Brazilian Society of Surgical Oncology surgical standards for resectable colorectal cancer liver metastases.

The management of colorectal cancer liver metastasis (CRLM) has become complex because of the increasing availability of medical, radiological, and surgical treatment options applied either alone or in combination. However, resection remains the only evidence-based curative therapy. These Brazilian Society of Surgical Oncology surgical standards are intended to guide clinicians in the decision-making process for modern surgical management of CRLM within a multidisciplinary team in an evidence-based framework, focusing on resectable disease.

Risk factors and prediction of acute kidney injury after liver transplantation: Logistic regression and artificial neural network approaches.

Background: Acute kidney injury (AKI) has serious consequences on the prognosis of patients undergoing liver transplantation. Recently, artificial neural network (ANN) was reported to have better predictive ability than the classical logistic regression (LR) for this postoperative outcome.

Aim: To identify the risk factors of AKI after deceased-donor liver transplantation (DDLT) and compare the prediction performance of ANN with that of LR for this complication.

Liver transplantation: survival and indexes of donor-recipient matching.

Objective: The aim of this study was to determine the prospective capacity and impact of donor risk index, preallocation survival outcomes following liver transplant, donor model for end-stage liver disease, and balance of risk on patients' 30-day survival after liver transplantation.

Methods: We prospectively analyzed patient survival in a multicentric observational cohort of adult liver transplantation through the year of 2019 at the state of Paraná, Brazil. The receiver operating characteristic curve, the area under the curve, and the best cutoff point (i.

Risk factors for acute kidney injury after partial hepatectomy.

Aim: To identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies.

Methods: Retrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified.

Acute renal injury after partial hepatectomy.

Currently, partial hepatectomy is the treatment of choice for a wide variety of liver and biliary conditions. Among the possible complications of partial hepatectomy, acute kidney injury (AKI) should be considered as an important cause of increased morbidity and postoperative mortality. Difficulties in the data analysis related to postoperative AKI after liver resections are mainly due to the multiplicity of factors to be considered in the surgical patients, moreover, there is no consensus of the exact definition of AKI after liver resection in the literature, which hampers comparison and analysis of the scarce data published on the subject.

Predictors of recurrence after a first hepatectomy for colorectal cancer liver metastases: a retrospective analysis.

Background: Surgical resection is considered the standard therapy in the treatment of liver metastases from colorectal cancer (CRCLM); however, most patients experience tumor recurrence after curative hepatic resection. The objective was to determine potential prognostic factors for tumor recurrence after an initial hepatectomy for CRCLM.

Methods: A study population of 101 patients who had undergone a first curative hepatectomy for CRCLM was retrospectively analyzed.

Morbidity after conventional dissection of axillary lymph nodes in breast cancer patients.

Background: Conventional axillary lymph node dissection (ALND) has recently become less radical. The treatment morbidity effects of reduced ALND aggressiveness are unknown. This article investigates the prevalence of the main complications of ALND: lymphedema, range-of-motion restriction, and arm paresthesia and pain.

Recurrence after liver transplantation for hepatocellular carcinoma according to up-to-seven criteria.

Background/aims: The Up7 criteria for HCC have recently emerged to identify potential candidates for OLT. The aim of this study was to assess the validity of the Up7 criteria according to the pathological analysis of the explanted livers.

Methodology: For recurrence risk calculation 669 HCC transplanted patients were classified according to both the pathological Milan and Up7 criteria.

A randomized controlled trial comparing fibrin glue and PlasmaJet on the raw surface of the liver after hepatic resection.

Background/aims: In order to reduce the rate of bleeding and bile leakage after hepatic resection, different operative techniques have been used such as selective suture, electrocautery, topical hemostatic agents, argon beam coagulation, omentoplasty and application of fibrin glue.

Methodology: The PlasmaJet, a recent tool that provides a high energy flow of ionized gas which seals small blood and lymph vessels has been recently introduced into clinical practice. We have conducted a randomized trial comparing the application of 5mL of fibrin glue (Tissucol) and the treatment by PlasmaJet (Plasma Surgical Limited, Theale, UK) on the raw surface of the liver stump after elective hepatic resection.

[Oncosurgical strategies for metastatic liver cancer].

Patients with liver metastases from colorectal cancer (CRC) present a major public health challenge with approximately, 1,2 million cases of CRC occur yearly worldwide. Resection of colorectal liver metastases (CRLM) is the only treatment offering the possibility of cure and has been shown to provide clear survival benefits. However, only 10 to 20% of patients with CRLM are eligible for this procedure upfront.

Evolution of neoadjuvant therapy for extended hepatic metastases--have we reached our (non-resectable) limit?

Surgical resection offers the best chance for cure in patients with colorectal liver metastases; however, only 15-25% of them can benefit from surgery. To increase resectability a number of strategies have been developed in different fields including chemotherapy, surgery, and radiology. Bringing them together into an integrated framework has expanded the number of patients that can be treated with curative intent.