1
|
Otto G, Budde K, Bara C, Gottlieb J. [The German Transplant Registry - An Analysis of Legacy Data 2006-2016]. Gesundheitswesen 2024. [PMID: 38467147 DOI: 10.1055/a-2251-5627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
INTRODUCTION In 2018, medical transplant data from three institutions were merged to create a German transplant registry. Since June 2021, access to data of the registry has been available. It was planned to analyze the registry data in order to compare special allocation rules with regular allocation for heart, liver, lung, and kidney transplantation. Our approach led to a quality analysis of the registry. METHODS Upon request, legacy data (2006-2016) of the registry was provided, divided into 61 elements. From these elements, the user had to compile the required dataset. Data checks were performed for completeness, correct allocation of information, and consistency among different sources. Software used for these tasks included R, SQL, and Excel. RESULTS The initial elements ("waiting list" elements) of the four types of transplantations contained data from a total of 80,259 originally listed patients. However, these patients were only partially present in other elements resulting in complete datasets reflecting waiting time in only 23%, 30%, 50%, and 96%, and for post-transplantation outcomes in 14%, 11%, 38%, and 13% (heart, liver, lung, and kidney transplantation, respectively). The linking of urgency information with clinical data was successful in only a small proportion, with only 6% for heart transplantation. Incorrect and thus implausible allocations in the case of special allocation rules indicated incorrect entries in the registry. Data from different data providers were inconsistent. DISCUSSION The incompleteness and incorrect data allocation raise doubts about the reliability of scientific studies based on the transplant registry. The complex structure also hinders the compilation of a reliable dataset, which is uncommon internationally. New data (acquisition since 2017) has only been available since December 2023. CONCLUSION The transplant registry urgently needs restructuring. Competent clinical data management, involving transplant medical expertise, and continuous quality controls are essential in this process.
Collapse
Affiliation(s)
- Gerd Otto
- Ehem. Abteilung für Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Klemens Budde
- Medizinische Klinik mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Bara
- Klinik für Herz-, Thorax- und Gefäßchirurgie, Universitätsmedizin Göttingen, Gottingen, Germany
- Deutsches Zentrums für Herz- und Kreislaufforschung (DZHK), Standort Göttingen, Deutsches Zentrum für Herz-Kreislauf-Forschung eV, Berlin, Germany
| | - Jens Gottlieb
- Klinik für Pneumologie und Infektiologie, Medizinische Hochschule Hannover, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover (BREATH), Deutsches Zentrum für Lungenforschung e V, Giessen, Germany
| |
Collapse
|
2
|
Le X, Paz-Ares L, Van Meerbeeck J, Viteri S, Cabrera-Galvez C, Baz D, Kim YC, Kang JH, Stroh C, Juraeva D, Bruns R, Otto G, Johne A, Paik P. OA01.08 Clinical Response to Tepotinib According to Circulating Tumor (ct)DNA Biomarkers in Patients with Advanced/Metastatic NSCLC with High-level MET Amplification (METamp) Detected by Liquid Biopsy (LBx). J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
3
|
Thomas M, Garassino M, Felip E, Sakai H, Le X, Veillon R, Smit E, Mazieres J, Cortot A, Raskin J, Viteri S, Yang JH, Ahn MJ, Wu YL, Ma R, Zhao J, O'Brate A, Berghoff K, Bruns R, Otto G, Paik P. OA03.05 Tepotinib in Patients with MET Exon 14 (METex14) Skipping NSCLC: Primary Analysis of the Confirmatory VISION Cohort C. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
4
|
Christopoulos P, Iams W, Oksen D, Mahmoudpour S, Thia T, Otto G, Thomas M. EP08.02-126 The MOMENT Disease Registry of Patients with Advanced Non-Small Cell Lung Cancer Harboring MET Exon 14 Skipping. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Yang JH, Ahn MJ, Sakai H, Morise M, Kato T, Chen YM, Han JY, Yang JJ, Zhao J, Huang J, Berghoff K, Bruns R, Otto G, Le X, Paik P. 25P Tepotinib in Asian patients with advanced NSCLC with MET exon 14 (METex14) skipping. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
6
|
Bestvina C, Patel J, Le X, Veillon R, Anderson I, Demedts I, Garassino M, Mazières J, Morise M, Smit E, Eggleton S, O'Brate A, Otto G, Bruns R, Schumacher K, Paik P. Intracranial Activity of Tepotinib in Patients (pts) With MET exon 14 (METex14) Skipping NSCLC Enrolled in VISION. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.10.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
7
|
Pitton MB, Weinmann A, Kloeckner R, Mittler J, Ruckes C, Düber C, Otto G. Transjugular Portosystemic Stent Shunt: Impact of Right Atrial Pressure on Portal Venous Hemodynamics Within the First Week. Cardiovasc Intervent Radiol 2021; 45:102-111. [PMID: 34853873 PMCID: PMC8716358 DOI: 10.1007/s00270-021-03003-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/30/2021] [Indexed: 12/15/2022]
Abstract
Purpose Porto-systemic pressure gradient is used to prognosticate rebleeding and resolution of ascites after TIPS. This study investigates the reliability of portal pressure characteristics as quantified immediately after TIPS placement and at short-term control. Patients and Methods Portal venous pressure (PVP) and right atrial pressure (RAP) were prospectively obtained before and after TIPS as well as ≥ 48 h after TIPS procedure. Porto-systemic pressure gradients (PSG) and pressure changes were calculated. A multivariate regression analysis was performed to predict portal hemodynamics at short-term control. Results The study included 124 consecutive patients. Indications for TIPS were refractory ascites, variceal bleeding or combinations of both. Pre- and post-interventional PSG yielded 16.4 ± 5.3 mmHg and 5.9 ± 2.7 mmHg, respectively. At that time, 105/124 patients (84.7%) met the target (PSG ≤ 8 mmHg). After 4 days (median), PSG was 8.5 ± 3.5 mmHg and only 66 patients (53%) met that target. In patients exceeding the target PSG at follow-up, PVP was significantly higher and RAP was lower resulting in the increased PSG. The highly variable changes of RAP were the main contributor to different pressure gradients. In the multivariate regression analysis, PVP and RAP immediately after TIPS were predictors for PSG at short-term control with moderately predictive capacity (AUC = 0.75). Conclusion Besides the reduction of portal vein pressure, the highly variable right atrial pressure was the main contributor to different pressure gradients. Thus, immediate post-TIPS measurements do not reliably predict portal hemodynamics during follow-up. These findings need to be further investigated with respect to the corresponding clinical course of the patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00270-021-03003-z.
Collapse
Affiliation(s)
- Michael Bernhard Pitton
- Department of Diagnostic and Interventional Radiology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131, Mainz, Germany.
| | - Arndt Weinmann
- Department of Internal Medicine, University Medical Center, Langenbeckstr.1, 55131, Mainz, Germany
| | - Roman Kloeckner
- Department of Diagnostic and Interventional Radiology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131, Mainz, Germany
| | - Jens Mittler
- Department of General and Visceral Surgery and Transplantation Surgery, University Medical Center, Langenbeckstr.1, 55131, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center, 55131, Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131, Mainz, Germany
| | - Gerd Otto
- Emeritus of the Division of Transplantation Surgery, University Medical Center, Langenbeckstr.1, 55131, Mainz, Germany
| |
Collapse
|
8
|
Felip E, Garassino M, Sakai H, Le X, Veillon R, Smit E, Mazieres J, Cortot A, Raskin J, Thomas M, Viteri S, Iams W, Kim H, Yang J, Stroh C, Otto G, Bruns R, Paik P. P45.03 Tepotinib in Patients with MET exon 14 (METex14) Skipping NSCLC as Identified by Liquid (LBx) or Tissue (TBx) biopsy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Scherz A, Sakai H, Le X, Felip E, Veillon R, Garassino M, Raskin J, Viteri S, Mazieres J, Cortot A, Smit E, Thomas M, Conte P, Gottfried M, Britschgi C, Bruns R, Otto G, Johne A, Paik P. 157P Tepotinib in patients (pts) with MET exon 14 (METex14) skipping NSCLC: Efficacy results from all pts enrolled in VISION cohort A. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01999-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
10
|
Mazieres J, Veillon R, Felip E, Le X, Garassino M, Stanton T, Morise M, Lee J, Matsumoto S, De Marinis F, Wehler T, Clark A, Friese-Hamin M, Stroh C, Bruns R, Otto G, Paik P. P85.01 Activity of Tepotinib in Brain Metastases (BM): Preclinical and Clinical Data in MET Exon 14 (METex14) Skipping NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
11
|
Veillon R, Sakai H, Le X, Felip E, Garassino M, Cortot A, Smit E, Park K, Griesinger F, Britschgi C, Wu Y, Berghoff K, Otto G, Bruns R, Paik P. FP14.09 Tepotinib Safety in MET Exon 14 (METex14) Skipping NSCLC: Updated Results from the VISION Trial. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
12
|
Paik P, Sakai H, Felip E, Veillon R, Garassino M, Raskin J, Viteri S, Mazieres J, Cortot A, Smit E, Thomas M, Cho B, Conte P, Yang J, Morise M, Chen Y, Park K, Gottfried M, Britschgi C, Bruns R, Otto G, Johne A, Le X. MA11.05 Tepotinib in Patients with MET exon 14 (METex14) Skipping Advanced NSCLC: Updated Efficacy Results from VISION Cohort A. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
13
|
Otto G, Pitton MB, Hoppe-Lotichius M, Weinmann A. Liver transplantation and BCLC classification: Limitations impede optimum treatment. Hepatobiliary Pancreat Dis Int 2021; 20:6-12. [PMID: 33349607 DOI: 10.1016/j.hbpd.2020.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 12/01/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Barcelona Clinic Liver Cancer (BCLC) system has been endorsed by international guidelines as a staging algorithm of hepatocellular carcinoma. This analysis was performed to assess the outcome of liver transplantation in patients treated against the BCLC recommendations. METHODS The data of 198 patients who underwent liver transplantation for hepatocellular carcinoma were extracted from a prospectively maintained database to classify the patients according to the BCLC system. RESULTS BCLC staging was as follows: 0, n = 5; A, n = 77; B, n = 41; C, n = 53; and D, n = 22. Accordingly, liver transplantation was performed in the majority of patients against BCLC recommendations. Surgery (n = 16), radiofrequency ablation (n = 15) and transarterial chemoembolization (n = 151) preceded liver transplantation in 182 patients. Sixteen patients were transplanted without pretreatment. The1-, 5- and 10-year survival rates were 83.8%, 62.4% and 45.9%, and 1-, 5-, and 10-year recurrence rates were 7.7%, 22.7% and 26.7%. The BCLC classification did neither impact survival (P = 0.796) nor recurrence (P = 0.693). In the Cox analysis, RECIST tumor progression and initial alpha fetoprotein were independent predictors of outcome. CONCLUSIONS Neither the oncological nor the functional stratification imposed by the BCLC system was of importance for outcome. Lack of flexibility and disregard of biological parameters hamper its clinical applicability in liver transplantation.
