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- Engstrand, J., et al.
(författare)
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Liver resection and ablation for squamous cell carcinoma liver metastases
- 2021
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Ingår i: BJS Open. - Oxford, United Kingdom : Oxford University Press. - 2474-9842. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS).METHOD: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS.RESULTS: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30).CONCLUSION: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.
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- Fusai, Giuseppe Kito, et al.
(författare)
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Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries
- 2023
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Ingår i: British Journal of Surgery. - : OXFORD UNIV PRESS. - 0007-1323 .- 1365-2168.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761).
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- Siriwardena, D. P., et al.
(författare)
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Probing the effect of Mg doping on triclinic Na2Mn3O7 transition metal oxide as cathode material for sodium-ion batteries
- 2021
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Ingår i: Electrochimica Acta. - : Elsevier Ltd. - 0013-4686 .- 1873-3859. ; 394
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Tidskriftsartikel (refereegranskat)abstract
- Triclinic Na2Mn3O7 has been identified as a promising material for high-capacity sodium-ion batteries. However, the knowledge on the effect of doping of metal ions and structural transformations of Na2Mn3O7 during dis(charge) is limited. Integration of alkali metal-ions, specially Mg2+ can enhance the electrochemical properties in transition metal oxides. Herein, a series of Mg2+ doped triclinic Na2Mn3O7 cathode materials was explored for the first time. Electrochemical analysis revealed that Mg2+ improves specific capacities, and rate capabilities. Ex situ X-ray diffraction (XRD) and Galvanostatic charge discharge cycling (GCD) showed that the triclinic phase reversibly converts into two monoclinic phases at high Na+ insertion levels. Na+ extraction at high potentials is supported by another biphasic region which converts to a major triclinic phase at the end of the charge. GCD, cyclic voltammetry (CV) and ex situ X-ray absorption spectroscopy (XAS) documented that the capacity mainly evolved through a Mn4+/3+ redox couple and a reversible O2-/n− redox reaction. CV and Galvanostatic intermittent titration techniques (GITT) showed that Mg2+ reduces the Na+-vacancy ordering and improves the Na+ diffusion. The 2 mol.% Mg-doped material exhibited a high specific capacity of 143 mAh/g after 30 cycles and a rate capability of 93 mAh/g (at 500 mA/g). GCD analysis demonstrated that O2-/n− redox is remarkably stable up to at least 90 cycles. Full cells made using the 0.5 mol.% Mg-doped material displayed a promising discharge specific capacity of 80 mAh/g. The effects of cation doping into the complex crystal structures, phase transformations during Na+ de(intercalation) and the importance of O2-/n− redox for achieving high capacities were uncovered. The findings of this work will guide the design of novel cathode materials for sodium-ion batteries. © 2021
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