhaiem, Vincent Leroy, Daniele Sommacale, Alain Luciani, Julien Calderaro, and Giuliana Amaddeo
Abstract: The subject of this narrative review is macrotrabecular-massive hepatocellular carcinoma (MTM-HCC). Despite their rarity, these tumours are of general interest because of their epidemiological and clinical features and for representing a distinct model of the interaction between the angiogenetic system and neoplastic cells. The MTM-HCC subtype is associated with various adverse biological and pathological parameters (the Alfa-foetoprotein (AFP) serum level, tumour size, vascular invasion, and satellite nodules) and is a key determinant of patient prognosis, with a strong and independent predictive value for early and overall tumour recurrence. Gene expression profiling has demonstrated that angiogenesis activation is a hallmark feature of MTM-HCC, with overexpression of both angiopoietin 2 (ANGPT2) and vascular endothelial growth factor A (VEGFA).
Published: 2022

18. Left hepatectomy and microwave ablation for bilobar colorectal metastases: video description of a 'complicated' robotic approach

Author: Flavio Milana, Jacopo Galvanin, Daniele Sommacale, and Raffaele Brustia
Subjects: Radiofrequency Ablation, Treatment Outcome, Robotic Surgical Procedures, Liver Neoplasms, Humans, Hepatectomy, Surgery, Microwaves, Colorectal Neoplasms
Published: 2022

19. Supplementary Data from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplemental figures 1-10
Published: 2023

20. Supplementary Table 5 from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplementary Table 5: Difference in gene expression between Immune High (IH) and Immune Low (IL) subgroups from the validation dataset (n=20, Coulouarn et al, Carcinogenesis, 2012) (33).
Published: 2023

21. Supplementary Table 3 from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplementary Table 3: Difference in gene expression between IH1 and IH2 subtypes IH: Immune - High
Published: 2023

22. Supplementary Table 1 from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplementary Table 1: Difference in gene expression between IL and IH subtypes
Published: 2023

23. Supplementary Table 6 from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplementary Table 6: Difference in gene expression between Immune High 1 (IH1) and Immune High 2 (IH2) subgroups in the validation dataset (n=20, Coulouarn et al, Carcinogenesis, 2012) (33).
Published: 2023

24. Supplementary Table 8 from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplementary Table 8: Molecular alterations identified in cHCC-CCA
Published: 2023

25. Supplementary Table 7 from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplementary Table 7: Difference in gene expression between Immune Low 1 (IL1) and Immune Low 2 (IL2) subgroups in the validation dataset (n=20, Coulouarn et al. Carcinogenesis. 2012) (33).
Published: 2023

26. Supplementary Table 4 from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Supplementary Table 4: Difference in gene expression between IL1 and IL2 subtypes IL: Immune - Low
Published: 2023

27. Data from Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Julien Calderaro, Valérie Paradis, Fouad Lafdil, Christophe Tournigand, Jean-Michel Pawlotsky, Jessica Zucman-Rossi, Sebastien Mulé, Manon Allaire, Jean Charles Nault, Audrey Rapinat, David Gentien, Thi Lan Tran, Hong Son Trinh, Van To Ta, Van Ky Le, Alexis Laurent, Vincent Leroy, Patrick Soussan, Daniele Sommacale, Isabelle Brochériou, Frédéric Charlotte, Olivier Scatton, Raffaele Brustia, Hélène Regnault, Alain Luciani, Luca di Tommaso, Giuliana Amaddeo, Rami Rhaiem, Camille Boulagnon-Rombi, Anaïs Pujals, Loetitia Favre, Jérémy Augustin, Aurélie Beaufrère, Pascale Maille, Stefano Caruso, and Cong Trung Nguyen
Abstract: Purpose:Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare malignancy associated with an overall poor prognosis. We aimed to investigate the immune profile of cHCC-CCA and determine its impact on disease outcome.Experimental Design:We performed a multicenter study of 96 patients with cHCC-CCA. Gene expression profile was analyzed using nCounter PanCancer IO 360 Panel. Densities of main immune cells subsets were quantified from digital slides of IHC stainings. Genetic alterations were investigated using targeted next-generation sequencing.Results:Two main immune subtypes of cHCC-CCA were identified by clustering analysis: an “immune-high” (IH) subtype (57% of the cases) and an “immune-low” (IL) subtype (43% of the cases). Tumors classified as IH showed overexpression of genes related to immune cells recruitment, adaptive and innate immunity, antigen presentation, cytotoxicity, immune suppression, and inflammation (P < 0.0001). IH cHCC-CCAs also displayed activation of gene signatures recently shown to be associated with response to immunotherapy in patients with HCC. Quantification of immunostainings confirmed that IH tumors were also characterized by higher densities of immune cells. Immune subtypes were not associated with any genetic alterations. Finally, multivariate analysis showed that the IH subtype was an independent predictor of improved overall survival.Conclusions:We have identified a subgroup of cHCC-CCA that displays features of an ongoing intratumor immune response, along with an activation of gene signatures predictive of response to immunotherapy in HCC. This tumor subclass is associated with an improved clinical outcome. These findings suggest that a subset of patients with cHCC-CCA may benefit from immunomodulating therapeutic approaches.
Published: 2023

28. Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study

Author: Jacob Ghotbi, Davit Aghayan, Åsmund Fretland, Bjørn Edwin, Nicholas L. Syn, Federica Cipriani, Mohammed Alzoubi, Chetana Lim, Olivier Scatton, Tran Cong duy Long, Paulo Herman, Fabricio Ferreira Coelho, Marco V. Marino, Vincenzo Mazzaferro, Adrian K.H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Sung-Hoon Choi, Jae Hoon Lee, Mikel Prieto, Marco Vivarelli, Felice Giuliante, Andrea Ruzzenente, Chee-Chien Yong, Mengqiu Yin, Constantino Fondevila, Mikhail Efanov, Zenichi Morise, Fabrizio Di Benedetto, Raffaele Brustia, Raffaele Dalla Valle, Ugo Boggi, David Geller, Andrea Belli, Riccardo Memeo, Alejandro Mejia, James O. Park, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles-Campos, Xiaoying Wang, Robert P. Sutcliffe, Johann Pratschke, Chung-Ngai Tang, Charing C.N. Chong, Mathieu D'Hondt, Kazuteru Monden, Santiago Lopez-Ben, T. Peter Kingham, Alessandro Ferrero, Giuseppe Maria Ettorre, Giovanni Battista Levi Sandri, Franco Pascual, Daniel Cherqui, Xiao Liang, Alessandro Mazzotta, Go Wakabayashi, Mariano Giglio, Roberto I. Troisi, Ho-Seong Han, Tan-To Cheung, Atsushi Sugioka, Kuo-Hsin Chen, Rong Liu, Olivier Soubrane, David Fuks, Luca Aldrighetti, Mohammad Abu Hilal, Brian K.P. Goh, Mikel Gastaca, Juul Meurs, Celine De Meyere, Kit-Fai Lee, Kelvin K. Ng, Diana Salimgereeva, Ruslan Alikhanov, Lip-Seng Lee, Jae Young Jang, Yutaro Kato, Masayuki Kojima, Jaime Arthur Pirola Kruger, Victor Lopez-Lopez, Margarida Casellas I Robert, Roberto Montalti, Boram Lee, Mizelle D'Silva, Hao-Ping Wang, Mansour Saleh, Zewei Chen, Shian Yu, Simone Vani, Francesco Ardito, Ugo Giustizieri, Davide Citterio, Federico Mocchegiani, Marco Colasanti, Yoelimar Guzmán, Kevin P. Labadie, Maria Conticchio, Epameinondas Dogeas, Emanuele F. Kauffmann, Mario Giuffrida, Daniele Sommacale, Alexis Laurent, Paolo Magistri, Phan Phuoc Nghia, Kohei Mishima, Bernardo Dalla Valle, Felix Krenzien, Moritz Schmelzle, Prashant Kadam, Qu Liu, Eric C.H. Lai, Junhao Zheng, Tiing Foong Siow, and Fabio Forchino
Subjects: Robotic liver resections, Oncology, Laparoscopic liver resections, Major resections, Settore MED/18 - CHIRURGIA GENERALE, Surgery, General Medicine, Difficulty, Neoadjuvant chemotherapy
Published: 2023

29. Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy

Author: Zewei Chen, Mengqiu Yin, Junhao Fu, Shian Yu, Nicholas L. Syn, Darren W. Chua, T. Peter Kingham, Wanguang Zhang, Tijs J. Hoogteijling, Davit L. Aghayan, Tiing Foong Siow, Olivier Scatton, Paulo Herman, Marco V. Marino, Vincenzo Mazzaferro, Adrian K.H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Sung Hoon Choi, Jae Hoon Lee, Mikel Prieto, Marco Vivarelli, Felice Giuliante, Andrea Ruzzenente, Chee-Chien Yong, Safi Dokmak, Constantino Fondevila, Mikhail Efanov, Zenichi Morise, Fabrizio Di Benedetto, Raffaele Brustia, Raffaele Dalla Valle, Ugo Boggi, David Geller, Andrea Belli, Riccardo Memeo, Salvatore Gruttadauria, Alejandro Mejia, James O. Park, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles-Campos, Xiaoying Wang, Robert P. Sutcliffe, Johann Pratschke, Eric C.H. Lai, Charing C.N. Chong, Mathieu D'Hondt, Kazuteru Monden, Santiago Lopez-Ben, Qu Liu, Rong Liu, Alessandro Ferrero, Giuseppe Maria Ettorre, Federica Cipriani, Daniel Cherqui, Xiao Liang, Olivier Soubrane, Go Wakabayashi, Roberto I. Troisi, Tan-To Cheung, Yutaro Kato, Atsushi Sugioka, Ho-Seong Han, Tran Cong duy Long, David Fuks, Mohammad Abu Hilal, Luca Aldrighetti, Kuo-Hsin Chen, Bjørn Edwin, Brian K.P. Goh, Mikel Gastaca, Juul Meurs, Celine De Meyere, Kit-Fai Lee, Kelvin K. Ng, Diana Salimgereeva, Ruslan Alikhanov, Lip-Seng Lee, Jae-Young Jang, Masayuki Kojima, Jaime Arthur Pirola Kruger, Fabricio Ferreira Coelho, Victor Lopez-Lopez, Margarida Casellas I Robert, Roberto Montalti, Mariano Giglio, Mizelle D'Silva, Boram Lee, Hao-Ping Wang, Franco Pascual, Mansour Saleh, Simone Vani, Francesco Ardito, Ugo Giustizieri, Davide Citterio, Federico Mocchegiani, Giammauro Berardi, Marco Colasanti, Yoelimar Guzmán, Kevin P. Labadie, Maria Conticchio, Epameinondas Dogeas, Emanuele F. Kauffmann, Mario Giuffrida, Daniele Sommacale, Alexis Laurent, Paolo Magistri, Kohei Mishima, Moritz Schmelzle, Felix Krenzien, Prashant Kadam, Jacob Ghotbi, Åsmund Avdem Fretland, Fabio Forchino, Alessandro Mazzotta, Francois Cauchy, Chetana Lim, Bernardo Dalla Valle, Junhao Zheng, Phan Phuoc Nghia, and Graduate School
Subjects: Minimally-invasive liver, Oncology, Left lateral sectionectomy, Laparoscopic hepatectomy, Laparoscopic liver, Minimally-invasive hepatectomy, Surgery, General Medicine, Body mass index
Abstract: Introduction: Currently, the impact of body mass index (BMI) on the outcomes of laparoscopic liver resections (LLR) is poorly defined. This study attempts to evaluate the impact of BMI on the peri-operative outcomes following laparoscopic left lateral sectionectomy (L-LLS). Methods: A retrospective analysis of 2183 patients who underwent pure L-LLS at 59 international centers between 2004 and 2021 was performed. Associations between BMI and selected peri-operative outcomes were analyzed using restricted cubic splines. Results: A BMI of >27kg/m2 was associated with increased in blood loss (Mean difference (MD) 21 mls, 95% CI 5–36), open conversions (Relative risk (RR) 1.13, 95% CI 1.03–1.25), operative time (MD 11 min, 95% CI 6–16), use of Pringles maneuver (RR 1.15, 95% CI 1.06–1.26) and reductions in length of stay (MD -0.2 days, 95% CI -0.3 to −0.1). The magnitude of these differences increased with each unit increase in BMI. However, there was a “U” shaped association between BMI and morbidity with the highest complication rates observed in underweight and obese patients. Conclusion: Increasing BMI resulted in increasing difficulty of L-LLS. Consideration should be given to its incorporation in future difficulty scoring systems in laparoscopic liver resections.
Published: 2023

30. Cholangiocarcinoma landscape in Europe: diagnostic, prognostic and therapeutic insights from the ENSCCA Registry

Author: Izquierdo-Sánchez, Laura, primary, Lamarca, Angela, additional, La Casta, Adelaida, additional, Buettner, Stefan, additional, Utpatel, Kirsten, additional, Klümpen, Heinz-Josef, additional, Adeva, Jorge, additional, Vogel, Arndt, additional, Lleo, Ana, additional, Fabris, Luca, additional, Ponz-Sarvise, Mariano, additional, Raffaele, Brustia, additional, Cardinale, Vincenzo, additional, Braconi, Chiara, additional, Vidili, Gianpaolo, additional, Jamieson, Nigel B., additional, Macias, Rocio IR, additional, Jonas, Philipp, additional, Marzioni, Marco, additional, Hołówko, Wacław, additional, Folseraas, Trine, additional, Kupcinskas, Juozas, additional, Sparchez, Zeno, additional, Krawczyk, Marcin, additional, Krupa, Łukasz, additional, Scripcariu, Viorel, additional, Grazi, Gianluca, additional, Landa-Magdalena, Ana, additional, Ijzermans, Jan, additional, Evert, Katja, additional, Erdmann, Joris, additional, López-López, Flora, additional, Saborowski, Anna, additional, Scheiter, Alexander, additional, Santos-Laso, Alvaro, additional, Carpino, Guido, additional, Andersen, Jesper, additional, Marin, Jose, additional, Alvaro, Domenico, additional, Bujanda, Luis, additional, Forner, Alejandro, additional, Valle, Juan, additional, Koerkamp, Bas Groot, additional, and Banales, Jesus Maria, additional
Published: 2022
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31. Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference

Author: Joerg M Pollok, Pascale Tinguely, Marina Berenguer, Claus U Niemann, Dimitri A Raptis, Michael Spiro, Andreas Mayr, Beatriz Dominguez, Elmi Muller, Karina Rando, Mary Anne Enoch, Noam Tamir, Pamela Healy, Tanja Manser, Tim Briggs, Abhideep Chaudhary, Abhinav Humar, Ali Jafarian, Arvinder Singh Soin, Bijan Eghtesad, Charles Miller, Daniel Cherqui, Didier Samuel, Dieter Broering, Elizabeth Pomfret, Federico Villamil, Francois Durand, Gabriela Berlakovich, Geoffrey McCaughan, Georg Auzinger, Giuliano Testa, Goran Klintmalm, Jacques Belghiti, James Findlay, Jennifer Lai, John Fung, John Klinck, John Roberts, Linda Liu, Mark Cattral, Mark Ghobrial, Markus Selzner, Michael Ramsay, Mohamed Rela, Nancy Ascher, Nancy Kwan Man, Nazia Selzner, Patrizia Burra, Peter Friend, Ronald Busuttil, Shin Hwang, Stuart McCluskey, Valeria Mas, Vijay Vohra, Vivek Vij, William Merritt, Yaman Tokat, Yoogoo Kang, Albert Chan, Alessandra Mazzola, Amelia Hessheimer, Ashwin Rammohan, Brian Hogan, Carmen Vinaixa, David Nasralla, David Victor, Eleonora De Martin, Felipe Alconchel, Garrett Roll, Gokhan Kabacam, Gonzalo Sapisochin, Isabel Campos-Varela, Jiang Liu, Madhukar S. Patel, Manhal Izzy, Marit Kalisvaart, Megan Adams, Nicholas Goldaracena, Roberto Hernandez-Alejandro, Ryan Chadha, Tamer Mahmoud Shaker, Tarunjeet S. Klair, Terry Pan, Tomohiro Tanaka, Uzung Yoon, Varvara Kirchner, Vivienne Hannon, Yee Lee Cheah, Carlo Frola, Clare Morkane, Don Milliken, Georg Lurje, Jonathan Potts, Thomas Fernandez, Adam Badenoch, Ahmed Mukhtar, Alberto Zanetto, Aldo Montano-Loza, Alfred Kow Wei Chieh, Amol Shetty, Andre DeWolf, Andrea Olmos, Anna Mrzljak, Annabel Blasi, Annalisa Berzigotti, Ashish Malik, Akila Rajakumar, Brian Davidson, Bryan O'Farrell, Camille Kotton, Charles Imber, Choon Hyuck David Kwon, Christopher Wray, Chul-Soo Ahn, Claus Krenn, Cristiano Quintini, Daniel Maluf, Daniel Santa Mina, Daniel Sellers, Deniz Balci, Dhupal Patel, Dianne LaPointe Rudow, Diethard Monbaliu, Dmitri Bezinover, Dominik Krzanicki, Dong-Sik Kim, Elizabeth Brombosz, Emily Blumberg, Emmanuel Weiss, Emmanuel Wey, Fady Kaldas, Faouzi Saliba, Gabriella Pittau, Gebhard Wagener, Gi-Won Song, Gianni Biancofiore, Gonzalo Crespo, Gonzalo Rodríguez, Graciela Martinez Palli, Gregory McKenna, Henrik Petrowsky, Hiroto Egawa, Iman Montasser, Jacques Pirenne, James Eason, James Guarrera, James Pomposelli, Jan Lerut, Jean Emond, Jennifer Boehly, Jennifer Towey, Jens G Hillingsø, Jeroen de Jonge, Juan Caicedo, Julie Heimbach, Juliet Ann Emamaullee, Justyna Bartoszko, Ka Wing Ma, Kate Kronish, Katherine T. Forkin, Kenneth Siu Ho Chok, Kim Olthoff, Koen Reyntjens, Kwang-Woong Lee, Kyung-Suk Suh, Linda Denehy, Luc J.W. van der Laan, Lucas McCormack, Lucy Gorvin, Luis Ruffolo, Mamatha Bhat, María Amalia Matamoros Ramírez, Maria-Carlota Londoño, Marina Gitman, Mark Levstik, Martin de Santibañes, Martine Lindsay, Matteo Parotto, Matthew Armstrong, Mureo Kasahara, Nick Schofield, Nicole Rizkalla, Nobuhisa Akamatsu, Olivier Scatton, Onur Keskin, Oscar Imventarza, Oya Andacoglu, Paolo Muiesan, Patricia Giorgio, Patrick Northup, Paulo Matins, Peter Abt, Philip N Newsome, Philipp Dutkowski, Pooja Bhangui, Prashant Bhangui, Puneeta Tandon, Raffaele Brustia, Raymond Planinsic, Robert Brown, Robert Porte, Rolf Barth, Rubén Ciria, Sander Florman, Sebastien Dharancy, Sher-Lu Pai, Shintaro Yagi, Silvio Nadalin, Srinath Chinnakotla, Stuart J Forbes, Suehana Rahman, Suk Kyun Hong, Sun Liying, Susan Orloff, Susan Rubman, Susumu Eguchi, Toru Ikegami, Trevor Reichman, Utz Settmacher, Varuna Aluvihare, Victor Xia, Young-In Yoon, Yuji Soejima, Yuri Genyk, Arif Jalal, Aditya Borakati, Adrian Gustar, Ahmed Mohamed, Alejandro Ramirez, Alex Rothnie, Aneya Scott, Anika Sharma, Annalise Munro, Arun Mahay, Belle Liew, Camila Hidalgo, Cara Crouch, Cheung Tsz Yan, Christoph Tschuor, Conrad Shaw, Dimitrios Schizas, Dominic Fritche, Fabia Ferdousi Huda, Gemma Wells, Giselle Farrer, Hiu Tat Kwok, Ioannis Kostakis, Joao Mestre-Costa, Ka Hay Fan, Ka Siu Fan, Kyra Fraser, Lelia Jeilani, Li Pang, Lorenzo Lenti, Manikandan Kathirvel, Marinos Zachiotis, Michail Vailas, Michele Mazza Milan, Mohamed Elnagar, Mohammad Alradhawi, Nikolaos Dimitrokallis, Nikolaos Machairas, Nolitha Morare, Oscar Yeung, Pragalva Khanal, Pranav Satish, Shahi Abdul Ghani, Shahroo Makhdoom, Sithhipratha Arulrajan, Stephanie Bogan, Stephanos Pericleous, Timon Blakemore, Vanessa Otti, Walter Lam, Whitney Jackson, and Zakee Abdi
Subjects: Consensus, Hepatology, Gastroenterology, Living Donors, Humans, Liver Transplantation
Abstract: There is much controversy regarding enhanced recovery for recipients of liver transplants from deceased and living donors. The objectives of this Review were to summarise current knowledge on individual enhanced recovery elements on short-term outcomes, identify key components for comprehensive pathways, and create internationally accepted guidelines on enhanced recovery for liver-transplant recipients. The ERAS4OLT.org collaborative partnered by the International Liver Transplantation Society performed systematic literature reviews on the effect of 32 relevant enhanced perioperative recovery elements on short-term outcomes, and global specialists prepared expert statements on deceased and living donor liver transplantation. The Grading Recommendations, Assessment, Development and Evaluations approach was used for rating of quality of evidence and grading of recommendations. A virtual international consensus conference was held in January, 2022, in which results were presented, voted on by the audience, and discussed by an independent international jury of eight members, applying the Danish model of consensus. 273 liver transplantation specialists from 30 countries prepared expert statements on elements of enhanced recovery for liver transplantation based on the systematic literature reviews. The consensus conference yielded 80 final recommendations, covering aspects of enhanced recovery for preoperative assessment and optimisation, intraoperative surgical and anaesthetic conduct, and postoperative management for the recipients of liver transplants from both deceased and living donors, and for the living donor. The recommendations represent a comprehensive overview of the relevant elements and areas of enhanced recovery for liver transplantation. These internationally established guidelines could direct the development of enhanced recovery programmes worldwide, allowing adjustments according to local resources and practices.
Published: 2022

32. French survey on a cohort of emergency general surgery modifications induced by lockdown of the SARS-CoV-2 pandemic

Author: Clement, Julien, Pauline, Duconseil, Diane, Mege, Damien, Massalou, Todor, Ivanov, Raffaele, Brustia, Ghislain, Pauleau, Stéphane V, Berdah, Thierry, Bège, Charles, Vanbrugghe, CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: medicine.medical_specialty, Multivariate analysis, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Acute abdominal surgery, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Humans, Medicine, In patient, 030212 general & internal medicine, Pandemics, Medical treatment, SARS-CoV-2, business.industry, General surgery, COVID-19, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, General Medicine, 3. Good health, Communicable Disease Control, Cohort, Original Article, Loss of chance, Digestive surgery, business, Healthcare system
Abstract: International audience; Purpose: The brutal COVID-19 pandemic has majorly impacted populations and health systems, and surgeons have observed dramatic changes in their daily clinical activities. A survey of French digestive surgeons was conducted to assess these changes.Methods: An electronic survey was sent to French digestive and general surgeons in the Societe Francaise de Chirurgie Digestive (SFCD) to assess the surgeons' daily activity during the pandemic and investigate changes in patients' management. The care deviations were classified as delay of management, modification of strategy, or modification of organization, and the impact of these changes on patients was evaluated by the surgeon's estimation of loss of chance.Results: A major reduction in surgical elective activity was observed in 50 (75%) of the 67 hospitals that responded. Of these, 48 hospitals (71.6%) reported receiving SARS-CoV-2 patients. A deviation from usual care was observed in 10% of patients admitted for emergency general surgery. Among 140 patients presenting a deviation from usual care, 74 (52.9%) had delayed management, 53 (37.9%) had a modification of strategy, and 64 (45.7%) had a modification of organization. Medical treatment instead of surgical treatment was decided for 37 (26.4%) patients, resulting in a high loss of chance for 6 patients. Delays (p < 0.001) and a switch from surgical to medical treatment (p = 0.002) were independently correlated with overall loss of chance based on multivariate analysis.Conclusion: This study highlighted the deviations in general emergency surgery patients and provided implications for the solutions that should be implemented during a new health crisis.
Published: 2021

33. Somatostatin perfusion and modulation of portal inflow after major liver resection: Response to 'Post hepatectomy liver failure (PHLF)-Recent advances in prevention and clinical management'

Author: P. Zimmermann, Raffaele Brustia, Daniele Sommacale, Rami Rhaiem, Reza Kianmanesh, Tullio Piardi, and Martin Lhuaire
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Urology, Liver failure, General Medicine, Resection, Somatostatin, Oncology, Medicine, Surgery, Hepatectomy, business, Perfusion
Published: 2021

34. Transarterial radioembolisation in non resectable hepatocellular carcinoma in curative strategies: a single centre experience

Author: Helene Regnault, Clara Perrin, Giuliana Amaddeo, Sebastien Mulé, Hicham Kobeiter, Edouard Reizine, Emmanuel Itti, Christophe Duvoux, Alexis Laurent, Vincent Leroy, Raffaele Brustia, Daniele Sommacale, Françoise Roudot-Thoraval, Lerman Lionel, Alain Luciani, Julien Calderaro, Julia Chalaye, Vania Tacher, and Athena Galletto
Subjects: Hepatology
Published: 2022