Collapse
Affiliation(s)
- Gerd Otto
- (Former) Department of Hepatobiliary and Transplant Surgery, University Medical Center, Mainz, Germany.
| | - Michael B Pitton
- Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz, Germany
| | - Maria Hoppe-Lotichius
- (Former) Department of Hepatobiliary and Transplant Surgery, University Medical Center, Mainz, Germany; Department of General, Abdominal and Transplant Surgery, University Medical Center, Mainz, Germany
| | - Arndt Weinmann
- Department of Internal Medicine I, University Medical Center, Mainz, Germany
| |
Collapse
|
14
|
Heinrich S, Mittler J, Theurer J, Ridder DA, Marquardt JU, Weinmann A, Scheuermann U, Otto G, Galle PR, Straub BK, Lang H. Microvascular invasion of hepatocellular carcinoma predicts microvascular invasion of its recurrence: potential implications for salvage liver transplantation? Hepatobiliary Surg Nutr 2021; 12:183-191. [PMID: 37124699 PMCID: PMC10129893 DOI: 10.21037/hbsn-21-346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/18/2021] [Indexed: 11/06/2022]
Abstract
Background Microvascular invasion (MVI) can only be assessed on a full surgical specimen. We aimed at evaluating, whether the histology of the primary tumor is predictive of MVI in a hepatocellular carcinoma (HCC) recurrence. Methods Patients, who underwent liver resection or orthotopic liver transplantation (OLT) for recurrent HCC from January 2001 until June 2018 were eligible for this retrospective analysis. Resected specimens were evaluated for HCC subtype/morphology, vessels encapsulating tumor clusters (VETC)-pattern and MVI. Dichotomous parameters were analyzed using χ2-test and ϕ-values, with P values <0.05 being considered significant. Results Of 230 HCC recurrences, 37 (16.1%) underwent repeated liver resection (n=22) or OLT (n=15). Of these, 67.6% initially exceeded the Milan criteria. MVI correlated Milan criteria (P=0.005), tumor size (P=0.015) and VETC-pattern (P=0.034) in the primary specimen. The recurrences shared many features of the primary HCC such as tumor grade (P=0.002), VETC-pattern (P=0.035), and MVI (P=0.046). In recurrences, however, only the concordance with the Milan criteria correlated with MVI (P=0.018). No patient without MVI in the primary HCC revealed MVI on early recurrence (<2 years) (P=0.035). Conclusions HCC recurrences share many biological features of the primary tumor. Moreover, early recurrences of MVI-negative HCC never revealed MVI. This finding offers novel concepts, e.g., patient selection for salvage OLT.
Collapse
Affiliation(s)
- Stefan Heinrich
- General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany
| | - Jens Mittler
- General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany
| | - Juliane Theurer
- General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany
| | - Dirk A. Ridder
- Institute of Pathology, University Hospital of Mainz, Mainz, Germany
| | - Jens U. Marquardt
- Department of Medicine I, University Medical Center Schleswig-Holstein, Campus Lübeck, Germany
| | - Arndt Weinmann
- Department of Medicine I, University Hospital of Mainz, Mainz, Germany
| | - Uwe Scheuermann
- Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Gerd Otto
- General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany
| | - Peter R. Galle
- Department of Medicine I, University Hospital of Mainz, Mainz, Germany
| | - Beate K. Straub
- Institute of Pathology, University Hospital of Mainz, Mainz, Germany
| | - Hauke Lang
- General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany
| |
Collapse
|
15
|
Czauderna C, Schmidtmann I, Koch S, Pilz L, Heinrich S, Otto G, Mittler J, Lang H, Kloeckner R, Düber C, Sprinzl MF, Worns MA, Galle PR, Marquardt JU, Weinmann A. High pre-treatment static and dynamic alpha-fetoprotein values predict reduced overall survival in hepatocellular carcinoma. United European Gastroenterol J 2020; 9:2050640620972611. [PMID: 33226301 PMCID: PMC8259127 DOI: 10.1177/2050640620972611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/13/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma is one of the most lethal cancers worldwide. Novel prognostic and/or predictive biomarkers are urgently needed to improve patient management. Alpha-fetoprotein is a well-established and widely used biomarker for hepatocellular carcinoma. However, diagnostic accuracy of static alpha-fetoprotein values is limited and the clinical potential is a matter of ongoing scientific discussion. OBJECTIVE We here evaluated the prognostic impact of pre-treatment static and dynamic alpha-fetoprotein variables on overall survival of hepatocellular carcinoma patients in a Western cohort. METHODS Patients with confirmed hepatocellular carcinoma (n = 809) treated at the Johannes Gutenberg-University Mainz between 1998 and 2014 and two available pre-treatment alpha-fetoprotein-values (AFP-slope) were retrospectively analysed. Clinico-pathological baseline parameters, pre-treatment static values and AFP-slope were assessed. Prognostic impact was determined by Kaplan-Meier analyses and Cox regression models. RESULTS High static and dynamic alpha-fetoprotein variables prior to therapy were associated with reduced survival rates of hepatocellular carcinoma patients. Several known clinical parameters such as Child-Pugh B (p < 0.01) and C stage (p < 0.001), portal vein thrombosis (p < 0.001) and extrahepatic spread (p < 0.001) were confirmed as independent predictors for overall survival. Addition of static and/or dynamic alpha-fetoprotein variable resulted in higher time-dependent area under the curves. Notably, in patients with more favourable prognosis, AFP-slope prior to therapy was a slightly stronger predictor for overall survival compared with static alpha-fetoprotein values. CONCLUSION Static and dynamic alpha-fetoprotein variables prior to therapy are predictive for overall survival of hepatocellular carcinoma patients. Addition of AFP-slope to established prognostic parameters might improve prognostic classification for a subgroup of hepatocellular carcinoma patients with preserved liver function and without portal vein tumour thrombosis.
Collapse
Affiliation(s)
- Carolin Czauderna
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
- Department of Medicine IUniversity Medical Centre SchleswigHolstein—Campus LübeckLübeckGermany
| | - Irene Schmidtmann
- Institute of Medical BiostatisticsEpidemiology and Informatics (IMBEI)Johannes Gutenberg UniversityMainzGermany
- Department of General, Visceral and Transplant SurgeryJohannes Gutenberg UniversityMainzGermany
| | - Sandra Koch
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
| | - Lukas Pilz
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
| | - Sophia Heinrich
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
| | - Gerd Otto
- Department of General, Visceral and Transplant SurgeryJohannes Gutenberg UniversityMainzGermany
| | - Jens Mittler
- Department of General, Visceral and Transplant SurgeryJohannes Gutenberg UniversityMainzGermany
| | - Hauke Lang
- Department of General, Visceral and Transplant SurgeryJohannes Gutenberg UniversityMainzGermany
| | - Roman Kloeckner
- Department of Diagnostic and Interventional RadiologyJohannes Gutenberg UniversityMainzGermany
| | - Christoph Düber
- Department of Diagnostic and Interventional RadiologyJohannes Gutenberg UniversityMainzGermany
| | - Martin F. Sprinzl
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
| | - Marcus A. Worns
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
| | - Peter R. Galle
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
| | - Jens U. Marquardt
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
- Department of Medicine IUniversity Medical Centre SchleswigHolstein—Campus LübeckLübeckGermany
| | - Arndt Weinmann
- Department of Internal Medicine IJohannes Gutenberg UniversityMainzGermany
| |
Collapse
|
16
|
Viteri S, Mazieres J, Veillon R, Felip E, Le X, Garassino M, Stanton T, Morise M, Lee JS, Matsumoto S, De Marinis F, Wehler T, Clark A, Friese-Hamim M, Stroh C, Bruns R, Otto G, Paik P. 1286P Activity of tepotinib in brain metastases (BM): Preclinical models and clinical data from patients (pts) with MET exon 14 (METex14) skipping NSCLC. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
17
|
Darstein F, Häuser F, Mittler J, Zimmermann A, Lautem A, Hoppe-Lotichius M, Otto G, Lang H, Galle PR, Zimmermann T. Hepatitis E Is a Rare Finding in Liver Transplant Patients With Chronic Elevated Liver Enzymes and Biopsy-Proven Acute Rejection. Transplant Proc 2020; 52:926-931. [PMID: 32139278 DOI: 10.1016/j.transproceed.2020.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/17/2019] [Accepted: 01/22/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND In past decades, liver transplant (LT) patients were not routinely screened for hepatitis E virus (HEV) infection, and thus it might have been misdiagnosed as an acute rejection episode. Our aim was to analyze a real-world cohort of LT patients who presented with at least 1 episode of biopsy-proven acute rejection (BPAR) and suffered from persistent elevated transaminases, to evaluate the frequency of HEV infection misdiagnosed as a rejection episode. METHODS Data from 306 patients transplanted between 1997 and 2017, including 565 liver biopsies, were analyzed. Biopsies from patients suffering from hepatitis C (n = 79; 25.8%) and from patients who presented with a Rejection Activity Index <5 (n = 134; 43.8%) were excluded. A subgroup of 74 patients (with 134 BPAR) with persistently elevated liver enzymes was chosen for further HEV testing. RESULTS Positive HEV IgG was detectable in 18 of 73 patients (24.7%). Positive HEV RNA was diagnosed in 3 of 73 patients with BPAR (4.1%). Patients with HEV infection showed no difference in etiology of the liver disease, type of immunosuppression, or median Rejection Activity Index. CONCLUSION Few HEV infections were misdiagnosed as acute rejection episodes in this real-world cohort. Thus, HEV infection is an infrequent diagnosis in cases with persistent elevated liver enzymes and BPAR after LT.
