Publications by authors named "Rhaiem R"

Background: The use of multiagent FOLFIRINOX chemotherapy for pancreatic adenocarcinoma in a neoadjuvant setting has been associated with an increased rate of complete pathological response (CPR) after surgery. This study investigated the long-term outcomes of patients with CPR in a multicenter setting to identify prognostic factors for overall survival (OS) and recurrence-free survival (RFS).

Methods: This retrospective cohort study examined biopsy-proven pancreatic adenocarcinomas with CPR after neoadjuvant chemotherapy or chemoradiotherapy and surgery, between January 2006 and December 2023 across 22 French and  2 Belgian centers.

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Ampullary composite gangliocytoma/neuroma and neuroendocrine tumor (CoGNET), previously called ampullary gangliocytic paragangliomas, is a rare entity, with only few reported cases in the literature. This is a multicentric retrospective cohort study of patients treated with endoscopy or surgery for ampullary CoGNET. A literature review of ampullary CoGNET was also performed.

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Background And Objective: Selective internal radiation therapy (SIRT) represents an endovascular treatment option for patients with hepatocellular carcinoma (HCC). Its use is widely recognized in the intermediate and advanced HCC, but it has become more prevalent in recent years in different Barcelona Clinic Liver Cancer (BCLC) stages. The aim of this review is to summarize the role of SIRT and its clinical implications through different stages of HCC.

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Background: Gastrointestinal (GI) bleeding is a leading cause of intensive care unit (ICU) admission in pancreatic cancer patients.

Aims: To analyze causes, ICU mortality and hemostatic treatment success rates of GI bleeding in pancreatic cancer patients requiring ICU admission.

Methods: Retrospective multicenter cohort study between 2009 and 2021.

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Selective internal radiation therapy (SIRT) has emerged as a viable endovascular treatment strategy for hepatocellular carcinoma (HCC). According to the Barcelona Clinic Liver Cancer (BCLC) classification, SIRT is currently recommended for early- and intermediate-stage HCC that is unsuitable for alternative locoregional therapies. Additionally, SIRT remains a recommended treatment for patients with advanced-stage HCC and portal vein thrombosis (PVT) without extrahepatic metastasis.

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Background: Knowledge about environmental pancreatic adenocarcinoma (PA) risk factors, including pesticide exposure, remains limited. Organochlorine (OC) accumulates in adipose tissue and can help reflect long-term exposure.

Patients And Methods: Age and body mass index (BMI) of patients with PA were matched with those undergoing a surgery for a benign disease on age and BMI (1:1).

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Article Synopsis
  • Hepatocellular carcinoma (HCC) has a poor prognosis, and this study examines the effectiveness of neoadjuvant transarterial chemoembolization (TACE) for large, resectable HCC tumors over 5 cm.
  • In a retrospective analysis of 384 patients, TACE showed no significant impact on disease-free survival or overall survival when compared to surgery alone, even after adjusting for other variables.
  • However, TACE may benefit specific patients, particularly those with very large tumors (≥10 cm), single tumors, or those needing portal vein embolization.
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  • KRAS mutation negatively impacts survival outcomes for patients with colorectal liver metastases, with those having mutated KRAS showing significantly shorter overall and disease-free survival compared to those with wild-type KRAS.
  • The study analyzed data from 593 patients to compare the effects of R0 (no cancer at margins) and R1 (cancer at margins) resections based on KRAS status, finding that R0 resections benefit wild-type patients but not those with KRAS mutations.
  • In KRAS wild-type tumors, R0 resections were linked to longer survival, while in KRAS-mutated tumors, the resection margin did not influence outcomes, emphasizing the aggressive nature of KRAS-mutated cancers.
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  • Totally IntraVenous Acess Devices (TIVAD) are used for long-term access to the bloodstream in cancer patients, with two types being valved (TIVAD-V) and open-ended (TIVAD-O).
  • A study involving 636 patients found that 8.7% of TIVADs were removed due to complications, mainly infections and occlusions, over a 54-month period.
  • The results indicated no significant differences in complication rates or time-to-removal between TIVAD-V and TIVAD-O, with average removal times of 17.0 and 18.4 months respectively.
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  • Primary liver cancer can originate from two cell types, leading to different types of tumors: hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICCA), with combined tumors (cHCC-CCA) displaying mixed characteristics.
  • Researchers utilized deep learning to categorize tumors in a study involving 405 cHCC-CCA patients, successfully distinguishing between HCC and ICCA types.
  • This deep learning method showed potential for enhancing treatment strategies and improving patient outcomes for those with complex liver cancers.
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  • Combined hepatocholangiocarcinoma is a rare and aggressive type of cancer combining features of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma, leading to a poor prognosis.
  • A multicenter international study analyzed the surgery outcomes for patients with combined hepatocholangiocarcinoma and compared them with those having either hepatocellular carcinoma or intrahepatic cholangiocarcinoma from 2000 to 2021.
  • The results showed significant differences in overall survival rates at 1, 3, and 5 years among the groups, with combined hepatocholangiocarcinoma having the lowest survival rates, while disease-free survival rates were similar across groups, suggesting that combined hepatochol
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Background: We sought to describe the reasons for intensive care unit (ICU) admission and outcomes of patients with pancreatic cancer requiring unplanned medical ICU admission.