35. Guidelines for Perioperative Care for Liver Transplantation: Enhanced Recovery After Surgery (ERAS) Recommendations

Author: Nicolas Demartines, Olivier Scatton, Helen Usher, Stephen J. Wigmore, Damiano Patrono, Eduardo Schiffer, Raffaele Brustia, Wellington Andraus, Emily Baird, Olivier Detry, Marieke T. de Boer, Stefano Skurzak, Gonzalo Rodriguez Laiz, Antoine Monsel, François Martin Carrier, Franck Vandenbroucke-Menu, Paulo Melgar, Philippe Compagnon, Abdourahamane Kaba, Luiz Marcelo Sá Malbouisson, Miriam Zeillemaker-Hoekstra, Gianni Biancofiore, Toshimi Kaido, Shinji Uemoto, Koen Reyntjen, Susan L. Orloff, and Carlijn I. Buis
Subjects: LIMITATIONS, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, 030230 surgery, Liver transplantation, Perioperative Care, DELPHI TECHNIQUE, 03 medical and health sciences, DOUBLE-BLIND, Postoperative Complications, 0302 clinical medicine, IMMUNONUTRITION, HYPERGLYCEMIA, CENTER VOLUME, medicine, MANAGEMENT, Humans, Prospective Studies, Intensive care medicine, Prospective cohort study, Enhanced recovery after surgery, Transplantation, OUTCOMES, ddc:617, business.industry, Perioperative, Length of Stay, medicine.disease, Liver Transplantation, 3. Good health, Malnutrition, RECIPIENTS, UNIT, Perioperative care, Nasogastric intubation, 030211 gastroenterology & hepatology, Enhanced Recovery After Surgery, business
Abstract: BACKGROUND: Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based, program of care developed to minimize the response to surgical stress, associated with reduced perioperative morbidity and hospital stay. This study presents the specific ERAS Society recommendations for liver transplantation (LT) based on the best available evidence and on expert consensus. METHODS: PubMed and ClinicalTrials.gov were searched in April 2019 for published and ongoing RCTs on LT in the last 15 years. Studies were selected by 5 independent reviewers, and were eligible if focusing on each validated ERAS items in the area of adult LT. An e-Delphi method was used with an extended interdisciplinary panel of experts to validate the final recommendations. RESULTS: Forty-three articles were included in the systematic review. Consensus was reached among experts after the second round. Patients should be screened for malnutrition and treated whenever possible. Prophylactic nasogastric intubation and prophylactic abdominal drainage may be omitted, and early extubation should be considered. Early oral intake, mobilization and multimodal-balanced analgesia are recommended. CONCLUSIONS: The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the e-Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.PROSPERO CRD4201913279.
Published: 2022

36. New ERAS in liver transplantation - Past, present, and next steps

Author: Vivienne N, Hannon, Pascale, Tinguely, Greg J, McKenna, Raffaele, Brustia, Fady M, Kaldas, Olivier, Scatton, Michael, Spiro, Dimitri Aristotle, Raptis, Ronald W, Busuttil, and Goran B, Klintmalm
Subjects: Transplantation, Consensus, Humans, Length of Stay, Enhanced Recovery After Surgery, Liver Transplantation
Abstract: There are parallels between the history of Enhanced Recovery after Surgery (ERAS) and liver transplantation. Both have been established and advanced by innovative individuals, often going against perceived wisdom and convention. Liver transplantation has traditionally been considered too complex for ERAS pathways, despite a small number of trials showing them to be both safe and of benefit. To date, there are very few randomized controlled trials and cohort studies publishing outcomes on liver transplant patients enrolled in comprehensive ERAS pathways. To progress our field, the 2022 International Liver Transplantation Society's Consensus Conference has created expert panels to analyze the evidence in 32 domains of the liver transplantation pathway using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to generate expert recommendations. These recommendations will be voted on by the international community to gain consensus using the Danish model, and create the ERAS4OLT.org Enhanced Recovery after Liver Transplantation Pathway.
Published: 2022

37. Educational interventions to integrate surgical staff within medical units during the COVID-19 pandemic: EDUCOVID survey

Author: Raffaele Brustia, Giuliana Amaddeo, Rami Rhaiem, Eric Levesque, Antoine Monsel, Vanessa Baaroun, Mylène Dimmock, Marc-Antoine Rousseau, Oriane Wagner-Ballon, Francoise Botterel, Pascal Andujar, Daniele Sommacale, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), IMRB - VHC/'Viruses-Hepatology-Cancers' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Chirurgie Digestive Hépato-Billiaire [Henri Mondor], Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Immunologie - Immunopathologie - Immunothérapeutique (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital universitaire Robert Debré [Reims], Université de Reims Champagne-Ardenne (URCA), École nationale vétérinaire - Alfort (ENVA), Dynamic Microbiology - EA 7380 (DYNAMIC), École nationale vétérinaire - Alfort (ENVA)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université Paris-Est (UPE)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Université Paris Diderot - Paris 7 (UPD7), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), CHI Créteil, and Brustia, Raffaele
Subjects: [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, educational intervention, pandemic, 2019-nCoV, COVID-19, Surgery, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, General Medicine, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, medical education, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Abstract: International audience; Background: The SARS-CoV-2 (COVID-19) pandemic required a rapid surge of healthcare capacity to face a growing number of critically ill patients. For this reason, a support reserve of physicians, including surgeons, were required to be reassigned to offer support.Objective: To realize a survey on the educational programs deployed (face-to-face or e-learning focusing on infective area, basic gestures, COVID clinical management and intensive care medicine), and their impact on behavior change (Kirkpatrick 3) of the target population of surgeons, measured on a five modalities Likert scale.Design: Cross-sectional online e-survey (NCT04732858) within surgeons from the Assistance Publique - Hôpitaux de Paris network, metropolitan area of Paris, France.Results: Cross-sectional e-Survey: among 382 surgeons invited, 37 (9.7%) participated. The effectiveness of the educational interventions on behavior changes was rated within the highest region of the Likert scale by 15% (n = 3) and 22% (n = 6) for 'e-learning' and 'face-to-face' delivery modes, respectively.Conclusions: Despite the low response rate, this survey suggests an overall low impact on behaviour change among responders affiliated to a surgical discipline.
Published: 2022

38. Cholangiocarcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry

Author: Laura Izquierdo-Sanchez, Angela Lamarca, Adelaida La Casta, Stefan Buettner, Kirsten Utpatel, Heinz-Josef Klümpen, Jorge Adeva, Arndt Vogel, Ana Lleo, Luca Fabris, Mariano Ponz-Sarvise, Raffaele Brustia, Vincenzo Cardinale, Chiara Braconi, Gianpaolo Vidili, Nigel B. Jamieson, Rocio IR. Macias, Jan Philipp Jonas, Marco Marzioni, Wacław Hołówko, Trine Folseraas, Juozas Kupčinskas, Zeno Sparchez, Marcin Krawczyk, Łukasz Krupa, Viorel Scripcariu, Gian Luca Grazi, Ana Landa-Magdalena, Jan NM. Ijzermans, Katja Evert, Joris I. Erdmann, Flora López-López, Anna Saborowski, Alexander Scheiter, Alvaro Santos-Laso, Guido Carpino, Jesper B. Andersen, Jose JG. Marin, Domenico Alvaro, Luis Bujanda, Alejandro Forner, Juan W. Valle, Bas Groot Koerkamp, Jesus M. Banales, European Commission, Internal medicine, Surgery, CCA - Cancer Treatment and quality of life, Oncology, and CCA - Cancer Treatment and Quality of Life
Subjects: Male, CA-19-9 Antigen, diagnosis, International Classification of Diseases 11 edition (ICD-11), International Classification of Diseases 11, NO, Cholangiocarcinoma, SDG 3 - Good Health and Well-being, risk factors, Humans, Registries, Intrahepatic, Manchester Cancer Research Centre, Hepatology, treatment, ResearchInstitutes_Networks_Beacons/mcrc, subtypes, edition (ICD-11), International Classification of Diseases 11(th) edition (ICD-11), cholangiocarcinoma, prognosis, bile ducts, intrahepatic, CA-19-9 antigen, female, humans, male, registries, bile duct neoplasms, Prognosis, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, th, Female, Bile Ducts, International Classification of Diseases 11th edition (ICD-11)
Abstract: Background & Aims: Cholangiocarcinoma (CCA) is a rare and heterogeneous biliary cancer, whose incidence and related mortality is increasing. This study investigates the clinical course of CCA and subtypes (intrahepatic [iCCA], perihilar [pCCA], and distal [dCCA]) in a pan-European cohort. Methods: The ENSCCA Registry is a multicenter observational study. Patients were included if they had a histologically proven diagnosis of CCA between 2010-2019. Demographic, histomorphological, biochemical, and clinical studies were performed. Results: Overall, 2,234 patients were enrolled (male/female=1.29). iCCA (n = 1,243) was associated with overweight/ obesity and chronic liver diseases involving cirrhosis and/or viral hepatitis; pCCA (n = 592) with primary sclerosing cholangitis; and dCCA (n = 399) with choledocholithiasis. At diagnosis, 42.2% of patients had local disease, 29.4% locally advanced disease (LAD), and 28.4% metastatic disease (MD). Serum CEA and CA199 showed low diagnostic sensitivity, but their concomitant elevation was associated with increased risk of presenting with LAD (odds ratio 2.16; 95% CI 1.43-3.27) or MD (odds ratio 5.88; 95% CI 3.69-9.25). Patients undergoing resection (50.3%) had the best outcomes, particularly with negative-resection margin (R0) (median overall survival [mOS] = 45.1 months); however, margin involvement (R1) (hazard ratio 1.92; 95% CI 1.53-2.41; mOS = 24.7 months) and lymph node invasion (hazard ratio 2.13; 95% CI 1.55-2.94; mOS = 23.3 months) compromised prognosis. Among patients with unresectable disease (49.6%), the mOS was 10.6 months for those receiving active palliative therapies, mostly chemotherapy (26.2%), and 4.0 months for those receiving best supportive care (20.6%). iCCAs were associated with worse outcomes than p/dCCAs. ECOG performance status, MD and CA19-9 were independent prognostic factors. Conclusion: CCA is frequently diagnosed at an advanced stage, a proportion of patients fail to receive cancer-specific therapies, and prognosis remains dismal. Identification of preventable risk factors and implementation of surveillance in high-risk populations are required to decrease cancer-related mortality. Lay summary: This is, to date, the largest international (pan-European: 26 hospitals and 11 countries) observational study, in which the course of cholangiocarcinoma has been investigated, comparing the 3 subtypes based on the latest International Classification of Diseases 11th Edition (ICD-11) (i.e., intrahepatic [2C12], perihilar [2C18], or distal [2C15] affected bile ducts), which come into effect in 2022. General and tumor-type specific features at diagnosis, risk factors, biomarker accuracy, as well as patient management and outcomes, are presented and compared, outlining the current clinical state of cholangiocarcinoma in Europe. The ENSCCA Registry is competitively funded by the European Association for the Study of the Liver (EASL; Registry grant awards 2016 and 2019) and Incyte Pharma (grant award 2020 to JMB). JMB also received grants from Spanish Carlos III Health Institute (ISCIII) [FIS PI18/01075,PI21/00922 and Miguel Servet Program CPII19/00008), CIBERehd (ISCIII), Department of Health of the Basque Country (2017111010), BIOEF (Basque Foundation for Innovation and Health Research: EiTB Maratoia BIO15/CA/016/BD), "Fundacion Cientifica de la Asociacion Espanola Contra el Cancer" (AECC Scientific Foundation) and the European Union's Horizon 2020 Research and Innovation Program [grant number 825510, ESCALON: to JMB, AL, AV and JWV]. AL also received funding from The Christie Charity. AF received grant support from ISCIII (PI18/00542). CB is recipient of the Lord Kelvin Adam Smith Leadership fellowship at University of Glasgow. ALl was funded by "Fondazione AIRC per la Ricerca sul Cancro" (IG2019 project number 23408). RIRM received grant support from ISCIII (PI20/00189), co-funded ERDF/ESF, "A way to make Europe"/"Investing in your future" and "Centro Internacional sobre el Envejecimiento" (0348_CIE_6_E), Spain. JJGM received grant support from ISCIII (PI19/00819), CIBERehd (ISCIII), "Fundacio la Marato de TV3" (201916-31) and Junta de Castilla y Leon (SA074P20), Spain. NBJ received grant support from Cancer Research UK (grant number A25813), and is a recipient of the Lord Kelvin Adam Smith Leadership fellowship at the University of Glasgow.
Published: 2022