Collapse
Affiliation(s)
- F Darstein
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany.
| | - F Häuser
- Institute for Clinical Chemistry and Laboratory Medicine, Universitätsmedizin Mainz, Mainz, Germany
| | - J Mittler
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - A Zimmermann
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany
| | - A Lautem
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - M Hoppe-Lotichius
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - G Otto
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - H Lang
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - P R Galle
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany
| | - T Zimmermann
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany
| |
Collapse
|
18
|
Firl DJ, Sasaki K, Agopian VG, Gorgen A, Kimura S, Dumronggittigule W, McVey JC, Iesari S, Mennini G, Vitale A, Finkenstedt A, Onali S, Hoppe-Lotichius M, Vennarecci G, Manzia TM, Nicolini D, Avolio AW, Agnes S, Vivarelli M, Tisone G, Ettorre GM, Otto G, Tsochatzis E, Rossi M, Viveiros A, Cillo U, Markmann JF, Ikegami T, Kaido T, Lai Q, Sapisochin G, Lerut J, Aucejo FN. Charting the Path Forward for Risk Prediction in Liver Transplant for Hepatocellular Carcinoma: International Validation of HALTHCC Among 4,089 Patients. Hepatology 2020; 71:569-582. [PMID: 31243778 DOI: 10.1002/hep.30838] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 06/17/2019] [Indexed: 12/14/2022]
Abstract
Prognosticating outcomes in liver transplant (LT) for hepatocellular carcinoma (HCC) continues to challenge the field. Although Milan Criteria (MC) generalized the practice of LT for HCC and improved outcomes, its predictive character has degraded with increasing candidate and oncological heterogeneity. We sought to validate and recalibrate a previously developed, preoperatively calculated, continuous risk score, the Hazard Associated with Liver Transplantation for Hepatocellular Carcinoma (HALTHCC), in an international cohort. From 2002 to 2014, 4,089 patients (both MC in and out [25.2%]) across 16 centers in North America, Europe, and Asia were included. A continuous risk score using pre-LT levels of alpha-fetoprotein, Model for End-Stage Liver Disease Sodium score, and tumor burden score was recalibrated among a randomly selected cohort (n = 1,021) and validated in the remainder (n = 3,068). This study demonstrated significant heterogeneity by site and year, reflecting practice trends over the last decade. On explant pathology, both vascular invasion (VI) and poorly differentiated component (PDC) increased with increasing HALTHCC score. The lowest-risk patients (HALTHCC 0-5) had lower rates of VI and PDC than the highest-risk patients (HALTHCC > 35) (VI, 7.7%[ 1.2-14.2] vs. 70.6% [48.3-92.9] and PDC:4.6% [0.1%-9.8%] vs. 47.1% [22.6-71.5]; P < 0.0001 for both). This trend was robust to MC status. This international study was used to adjust the coefficients in the HALTHCC score. Before recalibration, HALTHCC had the greatest discriminatory ability for overall survival (OS; C-index = 0.61) compared to all previously reported scores. Following recalibration, the prognostic utility increased for both recurrence (C-index = 0.71) and OS (C-index = 0.63). Conclusion: This large international trial validated and refined the role for the continuous risk metric, HALTHCC, in establishing pre-LT risk among candidates with HCC worldwide. Prospective trials introducing HALTHCC into clinical practice are warranted.
Collapse
Affiliation(s)
- Daniel J Firl
- Department of General Surgery and Cleveland Clinic Lerner College of Medicine, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH
| | - Kazunari Sasaki
- Department of General Surgery and Cleveland Clinic Lerner College of Medicine, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH
| | - Vatche G Agopian
- Dumont-UCLA Transplant and Liver Cancer Center, Department of Surgery, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Andre Gorgen
- Department of Abdominal Transplant and HPB Surgical Oncology, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Shoko Kimura
- Transplant Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Wethit Dumronggittigule
- Dumont-UCLA Transplant and Liver Cancer Center, Department of Surgery, Ronald Reagan UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - John C McVey
- Department of General Surgery and Cleveland Clinic Lerner College of Medicine, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH
| | - Samuele Iesari
- Starzl Unit of Abdominal Transplantation, St. Luc University Hospital, Université Catholique Louvain, Brussels, Belgium
| | - Gianluca Mennini
- Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Alessandro Vitale
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Armin Finkenstedt
- Department of Medicine I, Medical University Innsbruck, Innsbruck, Austria
| | - Simona Onali
- UCL Institute for Liver and Digestive Health and Royal Free Sherlock Liver Centre, Royal Free Hospital and UCL, London, United Kingdom
| | - Maria Hoppe-Lotichius
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Giovanni Vennarecci
- Division of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy
| | - Tommaso M Manzia
- Department of Transplant Surgery, Polyclinic Tor Vergata Foundation, Tor Vergata University, Rome, Italy
| | - Daniele Nicolini
- Unit of Hepatobiliary Surgery and Transplantation, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Torrette Ancona, Italy
| | - Alfonso W Avolio
- Liver Unit, Department of Surgery, Agostino Gemelli Hospital, Catholic University, Rome, Italy
| | - Salvatore Agnes
- Liver Unit, Department of Surgery, Agostino Gemelli Hospital, Catholic University, Rome, Italy
| | - Marco Vivarelli
- Unit of Hepatobiliary Surgery and Transplantation, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Torrette Ancona, Italy
| | - Giuseppe Tisone
- Department of Transplant Surgery, Polyclinic Tor Vergata Foundation, Tor Vergata University, Rome, Italy
| | - Giuseppe M Ettorre
- Division of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy
| | - Gerd Otto
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Emmanuel Tsochatzis
- UCL Institute for Liver and Digestive Health and Royal Free Sherlock Liver Centre, Royal Free Hospital and UCL, London, United Kingdom
| | - Massimo Rossi
- Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Andre Viveiros
- Department of Medicine I, Medical University Innsbruck, Innsbruck, Austria
| | - Umberto Cillo
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - James F Markmann
- Transplant Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | | | - Quirino Lai
- Starzl Unit of Abdominal Transplantation, St. Luc University Hospital, Université Catholique Louvain, Brussels, Belgium.,Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Gonzalo Sapisochin
- Department of Abdominal Transplant and HPB Surgical Oncology, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Jan Lerut
- Starzl Unit of Abdominal Transplantation, St. Luc University Hospital, Université Catholique Louvain, Brussels, Belgium
| | | | - Federico N Aucejo
- Department of General Surgery and Cleveland Clinic Lerner College of Medicine, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH
| |
Collapse
|
19
|
Lai Q, Iesari S, Finkenstedt A, Hoppe-Lotichius M, Foguenne M, Lehner K, Otto G, Lerut J. Hepatocellular carcinoma recurrence after acute liver allograft rejection treatment: A multicenter European experience. Hepatobiliary Pancreat Dis Int 2019; 18:517-524. [PMID: 31151807 DOI: 10.1016/j.hbpd.2019.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/10/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND During the last decades, several risk factors for the recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) have been investigated. However, the impact of two important drivers of oncogenesis, namely the immunosuppression and the treatment of acute cellular rejection (ACR) have been marginally addressed. This study aimed at investigating the impact of ACR treatment on the incidence of tumor recurrence in a large European HCC-LT population. METHODS Seven hundred and eighty-one adult patients transplanted between February 1, 1985 and June 30, 2016 were retrospectively analyzed. After propensity score match, 116 patients treated for ACR using steroid boluses were compared with 115 patients who did not present any ACR or a histologic but clinical irrelevant ACR. RESULTS Steroid boluses treated patients had a 18-fold higher overall incidence of HCC recurrence than those non-treated patients (16.4% vs. 0.9%; P<0.0001). At multivariate Cox regression analysis, steroid boluses used to treat ACR were an independent risk factor for HCC recurrence (HR=14.2; 95% CI: 1.8-110.4; P = 0.010). CONCLUSIONS The decision to treat ACR as well as to reinforce immunosuppression load should be cautiously taken in view of the presented results. Prospective studies are needed to further elucidate the clinical impact of immunosuppression on HCC recurrence after transplantation.
Collapse
Affiliation(s)
- Quirino Lai
- Starzl Unit of Abdominal Transplantation, University Hospitals Saint Luc, Université catholique Louvain, Brussels, Belgium; Hepato-biliary Surgery and Liver Transplantation Unit, Sapienza University of Rome, Umberto I Hospital, Rome, Italy.
| | - Samuele Iesari
- Starzl Unit of Abdominal Transplantation, University Hospitals Saint Luc, Université catholique Louvain, Brussels, Belgium; Department of Bio-technological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Armin Finkenstedt
- Department of Internal Medicine I, Innsbruck Medical University, Innsbruck, Austria
| | - Maria Hoppe-Lotichius
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Maxime Foguenne
- Starzl Unit of Abdominal Transplantation, University Hospitals Saint Luc, Université catholique Louvain, Brussels, Belgium
| | - Konrad Lehner
- Department of Internal Medicine I, Innsbruck Medical University, Innsbruck, Austria
| | - Gerd Otto
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Jan Lerut
- Starzl Unit of Abdominal Transplantation, University Hospitals Saint Luc, Université catholique Louvain, Brussels, Belgium
| |
Collapse
|
20
|
Lai Q, Vitale A, Iesari S, Finkenstedt A, Mennini G, Onali S, Hoppe-Lotichius M, Manzia TM, Nicolini D, Avolio AW, Mrzljak A, Kocman B, Agnes S, Vivarelli M, Tisone G, Otto G, Tsochatzis E, Rossi M, Viveiros A, Ciccarelli O, Cillo U, Lerut J. The Intention-to-Treat Effect of Bridging Treatments in the Setting of Milan Criteria-In Patients Waiting for Liver Transplantation. Liver Transpl 2019; 25:1023-1033. [PMID: 31087772 DOI: 10.1002/lt.25492] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/20/2019] [Indexed: 02/05/2023]
Abstract
In patients with hepatocellular carcinoma (HCC) meeting the Milan criteria (MC), the benefit of locoregional therapies (LRTs) in the context of liver transplantation (LT) is still debated. Initial biases in the selection between treated and untreated patients have yielded conflicting reported results. The study aimed to identify, using a competing risk analysis, risk factors for HCC-dependent LT failure, defined as pretransplant tumor-related delisting or posttransplant recurrence. The study was registered at www.clinicaltrials.gov (identification number NCT03723304). In order to offset the initial limitations of the investigated population, an inverse probability of treatment weighting (IPTW) analysis was used: 1083 MC-in patients (no LRT = 182; LRT = 901) were balanced using 8 variables: age, sex, Model for End-Stage Liver Disease (MELD) value, hepatitis C virus status, hepatitis B virus status, largest lesion diameter, number of nodules, and alpha-fetoprotein (AFP). All the covariates were available at the first referral. After the IPTW, a pseudo-population of 2019 patients listed for LT was analyzed, comparing 2 homogeneous groups of untreated (n = 1077) and LRT-treated (n = 942) patients. Tumor progression after LRT was the most important independent risk factor for HCC-dependent failure (subhazard ratio [SHR], 5.62; P < 0.001). Other independent risk factors were major tumor diameter, AFP, MELD, patient age, male sex, and period of wait-list registration. One single LRT was protective compared with no treatment (SHR, 0.51; P < 0.001). The positive effect was still observed when 2-3 treatments were performed (SHR, 0.66; P = 0.02), but it was lost in the case of ≥4 LRTs (SHR, 0.80; P = 0.27). In conclusion, for MC-in patients, up to 3 LRTs are beneficial for success in intention-to-treat LT patients, with a 49% to 34% reduction in failure risk compared with untreated patients. This benefit is lost if more LRTs are required. A poor response to LRT is associated with a higher risk for HCC-dependent transplant failure.
