Publications by authors named "George A. Poultsides"
Background: We sought to define whether and how hepatic ischemia/reperfusion (I/R) as manifested by perioperative aspartate aminotransferase (AST) and alanine aminotransaminase (ALT) levels impact long-term outcomes after curative-intent resection of hepatocellular carcinoma (HCC).
Patients And Methods: Intrasplenic injection of HCC cells was used to establish a murine model of HCC recurrence with versus without I/R injury. Patients who underwent curative resection for HCC were identified from a multi-institutional derivative cohort (DC) and separate external validation (VC) cohort.
Objective: To examine the optimal method of assessing response to neoadjuvant therapy (NAT) in operable pancreatic ductal adenocarcinoma (PDAC) patients.
Summary Of Background Data: PDAC response to NAT is measured with biochemical, radiographic and pathologic parameters, which can often be discordant with each other.
Methods: PDAC patients undergoing resection after NAT at a single institution were retrospectively analyzed.
ASO Visual Abstract: Improving Recurrence Prediction in Intrahepatic Cholangiocarcinoma-The Synergistic Impact of FIB-4 Index and Tumor Burden Score in Post-Hepatectomy Outcomes.
Ann Surg Oncol
February 2025
Background: The effect of "time to surgery (TTS)" on outcomes for curative-intent hepatectomy of hepatocellular carcinoma (HCC) remains debated. The interaction between tumor burden score (TBS) and TTS remains unclear. We sought to evaluate the effects of TBS and TTS on long-term HCC outcomes.
View Article and Find Full Text PDFBackground: The prognostic role of the fibrosis-4 (FIB-4) index relative to intrahepatic cholangiocarcinoma (ICC) after hepatectomy remains unclear. This study sought to characterize the impact of the FIB-4 index and tumor burden score (TBS) on recurrence and overall survival (OS).
Methods: ICC patients undergoing hepatectomy (2000-2020) were identified using a multi-institutional database.
Background: Distal pancreatectomy with celiac axis resection (DP-CAR) has been used for selected patients with pancreatic cancer infiltrating the celiac axis. We compared the short- and long-term outcomes between DP-CAR and distal pancreatectomy alone (DP) in patients receiving neoadjuvant therapy.
Methods: Patients undergoing DP-CAR from 2013 to 2022 were retrospectively reviewed.
Article Synopsis
- The advanced lung cancer inflammation index (ALI) combines inflammation and nutrition data to predict overall survival (OS) in patients with intrahepatic cholangiocarcinoma (ICC) who have undergone surgery.
- In a study of 1,045 patients, low ALI was found to be an independent risk factor for worse OS, with those having low ALI showing significantly lower 5-year survival rates.
- ALI performed comparably to other inflammatory markers in predicting survival while demonstrating slightly better model fit and accuracy, indicating the value of integrating nutritional and inflammatory data in prognostic assessments.
Background: Despite the well-known prognostic role of lymph node metastasis (LNM) in pNETs, less is known about the importance of lymphovascular invasion (LVI) among patients with these tumors.
Methods: Patients undergoing pancreatectomy for pNET between 2002 and 2020 were identified in the US Neuroendocrine Tumor Study Group database. Cox regression analysis was utilized to identify the impact of LVI on recurrence-free survival (RFS) among patients with node-negative pNET.
Background And Objectives: Among patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC), perioperative bleeding requiring blood transfusion is a common complication, yet preoperative identification of patients at risk for transfusion remains challenging. The objective of this study was to develop a preoperative risk score for blood transfusion requirement during surgery for ICC.
Methods: Patients undergoing curative-intent liver surgery for ICC (1990-2020) were identified from a multi-institutional database.
Article Synopsis
- Researchers aimed to understand the heterogeneity of pancreatic ductal adenocarcinoma by focusing on epigenetically regulated pathways that affect its progression.
- They discovered that hypermethylation of the Hepatocyte Nuclear Factor 4A (HNF4A) gene leads to its suppression, which is linked to the growth and severity of pancreatic cancer.
- The study concludes that loss of HNF4A due to DNA methylation contributes to the disease's development and is associated with worse survival outcomes for patients.
Preoperative platelet count as an independent predictor of long-term outcomes among patients undergoing resection for intrahepatic cholangiocarcinoma.
J Surg Oncol
October 2024
Article Synopsis
- Elevated platelet counts in patients undergoing liver surgery for intrahepatic cholangiocarcinoma (ICC) can indicate more severe disease and poor outcomes.
- A study of 825 patients revealed that those with high platelet counts (>300 *10/L) had worse cancer-specific survival (CSS) and overall survival (OS) compared to those with lower counts.
