The Experts below are selected from a list of 96 Experts worldwide ranked by ideXlab platform
Vadim Gushchin - One of the best experts on this subject based on the ideXlab platform.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix
Annals of Surgical Oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance. Methods Seventy-six preoperative CT scans of LGMA patients were evaluated by two surgeons unfamiliar with the patients’ medical history. Scores were assigned based on SPAAT criteria, with a SPAAT ≥3 predictive of IC. Binary regression analyses and area under the receiver operating characteristic (AUROC) curve analyses were performed. Patients with splenic resection were excluded due to the structure of the SPAAT assessment tool. Results Seventy-six LGMA patients underwent attempted cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Of 68 patients, 58 had complete cytoreduction and 10 had IC; 8 patients were ineligible due to prior splenectomy. The mean SPAAT score was 0.8, with six patients having SPAAT scores ≥3. SPAAT scores ≥3 were predictive of IC, with a hazard ratio (HR) of 19 (95% confidence interval 2.8–124.1) ( p = 0.002). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were 40, 97, 50, and 90%, respectively. A SPAAT score ≥3 was not associated with worse survival prognosis. Median follow-up was 2.4 years and AUROC curve was 71%. SPAAT components with respective HR and p -values were foreshortening of the bowel mesentery (29.5; p = 0.004), and scalloping of the pancreas (9; p = 0.008), spleen (4.3; p = 0.04), portal vein (3.1; p = 0.4), and liver (2.1; p = 0.3). Conclusion A SPAAT score ≥3 predicted IC based on a binary regression model. The clinical value of this score is controversial due to low sensitivity and PPV.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix.
Annals of surgical oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance.
Vladimir Milovanov - One of the best experts on this subject based on the ideXlab platform.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix
Annals of Surgical Oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance. Methods Seventy-six preoperative CT scans of LGMA patients were evaluated by two surgeons unfamiliar with the patients’ medical history. Scores were assigned based on SPAAT criteria, with a SPAAT ≥3 predictive of IC. Binary regression analyses and area under the receiver operating characteristic (AUROC) curve analyses were performed. Patients with splenic resection were excluded due to the structure of the SPAAT assessment tool. Results Seventy-six LGMA patients underwent attempted cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Of 68 patients, 58 had complete cytoreduction and 10 had IC; 8 patients were ineligible due to prior splenectomy. The mean SPAAT score was 0.8, with six patients having SPAAT scores ≥3. SPAAT scores ≥3 were predictive of IC, with a hazard ratio (HR) of 19 (95% confidence interval 2.8–124.1) ( p = 0.002). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were 40, 97, 50, and 90%, respectively. A SPAAT score ≥3 was not associated with worse survival prognosis. Median follow-up was 2.4 years and AUROC curve was 71%. SPAAT components with respective HR and p -values were foreshortening of the bowel mesentery (29.5; p = 0.004), and scalloping of the pancreas (9; p = 0.008), spleen (4.3; p = 0.04), portal vein (3.1; p = 0.4), and liver (2.1; p = 0.3). Conclusion A SPAAT score ≥3 predicted IC based on a binary regression model. The clinical value of this score is controversial due to low sensitivity and PPV.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix.
Annals of surgical oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance.
Paul H Sugarbaker - One of the best experts on this subject based on the ideXlab platform.
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utility of cea and ca 19 9 Tumor markers in diagnosis and prognostic assessment of mucinous epithelial cancers of the Appendix
Journal of Surgical Oncology, 2004Co-Authors: Pablo C Carmignani, Regina Hampton, Christina E Sugarbaker, David Chang, Paul H SugarbakerAbstract:Background and Objectives Tumor markers are a clinical tool frequently used in oncology in association with other clinical and radiologic information. For gastrointestinal cancer, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) Tumor markers have found selected clinical application. The use of these Tumor markers in mucinous epithelial Tumors of the Appendix has not been previously determined. Methods In patients with peritoneal dissemination of a mucinous epithelial malignancy of the Appendix, Tumor markers CEA and CA 19-9 were prospectively recorded preoperatively within 1 week prior to definitive treatment. Also, if the appendiceal Tumor recurred, the Tumor marker was determined. The accuracy of these two Tumor markers in the management of this disease was determined for these two specific clinical situations. Results CEA was elevated in 56% of 532 patients and CA 19-9 was elevated in 67.1% of these patients. Although the absolute level of Tumor marker did not correlate with prognosis, a normal value indicated an improved survival. CEA was elevated in 35.2% of 110 patients determined to have recurrent disease; CA 19-9 was elevated in 62.9% and at least one of the Tumor markers was elevated in 68.2% of patients. An elevated CEA Tumor marker at the time of recurrence indicated a reduced prognosis. Conclusions Both CEA and CA 19-9 Tumor markers were elevated in a majority of these patients and should be a valuable diagnostic tool previously underutilized in this group of patients. These Tumor markers were also of benefit in the assessment of prognosis in that a normal level indicated an improved prognosis. At the time of a reoperative procedure, CEA and CA 19-9 Tumor markers gave information regarding the progression of disease. These Tumor markers have practical value in the management of epithelial appendiceal malignancy with peritoneal dissemination. J. Surg. Oncol. 2004;87:162–166. © 2004 Wiley-Liss, Inc.