Collapse
Affiliation(s)
- Quirino Lai
- Starzl Abdominal Transplant Unit, Pôle de Chirurgie Expérimentale et Transplantation, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
- Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Alessandro Vitale
- Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Samuele Iesari
- Starzl Abdominal Transplant Unit, Pôle de Chirurgie Expérimentale et Transplantation, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Armin Finkenstedt
- Department of Medicine I, Medical University Innsbruck, Innsbruck, Austria
| | - Gianluca Mennini
- Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Simona Onali
- University College London Institute for Liver and Digestive Health and Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and University College London, London, United Kingdom
| | - Maria Hoppe-Lotichius
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Tommaso M Manzia
- Department of Transplant Surgery, Polyclinic Tor Vergata Foundation, Tor Vergata University, Rome, Italy
| | - Daniele Nicolini
- Unit of Hepatobiliary Surgery and Transplantation, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Polytechnic University of Marche, Torrette Ancona, Italy
| | - Alfonso W Avolio
- Liver Unit, Department of Surgery, Agostino Gemelli Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Mrzljak
- Liver Transplant Centre, Merkur University, Zagreb, Croatia
| | | | - Salvatore Agnes
- Liver Unit, Department of Surgery, Agostino Gemelli Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Marco Vivarelli
- Unit of Hepatobiliary Surgery and Transplantation, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Polytechnic University of Marche, Torrette Ancona, Italy
| | - Giuseppe Tisone
- Department of Transplant Surgery, Polyclinic Tor Vergata Foundation, Tor Vergata University, Rome, Italy
| | - Gerd Otto
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Emmanuel Tsochatzis
- University College London Institute for Liver and Digestive Health and Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and University College London, London, United Kingdom
| | - Massimo Rossi
- Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Andre Viveiros
- Department of Medicine I, Medical University Innsbruck, Innsbruck, Austria
| | - Olga Ciccarelli
- Starzl Abdominal Transplant Unit, Pôle de Chirurgie Expérimentale et Transplantation, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Umberto Cillo
- Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Jan Lerut
- Starzl Abdominal Transplant Unit, Pôle de Chirurgie Expérimentale et Transplantation, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | | |
Collapse
|
21
|
Foerster F, Hoppe-Lotichius M, Vollmar J, Marquardt JU, Weinmann A, Wörns MA, Otto G, Zimmermann T, Galle PR. Long-term observation of hepatocellular carcinoma recurrence after liver transplantation at a European transplantation centre. United European Gastroenterol J 2019; 7:838-849. [PMID: 31316788 DOI: 10.1177/2050640619840221] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/06/2019] [Indexed: 01/10/2023] Open
Abstract
Background The recurrence of hepatocellular carcinoma (HCC) is the strongest survival-limiting factor after liver transplantation (LT) in patients with HCC. In the face of donor organ shortage, it is necessary to identify factors associated with HCC recurrence in order to maximize the utility of the available grafts. Objective To study the phenomenon of HCC recurrence after LT at a European transplantation centre over the past 20 years. Methods Data from 304 HCC patients who underwent LT were prospectively recorded. Clinical and pathological factors were assessed for their association with recurrence. Results Fifty-one patients (16.8%) had HCC recurrence after LT. Patients exceeding the Milan criteria developed HCC recurrence more frequently. The time point of recurrence did not affect survival after recurrence. Furthermore, there was no difference in survival between patients with intra- and extrahepatic recurrence. However, patients with recurrence due to needle tract seeding had a significantly better outcome than patients with other sites of recurrence. Conclusion Our data support a restrictive use of patient selection criteria to help identify patients who have an increased risk of HCC recurrence after LT, and highlight the need to improve patient selection before LT in order to minimize the rate of HCC recurrence.
Collapse
Affiliation(s)
- Friedrich Foerster
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Maria Hoppe-Lotichius
- Department of General and Abdominal Surgery, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Johanna Vollmar
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Jens U Marquardt
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Arndt Weinmann
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marcus-Alexander Wörns
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Gerd Otto
- Department of General and Abdominal Surgery, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Tim Zimmermann
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Peter R Galle
- Department of Medicine I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| |
Collapse
|
22
|
Lautem A, Simon F, Hoppe-Lotichius M, Mittler J, Vollmar J, Schad A, Düber C, Galle PR, Otto G, Zimmermann T, Lang H. Expression and prognostic significance of insulin‑like growth factor-2 receptor in human hepatocellular carcinoma and the influence of transarterial chemoembolization. Oncol Rep 2019; 41:2299-2310. [PMID: 30720132 DOI: 10.3892/or.2019.6995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 12/11/2018] [Indexed: 11/06/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the most common human malignancies, the incidence of which is growing worldwide. The prognosis of HCC is very poor and it is often accompanied by a high rate of recurrence. Conventional chemotherapeutic approaches are largely inefficient. In order to develop novel effective methods for the early detection and prognosis of HCC, novel markers and therapeutic targets are urgently required. The present study focused on the effects of the expression of the tumor suppressor gene insulin‑like growth factor‑2 receptor (IGF2R) on patient survival and tumor recurrence in patients with HCC; this study paid specific attention to the influence of transarterial chemoembolization (TACE) prior to surgery. The mRNA expression levels of IGF2R were measured in primary human HCC and corresponding non‑neoplastic tumor‑surrounding tissue (TST) by reverse transcription‑polymerase chain reaction (RT‑PCR) (n=92). Subsequently, the associations between IGF2R expression and clinicopathological parameters, outcomes of HCC and TACE pretreatment prior to surgery were determined. Furthermore, the effects of the IGF2R gene polymorphisms rs629849 and rs642588 on susceptibility and on clinicopathological features of HCC were investigated. RT‑PCR demonstrated that the mRNA expression levels of IGF2R were downregulated in HCC compared with in TST samples (P=0.004), which was associated with a worse recurrence‑free survival of patients with HCC (P=0.002) and a lower occurrence of cirrhosis (P=0.05). TACE‑pretreated patients with HCC (n=26) exhibited significantly higher IGF2R mRNA expression in tumor tissues (P=0.019). In addition, significantly more patients with HCC in the TACE‑pretreated group exhibited upregulated IGF2R mRNA expression compared with in the non‑treated patients (P=0.032). The IGF2R SNPs rs629849 and rs642588 were not significantly associated with HCC risk, whereas a homozygous IGF2R rs629849 GG genotype was associated with a significantly elevated risk of non‑viral liver cirrhosis (P=0.05). In conclusion, these data suggested an important role for IGF2R expression in HCC, particularly with regards to TACE treatment prior to surgery.
Collapse
Affiliation(s)
- Anja Lautem
- Department of General, Visceral and Transplantation Surgery, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Frank Simon
- Department of General, Visceral and Transplantation Surgery, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Maria Hoppe-Lotichius
- Department of General, Visceral and Transplantation Surgery, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Jens Mittler
- Department of General, Visceral and Transplantation Surgery, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Johanna Vollmar
- 1st Department of Internal Medicine, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Arno Schad
- Institute of Pathology, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Peter Robert Galle
- 1st Department of Internal Medicine, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Gerd Otto
- Department of General, Visceral and Transplantation Surgery, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Tim Zimmermann
- 1st Department of Internal Medicine, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| | - Hauke Lang
- Department of General, Visceral and Transplantation Surgery, University Medicine of The Johannes Gutenberg University Mainz, D‑55131 Mainz, Germany
| |
Collapse
|
23
|
Abstract
With slightly more than 10 donors per million inhabitants, Germany belongs to the underdeveloped countries in Europe with regard to organ donation. Organ shortage is supposed to promote the usage of organs which are declined in case of less pronounced scarcity. This may result in deteriorated graft and patient survival. In the light of this situation, data on the centers' procedures and outcome of liver transplantation in Germany is presented based upon reports of Eurotransplant, the German Institutions for Quality Assessment, and the Deutsche Stiftung Organtransplantation. Surprisingly, along with an increasing organ scarcity, the outcome during waiting time and after transplantation has been improved. The 1- and 3-year patient survival improved by 7 and 9%, respectively. Reasons for this unexpected development are discussed.
Collapse
Affiliation(s)
- Gerd Otto
- Dir. em. of the Department of Hepatobiliary and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
24
|
Harbeck N, Wang J, Otto G, Krendyukov A. Safety analysis of proposed biosimilar pegfilgrastim in phase I and phase III studies. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
25
|
Li Y, Sun J, Skoletsky J, Milbury C, Burns C, Yip WK, Dewal N, He J, Tuesdell J, Peters E, Schleifman E, Noe J, Jenkins S, Elvin J, Otto G, Lipson D, Ross J, Miller V, Doherty M, Vietz C. Clinical and analytical validation of an FDA approved comprehensive genomic profiling (CGP) assay incorporating multiple companion diagnostics for targeted and immunotherapies. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
26
|
Nakov R, Schussler S, Schier-Mumzhiu S, Skerjanec A, Bellon A, Wang J, Krendyukov A, Otto G. A large multi-center, randomized, double-blind, crossover study in healthy volunteers to compare pharmacokinetics and pharmacodynamics of a proposed biosimilar pegfilgrastim with EU and US reference pegfilgrastim: Methodological approach. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
27
|
Foerster F, Mittler J, Darstein F, Heise M, Marquardt JU, Wörns MA, Weinmann A, Sälter L, Hoppe-Lotichius M, Heinrich S, Kloeckner R, Pitton MB, Schattenberg JM, Sprinzl MF, Düber C, Otto G, Lang H, Galle PR, Zimmermann T. Recipient liver function before liver transplantation influences post-transplantation survival in patients with HCC. Eur J Intern Med 2018; 55:57-65. [PMID: 29859798 DOI: 10.1016/j.ejim.2018.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/05/2018] [Accepted: 05/20/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Liver transplantation (LT) is a complex yet curative treatment for a subset of patients with hepatocellular carcinoma (HCC). Due to donor organ shortage, patients with HCC need to be carefully selected for LT. In European countries, selection of patients is based on the Milan criteria, and donor organs are allocated by Eurotransplant. In order to optimize the utilization of available liver grafts, the outcome of HCC patients after LT needs to be closely monitored and evaluated. METHODS We assessed the outcome of 304 HCC patients who underwent LT at a tertiary medical center over a period of nearly 20 years (February 1998 until June 2017). RESULTS The 5-, 10- and 15-year survival rates were 62, 47 and 30%, respectively. The strongest survival-determining factor was tumour recurrence. Apart from a high tumour grading, the pre-LT MELD score was significantly and negatively associated with survival after LT. CONCLUSION Our results confirm the importance of recurrence for the outcome of HCC patients after LT and highlight the relevance of HCC patients' liver function before LT. Our findings encourage efforts to identify prognostically relevant factors for LT in HCC with the overall goal of refining the organ allocation system and maximizing the survival benefit after LT.
