Karim A.Touijer,M.D.,M.P.H..FACS,Dr.Karim A.Touijer is an Attending Surgeon at Memorial Sloan Kettering Cancer Center(MSKCC)and Professor of Urology at Weill Medical College of Cornell University.Dr.Touijer graduated ...Karim A.Touijer,M.D.,M.P.H..FACS,Dr.Karim A.Touijer is an Attending Surgeon at Memorial Sloan Kettering Cancer Center(MSKCC)and Professor of Urology at Weill Medical College of Cornell University.Dr.Touijer graduated with honors from Université Hassan II,Facultéde Médecine de Casablanca,Morocco and completed his general surgery and Urology training at Centre Hospitalier Ibn Rochd,Casablanca,Morocco,the University of Kansas Medical Center,Kansas City,KS,USA,and the University of Arkansas for Medical Sciences,Little Rock,AR,USA.展开更多
A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial con...A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the experts.The Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this meeting.This effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these patients.This coordinated effort can minimise delays and give patients a chance for curative treatment and effective palliation.The diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance cholangiopancreato-graphy.Brush cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for diagnosis.However,histopathologic confirmation is not always required before resection.Endoscopic ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for staging.The only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette classification.Selected patients with unresectable hCCA can be considered for liver transplantation.Adjuvant chemotherapy should be offered to patients with a high risk of recurrence.The use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary discussions.Patients with acute cholangitis can be drained with endoscopic or percutaneous biliary drainage.Palliative chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.展开更多
BACKGROUND Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumor type in the gastrointestinal system. Presently, various classification systems to prognosticate GISTs have been proposed.AIM To e...BACKGROUND Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumor type in the gastrointestinal system. Presently, various classification systems to prognosticate GISTs have been proposed.AIM To evaluate the application value of four different risk stratification systems for GISTs.METHODS Patients who were diagnosed with GISTs and underwent surgical resection at four hospitals from 1998 to 2015 were identified from a database. Risk of recurrence was stratified by the modified National Institute of Health(NIH)criteria, the Armed Forces Institute of Pathology(AFIP) criteria, the Memorial Sloan Kettering Cancer Center(MSKCC) prognostic nomogram, and the contour maps. Receiver operating characteristic(ROC) curves were established to compare the four abovementioned risk stratification systems based on the area under the curve(AUC).RESULTS A total of 1303 patients were included in the study. The mean age of the patients was 55.77 ± 13.70 yr; 52.3% of the patients were male. The mean follow-up period was 64.91 ± 35.79 mo. Approximately 67.0% the tumors were located in the stomach, and 59.5% were smaller than 5 cm; 67.3% of the patients had a mitotic count ≤ 5/50 high-power fields(HPFs). Thirty-four tumors ruptured before and during surgery. Univariate analysis demonstrated that tumor size > 5 cm(P <0.05), mitotic count > 5/50 HPFs(P < 0.05), non-gastric location(P < 0.05), and tumor rupture(P < 0.05) were significantly associated with increased recurrence rates. According to the ROC curve, the AFIP criteria showed the largest AUC(0.754).CONCLUSION According to our data, the AFIP criteria were associated with a larger AUC than the NIH modified criteria, the MSKCC nomogram, and the contour maps, which might indicate that the AFIP criteria have better accuracy to support therapeutic decision-making for patients with GISTs.展开更多
国际科学合作已经成为当今大科学时代开展大科学项目研究的主流科学生产方式。研究大科学项目的国际科学合作的运行模式及其特征,对我国开展大科学项目研究具有一定的理论和实践指导意义。由美国牵头发起的斯隆数字巡天(SDSS)项目是21...国际科学合作已经成为当今大科学时代开展大科学项目研究的主流科学生产方式。研究大科学项目的国际科学合作的运行模式及其特征,对我国开展大科学项目研究具有一定的理论和实践指导意义。由美国牵头发起的斯隆数字巡天(SDSS)项目是21世纪以来典型的大科学项目,在Web of Science平台检索依托这一项目的科学论文,利用Cite Space信息可视化软件系统对这一项目的国家和机构两个层面的科学合作情况进行分析,揭示了该项目的国际科学合作中以多边交叉型合作模式、双边交互性合作模式和补充型合作模式为核心的"外、中、内"3层合作体系,总结了大科学项目国际科学合作的基本特征,为我国参与和主导国际大科学合作提供参考借鉴。展开更多
文摘Karim A.Touijer,M.D.,M.P.H..FACS,Dr.Karim A.Touijer is an Attending Surgeon at Memorial Sloan Kettering Cancer Center(MSKCC)and Professor of Urology at Weill Medical College of Cornell University.Dr.Touijer graduated with honors from Université Hassan II,Facultéde Médecine de Casablanca,Morocco and completed his general surgery and Urology training at Centre Hospitalier Ibn Rochd,Casablanca,Morocco,the University of Kansas Medical Center,Kansas City,KS,USA,and the University of Arkansas for Medical Sciences,Little Rock,AR,USA.
