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Peter J. Allen - One of the best experts on this subject based on the ideXlab platform.
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Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement
Annals of Surgical Oncology, 2020Co-Authors: Brian C. Brajcich, Peter J. Allen, David J. Bentrem, Anthony D. Yang, Mark E. Cohen, Ryan J. Ellis, Devalingam Mahalingam, Mary F. Mulcahy, Michael E. Lidsky, Ryan P. MerkowAbstract:Background Hepatic artery Infusion Pump (HAIP) chemotherapy is an advanced cancer therapy for primary and secondary hepatic malignancies. The risk of concurrent hepatic and/or colorectal operations with HAIP placement is unknown. Our objective was to characterize the short-term outcomes of concurrent surgery with HAIP placement. Methods The 2005–2017 ACS NSQIP dataset was queried for patients undergoing hepatic and colorectal operations with or without HAIP placement. Outcomes were compared for HAIP placement with different combined procedures. Patients who underwent procedures without HAIP placement were propensity score matched with those with HAIP placement. The primary outcome was 30-day death or serious morbidity (DSM). Secondary outcomes included infectious complications, wound complications, length of stay (LOS), and operative time. Results Of 467 patients who underwent HAIP placement, 83.9% had concurrent surgery. The rate of DSM was 10.7% for HAIP placement alone, 19.2% with concurrent minor hepatic procedures, 22.1% with concurrent colorectal resection, 23.2% with concurrent minor hepatic plus colorectal procedures, 28.4% with concurrent major hepatic resection, and 41.7% with concurrent major hepatic plus colorectal resection. On matched analyses, there was no difference in DSM, infectious, or wound complications for procedures with HAIP placement compared with the additional procedure alone, but operative time (294.7 vs 239.8 min, difference 54.9, 95% CI 42.8–67.0) and LOS (6 vs 5, IRR 1.20, 95% CI 1.08–1.33) were increased. Conclusions HAIP placement is not associated with additional morbidity when performed with hepatic and/or colorectal surgery. Decisions regarding HAIP placement should consider the risks of concurrent operations, and patient- and disease-specific factors.
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perioperative hepatic arterial Infusion Pump chemotherapy is associated with longer survival after resection of colorectal liver metastases a propensity score analysis
Journal of Clinical Oncology, 2017Co-Authors: Bas Groot Koerkamp, Peter J. Allen, Mithat Gonen, Nancy E Kemeny, Andrea Cercek, Peter T Kingham, Ronald P Dematteo, Eran Sadot, Julie N Leal, William R JarnaginAbstract:PurposeTo investigate whether perioperative hepatic arterial Infusion Pump chemotherapy (HAI) was associated with overall survival (OS) in patients who had a complete resection of colorectal liver metastases (CLM).MethodsPatients who underwent a complete resection of CLM between 1992 and 2012 were included from a single-center prospectively maintained database. All patients who received HAI also received perioperative systemic chemotherapy. Propensity score analysis was used to match patients for seven known prognostic factors.ResultsA total of 2,368 consecutive patients underwent a complete resection of CLM, with a median follow-up of 55 months. The median OS for patients with HAI (n = 785) was 67 months versus 44 months without HAI (n = 1,583; P < .001), despite more advanced disease in the HAI group. OS at 10 years was 38.0% versus 23.8% without HAI. For patients who received modern systemic chemotherapy (n = 1,442), the median OS was 67 months with HAI and 47 months without HAI (P < .001). The hazard ...
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biliary sclerosis after hepatic arterial Infusion Pump chemotherapy for patients with colorectal cancer liver metastasis incidence clinical features and risk factors
Annals of Surgical Oncology, 2012Co-Authors: Nancy E Kemeny, Peter J. Allen, Leslie H Blumgart, Philip Paty, Yuman Fong, Mithat Gonen, Ronald P Dematteo, William R Jarnagin, Michael I DangelicaAbstract:Background Hepatic arterial Infusion Pump chemotherapy (HAIPC) contributes to the prolonged survival of selected patients with colorectal cancer liver metastases (CRCLM). The most clinically important adverse event after HAIPC with floxuridine (FUDR) is biliary sclerosis (BS). Little is known about the etiology of BS.