Collapse
Affiliation(s)
- Friedrich Foerster
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Jens Mittler
- Department of General and Abdominal Surgery, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Felix Darstein
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Michael Heise
- Department of General and Abdominal Surgery, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Jens U Marquardt
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Marcus-Alexander Wörns
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Arndt Weinmann
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Lina Sälter
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Maria Hoppe-Lotichius
- Department of General and Abdominal Surgery, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Stefan Heinrich
- Department of General and Abdominal Surgery, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Roman Kloeckner
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Michael B Pitton
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Jörn M Schattenberg
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Martin F Sprinzl
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Gerd Otto
- Department of General and Abdominal Surgery, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Hauke Lang
- Department of General and Abdominal Surgery, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Peter R Galle
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany
| | - Tim Zimmermann
- Department of Internal Medicine I, University Medical Center Mainz, Germany; Interdiscliplinary Transplantation Center (ITx), Mainz, Germany.
| |
Collapse
|
28
|
Vollmar J, Schmid JC, Hoppe-Lotichius M, Barreiros AP, Azizi M, Emrich T, Geber C, Schad A, Weyer V, Otto G, Heise M, Mittler J, Birklein F, Lang H, Galle PR, Zimmermann T. Progression of transthyretin (TTR) amyloidosis in donors and recipients after domino liver transplantation-a prospective single-center cohort study. Transpl Int 2018; 31:1207-1215. [PMID: 30091268 DOI: 10.1111/tri.13326] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 03/30/2018] [Accepted: 07/27/2018] [Indexed: 11/30/2022]
Abstract
Liver transplantation (LT) is the first-line therapy in patients with transthyretin (TTR) amyloidosis and progressive familial amyloid polyneuropathy (FAP). Explanted organs from these patients can be used for domino liver transplantation (DLT). After DLT, de novo amyloidosis may develop in domino recipients (DR). Data were collected prospectively in a transplant database. Electroneurography by nerve conduction velocity (NCV), quantitative sensory testing, heart rate variability (HRV), sympathetic skin response, orthostatic reaction (tilt table test), transthoracic echocardiography, cardiac MRI and organ biopsy results were evaluated. The cohort included 24 FAP- (11 Val30Met, 13 nonVal30Met) and 23 DR-patients. DR symptoms referred to post-DLT only, while those of FAP patients were both pre- and post-transplantation. Symptoms of TTR-amyloidosis in Val30Met and Non-Val30Met patients pre- and post-LT were similarly distributed. Biopsy-proven de novo amyloidosis occurred in 4/23 DR after a mean observation of 10 years. Analysis for manifestations of amyloidosis only included patients with available 5-year follow-up data (n = 13 FAP, n = 12 DR). Compared to Val30Met FAP patients pre-LT, Val30Met DR patients had better NCV (P = 0.04) and HRV (P = 0.015). In the Non-Val30Met group no differences were found between DR and FAP patients pre-LT. TTR-amyloidosis symptoms showed no differences in FAP patients pre- and 5 years post-LT, irrespective of Val30Met status. In DR patients, de novo amyloidosis occurred earlier than expected. Therefore, recipients for DLT need to be carefully selected and followed.
Collapse
Affiliation(s)
- Johanna Vollmar
- I. Department of Internal Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.,Interdisciplinary Transplant Center, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julia C Schmid
- I. Department of Internal Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Maria Hoppe-Lotichius
- Department of General-, Abdominal- and Transplantation- Surgery, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ana P Barreiros
- I. Department of Internal Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.,Deutsche Stiftung Organtransplantation, Mainz, Germany
| | - Mimoun Azizi
- Department of Neurology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tilman Emrich
- Department of Radiology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Geber
- Department of Neurology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Arno Schad
- Institute of Pathology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Veronica Weyer
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Gerd Otto
- Department of General-, Abdominal- and Transplantation- Surgery, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael Heise
- Interdisciplinary Transplant Center, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.,Department of General-, Abdominal- and Transplantation- Surgery, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jens Mittler
- Interdisciplinary Transplant Center, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.,Department of General-, Abdominal- and Transplantation- Surgery, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Frank Birklein
- Department of Neurology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Hauke Lang
- Interdisciplinary Transplant Center, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.,Department of General-, Abdominal- and Transplantation- Surgery, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peter R Galle
- I. Department of Internal Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.,Interdisciplinary Transplant Center, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tim Zimmermann
- I. Department of Internal Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.,Interdisciplinary Transplant Center, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
29
|
Darstein F, Hoppe-Lotichius M, Vollmar J, Weyer-Elberich V, Zimmermann A, Mittler J, Otto G, Lang H, Galle PR, Zimmermann T. Pretransplant coronary artery disease is a predictor for myocardial infarction and cardiac death after liver transplantation. Eur J Intern Med 2018; 51:41-45. [PMID: 29229303 DOI: 10.1016/j.ejim.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 11/20/2017] [Accepted: 12/05/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cardiovascular disease is a serious problem of liver transplant (LT) recipients because of increased cardiovascular risk due to immunosuppressive therapy, higher age, intraoperative risk and comorbidities (such as diabetes and nicotine abuse). Reported frequency of cardiovascular events after LT shows a high variability between different LT cohorts. Our aim was to analyze a cohort of LT recipients from a single center in Germany to evaluate frequency of the cardiovascular endpoints (CVE) myocardial infarction and/or cardiac death after LT and to investigate correlations of CVE post LT with pretransplant patient characteristics. PATIENTS In total, data from 352 LT patients were analyzed. Patients were identified from an administrative transplant database, and all data were retrieved from patients' charts and reports. RESULTS During the median follow-up of 4.0 (0-13) years, 10 cases of CVE were documented (six myocardial infarctions and four coronary deaths). The frequency of CVE did not differ according to classic cardiovascular risk factors such as body mass index (p=0.071), total cholesterol (p=0.533), hypertension (p=0.747), smoking (p=1.000) and pretransplant diabetes mellitus (p=0.146). In patients with pretransplant coronary heart disease (n=24; 6.8%) CVE were found more frequently (p=0.024). CONCLUSION In summary, we found a rate of 2.8% CVE after LT in a German transplant cohort. Pretransplant CHD was the only risk factor for CVE, but showed no significant impact on overall survival.
Collapse
Affiliation(s)
- F Darstein
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany.
| | - M Hoppe-Lotichius
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - J Vollmar
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany
| | - V Weyer-Elberich
- Division of Biostatistics and Bioinformatics, Universitätsmedizin Mainz, Mainz, Germany
| | - A Zimmermann
- First Department of Internal Medicine, Endocrinology and Metabolic Diseases, Universitätsmedizin Mainz, Mainz, Germany
| | - J Mittler
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - G Otto
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - H Lang
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - P R Galle
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany
| | - T Zimmermann
- First Department of Internal Medicine, Gastroenterology and Hepatology, Universitätsmedizin Mainz, Mainz, Germany.
| |
Collapse
|
30
|
Rittmeyer A, Gandara D, Kowanetz M, Mok T, Fehrenbacher L, Fabrizio D, Otto G, Malboeuf C, Lieber D, Paul SM, Amler L, Riehl T, Schleifman E, Cummings C, Hegde PS, Zou W, Sandler A, Ballinger M, Shames DS. Blood-Based Biomarkers for Cancer Immunotherapy: Tumor Mutational Burden in Blood (bTMB) is Associated with Improved Atezolizumab (atezo) Efficacy in 2L+ NSCLC (POPLAR and OAK). Pneumologie 2018. [DOI: 10.1055/s-0037-1619250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - D Gandara
- UC Davis Comprehensive Cancer Center, Sacramento, CA
| | | | - T Mok
- State Key Laboratory of South China, Hong Kong Cancer Institute, The Chinese University of Hong Kong
| | | | - D Fabrizio
- Foundation Medicine Inc., Cambridge, USA
| | - G Otto
- Foundation Medicine Inc., Cambridge, USA
| | - C Malboeuf
- Foundation Medicine Inc., Cambridge, USA
| | - D Lieber
- Foundation Medicine Inc., Cambridge, USA
| | - SM Paul
- Genentech Inc., South San Francisco
| | - L Amler
- Genentech Inc., South San Francisco
| | - T Riehl
- Genentech Inc., South San Francisco
| | | | | | - PS Hegde
- Genentech Inc., South San Francisco
| | - W Zou
- Genentech Inc., South San Francisco
| | | | | | | |
Collapse
|
31
|
Abstract
Ischemic type biliary lesions lead to considerable morbidity following orthotopic liver transplantation. The exact pathogenesis is unknown. One major hypothesis is that insufficient perfusion of the arterial vessels of the biliary tree, especially under perfusion with the high viscous University of Wisconsin solution, might be responsible for ischemic type biliary lesions. Due to low viscosity, HTK solution is reported to have a lower incidence of biliary complications. However, there is no data concerning ischemic type biliary lesions in HTK preserved livers. In this paper we report our results after orthotopic liver transplantation with special regard to ischemic type biliary lesions in liver grafts preserved with HTK solution. Between 09/1997 and 01/2005 300 liver transplantations were performed in our center. Thirty-two (10.7%) liver grafts were preserved with HTK solution, 268 (89.3%) were preserved with UW solution. Six and 43 grafts showed ischemic type biliary lesions after orthotopic liver transplantation in HTK- (18.8%) and UW- (16.0%) groups, respectively (p=0.696). There was no statistical significant difference between the two groups. Donor related factors, recipient age, indication for transplantation, transplantation technique, immunosuppression and ischemia time were comparable in both groups. Ischemic type biliary lesions occurred with the same frequency in HTK preserved livers compared to UW preserved organs. We suggest that low viscosity of the preservation fluid by itself does not guarantee reliable perfusion of the small arteries of a liver graft and a pressure perfusion might be beneficial even in HTK solution.
