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Eren Berber - One of the best experts on this subject based on the ideXlab platform.

Allan Siperstein - One of the best experts on this subject based on the ideXlab platform.

Michael A. Choti - One of the best experts on this subject based on the ideXlab platform.

  • Rates and Patterns of Recurrence Following Curative Intent Surgery for Colorectal Liver Metastasis
    Transactions of the ... Meeting of the American Surgical Association, 2020
    Co-Authors: Mechteld C. De Jong, Dario Ribero, Lorenzo Capussotti, Carlo Pulitano, Jennifer Strub, Gilles Mentha, Richard D. Schulick, Michael A. Choti, Luca Aldrighetti, Timothy M Pawlik
    Abstract:

    OBJECTIVE(S): To investigate rates and patterns of recurrence in patients following curative intent surgery for Colorectal Liver Metastasis. BACKGROUND: Outcomes following surgical management of Colorectal Liver Metastasis have largely focused on overall survival. Contemporary data on rates and patterns of recurrence following surgery for Colorectal Liver Metastasis are limited. METHODS: One thousand six hundred sixty-nine patients treated with surgery (resection +/- radiofrequency ablation [RFA]) for Colorectal Liver Metastasis between 1982 and 2008 were identified from an international multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. RESULTS: At the time of the initial Liver-directed surgery, surgical treatment was resection only (90.2%), resection plus RFA (8.0%), or RFA alone (1.8%). While 5-year overall survival was 47.3%, 947 (56.7%) patients recurred with a median RFS time of 16.3 months. First recurrence site was intrahepatic only (43.2%), extrahepatic only (35.8%), intra- and extrahepatic (21.0%). There was no difference in RFS based on site of recurrence (intrahepatic: 16.9 months; extrahepatic: 16.6 months; intra- and extrahepatic: 16.2 month; P > 0.05). Receipt of adjuvant chemotherapy was associated with overall recurrence risk (hazard ratio [HR] = 0.56), while history of RFA (HR = 2.39, P = 0.001) and R1 margin status (HR = 1.36) were predictive of intrahepatic recurrence. Pattern of recurrence and RFS remained similar following repeat surgery for recurrent disease. CONCLUSIONS: While 5-year survival following surgery for Colorectal Liver Metastasis approaches 50%, over one-half of patients develop recurrence within 2 years. The pattern of failure is distributed relatively equally among intrahepatic, extrahepatic, and intra- plus extrahepatic sites. Patients undergoing repeat surgery for recurrent Metastasis have similar patterns of recurrence and RFS time

  • Colorectal Liver Metastasis in the setting of lymph node Metastasis defining the benefit of surgical resection
    Annals of Surgical Oncology, 2012
    Co-Authors: Carlo Pulitano, Richard D. Schulick, Michael A. Choti, Luca Aldrighetti, Martin Bodingbauer, Federico Castillo, Thomas Gruenberger, Timothy M Pawlik
    Abstract:

    Background For patients with Colorectal Liver Metastasis (CLM), the presence of concomitant perihepatic/para-aortic lymph node Metastasis (LNM) is considered a contraindication to Liver resection. We sought to determine the benefits of Liver resection among patients with CLM + LNM by examining long-term outcomes among a large cohort of patients.

  • sarcopenia negatively impacts short term outcomes in patients undergoing hepatic resection for Colorectal Liver Metastasis
    Hpb, 2011
    Co-Authors: Peter D Peng, Mechteld C. De Jong, Richard D. Schulick, Mark G Van Vledder, Susan Tsai, Martin A Makary, Julie Ng, Barish H Edil, Christopher L Wolfgang, Michael A. Choti
    Abstract:

    Background As indications for Liver resection expand, objective measures to assess the risk of peri-operative morbidity are needed. The impact of sarcopenia on patients undergoing Liver resection for Colorectal Liver Metastasis (CRLM) was investigated.

  • conditional survival after surgical resection of Colorectal Liver Metastasis an international multi institutional analysis of 949 patients
    Journal of The American College of Surgeons, 2010
    Co-Authors: Hari Nathan, Dario Ribero, Mechteld C. De Jong, Carlo Pulitano, Jennifer Strub, Gilles Mentha, Richard D. Schulick, Michael A. Choti, Jeanfrancois Gigot, Luca Aldrighetti
    Abstract:

    BACKGROUND: Traditionally, survival estimates have been reported solely as survival from the time of surgery, but future survival probability likely changes based on the survival time already accumulated after therapy-otherwise known as conditional survival (CS). We sought to assess the comparative performance of various Colorectal Liver Metastasis prognostic scoring systems, as well as to investigate the CS of patients who underwent resection of Colorectal Liver Metastasis. STUDY DESIGN: Between 1982 and 2008, 949 patients who underwent Colorectal Liver Metastasis resection were identified from an international multi-institutional database. Various prognostic scoring systems were evaluated using Cox proportional hazards models and calculated concordance index (c). CS estimates were calculated as CS = S(x+5)/S-(x). RESULTS: Overall survival after Liver resection was 65% at 3 years and 45% at 5 years, with a median survival of 52 months. All of the prognostic scoring systems had poor-to-moderate prognostic discriminatory ability (Fong c = 0.57, Nordlinger c = 0.56, Memorial Sloan-Kettering Cancer Center nomogram c = 0.58). Using CS, the probability of surviving an additional 5 years, given that the patient had already survived 1, 3, or 5 years, was 41%, 40%, or 50%, respectively. The inadequate performance of the prognostic scoring systems was explained by the fact that as survival from Liver resection increased from 0 to 5 years, the 5-year observed CS improved substantially for patients who were initially predicted to have poor survival at the time of surgery. CONCLUSIONS: Colorectal Liver Metastasis prognostic scoring systems have fair-to-moderate performance. CS can provide more accurate prognostic information for patients and physicians after Colorectal Liver Metastasis resection and should be incorporated into the quantification of survival. (I Am Coll Surg 2010;210:755-766. (C) 2010 by the American College of Surgeons)

  • repeat curative intent Liver surgery is safe and effective for recurrent Colorectal Liver Metastasis results from an international multi institutional analysis
    Journal of Gastrointestinal Surgery, 2009
    Co-Authors: Mechteld C. De Jong, Dario Ribero, Catherine Hubert, Carlo Pulitano, Jennifer Strub, Richard D. Schulick, Skye C Mayo, Serena Lanella, Jeanfrancois Gigot, Michael A. Choti
    Abstract:

    Introduction Although 5-year survival approaches 55% following resection of Colorectal Liver Metastasis, most patients develop recurrent disease that is often isolated to the Liver. Although repeat curative intent surgery (CIS) is increasingly performed for recurrent Colorectal Liver Metastasis, only small series have been reported. We sought to determine safety and efficacy of repeat CIS for recurrent Colorectal Liver Metastasis as well as determine factors predictive of survival in a large multicenter cohort of patients.

Mechteld C. De Jong - One of the best experts on this subject based on the ideXlab platform.

  • Rates and Patterns of Recurrence Following Curative Intent Surgery for Colorectal Liver Metastasis
    Transactions of the ... Meeting of the American Surgical Association, 2020
    Co-Authors: Mechteld C. De Jong, Dario Ribero, Lorenzo Capussotti, Carlo Pulitano, Jennifer Strub, Gilles Mentha, Richard D. Schulick, Michael A. Choti, Luca Aldrighetti, Timothy M Pawlik
    Abstract:

    OBJECTIVE(S): To investigate rates and patterns of recurrence in patients following curative intent surgery for Colorectal Liver Metastasis. BACKGROUND: Outcomes following surgical management of Colorectal Liver Metastasis have largely focused on overall survival. Contemporary data on rates and patterns of recurrence following surgery for Colorectal Liver Metastasis are limited. METHODS: One thousand six hundred sixty-nine patients treated with surgery (resection +/- radiofrequency ablation [RFA]) for Colorectal Liver Metastasis between 1982 and 2008 were identified from an international multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. RESULTS: At the time of the initial Liver-directed surgery, surgical treatment was resection only (90.2%), resection plus RFA (8.0%), or RFA alone (1.8%). While 5-year overall survival was 47.3%, 947 (56.7%) patients recurred with a median RFS time of 16.3 months. First recurrence site was intrahepatic only (43.2%), extrahepatic only (35.8%), intra- and extrahepatic (21.0%). There was no difference in RFS based on site of recurrence (intrahepatic: 16.9 months; extrahepatic: 16.6 months; intra- and extrahepatic: 16.2 month; P > 0.05). Receipt of adjuvant chemotherapy was associated with overall recurrence risk (hazard ratio [HR] = 0.56), while history of RFA (HR = 2.39, P = 0.001) and R1 margin status (HR = 1.36) were predictive of intrahepatic recurrence. Pattern of recurrence and RFS remained similar following repeat surgery for recurrent disease. CONCLUSIONS: While 5-year survival following surgery for Colorectal Liver Metastasis approaches 50%, over one-half of patients develop recurrence within 2 years. The pattern of failure is distributed relatively equally among intrahepatic, extrahepatic, and intra- plus extrahepatic sites. Patients undergoing repeat surgery for recurrent Metastasis have similar patterns of recurrence and RFS time

