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An Attempt to Establish and Apply Global Benchmarks for Liver Resection of Mali...

Alaimo, L; Moazzam, Z; Lima, H; Endo, Y; Ruzzenente, A; Guglielmi, A; Ratti, F; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S; Popescu, I

Background: Benchmarking is a process of continuous self-evaluation and comparison with best-in-class hospitals to guide quality improvement initiatives. We sought to define global benchmarks relative to liver resection for malignancy and to assess their achievement in hospitals in the United States. Methods: Patients who underwent curative-intent liver resection for hepatocellular carcinoma, intrahepatic chola...


Dynamic Prediction of Survival After Curative Resection of Intrahepatic Cholang...

Spolverato, G; Capelli, G; Lorenzoni, G; Gregori, D; He, J; Popescu, I; Pinto Marques, H; Aldrighetti, L; Maithel, S; Pulitano, C; Bauer, T; Shen, F

Background: The current study aimed to develop a dynamic prognostic model for patients undergoing curative-intent resection for intrahepatic cholangiocarcinoma (ICC) using landmark analysis. Methods: Patients who underwent curative-intent surgery for ICC from 1999 to 2017 were selected from a multi-institutional international database. A landmark analysis to undertake dynamic overall survival (OS) prediction wa...


Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Lef...

Zhang, XF; Xue, F; Weiss, M; Popescu, Irinel; Pinto Marques, H; Aldrighetti, L; Maithel, S; Pulitano, C; Bauer, T; Shen, F; Poultsides, G; Cauchy, F

Background: We sought to investigate whether the unique lateral patterns of lymphatic drainage impacted lymphadenectomy (LND), lymph node metastasis (LNM), and long-term survival of patients after curative hemi-hepatectomy for left- versus right-sided intrahepatic cholangiocarcinoma (ICC). Methods: Data on patients who underwent curative hemi-hepatectomy for left- or right-sided ICC were collected from 15 high-...


Long-Term Recurrence-Free and Overall Survival Differ Based on Common, Prolifer...

Alaimo, L; Moazzam, Z; Endo, Y; Lima, H; Ruzzenente, A; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S; Poultsides, G; Maithel, S

Introduction: While generally associated with poor prognosis, intrahepatic cholangiocarcinoma (ICC) can have a heterogeneous presentation and natural history. We sought to identify specific ICC subtypes that may be associated with varied long-term outcomes and patterns of recurrence after liver resection. Methods: Patients who underwent curative-intent resection for ICC from 2000 to 2020 were identified from a ...


Higher Tumor Burden Status Dictates the Impact of Surgical Margin Status on Ove...

Endo, Y; Sasaki, K; Moazzam, Z; Lima, H; Alaimo, L; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S; Poultsides, G; Kitago, M

Background: The present study aimed to examine the prognostic significance of margin status following hepatectomy of intrahepatic cholangiocarcinoma (ICC) relative to overall tumor burden and nodal status. Method: Patients who underwent curative-intent surgery for ICC between 1990 and 2017 were included from a multi-institutional database. The impact of margin status and width on overall survival (OS) was exami...


Proposed Modification of the Eighth Edition of the AJCC Staging System for Intr...

Zhang, XF; Xue, F; He, J; Alexandrescu, S; Pinto Marques, H; Aldrighetti, L; Maithel, S; Pulitano, C; Bauer, T; Shen, F; Poultsides, G; Soubrane, O

Background: To improve the prognostic accuracy of the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for intrahepatic cholangiocarcinoma (ICC) with establishment and validation of a modified TNM (mTNM) staging system. Methods: Data on patients who underwent curative-intent resection for ICC was collected from 15 high-volume centers worldwide (n = 643). An external validation dataset...


A Machine-Based Approach to Preoperatively Identify Patients with the Most and ...

Tsilimigras, D; Mehta, R; Moris, D; Sahara, K; Bagante, F; Paredes, A; Moro, A; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S

Background: Accurate risk stratification and patient selection is necessary to identify patients who will benefit the most from surgery or be better treated with other non-surgical treatment strategies. We sought to identify which patients in the preoperative setting would likely derive the most or least benefit from resection of intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent curative-in...


Very Early Recurrence After Liver Resection for Intrahepatic Cholangiocarcinoma...

Tsilimigras, D; Sahara, K; Wu, L; Moris, D; Bagante, F; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S; Poultsides, G; Maithel, S

Importance: Although surgery offers the best chance of a potential cure for patients with localized, resectable intrahepatic cholangiocarcinoma (ICC), prognosis of patients remains dismal largely because of a high incidence of recurrence. Objective: To predict very early recurrence (VER) (ie, recurrence within 6 months after surgery) following resection for ICC in the pre- and postoperative setting. Design, set...


Antibodies Towards High-Density Lipoprotein Components in Patients with Psoriasis

Hu, LS; Zhang, XF; Weiss, M; Popescu, I; Pinto Marques, H; Delgado Alves, L; Maithel, S; Pulitano, C; Bauer, T; Shen, F; Poultsides, G; Soubrane, O

Objectives: To assess conditional survival (CS) according to recurrence status, as well as conditional disease-free survival (cDFS) among patients with intrahepatic cholangiocarcinoma (ICC). Methods: CS and cDFS were evaluated among ICC patients who underwent curative-intent resection for ICC by using a multi-institutional database. Five-year CS (CS5) at "x" years was calculated separately for patients who did ...


Recurrence Patterns and Timing Courses Following Curative-Intent Resection for ...

Hu, LS; Zhang, XF; Weiss, M; Popescu, I; Pinto Marques, H; Aldrighetti, L; Maithel, S; Pulitano, C; Bauer, T; Shen, F; Poultsides, GA; Soubrane, O

Background: Recurrence of intrahepatic cholangiocarcinoma (ICC) after curative resection is common. Objective: The aim of this study was to investigate the patterns, timing and risk factors of disease recurrence after curative-intent resection for ICC. Methods: Patients undergoing curative resection for ICC were identified from a multi-institutional database. Data on clinicopathological and initial operation in...


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