Collapse
Affiliation(s)
- C Moench
- Department of Transplantation and Hepatobiliary Surgery, Johannes Gutenberg University, Mainz, Germany.
| | | |
Collapse
|
32
|
Bagryansky P, Anikeev A, Collatz S, Deichuli P, Ivanov A, Karpushov A, Korepanov S, Lizunov A, Maximov V, Murachtin S, Noack K, Otto G, Saunichev K, Shikhovtsev I, Shukaev A, Stupishin N. Recent Results of Experiments on the Gas Dynamic Trap. ACTA ACUST UNITED AC 2018. [DOI: 10.13182/fst99-a11963829] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- P.A. Bagryansky
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - A.V. Anikeev
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - S Collatz
- Research Center Rossendorf Inc., Dresden, PO 510119 D-01314, Germany
| | - P.P. Deichuli
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - A.A. Ivanov
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - A.N. Karpushov
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - S.A. Korepanov
- Novosibirsk State Technical University, 630092 Novosibirsk, Russia
| | - A.A. Lizunov
- Novosibirsk State University, 630090, Novosibirsk, Russia
| | - V.V. Maximov
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - S.V. Murachtin
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - K Noack
- Research Center Rossendorf Inc., Dresden, PO 510119 D-01314, Germany
| | - G Otto
- Research Center Rossendorf Inc., Dresden, PO 510119 D-01314, Germany
| | - K.N. Saunichev
- Novosibirsk State University, 630090, Novosibirsk, Russia
| | - I.V. Shikhovtsev
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - A.N. Shukaev
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| | - N.V. Stupishin
- Budker Institute of Nuclear Physics, 630090, Novosibirsk, Russia
| |
Collapse
|
33
|
Ivanov A, Abdrashitov G, Anikeev A, Bagryansky P, Deichuli P, Karpushov A, Korepanov S, Lizunov A, Maximov V, Murakhtin S, Smirnov AY, Zouev A, Noack K, Otto G. GDT Device. Recent Results and Future Plans for GDT Upgrade. Fusion Science and Technology 2018. [DOI: 10.13182/fst03-a11963562] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A.A. Ivanov
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | | | - A.V. Anikeev
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - P.A. Bagryansky
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - P.P. Deichuli
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - A.N. Karpushov
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - S.A. Korepanov
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - A.A. Lizunov
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - V.V. Maximov
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - S.V. Murakhtin
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - A. Yu. Smirnov
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - A.A. Zouev
- Budker Institute of Nuclear Physics, 630090 Novosibirsk, Russia
| | - K. Noack
- Forschungszentrum Rossendorf e.V., D-01314 Dresden, Germany
| | - G. Otto
- Forschungszentrum Rossendorf e.V., D-01314 Dresden, Germany
| |
Collapse
|
34
|
Lai Q, Vitale A, Iesari S, Finkenstedt A, Mennini G, Spoletini G, Hoppe-Lotichius M, Vennarecci G, Manzia TM, Nicolini D, Avolio AW, Frigo AC, Graziadei I, Rossi M, Tsochatzis E, Otto G, Ettorre GM, Tisone G, Vivarelli M, Agnes S, Cillo U, Lerut J. Intention-to-treat survival benefit of liver transplantation in patients with hepatocellular cancer. Hepatology 2017; 66:1910-1919. [PMID: 28653750 DOI: 10.1002/hep.29342] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 05/10/2017] [Accepted: 06/23/2017] [Indexed: 12/12/2022]
Abstract
UNLABELLED The debate about the best approach to select patients with hepatocellular cancer (HCC) waiting for liver transplantation (LT) is still ongoing. This study aims to identify the best variables allowing to discriminate between "high-" and "low-benefit" patients. To do so, the concept of intention-to-treat (ITT) survival benefit of LT has been created. Data of 2,103 adult HCC patients consecutively enlisted during the period 1987-2015 were analyzed. Three rigorous statistical steps were used in order to create the ITT survival benefit of LT: the development of an ITT LT and a non-LT survival model, and the individual prediction of the ITT survival benefit of LT defined as the difference between the median ITT survival with (based on the first model) and without LT (based on the second model) calculated for each enrolled patient. Four variables (Model for End-Stage Liver Disease, alpha-fetoprotein, Milan-Criteria status, and radiological response) displayed a high effect in terms of delta benefit. According to these risk factors, four benefit groups were identified. Patients with three to four factors ("no-benefit group"; n = 405 of 2,103; 19.2%) had no benefit of LT compared to alternative treatments. Conversely, patients without any risk factor ("large-benefit group"; n = 108; 5.1%) yielded the highest benefit from LT reaching 60 months. CONCLUSION The ITT transplant survival benefit presented here allows physicians to better select HCC patients waiting for LT. The obtained stratification may lead to an improved and more equitable method of organ allocation. Patients without benefit should be de-listed, whereas patients with large benefit ratio should be prioritized for LT. (Hepatology 2017;66:1910-1919).
Collapse
Affiliation(s)
- Quirino Lai
- Starzl Unit of Abdominal Transplantation, St. Luc University Hospital, Catholic University of Louvain, Brussels, Belgium
| | - Alessandro Vitale
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Samuele Iesari
- Starzl Unit of Abdominal Transplantation, St. Luc University Hospital, Catholic University of Louvain, Brussels, Belgium
| | - Armin Finkenstedt
- Gastroenterology and Hepatology, Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria
| | - Gianluca Mennini
- Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Gabriele Spoletini
- UCL Institute for Liver and Digestive Health and Royal Free Sheila Sherlock Liver Center, Royal Free Hospital and UCL, London, United Kingdom
| | - Maria Hoppe-Lotichius
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Giovanni Vennarecci
- Division of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy
| | - Tommaso M Manzia
- Department of Transplant Surgery, Polyclinic Tor Vergata Foundation, Tor Vergata University, Rome, Italy
| | - Daniele Nicolini
- Unit of Hepatobiliary Surgery and Transplantation, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Torrette Ancona, Italy
| | - Alfonso W Avolio
- Liver Unit, Department of Surgery, Agostino Gemelli Hospital, Catholic University, Rome, Italy
| | | | | | - Massimo Rossi
- Department of General Surgery and Organ Transplantation, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Emmanouil Tsochatzis
- UCL Institute for Liver and Digestive Health and Royal Free Sheila Sherlock Liver Center, Royal Free Hospital and UCL, London, United Kingdom
| | - Gerd Otto
- Department of Transplantation and Hepatobiliary Surgery, University of Mainz, Mainz, Germany
| | - Giuseppe M Ettorre
- Division of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy
| | - Giuseppe Tisone
- Department of Transplant Surgery, Polyclinic Tor Vergata Foundation, Tor Vergata University, Rome, Italy
| | - Marco Vivarelli
- Unit of Hepatobiliary Surgery and Transplantation, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Torrette Ancona, Italy
| | - Salvatore Agnes
- Liver Unit, Department of Surgery, Agostino Gemelli Hospital, Catholic University, Rome, Italy
| | - Umberto Cillo
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Jan Lerut
- Starzl Unit of Abdominal Transplantation, St. Luc University Hospital, Catholic University of Louvain, Brussels, Belgium
| | | |
Collapse
|
35
|
Sun J, Li Y, Milbury C, Skoletsky J, Burns C, Yip W, Luo J, Dewal N, Johnson A, Gowen K, Tong J, He Y, He J, White J, Roels S, Tsuji A, Truesdell J, Peters E, Gilbert H, Wu C, Schleifman E, Barrett C, Thress K, Jenkins S, Elvin J, Otto G, Lipson D, Ross J, Miller V, Stephens P, Doherty M, Vietz C. P2.02-052 A Clinically-Validated Universal Companion Diagnostic Platform for Cancer Patient Care. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Gandara D, Kowanetz M, Mok T, Rittmeyer A, Fehrenbacher L, Fabrizio D, Otto G, Malboeuf C, Lieber D, Paul S, Amler L, Riehl T, Schleifman E, Cummings C, Hegde P, Zou W, Sandler A, Ballinger M, Shames D. Blood-based biomarkers for cancer immunotherapy: Tumor mutational burden in blood (bTMB) is associated with improved atezolizumab (atezo) efficacy in 2L+ NSCLC (POPLAR and OAK). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
37
|
Fabrizio D, Malboeuf C, Lieber D, Zhong S, He J, White E, Coyne M, Silterra J, Brennan T, Ma J, Kennedy M, Schleifman E, Paul S, Li Y, Shames D, Cummings C, Peters E, Kowanetz M, Lipson D, Otto G. Analytic validation of a next generation sequencing assay to identify tumor mutational burden from blood (bTMB) to support investigation of an anti-PD-L1 agent, atezolizumab, in a first line non-small cell lung cancer trial (BFAST). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
38
|
Grossman RL, Abel B, Angiuoli S, Barrett JC, Bassett D, Bramlett K, Blumenthal GM, Carlsson A, Cortese R, DiGiovanna J, Davis-Dusenbery B, Dittamore R, Eberhard DA, Febbo P, Fitzsimons M, Flamig Z, Godsey J, Goswami J, Gruen A, Ortuño F, Han J, Hayes D, Hicks J, Holloway D, Hovelson D, Johnson J, Juhl H, Kalamegham R, Kamal R, Kang Q, Kelloff GJ, Klozenbuecher M, Kolatkar A, Kuhn P, Langone K, Leary R, Loverso P, Manmathan H, Martin AM, Martini J, Miller D, Mitchell M, Morgan T, Mulpuri R, Nguyen T, Otto G, Pathak A, Peters E, Philip R, Posadas E, Reese D, Reese MG, Robinson D, Dei Rossi A, Sakul H, Schageman J, Singh S, Scher HI, Schmitt K, Silvestro A, Simmons J, Simmons T, Sislow J, Talasaz A, Tang P, Tewari M, Tomlins S, Toukhy H, Tseng HR, Tuck M, Tzou A, Vinson J, Wang Y, Wells W, Welsh A, Wilbanks J, Wolf J, Young L, Lee J, Leiman LC. Collaborating to Compete: Blood Profiling Atlas in Cancer (BloodPAC) Consortium. Clin Pharmacol Ther 2017; 101:589-592. [PMID: 28187516 PMCID: PMC5525192 DOI: 10.1002/cpt.666] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 01/02/2023]
Abstract
The cancer community understands the value of blood profiling measurements in assessing and monitoring cancer. We describe an effort among academic, government, biotechnology, diagnostic, and pharmaceutical companies called the Blood Profiling Atlas in Cancer (BloodPAC) Project. BloodPAC will aggregate, make freely available, and harmonize for further analyses, raw datasets, relevant associated clinical data (e.g., clinical diagnosis, treatment history, and outcomes), and sample preparation and handling protocols to accelerate the development of blood profiling assays.