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the management of variant arterial anatomy during hepatic arterial Infusion Pump placement
Annals of Surgical Oncology, 2002Co-Authors: Peter J. Allen, Leah Benporat, Alexander Stojadinovic, Leslie H Blumgart, Philip Paty, David A. Kooby, Mithat Gonen, Yuman FongAbstract:Background The success of hepatic arterial Infusion Pump (HAIP) placement in patients with variant arterial anatomy has not been well described.
Andrea Cercek - One of the best experts on this subject based on the ideXlab platform.
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adjuvant hepatic arterial Infusion Pump chemotherapy and resection versus resection alone in patients with low risk resectable colorectal liver metastases the multicenter randomized controlled Pump trial
BMC Cancer, 2019Co-Authors: Florian E Buisman, Andrea Cercek, Dirk J Grunhagen, Marjolein Y V Homs, Wills Filipe, R J Bennink, Marc G Besselink, I Borel H M Rinkes, Rutger C G Bruijnen, M I DangelicaAbstract:Background Recurrences are reported in 70% of all patients after resection of colorectal liver metastases (CRLM), in which half are confined to the liver. Adjuvant hepatic arterial Infusion Pump (HAIP) chemotherapy aims to reduce the risk of intrahepatic recurrence. A large retrospective propensity score analysis demonstrated that HAIP chemotherapy is particularly effective in patients with low-risk oncological features. The aim of this randomized controlled trial (RCT) --the Pump trial-- is to investigate the efficacy of adjuvant HAIP chemotherapy in low-risk patients with resectable CRLM.
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adjuvant hepatic arterial Infusion Pump chemotherapy after resection of colorectal liver metastases results of a safety and feasibility study in the netherlands
Annals of Surgical Oncology, 2019Co-Authors: Florian E Buisman, Nancy E Kemeny, Andrea Cercek, Dirk J Grunhagen, Marjolein Y V Homs, Cecile Grootscholten, Wills Filipe, M I Dangelica, Maarten L Donswijk, Leni Van DoornAbstract:Background The 10-year overall survival with adjuvant hepatic arterial Infusion Pump (HAIP) chemotherapy after resection of colorectal liver metastases (CRLMs) was 61% in clinical trials from Memorial Sloan Kettering Cancer Center. A pilot study was performed to evaluate the safety and feasibility of adjuvant HAIP chemotherapy in patients with resectable CRLMs.
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robotic hepatic arterial Infusion Pump placement
Hpb, 2017Co-Authors: Motaz Qadan, Michael I Dangelica, Nancy E Kemeny, Andrea Cercek, Peter T KinghamAbstract:Abstract Background Hepatic artery Infusion Pump (HAIP) placement is associated with improved outcomes in the treatment of colorectal liver metastases (CRLM). In this study, we examined outcomes following robotic HAIP placement, which were compared with open and laparoscopic placement. Methods A retrospective review of HAIP placements by 2 surgeons at a single institution was carried out. All statistical tests were 2-sided and p Results There were a total of 53 open HAIP cases, 21 laparoscopic cases, and 24 robotic cases. Robotic HAIP placement was associated with a significantly lower conversion rate to open operation than laparoscopic Pump placement (17 vs. 67%; p = 0.0009). When cases with concomitant resections were excluded, there was a trend towards shorter median length of hospital stay with robotic Pump placement compared with open and laparoscopic placement (4 vs. 5 vs. 5 days, respectively; p = 0.09). Complication rates were equivalent among the 3 groups when concomitant resections were excluded. Conclusion Robotic HAIP placement is a safe minimally-invasive procedure that is associated with a significantly lower conversion rate to open operation compared with laparoscopic placement and a trend towards shorter hospitalization compared with open placement.
