60 research outputs found
Blood trasnfusions and local tumour recurrence in colorectal cancer evidence of a noncausal relationship
Blood trasnfusions and local tumour recurrence in colorectal cancer evidence of a noncausal relationship
Impact of time interval between multidisciplinary team meeting and intended pancreatoduodenectomy on oncological outcomes
Background: Dutch guidelines indicate that treatment of pancreatic head and periampullary malignancies should be started within 3 weeks of the multidisciplinary team (MDT) meeting. This study aimed to
assess the impact of time to surgery on oncological outcomes.
Methods: This was a retrospective population-based cohort study of patients with pancreatic head
and periampullary malignancies included in the Netherlands Cancer Registry. Patients scheduled for
pancreatoduodenectomy and who were discussed in an MDT meeting from May 2012 to December 2016
were eligible. Time to surgery was defined as days between the final preoperative MDT meeting and
surgery, categorized in tertiles (short interval, 18 days or less; intermediate, 19–32 days; long, 33 days or
more). Oncological outcomes included overall survival, resection rate and R0 resection rate.
Results: A total of 2027 patients were included, of whom 677, 665 and 685 had a short, intermediate
and long time interval to surgery respectively. Median time to surgery was 25 (i.q.r. 14–36) days. Longer
time to surgery was not associated with overall survival (hazard ratio 0â‹…99, 95 per cent c.i. 0â‹…87 to 1â‹…13;
P = 0â‹…929), resection rate (relative risk (RR) 0â‹…96, 95 per cent c.i. 0â‹…91 to 1â‹…01; P = 0â‹…091) or R0 resection
rate (RR 1â‹…01, 0â‹…94 to 1â‹…09; P = 0â‹…733). Patients with pancreatic ductal adenocarcinoma and a long time
interval had a lower resection rate (RR 0â‹…92, 0â‹…85 to 0â‹…99; P = 0â‹…029).
Discussion: A longer time interval between the last MDT meeting and pancreatoduodenectomy did not
decrease overall survival
Pathological validation and prognostic potential of quantitative MRI in the characterization of pancreas cancer: preliminary experience
Neoadjuvant chemoradiation followed by surgery versus surgery alone for patients with adenocarcinoma or squamous cell carcinoma of the esophagus (CROSS)
textabstractBackground. A surgical resection is currently the preferred treatment for esophageal cancer if the tumor is considered to be resectable without evidence of distant metastases (cT1-3 N0-1 M0). A high percentage of irradical resections is reported in studies using neoadjuvant chemotherapy followed by surgery versus surgery alone and in trials in which patients are treated with surgery alone. Improvement of locoregional control by using neoadjuvant chemoradiotherapy might therefore improve the prognosis in these patients. We previously reported that after neoadjuvant chemoradiotherapy with weekly administrations of Carboplatin and Paclitaxel combined with concurrent radiotherapy nearly always a complete R0-resection could be performed. The concept that this neoadjuvant chemoradiotherapy regimen improves overall survival has, however, to be proven in a randomized phase III trial. Methods/design. The CROSS trial is a multicenter, randomized phase III, clinical trial. The study compares neoadjuvant chemoradiotherapy followed by surgery with surgery alone in patients with potentially curable esophageal cancer, with inclusion of 175 patients per arm. The objectives of the CROSS trial are to compare median survival rates and quality of life (before, during and after treatment), pathological responses, progression free survival, the number of R0 resections, treatment toxicity and costs between patients treated with neoadjuvant chemoradiotherapy followed by surgery with surgery alone for surgically resectable esophageal adenocarcinoma or squamous cell carcinoma. Over a 5 week period concurrent chemoradiotherapy will be applied on an outpatient basis. Paclitaxel (50 mg/m2) and Carboplatin (Area-Under-Curve = 2) are administered by i.v. infusion on days 1, 8, 15, 22, and 29. External beam radiation with a total dose of 41.4 Gy is given in 23 fractions of 1.8 Gy, 5 fractions a week. After completion of the protocol, patients will be followed up every 3 months for the first year, every 6 months for the second year, and then at the end of each year until 5 years after treatment. Quality of life questionnaires will be filled out during the first year of follow-up. Discussion. This study will contribute to the evidence on any benefits of neoadjuvant treatment in esophageal cancer patients using a promising chemoradiotherapy regimen. Trial registration. ISRCTN80832026
Drain use in pancreatic surgery: Results from an international survey among experts in the field
Blood Transfusions and Prognosis in Colorectal Cancer: Long-term Results of a Randomized Controlled Trial Reply
Are allogeneic blood transfusions acceptable in elective surgery in colorectal carcinoma?
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