Collapse
Affiliation(s)
- R L Grossman
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - B Abel
- Genomic Health, Redwood City, California, USA
| | - S Angiuoli
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | | | | | - K Bramlett
- Thermo Fisher Scientific, Austin, Texas, USA
| | - G M Blumenthal
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Springs, Maryland, USA
| | - A Carlsson
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - R Cortese
- Seven Bridges, Cambridge, Massachusetts, USA
| | | | | | - R Dittamore
- Epic Research and Diagnostics, San Diego, California, USA
| | | | - P Febbo
- Genomic Health, Redwood City, California, USA
| | - M Fitzsimons
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - Z Flamig
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Godsey
- Thermo Fisher Scientific, Waltham, Massachusetts, USA
| | - J Goswami
- Thermo Fisher Scientific, Carlsbad, California, USA
| | - A Gruen
- Seven Bridges, Cambridge, Massachusetts, USA
| | - F Ortuño
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Han
- Genomic Health, Redwood City, California, USA
| | - D Hayes
- University of Michigan, Ann Arbor, Michigan, USA
| | - J Hicks
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - D Holloway
- Seven Bridges, Cambridge, Massachusetts, USA
| | - D Hovelson
- University of Michigan, Ann Arbor, Michigan, USA
| | - J Johnson
- AstraZeneca, Waltham, Massachusetts, USA
| | - H Juhl
- Indivumed GmbH, Hamburg, Germany
| | - R Kalamegham
- Genentech, Washington, District of Columbia, USA
| | - R Kamal
- Omicia, Oakland, California, USA
| | - Q Kang
- University of Michigan, Ann Arbor, Michigan, USA
| | - G J Kelloff
- Office of the Director, National Cancer Institute, Bethesda, Maryland, USA
| | | | - A Kolatkar
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - P Kuhn
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - K Langone
- Genomic Health, Redwood City, California, USA
| | - R Leary
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - P Loverso
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | - H Manmathan
- Seven Bridges, Cambridge, Massachusetts, USA
| | - A-M Martin
- Novartis Pharmaceuticals, East Hanover, New Jersey, USA
| | | | - D Miller
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - M Mitchell
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - T Morgan
- University of Michigan, Ann Arbor, Michigan, USA
| | - R Mulpuri
- Provista Diagnostics Inc., New York, New York, USA
| | - T Nguyen
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - G Otto
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - A Pathak
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - E Peters
- Genentech, South San Francisco, California, USA
| | - R Philip
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - E Posadas
- CytoLumina, Inc., Los Angeles, California, USA.,Cedar-Sinai Medical Center, Los Angeles, California, USA
| | - D Reese
- Provista Diagnostics Inc., New York, New York, USA
| | | | - D Robinson
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - A Dei Rossi
- Genomic Health, Redwood City, California, USA
| | - H Sakul
- Pfizer, San Diego, California, USA
| | - J Schageman
- Thermo Fisher Scientific, Austin, Texas, USA
| | - S Singh
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - H I Scher
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - K Schmitt
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - A Silvestro
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - J Simmons
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | - T Simmons
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Sislow
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - A Talasaz
- Guardant Health, Inc., Redwood City, California, USA
| | - P Tang
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - M Tewari
- University of Michigan, Ann Arbor, Michigan, USA
| | - S Tomlins
- University of Michigan, Ann Arbor, Michigan, USA
| | - H Toukhy
- Guardant Health, Inc., Redwood City, California, USA
| | - H R Tseng
- CytoLumina, Inc., Los Angeles, California, USA.,Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - M Tuck
- University of Michigan, Ann Arbor, Michigan, USA
| | - A Tzou
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - J Vinson
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Y Wang
- Epic Research and Diagnostics, San Diego, California, USA
| | - W Wells
- Open Commons Consortium, Chicago, Illinois, USA
| | - A Welsh
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - J Wilbanks
- Sage Bionetworks, Seattle, Washington, USA
| | - J Wolf
- Provista Diagnostics Inc., New York, New York, USA
| | - L Young
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - Jsh Lee
- Office of the Director, National Cancer Institute, Bethesda, Maryland, USA
| | | |
Collapse
|
39
|
Stephens P, Clark T, Kennedy M, He J, Young G, Zhao M, Coyne M, Breese V, Young L, Zhong S, Bailey M, Fendler B, Miller V, Schleifman E, Peters E, Otto G, Lipson D, Ross J. Analytic validation of a clinical circulating tumor DNA assay for patients with solid tumors. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw380.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
40
|
Duvinage Née Krey C, Nagels S, Hampel G, Kratz JV, Aguilar AL, Minouchehr S, Otto G, Schmidberger H, Schütz C, Vogtländer L, Wortmann B, Burgkhardt B. Erratum to "Determination of the irradiation field at the research reactor TRIGA Mainz for BNCT" [J. Appl. Radiat. Isot. 67 (2009) S242-S246]. Appl Radiat Isot 2016; 115:312. [PMID: 27263359 DOI: 10.1016/j.apradiso.2016.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C Duvinage Née Krey
- Forschungszentrum Karlsruhe GmbH, Institut für Strahlenforschung, PO Box 3640, D-76021 Karlsruhe, Germany
| | - S Nagels
- Forschungszentrum Karlsruhe GmbH, Institut für Strahlenforschung, PO Box 3640, D-76021 Karlsruhe, Germany.
| | - G Hampel
- Institut für Kernchemie, Johannes Gutenberg-Universität Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz, Germany
| | - J V Kratz
- Institut für Kernchemie, Johannes Gutenberg-Universität Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz, Germany
| | - A L Aguilar
- Institut für Kernchemie, Johannes Gutenberg-Universität Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz, Germany; Evonik Energy Services GmbH Essen, Rüttenscheider Str. 1-3, D-45128 Essen, Germany
| | - S Minouchehr
- Transplantationschirurgie, Universitätsklinikum Mainz, Langenbeckstr. 1, D-55131 Mainz, Germany
| | - G Otto
- Transplantationschirurgie, Universitätsklinikum Mainz, Langenbeckstr. 1, D-55131 Mainz, Germany
| | - H Schmidberger
- Klinik und Poliklinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Mainz, Langenbeckstr. 1, D-55131 Mainz, Germany
| | - C Schütz
- Institut für Kernchemie, Johannes Gutenberg-Universität Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz, Germany
| | - L Vogtländer
- Institut für Kernchemie, Johannes Gutenberg-Universität Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz, Germany
| | - B Wortmann
- Evonik Energy Services GmbH Essen, Rüttenscheider Str. 1-3, D-45128 Essen, Germany
| | - B Burgkhardt
- Forschungszentrum Karlsruhe GmbH, Institut für Strahlenforschung, PO Box 3640, D-76021 Karlsruhe, Germany
| |
Collapse
|
41
|
Otto G. Pathologic response to preoperative transarterial chemoembolization for resectable hepatocellular carcinoma may not predict recurrence after liver resection. Hepatobiliary Pancreat Dis Int 2016; 15:122-4. [PMID: 27020626 DOI: 10.1016/s1499-3872(16)60071-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Gerd Otto
- Department of Transplantation and Hepatobiliary Surgery, University Medical Center, Johannes Gutenberg-University, Mainz, Germany.
| |
Collapse
|
42
|
Wege H, Lohse AW, Arnold D, Otto G, Vogel A. Treatment of Non-Colorectal Liver Metastases. Visc Med 2015. [DOI: 10.1159/000442359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
43
|
Houben P, Manzini G, Kremer M, Arend J, Berlakovich GA, Klar E, Klempnauer J, Lerut J, Otto G, Pirenne J, Rogiers X, Seehofer D, Stippel DL, Schemmer P. Graft rinse prior to reperfusion in liver transplantation: literature review and online survey within the Eurotransplant community. Transpl Int 2015; 28:1291-8. [DOI: 10.1111/tri.12631] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 12/30/2014] [Accepted: 06/22/2015] [Indexed: 01/27/2023]
Affiliation(s)
- Philipp Houben
- Department of General and Transplant Surgery; University of Heidelberg; Heidelberg Germany
| | - Giulia Manzini
- Department of General and Visceral Surgery; University of Ulm; Ulm Germany
| | - Michael Kremer
- Department of General and Visceral Surgery; University of Ulm; Ulm Germany
| | - Joerg Arend
- Department of General, Visceral and Vascular Surgery; Otto-von-Guericke University; Magdeburg Germany
| | | | - Ernst Klar
- Department of General, Thoracic, Vascular and Transplantation Surgery; University of Rostock; Rostock Germany
| | - Jürgen Klempnauer
- Department of General, Visceral and Transplant Surgery; Klinikum der Medizinischen Hochschule; Hannover Germany
| | - Jan Lerut
- Department of Liver Transplant Surgery; University Clinic Saint-Luc; Bruxelles Belgium
| | - Gerd Otto
- Department of Transplant and Hepato-Biliary-Pancreatic Surgery; Johannes-Gutenberg-University; Mainz Germany
| | - Jacques Pirenne
- Department of Abdominal Transplant Surgery; University of Leuven; Leuven Belgium
| | - Xavier Rogiers
- Department of Transplant Surgery; University of Gent; Gent Belgium
| | - Daniel Seehofer
- Department of General, Visceral and Transplantation Surgery; University of Berlin; Berlin Germany
| | - Dirk L. Stippel
- Department of General, Visceral and Cancer Surgery; University of Cologne; Köln Germany
| | - Peter Schemmer
- Department of General and Transplant Surgery; University of Heidelberg; Heidelberg Germany
| |
Collapse
|
44
|
Watzka FM, Fottner C, Miederer M, Schad A, Weber MM, Otto G, Lang H, Musholt TJ. Erratum to: surgical therapy of neuroendocrine neoplasm with hepatic metastasis: patient selection and prognosis. Langenbecks Arch Surg 2015; 400:359. [PMID: 25846243 DOI: 10.1007/s00423-015-1294-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- F M Watzka
- Clinic of General, Visceral and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Weinmann A, Alt Y, Koch S, Nelles C, Düber C, Lang H, Otto G, Zimmermann T, Marquardt JU, Galle PR, Wörns MA, Schattenberg JM. Treatment and survival of non-alcoholic steatohepatitis associated hepatocellular carcinoma. BMC Cancer 2015; 15:210. [PMID: 25884354 PMCID: PMC4407550 DOI: 10.1186/s12885-015-1197-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/17/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The incidence of non-alcoholic steatohepatitis (NASH) is increasing worldwide and a poorly defined subset of patients develops end-stage liver disease and hepatocellular carcinoma (HCC). Differences in the biological behaviour, tumour characteristics, associated risk factors, treatment outcomes and overall survival of patients with NASH-HCC remain poorly defined. The aim of this study was to determine and analyze these differences in a large clinical cohort to guide treatment decisions. METHODS 1119 patients with HCC treated in an 11 year period at the University Medical Centre of the Johannes Gutenberg University Mainz were retrospectively analyzed. RESULTS Patients with NASH-HCC (n = 45) were older (67.6 vs. 65 years), had an increased frequency of the metabolic syndrome and complications with a higher incidence of obesity (31.1% vs. 14.7%), type II diabetes mellitus (66.7% vs. 37.85%), a higher rate of myocardial infarction (13.3% vs. 4.8%) and apoplectic stroke (8.9% vs. 2.1%) (all p < 0.05). Interestingly, liver function was preserved to a higher extent and MELD scores were significantly lower in NASH-HCC. Nonetheless, resection or orthotopic liver transplantation was performed only in 17.8% and 4.4% of NASH-HCC respectively. Overall survival was lower compared to HCC of other aetiologies. Independent of the underlying aetiology BMI exhibited a positive correlation with overall survival. CONCLUSION Despite retained liver function, patients with NASH-associated HCC showed a decreased overall survival. With regards to the expected increasing prevalence of NASH, it will be necessary to improve screening and surveillance strategies to identify HCC in NASH early and improve survival.