Patients And Methods: Retrospective cohort study in five ICUs from 2009 to 2020. All patients with pancreatic cancer admitted to the ICU were included.

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  • Surgical resection (SR) is a potential cure for hepatocellular carcinoma (HCC), but high recurrence rates pose a challenge, necessitating the development of better risk stratification tools for predicting recurrence.
  • A new scoring system, called the Early Recurrence Score (ERS), was created from data of 2359 patients who underwent SR for HCC, evaluating factors like alpha-fetoprotein levels and tumor characteristics to forecast 2-year recurrence risk.
  • The ERS effectively stratified patients into four risk categories with good accuracy and can help personalize surveillance and therapy plans post-surgery.
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Background: Eastern data highlight the oncological benefits of the anterior approach (AA) during right hepatectomy (RH) for hepatocellular carcinoma (HCC). However, to our knowledge, previous western data on this topic are scarce. In this study, the oncological outcomes of AA and classical approach (CA) during RH for HCC were compared.

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Background: Anastomotic leak (AL) is a serious complication in digestive surgery. Early diagnosis might allow clinicians to anticipate appropriate management. The aim of this study was to assess the predictive value of amylase concentration in drain fluid for the early diagnosis of digestive tract AL.

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Background: Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic neoplasm. Surgery is the factual curative option, but most patients present with advanced disease. In order to increase resectability, results of neoadjuvant chemotherapy (NAC) on metastatic disease were extrapolated to the neoadjuvant setting by many centers.

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Background: The SARS-CoV-2 (COVID-19) pandemic required a rapid surge of healthcare capacity to face a growing number of critically ill patients. For this reason, a support reserve of physicians, including surgeons, were required to be reassigned to offer support.

Objective: To realize a survey on the educational programs deployed (face-to-face or e-learning focusing on infective area, basic gestures, COVID clinical management and intensive care medicine), and their impact on behavior change (Kirkpatrick 3) of the target population of surgeons, measured on a five modalities Likert scale.

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Background & Aims: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer (PLC) associated with a poor prognosis. Given the challenges in its identification and its clinical implications, biomarkers are critically needed. We aimed to investigate the diagnostic and prognostic value of the immunohistochemical expression of Nestin, a progenitor cell marker, in a large multicentric series of PLCs.

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The subject of this narrative review is macrotrabecular-massive hepatocellular carcinoma (MTM-HCC). Despite their rarity, these tumours are of general interest because of their epidemiological and clinical features and for representing a distinct model of the interaction between the angiogenetic system and neoplastic cells. The MTM-HCC subtype is associated with various adverse biological and pathological parameters (the Alfa-foetoprotein (AFP) serum level, tumour size, vascular invasion, and satellite nodules) and is a key determinant of patient prognosis, with a strong and independent predictive value for early and overall tumour recurrence.

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Article Synopsis
  • - The study explores the effectiveness of different chemotherapy approaches (neoadjuvant vs. perioperative) in patients with resectable colorectal liver metastases (CRLM) and assesses their long-term survival outcomes.
  • - A total of 252 patients were retrospectively analyzed, showing that those who received perioperative chemotherapy had significantly better recurrence-free survival (RFS) and overall survival (OS) rates compared to those who only received neoadjuvant chemotherapy.
  • - The results suggest that combining neoadjuvant and adjuvant chemotherapy (perioperative strategy) enhances survival outcomes, especially in patients who can handle postoperative chemotherapy following liver resection, regardless of their initial risk level.
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Celiacomesenteric trunk is a rare variant of celiac artery anatomical variations. Stenosis of celiacomesenteric trunk is a severe usually symptomatic condition which might jeopardize the arterial supply of both supramesocolic organs and the midgut. It was diagnosed in a 79-year-old male during the preoperative workup for a pancreatic adenocarcinoma.

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Introduction And Objectives: Liver resection is the only curative therapeutic option for large hepatocellular carcinoma (> 5 cm), but survival is worse than in smaller tumours, mostly due to the high recurrence rate. There is currently no proper tool for stratifying relapse risk. Herein, we investigated prognostic factors before hepatectomy in patients with a single large hepatocellular carcinoma (HCC).

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(1) Background: colorectal liver metastases (CRLM) are the most common extra-lymphatic metastases in colorectal cancer; however, few patients are fit for curative surgery. Microwave ablation (MWA) showed promising outcomes in this cohort of patients. This systematic review and pooled analysis aimed to analyze the oncological results of MWA for CRLM.

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