  • the Liver first approach for synchronous Colorectal Liver Metastasis a 5 year single centre experience
    Hpb, 2011
    Co-Authors: Mechteld C. De Jong, Monique Maas, Marc H A Bemelmans, Steven Olde W M Damink, Geerard L Beets, Cornelis H C Dejong
    Abstract:

    Background For patients who present with synchronous Colorectal carcinoma and Colorectal Liver Metastasis (CRLM), a reversed treatment sequence in which the CRLM are resected before the primary carcinoma has been proposed (Liver-first approach). The aim of the present study was to assess the feasibility and outcome of this approach for synchronous CRLM.

  • sarcopenia negatively impacts short term outcomes in patients undergoing hepatic resection for Colorectal Liver Metastasis
    Hpb, 2011
    Co-Authors: Peter D Peng, Mechteld C. De Jong, Richard D. Schulick, Mark G Van Vledder, Susan Tsai, Martin A Makary, Julie Ng, Barish H Edil, Christopher L Wolfgang, Michael A. Choti
    Abstract:

    Background As indications for Liver resection expand, objective measures to assess the risk of peri-operative morbidity are needed. The impact of sarcopenia on patients undergoing Liver resection for Colorectal Liver Metastasis (CRLM) was investigated.

  • conditional survival after surgical resection of Colorectal Liver Metastasis an international multi institutional analysis of 949 patients
    Journal of The American College of Surgeons, 2010
    Co-Authors: Hari Nathan, Dario Ribero, Mechteld C. De Jong, Carlo Pulitano, Jennifer Strub, Gilles Mentha, Richard D. Schulick, Michael A. Choti, Jeanfrancois Gigot, Luca Aldrighetti
    Abstract:

    BACKGROUND: Traditionally, survival estimates have been reported solely as survival from the time of surgery, but future survival probability likely changes based on the survival time already accumulated after therapy-otherwise known as conditional survival (CS). We sought to assess the comparative performance of various Colorectal Liver Metastasis prognostic scoring systems, as well as to investigate the CS of patients who underwent resection of Colorectal Liver Metastasis. STUDY DESIGN: Between 1982 and 2008, 949 patients who underwent Colorectal Liver Metastasis resection were identified from an international multi-institutional database. Various prognostic scoring systems were evaluated using Cox proportional hazards models and calculated concordance index (c). CS estimates were calculated as CS = S(x+5)/S-(x). RESULTS: Overall survival after Liver resection was 65% at 3 years and 45% at 5 years, with a median survival of 52 months. All of the prognostic scoring systems had poor-to-moderate prognostic discriminatory ability (Fong c = 0.57, Nordlinger c = 0.56, Memorial Sloan-Kettering Cancer Center nomogram c = 0.58). Using CS, the probability of surviving an additional 5 years, given that the patient had already survived 1, 3, or 5 years, was 41%, 40%, or 50%, respectively. The inadequate performance of the prognostic scoring systems was explained by the fact that as survival from Liver resection increased from 0 to 5 years, the 5-year observed CS improved substantially for patients who were initially predicted to have poor survival at the time of surgery. CONCLUSIONS: Colorectal Liver Metastasis prognostic scoring systems have fair-to-moderate performance. CS can provide more accurate prognostic information for patients and physicians after Colorectal Liver Metastasis resection and should be incorporated into the quantification of survival. (I Am Coll Surg 2010;210:755-766. (C) 2010 by the American College of Surgeons)

  • repeat curative intent Liver surgery is safe and effective for recurrent Colorectal Liver Metastasis results from an international multi institutional analysis
    Journal of Gastrointestinal Surgery, 2009
    Co-Authors: Mechteld C. De Jong, Dario Ribero, Catherine Hubert, Carlo Pulitano, Jennifer Strub, Richard D. Schulick, Skye C Mayo, Serena Lanella, Jeanfrancois Gigot, Michael A. Choti
    Abstract:

    Introduction Although 5-year survival approaches 55% following resection of Colorectal Liver Metastasis, most patients develop recurrent disease that is often isolated to the Liver. Although repeat curative intent surgery (CIS) is increasingly performed for recurrent Colorectal Liver Metastasis, only small series have been reported. We sought to determine safety and efficacy of repeat CIS for recurrent Colorectal Liver Metastasis as well as determine factors predictive of survival in a large multicenter cohort of patients.

Michael Tsinberg - One of the best experts on this subject based on the ideXlab platform.