Collapse
Affiliation(s)
- Arndt Weinmann
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Cirrhosis Center Mainz (CCM), University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Clinical Registry Unit (CRU), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Yvonne Alt
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Cirrhosis Center Mainz (CCM), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Sandra Koch
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Clinical Registry Unit (CRU), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Carina Nelles
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Hauke Lang
- Department of General, Visceral and Transplant Surgery, University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Gerd Otto
- Department of Transplantation and Hepatobiliopancreatic Surgery, University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Tim Zimmermann
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Cirrhosis Center Mainz (CCM), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Jens U Marquardt
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Cirrhosis Center Mainz (CCM), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Peter R Galle
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Cirrhosis Center Mainz (CCM), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Marcus A Wörns
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Cirrhosis Center Mainz (CCM), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| | - Jörn M Schattenberg
- Department of Medicine I, University Medical Center Johannes Gutenberg University, Mainz, Germany. .,Cirrhosis Center Mainz (CCM), University Medical Center Johannes Gutenberg University, Mainz, Germany.
| |
Collapse
|
46
|
Hornstein I, Schwarz C, Ebbing S, Hoppe-Lotichius M, Otto G, Lang H, Musholt TJ. Surgical resection of metastases to the adrenal gland: a single center experience. Langenbecks Arch Surg 2015; 400:333-9. [PMID: 25726026 DOI: 10.1007/s00423-015-1293-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 02/18/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Only limited data exist on the treatment and outcome of adrenal metastases that derive from different primary tumor entities. Due to the lack of evidence, it is difficult to determine the indication for surgical resection. METHODS We assessed the outcome of 45 patients (28 men, 17 women) with adrenal metastases who underwent surgery (1990-2014). The median age at the time of adrenal surgery was 62 years (range 44-77 years). We were able to evaluate follow-up data of 41 patients. RESULTS Primary tumor types were liver n = 12 (hepatocellular carcinoma n = 9, cholangiocellular carcinoma n = 2, sarcoma n = 1), upper GI tract n = 5 (esophagus n = 2, stomach n = 3), lung n = 9, kidney n = 6, neuroendocrine tumors n = 3, colon n = 2, ovarial n = 2, melanoma n = 2, others n = 4. The overall median survival time was 14 months (95 % CI 8.375-19.625). The survival rates at 1, 2, 5, and 10 years were 60, 31, 21, and 11 %, respectively. There were statistically significant differences in the survival time according to the resection status (R0 vs. R1/R2) (p < 0.001) and the type of the primary tumor (p = 0.009), while the metachronous or synchronous occurrence of adrenal metastases did not affect the prognosis. CONCLUSIONS Resection of adrenal metastases can improve the survival if patients are carefully selected, the tumor is completely resected, and the intervention is integrated into a multidisciplinary oncologic treatment strategy.
Collapse
Affiliation(s)
- I Hornstein
- Department of General, Visceral and Transplantation Surgery, University Medicine of the Johannes, Gutenberg University Mainz, Mainz, Germany
| | | | | | | | | | | | | |
Collapse
|
47
|
Watzka FM, Fottner C, Miederer M, Schad A, Weber MM, Otto G, Lang H, Musholt TJ. Surgical therapy of neuroendocrine neoplasm with hepatic metastasis: patient selection and prognosis. Langenbecks Arch Surg 2015; 400:349-58. [PMID: 25682055 DOI: 10.1007/s00423-015-1277-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 01/27/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND Patients with neuroendocrine neoplasms (NEN) develop hepatic metastases in 50-95 %. The aims of this study were to evaluate the outcome/prognosis of patients following hepatic surgery and to identify predictive factors for the selection of patient that benefit from hepatic tumor resection. PATIENTS AND METHODS In a retrospective single-center study (1990 to 2014), 204 patients with hepatic metastasis of NEN were included. Ninety-four were subjected to various forms of liver resection. According to the overall survival, the influence of several prognostic factors like the Ki-67 index, stage of disease, and resection status was evaluated. RESULTS The primary tumor was located in the small intestine (n = 73), pancreas (n = 58), colon (n = 26), esophagus or stomach (n = 9) and in 38 patients the primary site was unknown. The Ki-67 index was associated with significant different overall survival. Patients with an R0 resection (n = 38) of their hepatic metastasis had a very good 10-year survival of 90.4 %. Patients in whom an R1 (n = 23) or R2 (n = 33) resection of their hepatic metastasis could be achieved had a 10-year survival of 53.4 and 51.4 %, respectively. The majority of the patients (53.9 %) could not be resected and had a poor 10-year survival rate of 19.4 %. Partial or complete control of endocrine-related symptoms was achieved in all patients with functioning tumors following surgery. The overall 5- and 10-year survival rates were 77.9 and 65.2 %, respectively. CONCLUSION Surgical resection of hepatic NEN metastases can reduce symptoms and improve the survival in selected patients with a Ki-67 index less than 20 %. The expected outcome has to be compared to the outcome of alternative treatment strategies. An R0 situation should be the aim of hepatic surgery, but also patients with R1 or R2 resection show a good survival benefit.
Collapse
Affiliation(s)
- F M Watzka
- Clinic of General, Visceral- and Transplantation Surgery, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Barreiros AP, Otto G, Kahlen B, Teufel A, Galle PR. Familial amyloidosis: great progress for an orphan disease. J Hepatol 2015; 62:483-5. [PMID: 25220252 DOI: 10.1016/j.jhep.2014.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 08/19/2014] [Accepted: 09/04/2014] [Indexed: 12/04/2022]
Affiliation(s)
- Ana Paula Barreiros
- Department of Internal Medicine I, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Germany; Department of Internal Medicine I, Universitätsklinikum of the University Regensburg, Germany.
| | - Gerd Otto
- Department of Hepatobiliary and Transplantation Surgery, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Germany
| | - Bita Kahlen
- Department of Internal Medicine I, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Germany
| | - Andreas Teufel
- Department of Internal Medicine I, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Germany; Department of Internal Medicine I, Universitätsklinikum of the University Regensburg, Germany
| | - Peter R Galle
- Department of Internal Medicine I, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Germany
| |
Collapse
|
49
|
Weinmann A, Koch S, Sprinzl M, Kloeckner R, Schulze-Bergkamen H, Düber C, Lang H, Otto G, Wörns MA, Galle PR. Survival analysis of proposed BCLC-B subgroups in hepatocellular carcinoma patients. Liver Int 2015; 35:591-600. [PMID: 25290314 DOI: 10.1111/liv.12696] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 09/15/2014] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS The BCLC-staging system is used to facilitate treatment decisions in patients with hepatocellular carcinoma (HCC). Owing to the observed clinical heterogeneity of the intermediate stage BCLC-B, a subclassification was proposed taking Child-Pugh score and extended criteria for transplantation into account. Analysis of the prognostic significance of a proposed subclassification of the BCLC-B score in a European cohort of HCC patients. METHODS Eight hundred and eighty four consecutive HCC patients were retrospectively analysed. Patients with stage BCLC-B were grouped according to the proposed subclassification. Baseline patient and tumour characteristics, therapy and overall survival were analysed. RESULTS Two hundred and fifty four patients with stage BCLC-B were classified as B1/B2/B3 and B4 in 16.1/56.7/7.9 and 19.3%. OS compared between adjacent subgroups (B1 vs. B2, B2 vs. B3, B3 vs. B4) did not reach statistical significance. Groupwise comparison showed significant differences between B1 vs. B3 (P = 0.035), B1 vs. B4 (P = 0.006) and B2 vs. B4 (P < 0.0001). OS was significantly improved in patients undergoing OLT (P < 0.0001). Cox regression showed no significant influence of the BCLC-B substage on survival. CONCLUSIONS No significant survival differences between subgroups were found in the retrospective analysis. We could not confirm the BCLC-B subclassification to be prognostically meaningful in our cohort. As liver function and therapy influenced survival in this study, a more refined BCLC-B subclassification has the potential to be a useful tool to better stratify treatment decisions. Further studies in larger collectives with homogenous staging and treatment strategies are warranted to confirm the prognostic significance of the proposed subclassifications.
Collapse
Affiliation(s)
- Arndt Weinmann
- Clinical Registry Unit (CRU), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Pitton MB, Kloeckner R, Ruckes C, Wirth GM, Eichhorn W, Wörns MA, Weinmann A, Schreckenberger M, Galle PR, Otto G, Dueber C. Randomized comparison of selective internal radiotherapy (SIRT) versus drug-eluting bead transarterial chemoembolization (DEB-TACE) for the treatment of hepatocellular carcinoma. Cardiovasc Intervent Radiol 2014; 38:352-60. [PMID: 25373796 PMCID: PMC4355443 DOI: 10.1007/s00270-014-1012-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 08/31/2014] [Indexed: 12/11/2022]
Abstract
Purpose To prospectively compare SIRT and DEB-TACE for treating hepatocellular carcinoma (HCC). Methods From 04/2010–07/2012, 24 patients with histologically proven unresectable N0, M0 HCCs were randomized 1:1 to receive SIRT or DEB-TACE. SIRT could be repeated once in case of recurrence; while, TACE was repeated every 6 weeks until no viable tumor tissue was detected by MRI or contraindications prohibited further treatment. Patients were followed-up by MRI every 3 months; the final evaluation was 05/2013. Results Both groups were comparable in demographics (SIRT: 8males/4females, mean age 72 ± 7 years; TACE: 10males/2females, mean age 71 ± 9 years), initial tumor load (1 patient ≥25 % in each group), and BCLC (Barcelona Clinic Liver Cancer) stage (SIRT: 12×B; TACE 1×A, 11×B). Median progression-free survival (PFS) was 180 days for SIRT versus 216 days for TACE patients (p = 0.6193) with a median TTP of 371 days versus 336 days, respectively (p = 0.5764). Median OS was 592 days for SIRT versus 788 days for TACE patients (p = 0.9271). Seven patients died in each group. Causes of death were liver failure (n = 4 SIRT group), tumor progression (n = 4 TACE group), cardiovascular events, and inconclusive (n = 1 in each group). Conclusions No significant differences were found in median PFS, OS, and TTP. The lower rate of tumor progression in the SIRT group was nullified by a greater incidence of liver failure. This pilot study is the first prospective randomized trial comparing SIRT and TACE for treating HCC, and results can be used for sample size calculations of future studies.
Collapse
Affiliation(s)
- Michael B Pitton
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|