基金Nature Science Foundation of Shanxi(201601D011042)Program for the Outstanding Innovative Team of High Learning Learning Instituttions of ShanxiOutstanding Youth Funds of North University of China
文摘A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the experts.The Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this meeting.This effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these patients.This coordinated effort can minimise delays and give patients a chance for curative treatment and effective palliation.The diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance cholangiopancreato-graphy.Brush cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for diagnosis.However,histopathologic confirmation is not always required before resection.Endoscopic ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for staging.The only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette classification.Selected patients with unresectable hCCA can be considered for liver transplantation.Adjuvant chemotherapy should be offered to patients with a high risk of recurrence.The use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary discussions.Patients with acute cholangitis can be drained with endoscopic or percutaneous biliary drainage.Palliative chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.
基金the State Key Project of Research and Development Plan,No.2017YFC0108300 and No.2017YFC01083032018 Special Funds for the Cultivation of Guangdong College Students'Scientific and Technological Innovation(Climbing Program Special Funds),No.pdjha0094
文摘BACKGROUND Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumor type in the gastrointestinal system. Presently, various classification systems to prognosticate GISTs have been proposed.AIM To evaluate the application value of four different risk stratification systems for GISTs.METHODS Patients who were diagnosed with GISTs and underwent surgical resection at four hospitals from 1998 to 2015 were identified from a database. Risk of recurrence was stratified by the modified National Institute of Health(NIH)criteria, the Armed Forces Institute of Pathology(AFIP) criteria, the Memorial Sloan Kettering Cancer Center(MSKCC) prognostic nomogram, and the contour maps. Receiver operating characteristic(ROC) curves were established to compare the four abovementioned risk stratification systems based on the area under the curve(AUC).RESULTS A total of 1303 patients were included in the study. The mean age of the patients was 55.77 ± 13.70 yr; 52.3% of the patients were male. The mean follow-up period was 64.91 ± 35.79 mo. Approximately 67.0% the tumors were located in the stomach, and 59.5% were smaller than 5 cm; 67.3% of the patients had a mitotic count ≤ 5/50 high-power fields(HPFs). Thirty-four tumors ruptured before and during surgery. Univariate analysis demonstrated that tumor size > 5 cm(P <0.05), mitotic count > 5/50 HPFs(P < 0.05), non-gastric location(P < 0.05), and tumor rupture(P < 0.05) were significantly associated with increased recurrence rates. According to the ROC curve, the AFIP criteria showed the largest AUC(0.754).CONCLUSION According to our data, the AFIP criteria were associated with a larger AUC than the NIH modified criteria, the MSKCC nomogram, and the contour maps, which might indicate that the AFIP criteria have better accuracy to support therapeutic decision-making for patients with GISTs.
文摘国际科学合作已经成为当今大科学时代开展大科学项目研究的主流科学生产方式。研究大科学项目的国际科学合作的运行模式及其特征,对我国开展大科学项目研究具有一定的理论和实践指导意义。由美国牵头发起的斯隆数字巡天(SDSS)项目是21世纪以来典型的大科学项目,在Web of Science平台检索依托这一项目的科学论文,利用Cite Space信息可视化软件系统对这一项目的国家和机构两个层面的科学合作情况进行分析,揭示了该项目的国际科学合作中以多边交叉型合作模式、双边交互性合作模式和补充型合作模式为核心的"外、中、内"3层合作体系,总结了大科学项目国际科学合作的基本特征,为我国参与和主导国际大科学合作提供参考借鉴。
