Hilar Biliary Cancer – Are We Getting It Right?

Recent reviews of the management of hilar biliary cancer suggest that radical resection is the preferred treatment option. It seems true that most of the long term survivors are treated this way, but it is equally true that most patients receive palliative rather than curative treatment. Before we go too far in our advocacy of radical treatment, we need to develop methods for quantifying palliation because that is in truth what we usually achieve. A method of quantifying palliation is described. Surgeons are encouraged to use methods of this kind in order to allow valid comparison of the results of different methods of treatment.

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HEART RETRANSPLANTATION

Russian Journal of Transplantology and Artificial Organs ◽

10.15825/1995-1191-2016-2-142-151 ◽

2016 ◽

Vol 18 (2) ◽

pp. 142-151

Author(s):

R. Sh. Saitgareev ◽

V. M. Zakharevich ◽

A. M. Golts ◽

T. A. Khalilulin ◽

D. V. Borisov

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Treatment Option ◽

Cardiac Transplantation ◽

Cardiac Allograft ◽

The Other ◽

Radical Treatment ◽

Number Of Patients ◽

Long Term Prognosis

The number of patients with transplanted heart is continuously increasing; therefore, the number of patients requiring heart retransplantation grows. Analysis of the results of published studies focused on safety of cardiac retransplantation and risk factors for adverse events in perioperative, early and late postoperative periods is presented in our review. The results of published studies suggest that heart retransplantation is the main radical treatment option for cardiac allograft dysfunction, but the results of heart retransplantation are slightly worse than those of primary cardiac transplantation. On the other hand, the favorable long-term prognosis after heart retransplantation should be expected in carefully selected recipients.

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63P Multicentre match-paired analysis of advanced biliary cancer (ABC) long-term survivors: The BILONG study

Annals of Oncology ◽

10.1016/j.annonc.2020.08.041 ◽

2020 ◽

Vol 31 ◽

pp. S265

Author(s):

F. Caputo ◽

F. Gelsomino ◽

A. Spallanzani ◽

E. Pettorelli ◽

S. Benatti ◽

...

Keyword(s):

Biliary Cancer ◽

Long Term Survivors ◽

Paired Analysis

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Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism

Case Reports in Endocrinology ◽

10.1155/2021/5556977 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Iván Emilio de la Cruz Rodríguez ◽

Elsy Sarahí García Montesinos ◽

María Fernanda Rodríguez-Delgado ◽

Guadalupe Vargas Ortega ◽

Lourdes Balcázar Hernández ◽

...

Keyword(s):

Case Report ◽

Primary Hyperparathyroidism ◽

Treatment Option ◽

Serum Calcium ◽

Curative Treatment ◽

Long Term Outcomes ◽

Medium Term ◽

Short Term ◽

Preoperative Serum

Introduction. Parathyroidectomy is the curative treatment option in primary hyperparathyroidism (PHPT). The decrease of parathormone (PTH) by 50% or more from levels prior to surgery after excision predicts successful parathyroidectomy. Serum calcium is expected to return to normal within 24–72 hours after the surgery; however, nearly 10% have transient, persistent postoperative hypercalcemia. We present a case report of delayed calcium normalization after successful parathyroidectomy in a 38-year-old patient with PHPT. Methods. Parathyroidectomy was performed, with evidence of a decrease in PTH levels of more than 50% in the first 24 hours postoperatively compared to presurgical PTH; however, despite curative parathyroidectomy, a delayed calcium normalization was evidenced, with hypercalcemia persistence up to 120 hours postoperatively. Results. After the first month postoperatively, serum calcium remained normal. In conclusion, approximately 10% of patients with curative parathyroidectomy have transient, persistent postoperative hypercalcemia, which is more likely to occur in patients with higher preoperative serum calcium and PTH levels. Conclusion. Persistent hypercalcemia after the first month postoperatively is related with persistent PHPT, highlighting the importance of calcium monitoring after parathyroidectomy to predict short-term, medium-term, and long-term outcomes and prognosis.

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Conditional probability of survival in gallbladder carcinoma as a prognostic tool for long term survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.455 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 455-455

Author(s):

Rahul Rajeev ◽

Nicholas Gerard Berger ◽

Abdulrahman Y Hammad ◽

John Thomas Miura ◽

Fabian McCartney Johnston ◽

...

Keyword(s):

Conditional Probability ◽

Gallbladder Carcinoma ◽

Stage Iv ◽

Radical Resection ◽

Prognostic Information ◽

Curative Surgery ◽

Probability Of Survival ◽

Stage Iv Disease ◽

Long Term Survivors

455 Background: Gallbladder carcinoma (GBC) often presents in an advanced stage and despite radical resection and nodal harvest, prognosis remains poor. Conventional survival statistics do not account for time elapsed from diagnosis and may not carry relevant prognostic information for long term survivors. This study sought to estimate the conditional probability of survival (CS) in patients of GBC. Methods: Patients with GBC were identified from the Surveillance, Epidemiology and End Results (SEER) database (1988-2012). Overall probability of survival (OS) was estimated using Kaplan-Meier method. Cumulative incidence method was employed to calculate CS. Results: Of 15,046 GBC patients identified, Stage IV disease was the most common presentation (n = 5625). Surgical intervention was reported in 9,720(65%) patients with cholecystectomies (n = 8254) outnumbering radical resections (n = 1116). 3-year OS for all stages was 18% and conditional probability of surviving additional 3 years (CS3) at 1, 2 and 3 years from diagnosis was 42%, 57% and 66% respectively. Stage III and IV disease had 3-year OS rates of 19% and 3% respectively while CS3 increased progressively with each year survived(33% and 17% at 1 year, 51% and 34% at 2 years, 60% and 56% at 3 years). Conclusions: Conditional probability of survival is favorable in patients surviving one year from diagnosis and shows an increasing trend with time. Improvements in survival are more substantial in patients with adverse initial prognosis. Conditional survival provides valuable information on prognosis to patients after curative surgery and can be the basis of follow-up guidelines.

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