- High platelet count remained an independent predictor of worse outcomes even after accounting for other clinical factors, suggesting it may help in preoperative risk assessment for surgery.
Background: We sought to assess the impact of various perioperative factors on the risk of severe complications and post-surgical mortality using a novel maching learning technique.
Methods: Data on patients undergoing resection for HCC were obtained from an international, multi-institutional database between 2000 and 2020. Gradient boosted trees were utilized to construct predictive models.
Introduction: Pancreatic pathologies causing portomesenteric occlusion complicate extirpative pancreatic resection due to portomesenteric hypertension and collateral venous drainage.
Methods: Patients with portomesenteric occlusion undergoing pancreatectomy were identified between 2007 and 2020 at Stanford University Hospital. Demographic and clinical data, technique and perioperative factors, and post-operative outcomes were analyzed.
Objectives: The objective of the current study was to characterize prognostic factors related to long-term recurrence-free survival after curative-intent resection of intrahepatic cholangiocarcinoma (ICC).
Methods: Data on patients who underwent curative-intent resection for ICC between 2000 and 2020 were collected from an international multi-institutional database. Prognostic factors were investigated among patients who recurred within 5 years versus long-term survivors who survived more than 5 years with no recurrence.
Article Synopsis
- The study looked at how problems after surgery affect patients with liver cancer (HCC) based on a measure called the alpha-fetoprotein-tumor burden score (ATS).
- They found that patients with serious complications after surgery had a lower chance of being cancer-free after 2 years compared to those with fewer complications.
- Reducing these complications is important to help patients with certain types of liver cancer have better outcomes.
Background: We sought to investigate whether minimally invasive hepatectomy (MIH) was superior to open hepatectomy (OH) in terms of achieving textbook outcome in liver surgery (TOLS) after resection of hepatocellular carcinoma (HCC).
Methods: Patients who underwent resection of HCC between 2000 and 2020 were identified from an international database. TOLS was defined by the absence of intraoperative grade ≥2 events, R1 resection margin, posthepatectomy liver failure, bile leakage, major complications, in-hospital mortality, and readmission.
Introduction: Although up to 50-70% of patients with intrahepatic cholangiocarcinoma (ICC) recur following resection, data to predict post-recurrence survival (PRS) and guide treatment of recurrence are limited.
Methods: Patients who underwent resection of ICC between 2000 and 2020 were identified from an international, multi-institutional database. Data on primary disease as well as laboratory and radiologic data on recurrent disease were collected.
The complication-overall survival (CompOS) risk tool predicts risk of a severe postoperative complications relative to long-term survival among patients with primary liver cancer.
J Gastrointest Surg
February 2024
Article Synopsis
- Researchers created a tool to help predict risks for patients who have liver surgery for cancer based on their health before the surgery.
- They looked at data from over 1,400 patients who had surgery between 1990 and 2020 and found that nearly half had problems afterward.
- The tool helps identify patients who might face serious complications and those who may not live as long, allowing doctors to make better decisions for their treatment.
Background: Minimally invasive distal pancreatectomy (MIDP) has established advantages over the open approach. The costs associated with robotic DP (RDP) versus laparoscopic DP (LDP) make the robotic approach controversial. We sought to compare outcomes and cost of LDP and RDP using propensity matching analysis at our institution.
View Article and Find Full Text PDFArticle Synopsis
- Early-stage intrahepatic cholangiocarcinoma (ICC) is a type of cancer that can be treated with surgery, but many patients still have a chance of the cancer coming back.
- A study looked at 430 patients who had surgery for this cancer and found that about 51% experienced a recurrence, often within the first year.
- Researchers developed an online tool that helps doctors predict which patients are at higher risk of recurrence based on certain factors, helping to decide who might need different treatments.
Objectives: To define how dynamic changes in pre- versus post-operative serum aspartate aminotransferase (AST) and alanine aminotransaminase (ALT) levels may impact postoperative morbidity after curative-intent resection of hepatocellular carcinoma (HCC).
Background: Hepatic ischemia/reperfusion can occur at the time of liver resection and may be associated with adverse outcomes following liver resection.
Methods: Patients who underwent curative resection for HCC between 2010-2020 were identified from an international multi-institutional database.
Introduction: Data on clinical characteristics and disease-specific prognosis among patients with early onset intrahepatic cholangiocarcinoma (ICC) are currently limited.
Methods: Patients undergoing hepatectomy for ICC between 2000 and 2020 were identified by using a multi-institutional database. The association of early (≤50 years) versus typical onset (>50 years) ICC with recurrence-free (RFS) and disease-specific survival (DSS) was assessed in the multi-institutional database and validated in an external cohort.