39. Liver transplantation for hepatocellular carcinoma after successful treatment of macrovascular invasion – a multi‐center retrospective cohort study

Author: Michela Assalino, Giulio Cesare Vitali, Marco Bongini, Neil Mehta, Sylvain Terraz, Enrico Gringeri, Laura Kulik, Axel Andres, Philippe Compagnon, Quirino Lai, M. Grat, Raffaele Brustia, Christian Toso, Thierry Berney, Pietro Majno, Olivier Scatton, Vatche G. Agopian, Neeta Vachharajani, Vincenzo Mazzaferro, Parissa Tabrizian, Krzysztof Zieniewicz, Umberto Cillo, and William C. Chapman
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, 030230 surgery, Liver transplantation, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, In patient, Contraindication, Neoplasm Staging, Retrospective Studies, Transplantation, liver transplantation, downstaging, hepatocellular carcinoma, locoregional therapy, macrovascular invasion, tumor recurrence, business.industry, Medical record, Liver Neoplasms, Retrospective cohort study, medicine.disease, digestive system diseases, Treatment Outcome, Multicenter study, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, alpha-Fetoproteins, Neoplasm Recurrence, Local, business
Abstract: Macrovascular invasion is considered a contraindication to liver transplantation for hepatocellular carcinoma (HCC) due to a high risk of recurrence. The aim of the present multicenter study was to explore the outcome of HCC patients transplanted after a complete radiological regression of the vascular invasion by locoregional therapies and define sub-groups with better outcomes. Medical records of 45 patients were retrospectively reviewed, and imaging was centrally assessed by an expert liver radiologist. In the 30 patients with validated diagnosis of macrovascular invasion, overall survival was 60% at 5 years. Pretransplant alpha-fetoprotein (AFP) value was significantly different between patients with and without recurrence (P = 0.019), and the optimal AFP cutoff was 10ng/ml (area under curve = 0.78). Recurrence rate was 11% in patients with pretransplant AFP < 10ng/ml. The number of viable nodules (P = 0.008), the presence of residual HCC (P = 0.036), and satellite nodules (P = 0.001) on the explant were also significantly different between patients with and without recurrence. Selected HCC patients with radiological signs of vascular invasion could be considered for transplantation, provided that they previously underwent successful treatment of the macrovascular invasion resulting in a pretransplant AFP < 10 ng/ml. Their expected risk of post-transplant HCC recurrence is 11%, and further prospective validation is needed.
Published: 2020

40. Nestin as a diagnostic and prognostic marker for combined hepatocellular-cholangiocarcinoma

Author: Julien Calderaro, Luca Di Tommaso, Pascale Maillé, Aurélie Beaufrère, Cong Trung Nguyen, Lara Heij, Viviane Gnemmi, Rondell P. Graham, Frédéric Charlotte, Suzanne Chartier, Dominique Wendum, Mukul Vij, Daniela Allende, Alba Diaz, Carla Fuster, Benjamin Rivière, Astrid Herrero, Jérémy Augustin, Katja Evert, Diego Francesco Calvisi, Wei Qiang Leow, Howard Ho Wai Leung, Jan Bednarsch, Emmanuel Boleslawski, Mohamed Rela, Anthony Wing-Hung Chan, Alejandro Forner, Maria Reig, Anaïs Pujals, Loetitia Favre, Manon Allaire, Olivier Scatton, Arnaud Uguen, Eric Trépo, Lukas Otero Sanchez, Denis Chatelain, Myriam Remmelink, Camille Boulagnon-Rombi, Céline Bazille, Nathalie Sturm, Benjamin Menahem, Eric Frouin, David Tougeron, Christophe Tournigand, Emmanuelle Kempf, Haeryoung Kim, Massih Ningarhari, Sophie Michalak-Provost, Jakob Nikolas Kather, Annette S.H. Gouw, Purva Gopal, Raffaele Brustia, Eric Vibert, Kornelius Schulze, Darius F. Rüther, Sören A. Weidemann, Rami Rhaiem, Jean-Charles Nault, Alexis Laurent, Giuliana Amaddeo, Hélène Regnault, Eleonora de Martin, Christine Sempoux, Pooja Navale, Jayendra Shinde, Ketan Bacchuwar, Maria Westerhoff, Regina Cheuk-Lam Lo, Mylène Sebbagh, Catherine Guettier, Marie Lequoy, Mina Komuta, Marianne Ziol, Valérie Paradis, Jeanne Shen, Stefano Caruso, Hôpital Henri Mondor, Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Pathologie [Hôpital Beaujon - APHP], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 (CANTHER), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), CHU Lille, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Université libre de Bruxelles (ULB), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Laboratoire de Signalisation et Récepteurs Matriciels (SiRMa), Matrice extracellulaire et dynamique cellulaire - UMR 7369 (MEDyC), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS)-Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS), Imagerie et Stratégies Thérapeutiques des pathologies Cérébrales et Tumorales (ISTCT), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Département de Pathologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Grenoble, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Viscérale et Digestive [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Groupe Henri Mondor-Albert Chenevier, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Johns Hopkins University (JHU), Hôpital Claude Huriez [Lille], Physiopathologie et traitement des maladies du foie, Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Centre Hospitalier Universitaire de Reims (CHU Reims), Génomique fonctionnelle des tumeurs solides = Functional Genomics of Solid Tumors [CRC] (FunGeST), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Labex OncoImmunology, Equipe labellisée Ligue Contre le Cancer, Université Paris Descartes - Paris 5 (UPD5), Service d'Hépatologie [Avicenne], Hôpital Avicenne [AP-HP], Unité de Formation et de Recherche Santé, Médecine, Biologie Humaine [Bobigny], Université Paris 13 (UP13)-Sorbonne Paris Cité, Danmarks Tekniske Universitet = Technical University of Denmark (DTU), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Crosscope, University of Michigan [Ann Arbor], University of Michigan System, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d’Anatomie Pathologique [CHU Beaujon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Beaujon [AP-HP], Labex Immuno-oncology [Paris] ( Université Paris Descartes - Paris 5 - PRES Sorbonne Paris Cité), Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité, Service d'Anatomie et cytologie pathologiques [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Anatomie et cytologie pathologiques = Service de Pathologie [CHU Pitié-Salpêtrière] (ACP), CHU Henri Mondor, Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS)-Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE), Service d'Hépato-gastro-entérologie [CHU Saint-Antoine], and Groningen Institute for Organ Transplantation (GIOT)
Subjects: Carcinoma, Hepatocellular, Hepatology, combined hepatocellular-cholangiocarcinoma, Liver Neoplasms, hepatocellular carcinoma, liver, Prognosis, Nestin, Cholangiocarcinoma, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, cancer, Humans, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background & Aims: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer (PLC) associated with a poor prognosis. Given the challenges in its identification and its clinical implications, biomarkers are critically needed. We aimed to investigate the diagnostic and prognostic value of the immunohistochemical expression of Nestin, a progenitor cell marker, in a large multicentric series of PLCs.Methods: We collected 461 cHCC-CCA samples from 32 different clinical centers. Control cases included 368 hepatocellular carcinomas (HCCs) and 221 intrahepatic cholangiocarcinomas (iCCAs). Nestin immunohistochemistry was performed on whole tumor sections. Diagnostic and prognostic performances of Nestin expression were determined using receiver-operating characteristic curves and Cox regression modeling.Results: Nestin was able to distinguish cHCC-CCA from HCC with AUCs of 0.85 and 0.86 on surgical and biopsy samples, respectively. Performance was lower for the distinction of cHCC-CCA from iCCA (AUCs of 0.59 and 0.60). Nestin, however, showed a high prognostic value, allowing identification of the subset of cHCC-CCA (“Nestin High”, >30% neoplastic cells with positive staining) associated with the worst clinical outcome (shorter disease-free and overall survival) after surgical resection and liver transplantation, as well as when assessment was performed on biopsies.Conclusion: We show in different clinical settings that Nestin has diagnostic value and that it is a useful biomarker to identify the subset of cHCC-CCA associated with the worst clinical outcome. Nestin immunohistochemistry may be used to refine risk stratification and improve treatment allocation for patients with this highly aggressive malignancy. Lay summary: There are different types of primary liver cancers (i.e. cancers that originate in the liver). Accurately identifying a specific subtype of primary liver cancer (and determining its associated prognosis) is important as it can have a major impact on treatment allocation. Herein, we show that a protein called Nestin could be used to refine risk stratification and improve treatment allocation for patients with combined hepatocellular carcinoma, a rare but highly aggressive subtype of primary liver cancer.
Published: 2021

