Over the last forty years,many methodologies have been initiated within the framework of the participatory approach,the objective of which is to encourage the involvement of citizens in the definition and implementati...Over the last forty years,many methodologies have been initiated within the framework of the participatory approach,the objective of which is to encourage the involvement of citizens in the definition and implementation of projects and policies concerning them.The implementation of these participatory approaches in the field of interventional research in population health reveals several scientific,organizational,inter-individual,and ethical issues that must be discussed.Thus,we propose to present here the fruit of a collective reflection of the members of a research group,composed of patient-researchers and researchers in social psychology,on the implementation of the IMPAQT research project,which aimed to promote a community-based research approach in oncology.The discussion will be structured around three topics:the implementation of the participatory research mechanism,the sustainability of the commitment involved in participating in research,and the valorization of the participation of the patient-researchers.These issues are particularly important to consider in guiding the implementation of a solid and balanced partnership with those concerned in the co-construction of interventional research devices in cancerology.展开更多
BACKGROUND Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma(HCC),also in elderly population.Despite this,the evaluation of patient condition,liver function...BACKGROUND Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma(HCC),also in elderly population.Despite this,the evaluation of patient condition,liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality.AIM To identify new perioperative risk factors that could be associated with higher 90-and 180-d mortality in elderly patients eligible for liver resection for HCC considering traditional perioperative risk scores and to develop a risk score.METHODS A multicentric,retrospective study was performed by reviewing the medical records of patients aged 70 years or older who electively underwent liver resection for HCC;several independent variables correlated with death from all causes at 90 and 180 d were studied.The coefficients of Cox regression proportional-hazards model for sixmonth mortality were rounded to the nearest integer to assign risk factors'weights and derive the scoring algorithm.RESULTS Multivariate analysis found variables(American Society of Anesthesiology score,high rate of comorbidities,Mayo end stage liver disease score and size of biggest lesion)that had independent correlations with increased 90-and 180-d mortality.A clinical risk score was developed with survival profiles.CONCLUSION This score can aid in stratifying this population in order to assess who can benefit from surgical treatment in terms of postoperative mortality.展开更多
We read with great interest the recently published article of Boudjema and collaborators(1).The authors evaluated the safety and efficacy of delayed resection(DR)versus simultaneous resection(SR)for patients with init...We read with great interest the recently published article of Boudjema and collaborators(1).The authors evaluated the safety and efficacy of delayed resection(DR)versus simultaneous resection(SR)for patients with initially resectable synchronous colorectal cancer liver metastases(CRC-SLM).The aforementioned study(METASYNC)was the first randomized controlled trial comparing two resection strategies for CRC-SLM.In the literature,large retrospective studies didn’t seem to favor one type of treatment,particularly when comparisons are based on a propensity match score(2).展开更多
文摘Over the last forty years,many methodologies have been initiated within the framework of the participatory approach,the objective of which is to encourage the involvement of citizens in the definition and implementation of projects and policies concerning them.The implementation of these participatory approaches in the field of interventional research in population health reveals several scientific,organizational,inter-individual,and ethical issues that must be discussed.Thus,we propose to present here the fruit of a collective reflection of the members of a research group,composed of patient-researchers and researchers in social psychology,on the implementation of the IMPAQT research project,which aimed to promote a community-based research approach in oncology.The discussion will be structured around three topics:the implementation of the participatory research mechanism,the sustainability of the commitment involved in participating in research,and the valorization of the participation of the patient-researchers.These issues are particularly important to consider in guiding the implementation of a solid and balanced partnership with those concerned in the co-construction of interventional research devices in cancerology.
文摘BACKGROUND Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma(HCC),also in elderly population.Despite this,the evaluation of patient condition,liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality.AIM To identify new perioperative risk factors that could be associated with higher 90-and 180-d mortality in elderly patients eligible for liver resection for HCC considering traditional perioperative risk scores and to develop a risk score.METHODS A multicentric,retrospective study was performed by reviewing the medical records of patients aged 70 years or older who electively underwent liver resection for HCC;several independent variables correlated with death from all causes at 90 and 180 d were studied.The coefficients of Cox regression proportional-hazards model for sixmonth mortality were rounded to the nearest integer to assign risk factors'weights and derive the scoring algorithm.RESULTS Multivariate analysis found variables(American Society of Anesthesiology score,high rate of comorbidities,Mayo end stage liver disease score and size of biggest lesion)that had independent correlations with increased 90-and 180-d mortality.A clinical risk score was developed with survival profiles.CONCLUSION This score can aid in stratifying this population in order to assess who can benefit from surgical treatment in terms of postoperative mortality.
文摘We read with great interest the recently published article of Boudjema and collaborators(1).The authors evaluated the safety and efficacy of delayed resection(DR)versus simultaneous resection(SR)for patients with initially resectable synchronous colorectal cancer liver metastases(CRC-SLM).The aforementioned study(METASYNC)was the first randomized controlled trial comparing two resection strategies for CRC-SLM.In the literature,large retrospective studies didn’t seem to favor one type of treatment,particularly when comparisons are based on a propensity match score(2).