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perioperative hepatic arterial Infusion Pump chemotherapy is associated with longer survival after resection of colorectal liver metastases a propensity score analysis
Journal of Clinical Oncology, 2017Co-Authors: Bas Groot Koerkamp, Peter J. Allen, Mithat Gonen, Nancy E Kemeny, Andrea Cercek, Peter T Kingham, Ronald P Dematteo, Eran Sadot, Julie N Leal, William R JarnaginAbstract:PurposeTo investigate whether perioperative hepatic arterial Infusion Pump chemotherapy (HAI) was associated with overall survival (OS) in patients who had a complete resection of colorectal liver metastases (CLM).MethodsPatients who underwent a complete resection of CLM between 1992 and 2012 were included from a single-center prospectively maintained database. All patients who received HAI also received perioperative systemic chemotherapy. Propensity score analysis was used to match patients for seven known prognostic factors.ResultsA total of 2,368 consecutive patients underwent a complete resection of CLM, with a median follow-up of 55 months. The median OS for patients with HAI (n = 785) was 67 months versus 44 months without HAI (n = 1,583; P < .001), despite more advanced disease in the HAI group. OS at 10 years was 38.0% versus 23.8% without HAI. For patients who received modern systemic chemotherapy (n = 1,442), the median OS was 67 months with HAI and 47 months without HAI (P < .001). The hazard ...
Nancy E Kemeny - One of the best experts on this subject based on the ideXlab platform.
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adjuvant hepatic arterial Infusion Pump chemotherapy after resection of colorectal liver metastases results of a safety and feasibility study in the netherlands
Annals of Surgical Oncology, 2019Co-Authors: Florian E Buisman, Nancy E Kemeny, Andrea Cercek, Dirk J Grunhagen, Marjolein Y V Homs, Cecile Grootscholten, Wills Filipe, M I Dangelica, Maarten L Donswijk, Leni Van DoornAbstract:Background The 10-year overall survival with adjuvant hepatic arterial Infusion Pump (HAIP) chemotherapy after resection of colorectal liver metastases (CRLMs) was 61% in clinical trials from Memorial Sloan Kettering Cancer Center. A pilot study was performed to evaluate the safety and feasibility of adjuvant HAIP chemotherapy in patients with resectable CRLMs.
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robotic hepatic arterial Infusion Pump placement
Hpb, 2017Co-Authors: Motaz Qadan, Michael I Dangelica, Nancy E Kemeny, Andrea Cercek, Peter T KinghamAbstract:Abstract Background Hepatic artery Infusion Pump (HAIP) placement is associated with improved outcomes in the treatment of colorectal liver metastases (CRLM). In this study, we examined outcomes following robotic HAIP placement, which were compared with open and laparoscopic placement. Methods A retrospective review of HAIP placements by 2 surgeons at a single institution was carried out. All statistical tests were 2-sided and p Results There were a total of 53 open HAIP cases, 21 laparoscopic cases, and 24 robotic cases. Robotic HAIP placement was associated with a significantly lower conversion rate to open operation than laparoscopic Pump placement (17 vs. 67%; p = 0.0009). When cases with concomitant resections were excluded, there was a trend towards shorter median length of hospital stay with robotic Pump placement compared with open and laparoscopic placement (4 vs. 5 vs. 5 days, respectively; p = 0.09). Complication rates were equivalent among the 3 groups when concomitant resections were excluded. Conclusion Robotic HAIP placement is a safe minimally-invasive procedure that is associated with a significantly lower conversion rate to open operation compared with laparoscopic placement and a trend towards shorter hospitalization compared with open placement.