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Utility of CEA and CA 19‐9 Tumor markers in diagnosis and prognostic assessment of mucinous epithelial cancers of the Appendix
Journal of surgical oncology, 2004Co-Authors: C. Pablo Carmignani, Regina Hampton, Christina E Sugarbaker, David Chang, Paul H SugarbakerAbstract:Background and Objectives Tumor markers are a clinical tool frequently used in oncology in association with other clinical and radiologic information. For gastrointestinal cancer, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) Tumor markers have found selected clinical application. The use of these Tumor markers in mucinous epithelial Tumors of the Appendix has not been previously determined. Methods In patients with peritoneal dissemination of a mucinous epithelial malignancy of the Appendix, Tumor markers CEA and CA 19-9 were prospectively recorded preoperatively within 1 week prior to definitive treatment. Also, if the appendiceal Tumor recurred, the Tumor marker was determined. The accuracy of these two Tumor markers in the management of this disease was determined for these two specific clinical situations. Results CEA was elevated in 56% of 532 patients and CA 19-9 was elevated in 67.1% of these patients. Although the absolute level of Tumor marker did not correlate with prognosis, a normal value indicated an improved survival. CEA was elevated in 35.2% of 110 patients determined to have recurrent disease; CA 19-9 was elevated in 62.9% and at least one of the Tumor markers was elevated in 68.2% of patients. An elevated CEA Tumor marker at the time of recurrence indicated a reduced prognosis. Conclusions Both CEA and CA 19-9 Tumor markers were elevated in a majority of these patients and should be a valuable diagnostic tool previously underutilized in this group of patients. These Tumor markers were also of benefit in the assessment of prognosis in that a normal level indicated an improved prognosis. At the time of a reoperative procedure, CEA and CA 19-9 Tumor markers gave information regarding the progression of disease. These Tumor markers have practical value in the management of epithelial appendiceal malignancy with peritoneal dissemination. J. Surg. Oncol. 2004;87:162–166. © 2004 Wiley-Liss, Inc.
Michelle Sittig - One of the best experts on this subject based on the ideXlab platform.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix
Annals of Surgical Oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance. Methods Seventy-six preoperative CT scans of LGMA patients were evaluated by two surgeons unfamiliar with the patients’ medical history. Scores were assigned based on SPAAT criteria, with a SPAAT ≥3 predictive of IC. Binary regression analyses and area under the receiver operating characteristic (AUROC) curve analyses were performed. Patients with splenic resection were excluded due to the structure of the SPAAT assessment tool. Results Seventy-six LGMA patients underwent attempted cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Of 68 patients, 58 had complete cytoreduction and 10 had IC; 8 patients were ineligible due to prior splenectomy. The mean SPAAT score was 0.8, with six patients having SPAAT scores ≥3. SPAAT scores ≥3 were predictive of IC, with a hazard ratio (HR) of 19 (95% confidence interval 2.8–124.1) ( p = 0.002). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were 40, 97, 50, and 90%, respectively. A SPAAT score ≥3 was not associated with worse survival prognosis. Median follow-up was 2.4 years and AUROC curve was 71%. SPAAT components with respective HR and p -values were foreshortening of the bowel mesentery (29.5; p = 0.004), and scalloping of the pancreas (9; p = 0.008), spleen (4.3; p = 0.04), portal vein (3.1; p = 0.4), and liver (2.1; p = 0.3). Conclusion A SPAAT score ≥3 predicted IC based on a binary regression model. The clinical value of this score is controversial due to low sensitivity and PPV.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix.
Annals of surgical oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance.
Carol Nieroda - One of the best experts on this subject based on the ideXlab platform.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix
Annals of Surgical Oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance. Methods Seventy-six preoperative CT scans of LGMA patients were evaluated by two surgeons unfamiliar with the patients’ medical history. Scores were assigned based on SPAAT criteria, with a SPAAT ≥3 predictive of IC. Binary regression analyses and area under the receiver operating characteristic (AUROC) curve analyses were performed. Patients with splenic resection were excluded due to the structure of the SPAAT assessment tool. Results Seventy-six LGMA patients underwent attempted cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Of 68 patients, 58 had complete cytoreduction and 10 had IC; 8 patients were ineligible due to prior splenectomy. The mean SPAAT score was 0.8, with six patients having SPAAT scores ≥3. SPAAT scores ≥3 were predictive of IC, with a hazard ratio (HR) of 19 (95% confidence interval 2.8–124.1) ( p = 0.002). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were 40, 97, 50, and 90%, respectively. A SPAAT score ≥3 was not associated with worse survival prognosis. Median follow-up was 2.4 years and AUROC curve was 71%. SPAAT components with respective HR and p -values were foreshortening of the bowel mesentery (29.5; p = 0.004), and scalloping of the pancreas (9; p = 0.008), spleen (4.3; p = 0.04), portal vein (3.1; p = 0.4), and liver (2.1; p = 0.3). Conclusion A SPAAT score ≥3 predicted IC based on a binary regression model. The clinical value of this score is controversial due to low sensitivity and PPV.
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External Validation of the Simplified Preoperative Assessment for Low-Grade Mucinous Adenocarcinoma of the Appendix.
Annals of surgical oncology, 2017Co-Authors: Vladimir Milovanov, Armando Sardi, Nail Aydin, Carol Nieroda, Michelle Sittig, Vadim GushchinAbstract:Background MD Anderson Cancer Center developed a computed tomography (CT)-based preoperative assessment tool simplified preoperative assessment for Appendix Tumor (SPAAT) for predicting incomplete cytoreduction (IC) in low-grade mucinous adenocarcinoma (LGMA) of the Appendix, based on preoperative CT scans. This study independently evaluates the tool’s performance.