41. Robotic-assisted posterior sectionectomy and hanging maneuver – with video

Author: Jacopo Galvanin, Daniele Sommacale, and Raffaele Brustia
Subjects: General Medicine
Published: 2022

42. Liver Venous Deprivation or Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy?: A Retrospective Multicentric Study

Author: Stéphanie Truant, Alexandre Chebaro, Alexandre Didier, François-René Pruvot, Fabrice Muscari, Mehdi El Amrani, Ercin Sonmez, Emmanuel Buc, Marie Bougard, Yuki Kitano, Christophe Laurent, Ahmet Ayav, Laurence Chiche, Katia Lecolle, René Adam, Laurent Sulpice, C. Maulat, Raffaele Brustia, Thibault Durin, Daniele Sommacale, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, CHU Bordeaux [Bordeaux], CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Paul Brousse, Université Paris-Saclay, Kumamoto University, Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 (CANTHER), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), CHU Henri Mondor [Créteil], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rennes (UR), CHU Lille, Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hépato-Biliaire [Hôpital Paul Brousse] (CHB), and Hôpital Paul Brousse-Assistance Publique - Hôpitaux de Paris
Subjects: Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Portal vein ligation, 030230 surgery, Hepatic Veins, Muscle hypertrophy, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Medicine, Hepatectomy, Humans, Embolization, Vein, Prospective cohort study, Ligation, Aged, Retrospective Studies, Aged, 80 and over, Chemotherapy, business.industry, Portal Vein, Liver Neoplasms, Middle Aged, French Editorial from the ACHBPT, Embolization, Therapeutic, Surgery, Intention to Treat Analysis, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Partition (politics), Feasibility Studies, Female, business
Abstract: International audience; OBJECTIVE: To compare two techniques of remnant liver hypertrophy in candidates for extended hepatectomy: radiological simultaneous portal vein (PVE) and hepatic vein embolization (HVE); namely liver venous deprivation (LVD), and ALPPS. SUMMARY BACKGROUND DATA: Recent advances in chemotherapy and surgical techniques have widened indications for extended hepatectomy, before which remnant liver augmentation is mandatory. ALPPS and LVD typically show higher hypertrophy rates than PVE, but their respective places in patient management remain unclear. METHODS: All consecutive ALPPS and LVD procedures performed in eight French centers between 2011 and 2020 were included. The main endpoint was the successful resection rate (resection rate without 90-day mortality) analyzed according to an intention-to-treat principle. Secondary endpoints were hypertrophy rates, intra- and post-operative outcomes. RESULTS: Among 209 patients, 124 had LVD 37 [13,1015] days before surgery, while 85 underwent ALPPS with an inter-stages period of 10 [6, 69] days. ALPPS was mostly-performed for colorectal liver metastases (CRLM), LVD for CRLM and perihilar cholangiocarcinoma. Hypertrophy was faster for ALPPS. Successful resection rates were 72.6% for LVD ± rescue ALPPS (n=6) versus 90.6% for ALPPS (p
Published: 2021

43. Enhanced recovery in liver transplantation: A value-based approach to complex surgical care, but compliance is missing

Author: Raffaele Brustia, Daniele Sommacale, and Olivier Scatton
Subjects: Postoperative Complications, Humans, Surgery, Length of Stay, Perioperative Care, Liver Transplantation
Published: 2022

44. Liver resection for single large hepatocellular carcinoma: a prognostic factors study

Author: Giuliana Amaddeo, Vincent Nguyen-Khac, Rami Rhaiem, Vincent Leroy, Helene Regnault, Raffaele Brustia, Alexis Laurent, Françoise Roudot-Thoraval, and Daniele Sommacale
Subjects: Hepatology
Published: 2022

45. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author: Roberto Bini, Boris Sakakushev, Carlos Domingo, Michele Pisano, Nassiba Beghdadi, Christian Cotsoglou, Giorgos Veloudis, Fikri M. Abu-Zidan, Franca Patrizi, Federica Gaiani, Mario Serradilla-Martin, Ronald V. Maier, Amine Benkabbou, Daniel Casanova, Marco Ceresoli, Anne Sophie Schneck, Angela Gurrado, Niccolò Allievi, Maria Clotilde Carra, Daniele Sommacale, Philip R. de Reuver, Gian Luigi de’Angelis, Salomone Di Saverio, Fernando Machado, Roberto Valinas, Felice Giuliante, Roberta Iadarola, Stefania Cimbanassi, Offir Ben-Ishay, Manuel Planells, Raffaele Romito, Richard P. G. ten Broek, Serena Langella, Giulio Cesare Vitali, Federico Gheza, Jeffry L. Kashuk, Miklosh Bala, Belinda De Simone, Nicola de’Angelis, Osvaldo Chiara, Umberto Maggi, Maria Conticchio, Raffaele Brustia, Olivier Scatton, Rami Rhaiem, Valerio Celentano, Juan Carlos Puyana, Alessandro Ferrero, Luca Ansaloni, Bruno M. Pereira, Stefan Hofmeyr, Alain Chichom Mefire, Francesco Decembrino, Giuliana Amaddeo, Bertrand Le Roy, Réal Lapointe, Francesco Brunetti, Kazuhiro Hiramatsu, Walter L. Biffl, Ruslan Alikhanov, Oreste Romeo, Mario Testini, Iradj Sobhani, Luigi Zorcolo, Luca Portigliotti, Reza Kianmanesh, Mohammad Azfar, Andrea De Palma, Andrew W. Kirkpatrick, Ewen M Harrison, Federico Coccolini, Enrico Andolfi, Roland Andersson, Alain Luciani, Andrew B. Peitzman, Aleix Martínez-Pérez, Yoram Kluger, Gustavo Pereira Fraga, Juan Pekolj, Dieter G. Weber, Behnam Sanei, Carlos A. Ordoñez, Fausto Catena, Giorgio Bianchi, Angel Henriquez, Riccardo Memeo, Fabiano Perdigao, Francesco Marchegiani, David Fuks, Marc Antoine Allard, Mohammed Lamine Sissoko, Raul Coimbra, Patrick Pessaux, Paschalis Gavriilidis, Filippo Landi, Tullio Piardi, Sandro Rizoli, De'Angelis, N, Catena, F, Memeo, R, Coccolini, F, Martinez-Perez, A, Romeo, O, De Simone, B, Di Saverio, S, Brustia, R, Rhaiem, R, Piardi, T, Conticchio, M, Marchegiani, F, Beghdadi, N, Abu-Zidan, F, Alikhanov, R, Allard, M, Allievi, N, Amaddeo, G, Ansaloni, L, Andersson, R, Andolfi, E, Azfar, M, Bala, M, Benkabbou, A, Ben-Ishay, O, Bianchi, G, Biffl, W, Brunetti, F, Carra, M, Casanova, D, Celentano, V, Ceresoli, M, Chiara, O, Cimbanassi, S, Bini, R, Coimbra, R, Luigi de'Angelis, G, Decembrino, F, De Palma, A, de Reuver, P, Domingo, C, Cotsoglou, C, Ferrero, A, Fraga, G, Gaiani, F, Gheza, F, Gurrado, A, Harrison, E, Henriquez, A, Hofmeyr, S, Iadarola, R, Kashuk, J, Kianmanesh, R, Kirkpatrick, A, Kluger, Y, Landi, F, Langella, S, Lapointe, R, Le Roy, B, Luciani, A, Machado, F, Maggi, U, Maier, R, Mefire, A, Hiramatsu, K, Ordonez, C, Patrizi, F, Planells, M, Peitzman, A, Pekolj, J, Perdigao, F, Pereira, B, Pessaux, P, Pisano, M, Puyana, J, Rizoli, S, Portigliotti, L, Romito, R, Sakakushev, B, Sanei, B, Scatton, O, Serradilla-Martin, M, Schneck, A, Sissoko, M, Sobhani, I, ten Broek, R, Testini, M, Valinas, R, Veloudis, G, Vitali, G, Weber, D, Zorcolo, L, Giuliante, F, Gavriilidis, P, Fuks, D, Sommacale, D, de’Angelis, Nicola [0000-0002-1211-4916], Apollo - University of Cambridge Repository, and de'Angelis, Nicola [0000-0002-1211-4916]
Subjects: Laparoscopic surgery, medicine.medical_specialty, RD1-811, medicine.medical_treatment, Iatrogenic Disease, education, Psychological intervention, Review, 030230 surgery, Guideline, Guidelines, Sciences du Vivant [q-bio]/Médecine humaine et pathologie, behavioral disciplines and activities, Laparoscopic cholecystectomy, Biliary duct injury, Magnetic resonance imaging, Antibiotic therapy, Computed tomography, Intraoperative Period, 03 medical and health sciences, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Quality of life, medicine, Humans, Cholecystectomy, Stage (cooking), Laparoscopy, medicine.diagnostic_test, RC86-88.9, business.industry, Bile duct, Kirurgi, General surgery, Medical emergencies. Critical care. Intensive care. First aid, medicine.anatomical_structure, Quality of Life, Emergency Medicine, 030211 gastroenterology & hepatology, Surgery, Bile Ducts, business, Complication
Abstract: Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI. Supplementary Information The online version contains supplementary material available at 10.1186/s13017-021-00369-w.
Published: 2021

46. Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Daniele Sommacale, Fouad Lafdil, Olivier Scatton, Hong Son Trinh, Thi Lan Tran, Christophe Tournigand, David Gentien, Isabelle Brocheriou, Van To Ta, Cong Trung Nguyen, Giuliana Amaddeo, Jean-Charles Nault, Luca Di Tommaso, Van Ky Le, Camille Boulagnon-Rombi, Stefano Caruso, Jessica Zucman-Rossi, Patrick Soussan, Manon Allaire, Jérémy Augustin, Hélène Regnault, Alain Luciani, Aurélie Beaufrère, Julien Calderaro, Valérie Paradis, Sébastien Mulé, Vincent Leroy, Frédéric Charlotte, Audrey Rapinat, Pascale Maillé, Anaïs Pujals, Raffaele Brustia, Alexis Laurent, Rami Rhaiem, Loëtitia Favre, and Jean-Michel Pawlotsky
Subjects: Adult, Male, Cancer Research, Carcinoma, Hepatocellular, medicine.medical_treatment, Antigen presentation, Inflammation, Malignancy, Subclass, Cholangiocarcinoma, Neoplasms, Multiple Primary, Immune system, medicine, Humans, Aged, Aged, 80 and over, Innate immune system, business.industry, Liver Neoplasms, Immunotherapy, Middle Aged, medicine.disease, Treatment Outcome, Oncology, Bile Duct Neoplasms, Cancer research, Immunohistochemistry, Female, medicine.symptom, business, Forecasting
Abstract: Purpose: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare malignancy associated with an overall poor prognosis. We aimed to investigate the immune profile of cHCC-CCA and determine its impact on disease outcome. Experimental Design: We performed a multicenter study of 96 patients with cHCC-CCA. Gene expression profile was analyzed using nCounter PanCancer IO 360 Panel. Densities of main immune cells subsets were quantified from digital slides of IHC stainings. Genetic alterations were investigated using targeted next-generation sequencing. Results: Two main immune subtypes of cHCC-CCA were identified by clustering analysis: an “immune-high” (IH) subtype (57% of the cases) and an “immune-low” (IL) subtype (43% of the cases). Tumors classified as IH showed overexpression of genes related to immune cells recruitment, adaptive and innate immunity, antigen presentation, cytotoxicity, immune suppression, and inflammation (P < 0.0001). IH cHCC-CCAs also displayed activation of gene signatures recently shown to be associated with response to immunotherapy in patients with HCC. Quantification of immunostainings confirmed that IH tumors were also characterized by higher densities of immune cells. Immune subtypes were not associated with any genetic alterations. Finally, multivariate analysis showed that the IH subtype was an independent predictor of improved overall survival. Conclusions: We have identified a subgroup of cHCC-CCA that displays features of an ongoing intratumor immune response, along with an activation of gene signatures predictive of response to immunotherapy in HCC. This tumor subclass is associated with an improved clinical outcome. These findings suggest that a subset of patients with cHCC-CCA may benefit from immunomodulating therapeutic approaches.
Published: 2021

47. Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: Report of an international multicenter cohort study with propensity score matching

Author: Raffaele Brustia, Alexis Laurent, Claire Goumard, Serena Langella, Daniel Cherqui, Takayuki Kawai, Olivier Soubrane, Francois Cauchy, Olivier Farges, Benjamin Menahem, Christian Hobeika, Rami Rhaiem, Daniele Sommacale, Shinya Okumura, Stefan Hofmeyr, Alessandro Ferrero, François-René Pruvot, Jean-Marc Regimbeau, David Fuks, Eric Vibert, Olivier Scatton, Julio Abba, René Adam, Mustapha Adham, Marc-Antoine Allard, Ahmet Ayav, Daniel Azoulay, Philippe Bachellier, Pierre Balladur, Louise Barbier, Julien Barbieux, Emmanuel Boleslawski, Karim Boudjema, M. Bougard, Emmanuel Buc, Petru Bucur, Antoine Carmelo, Denis Chatelain, Jean Chauvat, Zineb Cherkaoui, Laurence Chiche, Mircea Chirica, Oriana Ciacio, Tatiana Codjia, Fabio Colli, Luciano De Carlis, Jean-Robert Delpero, Nicolas Demartines, Olivier Detry, Marcelo Dias Sanches, Momar Diouf, Alexandre Doussot, Christian Ducerf, Mehdi El Amrani, Jacques Ewald, Jean-Marc Fabre, Hervé Fagot, Simone Famularo, Léo Ferre, Francesco Fleres, Gilton Marques Fonseca, Brice Gayet, Alessandro Giacomoni, Jean-Francois Gigot, E. Girard, Nicolas Golse, Emilie Gregoire, Jean Hardwigsen, Paulo Herman, Thevi Hor, François Jehaes, Ali-Reza Kianmanesh, Shohei Komatsu, Sophie Laroche, Christophe Laurent, Yves-Patrice Le Treut, K. Lecolle, Philippe Leourier, Emilie Lermite, Mikael Lesurtel, Christian Letoublon, Paul Leyman, Jean Lubrano, Jean-Yves Mabrut, Georges Mantion, Ugo Marchese, Riccardo Memeo, Guillaume Millet, Kayvan Mohkam, André Mulliri, Fabrice Muscari, Francis Navarro, Francisco Nolasco, Takeo Nomi, Jean Nunoz, Gennaro Nuzzo, Nassima Oudafal, Gerard Pascal, Guillaume Passot, D. Patrice, Damiano Patrono, François Paye, Fabiano Perdigao, Patrick Pessaux, Niccolo Petrucciani, Gabriella Pittau, C. Ratajczak, Artigas Raventos, Lionel Rebibo, Vivian Resende, Michel Rivoire, Renato Romagnoli, Didier Roulin, Antonio Sa-Cunha, Ephrem Salame, Astrid Schielke, Lilian Schwarz, Michel Scotte, François-Regis Souche, Bertrand Suc, Michele Tedeschi, Alexandre Thobie, Boris Trechot, Stéphanie Truant, Olivier Turini, Shinji Uemoto, Xavier Unterteiner, Charles Vanbrugghe, and Jean Zemour
Subjects: medicine.medical_specialty, Cholangiocarcinoma, Cohort Studies, Postoperative Complications, Open Resection, medicine, Hepatectomy, Humans, Propensity Score, Intrahepatic Cholangiocarcinoma, Retrospective Studies, business.industry, Proportional hazards model, Hazard ratio, Perioperative, Confidence interval, Surgery, Bile Ducts, Intrahepatic, Treatment Outcome, Bile Duct Neoplasms, Liver, Propensity score matching, Laparoscopy, business, Cohort study
Abstract: Intrahepatic cholangiocarcinoma is a rare disease with a poor prognosis. In patients where surgical resection is possible, outcome is influenced by perioperative morbidity and lymph node status. Laparoscopic liver resection is associated with improved clinical and oncological outcomes in primary and metastatic liver cancer compared with open liver resection, but evidence on intrahepatic cholangiocarcinoma is still insufficient. The primary aim of this study was to compare overall survival for a large series of patients treated for intrahepatic cholangiocarcinoma by open or laparoscopic approach. Secondary objectives were to compare disease-free survival, predictors of death, and recurrence.Patients treated with laparoscopic or open liver resection for intrahepatic cholangiocarcinoma from 2000 to 2018 from 3 large international databases were analyzed retrospectively. Each patient in the laparoscopic resection group (case) was matched with 1 open resection control (1:1 ratio), through a propensity score calculated on clinically relevant preoperative covariates. Overall and disease-free survival were compared between the matched groups. Predictors of mortality and recurrence were analyzed with Cox regression, and the Textbook Outcomes were described.During the study period, 855 patients met the inclusion criteria (open liver resection = 709, 82.9%; laparoscopic liver resection = 146, 17.1%). Two groups of 89 patients each were analyzed after propensity score matching, with no significant difference regarding pre- and postoperative variables. Overall survival at 1, 3, and 5 years was 92%, 75%, and 63% in the laparoscopic liver resection group versus 92%, 58%, and 49% in the open liver resection group (P = .0043). Adjusted Cox regression revealed severe postoperative complications (hazard ratio: 10.5, 95% confidence interval [1.01-109] P = .049) and steatosis (hazard ratio: 13.8, 95% confidence interval [1.23-154] P = .033) as predictors of death, and transfusion (hazard ratio: 19.2, 95% confidence interval [4.04-91.4] P.001) and severe postoperative complications (hazard ratio: 4.07, 95% confidence interval [1.15-14.4] P = .030) as predictors of recurrence.The survival advantage of laparoscopic liver resection over open liver resection for intrahepatic cholangiocarcinoma is equivocal, given historical bias and missing data.
Published: 2021

48. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area

Author: Olivier Seror, Daniele Sommacale, Alain Luciani, Nathalie Ganne-Carrié, Pierre Balladur, Violaine Ozenne, Manon Allaire, Ailton Sepulveda, François Cauchy, Clémence Hollande, Giuliana Amaddeo, Lorraine Blaise, Hélène Regnault, Marco Dioguardi Burgio, François Paye, Mohamed Bouattour, Chetana Lim, Pierre-Philippe Massault, Vincent Leroy, Anthony Dohan, Edouard Larrey, Stanislas Pol, Françoise Roudot-Thoraval, Raffaele Brustia, Sanaa El Mouhadi, Olivier Scatton, Marie Lequoy, Valérie Vilgrain, Jean-Charles Nault, CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Cirrhosis, Hepatocellular carcinoma, medicine.medical_treatment, TACE, Trans-arterial-chemo-embolization, Liver transplantation, law.invention, MTB, multi-disciplinary tumour board, MELD, Model for End stage Liver Disease, 0302 clinical medicine, Model for End-Stage Liver Disease, Interquartile range, law, Immunology and Allergy, OR, Odd Ratio, AP-HP, Assistance Publique-Hôpitaux de Paris, BCLC, Barcelona Clinic Liver Cancer, Gastroenterology, ICU, intensive care unit, Intensive care unit, 3. Good health, Management, 030220 oncology & carcinogenesis, 2019-nCoV, 030211 gastroenterology & hepatology, medicine.medical_specialty, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, LT, liver transplantation, Article, AFP, Alpha-fetoprotein, 03 medical and health sciences, IR, interventional radiology, Internal medicine, Internal Medicine, medicine, lcsh:RC799-869, IQR, interquartile range, Intention-to-treat analysis, Hepatology, AFEF, Societé Francaise d’Hépatologie, business.industry, COVID-19, SIRT, Selective internal radiation therapy, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Odds ratio, medicine.disease, PCR-RT, PCR real time, aOR, adjusted OR, CI, Confidence Interval, digestive system diseases, ITT, intention to treat, LR, liver resection, CT, computerized-tomography, EASL, European Association of Study of Liver, lcsh:Diseases of the digestive system. Gastroenterology, HCC, hepatocellular carcinoma, business
Abstract: Background Patients affected by HCC represent a vulnerable population during the COVID-19 pandemic and may suffer from the unusual allocation of healthcare resources. The aim of this study was to determine the impact of the COVID-19 pandemic on the management of HCC patients within six French referral centers of the metropolitan area of Paris. Materials and methods We performed a multicenter, retrospective, cross-sectional study on the management of patients affected by HCC during the first six weeks of COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed). Were included all patients discussed in multidisciplinary tumor meeting (MTB) and/or undergoing radiological or surgical programmed procedure during the study period, in a curative or palliative intent. Endpoints were the number of patients with a modification in the treatment strategy, or a delay in decision-to-treatment. Results After screening, n=670 patients were included (n=293 Exposed to COVID, n=377 Unexposed to COVID). A decrease of the numbers of patients with HCC presented in MTB in 2020 (p=0.034) and with a first diagnosis of HCC (n=104 Exposed to COVID, n=143 Unexposed to COVID, p=0.083) was find. Modification in the treatment strategy was observed in 13.1% of patients, with no differences between the two periods. Nevertheless 21.5% versus 9.5% of patients experienced a treatment delay longer than 1 month in 2020 compared to 2019 (p, Graphical abstract, Highlights • In COVID period, a decrease of the numbers of patients with hepatocellular carcinoma presented in Multidisciplinary Tumour Board and, in particular, with a first diagnosis of HCC was find. • Globally, modification in the treatment strategy was observed in 13.1% of patients, with no differences between the two periods but the main reason was significantly different in 2020 compared to 2019: COVID-19 in 2020 vs tumour progression in 2019. • More than 21% of patients experienced a treatment delay longer than 1 month in COVID period compared to 9.5% in 2019 , specially, in subgroup with active, recurrent HCC. The main reasons for the delay of treatment in 2020 was COVID-19 infection related • In 2020, 7.1% of patients had a diagnosis of an active COVID-19 infection and 4/21 (19.1%) died., During COVID pandemic era, less patients with hepatocellular carcinoma (HCC) have been presented in multidisciplinary tumor bord, specially with a first diagnosis of HCC
Published: 2021

49. Presentation, Management and Outcome of Cholangiocarcinoma in Europe: Results From Real-World Patient Registry

Author: Adelaida La Casta, Mariano Ponz-Sarvise, Chiara Braconi, Rócio I.R. Macias, Marco Marzioni, Alvaro Santos-Laso, Wacław Hołówko, Jouzas Kupčinskas, Angela Lamarca, Ana Landa-Magdalena, Juan W. Valle, Arndt Vogel, Raffaele Brustia, Vincenzo Cardinale, L. Fabris, Flora López-López, Trine Folseraas, Nigel B. Jamieson, Carpino Guido, Domenico Alvaro, Joris Erdmann, Jan Nm Ijzermans, Stefan Buettner, Anna Saborowski, Alejandro Forner, Laura Izquierdo-Sanchez, Gianpaolo Vidili, Marcin Krawczyk, Ana Lleo, Katja Evert, Viorel Scripcariu, Luis Bujanda, Jorge Adeva, Jan Philipp Jonas, Alexander Scheiter, Zeno Sparchez, Bas Groot Koerkamp, J. Andersen, Jesus M. Banales, Jose J.G. Marín, Kirsten Utpatel, Heinz-Josef Klümpen, and Łukasz Krupa
Subjects: medicine.medical_specialty, Patient registry, business.industry, General surgery, medicine, Presentation (obstetrics), business, Outcome (game theory)
Published: 2021

50. Use of Artificial Intelligence as an Innovative Method for Liver Graft Macrosteatosis Assessment

Author: Federica Dondero, Nicolas Poté, François Cauchy, Claire Goumard, Alberto Diaspro, Raffaele Brustia, Manuela Cesaretti, François Durand, Olivier Soubrane, Valérie Paradis, Sara Moccia, Leonardo S. Mattos, Olivier Scatton, and Catherine Paugam-Burtz
Subjects: medicine.medical_specialty, medicine.medical_treatment, 030230 surgery, Liver transplantation, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Liver steatosis, Artificial Intelligence, Biopsy, medicine, Humans, Transplantation, Hepatology, medicine.diagnostic_test, business.industry, Graft Survival, medicine.disease, Tissue Donors, Liver Transplantation, Fatty Liver, Liver graft, surgical procedures, operative, Liver, Liver biopsy, 030211 gastroenterology & hepatology, Surgery, Histopathology, Artificial intelligence, Steatosis, business
Abstract: The worldwide implementation of a liver graft pool using marginal livers (ie, grafts with a high risk of technical complications and impaired function or with a risk of transmitting infection or malignancy to the recipient) has led to a growing interest in developing methods for accurate evaluation of graft quality. Liver steatosis is associated with a higher risk of primary nonfunction, early graft dysfunction, and poor graft survival rate. The present study aimed to analyze the value of artificial intelligence (AI) in the assessment of liver steatosis during procurement compared with liver biopsy evaluation. A total of 117 consecutive liver grafts from brain-dead donors were included and classified into 2 cohorts: ≥30 versus
Published: 2020

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