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perioperative hepatic arterial Infusion Pump chemotherapy is associated with longer survival after resection of colorectal liver metastases a propensity score analysis
Journal of Clinical Oncology, 2017Co-Authors: Bas Groot Koerkamp, Peter J. Allen, Mithat Gonen, Nancy E Kemeny, Andrea Cercek, Peter T Kingham, Ronald P Dematteo, Eran Sadot, Julie N Leal, William R JarnaginAbstract:PurposeTo investigate whether perioperative hepatic arterial Infusion Pump chemotherapy (HAI) was associated with overall survival (OS) in patients who had a complete resection of colorectal liver metastases (CLM).MethodsPatients who underwent a complete resection of CLM between 1992 and 2012 were included from a single-center prospectively maintained database. All patients who received HAI also received perioperative systemic chemotherapy. Propensity score analysis was used to match patients for seven known prognostic factors.ResultsA total of 2,368 consecutive patients underwent a complete resection of CLM, with a median follow-up of 55 months. The median OS for patients with HAI (n = 785) was 67 months versus 44 months without HAI (n = 1,583; P < .001), despite more advanced disease in the HAI group. OS at 10 years was 38.0% versus 23.8% without HAI. For patients who received modern systemic chemotherapy (n = 1,442), the median OS was 67 months with HAI and 47 months without HAI (P < .001). The hazard ...
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hepatic arterial Infusion Pump chemotherapy in the management of colorectal liver metastases expert consensus statement
Current Oncology, 2013Co-Authors: Paul J Karanicolas, Nancy E Kemeny, Peter Metrakos, Kelvin K Chan, Timothy R Asmis, E Chen, T P Kingham, Geoffrey A Porter, Ryan C Fields, J PingpankAbstract:Despite significant improvements in systemic therapy for patients with colorectal liver metastases (crlms), response rates in the first-line setting are not optimal, and response rates in the second-line setting remain disappointing. Hepatic arterial Infusion Pump (haip) chemotherapy has been extensively studied in patients with crlms, but it remains infrequently used. We convened an expert panel to discuss the role of haip in the contemporary management of patients with crlm. Using a consensus process, we developed these statements: haip chemotherapy should be given in combination with systemic chemotherapy. haip chemotherapy should be offered in the context of a multidisciplinary program that includes expertise in hepatobiliary surgery, medical oncology, interventional radiology, nursing, and nuclear medicine. haip chemotherapy in combination with systemic therapy should be considered in patients with unresectable crlms who have progressed on first-line systemic treatment. In addition, haip chemotherapy is acceptable as first-line treatment in patients with unresectable colorectal liver metastases. haip chemotherapy is not recommended in the setting of extrahepatic disease outside the context of a clinical trial. haip chemotherapy in combination with systemic therapy is an option for select patients with resected colorectal liver metastases. These consensus statements provide a framework that clinicians who treat patients with crlm can use when considering treatment with haip
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biliary sclerosis after hepatic arterial Infusion Pump chemotherapy for patients with colorectal cancer liver metastasis incidence clinical features and risk factors
Annals of Surgical Oncology, 2012Co-Authors: Nancy E Kemeny, Peter J. Allen, Leslie H Blumgart, Philip Paty, Yuman Fong, Mithat Gonen, Ronald P Dematteo, William R Jarnagin, Michael I DangelicaAbstract:Background Hepatic arterial Infusion Pump chemotherapy (HAIPC) contributes to the prolonged survival of selected patients with colorectal cancer liver metastases (CRCLM). The most clinically important adverse event after HAIPC with floxuridine (FUDR) is biliary sclerosis (BS). Little is known about the etiology of BS.
Peter T Kingham - One of the best experts on this subject based on the ideXlab platform.
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robotic hepatic arterial Infusion Pump placement
Hpb, 2017Co-Authors: Motaz Qadan, Michael I Dangelica, Nancy E Kemeny, Andrea Cercek, Peter T KinghamAbstract:Abstract Background Hepatic artery Infusion Pump (HAIP) placement is associated with improved outcomes in the treatment of colorectal liver metastases (CRLM). In this study, we examined outcomes following robotic HAIP placement, which were compared with open and laparoscopic placement. Methods A retrospective review of HAIP placements by 2 surgeons at a single institution was carried out. All statistical tests were 2-sided and p Results There were a total of 53 open HAIP cases, 21 laparoscopic cases, and 24 robotic cases. Robotic HAIP placement was associated with a significantly lower conversion rate to open operation than laparoscopic Pump placement (17 vs. 67%; p = 0.0009). When cases with concomitant resections were excluded, there was a trend towards shorter median length of hospital stay with robotic Pump placement compared with open and laparoscopic placement (4 vs. 5 vs. 5 days, respectively; p = 0.09). Complication rates were equivalent among the 3 groups when concomitant resections were excluded. Conclusion Robotic HAIP placement is a safe minimally-invasive procedure that is associated with a significantly lower conversion rate to open operation compared with laparoscopic placement and a trend towards shorter hospitalization compared with open placement.
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perioperative hepatic arterial Infusion Pump chemotherapy is associated with longer survival after resection of colorectal liver metastases a propensity score analysis
Journal of Clinical Oncology, 2017Co-Authors: Bas Groot Koerkamp, Peter J. Allen, Mithat Gonen, Nancy E Kemeny, Andrea Cercek, Peter T Kingham, Ronald P Dematteo, Eran Sadot, Julie N Leal, William R JarnaginAbstract:PurposeTo investigate whether perioperative hepatic arterial Infusion Pump chemotherapy (HAI) was associated with overall survival (OS) in patients who had a complete resection of colorectal liver metastases (CLM).MethodsPatients who underwent a complete resection of CLM between 1992 and 2012 were included from a single-center prospectively maintained database. All patients who received HAI also received perioperative systemic chemotherapy. Propensity score analysis was used to match patients for seven known prognostic factors.ResultsA total of 2,368 consecutive patients underwent a complete resection of CLM, with a median follow-up of 55 months. The median OS for patients with HAI (n = 785) was 67 months versus 44 months without HAI (n = 1,583; P < .001), despite more advanced disease in the HAI group. OS at 10 years was 38.0% versus 23.8% without HAI. For patients who received modern systemic chemotherapy (n = 1,442), the median OS was 67 months with HAI and 47 months without HAI (P < .001). The hazard ...
M Weiss - One of the best experts on this subject based on the ideXlab platform.
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Infusion Pump performance with vertical displacement effect of syringe Pump and assembly type
Intensive Care Medicine, 2001Co-Authors: Thomas Neff, Joachim E Fischer, Gabriele Schulz, Oskar Baenziger, M WeissAbstract:Objective: To evaluate the effect of different Infusion Pump models on continuity of drug delivery during vertical displacement of syringe Pumps. Design: Zero-drug delivery time (ZDDT), retrograde aspiration volume, and Infusion bolus were recorded using the same syringe in three different models of syringe Pump after lowering and elevating the Pump. Compliance of each Infusion assembly was measured using the occlusion release technique at 38 mmHg. Results: Lowering the Pump by 50 cm at an Infusion rate of 1 ml/h resulted in ZDDT values ranging from 2.78±0.29 to 5.99±1.09 min. Elevating the syringe Pump to its original position caused Infusion boluses between 44.1±3.2 and 77.1±5.1 µl. The results demonstrated that there are large differences between syringe Pump models (F=66.8, df=2/33, p<0.0001) and between Pumps of the same model (F=21.3, df=1/34, p<0.0001). A similar pattern was found in retrograde aspiration volume and Infusion bolus. Conclusion: All tested Pumps led to clinically relevant flow irregularities during vertical displacement of the syringe Pump. Thus, vertical displacement of any syringe Pump connected to an Infusion line delivering highly potent drugs at low Infusion rates should be avoided. The variability across syringe Pumps indicates that syringe Pump design remains an area of potential further improvement for reducing the risk of adverse patient events.