كتاب
Improving outcomes in patients with perihilar cholangiocarcinoma
| العنوان: | Improving outcomes in patients with perihilar cholangiocarcinoma |
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| المؤلفون: | Nooijen, Lynn Eline |
| المصدر: | Nooijen , L E 2024 , ' Improving outcomes in patients with perihilar cholangiocarcinoma ' , PhD , Vrije Universiteit Amsterdam , Amsterdam . https://doi.org/10.5463/thesis.496Test |
| سنة النشر: | 2024 |
| مصطلحات موضوعية: | perihilair cholangiocarcinoma, verbeteren uitkomsten, preoperatieve chemotherapie, perihilar cholangiocarcinoma, improving outcomes, preoperative chemotherapy |
| الوصف: | The aim of this thesis was to investigate how to improve outcomes in patients with perihilar cholangiocarcinoma (pCCA). To achieve this, several topics including resection margin, lymph node status, additional resection, preoperative (chemo) therapy and follow-up methods were covered. In Chapter 1, we gave an introduction on how to improve outcome in patients with pCCA. After imaging and defining resectability, the first step towards optimal surgical treatment is optimizing biliary drainage and preventing cholangitis, followed by securing adequate future liver remnant volume and/or function. The main goal of resection for pCCA is achieving radical resection and ultimately long-term survival. In Chapter 2, we described the long-term outcomes of patients with initially resectable pCCA who were randomized between endoscopic (EBD) and percutaneous biliary drainage (PTBD) in the DRAINAGE trial. This study demonstrates the complexity of biliary drainage for patients with potentially resectable pCCA. To date, the decision whether a patient seems resectable is based on expert opinion and decided by consensus. Resectability is based on preoperative imaging and actual resectability is determined during surgical exploration. Unfortunately, 10 to 30 % turns out to have unresectable disease during exploration due to more extensive disease than expected on imaging. Preoperative chemotherapy may downstage and convert unresectable tumors to resectable. However, in order to allocate patients for the best possible treatment, (e.g. resection, preoperative (chemo) therapy, or palliative (chemo) therapy) universal, widely implemented, and reproducible resectability criteria are needed. Therefore a study using the modified Delphi method, including Thirteen HPB-surgeons, from six tertiary referral centers in the Netherlands, was presented in Chapter 3. In Chapter 4, a systematic literature review is described. In this study we aimed to investigate the efficacy and safety of systemic induction therapy in initially unresectable locally ... |
| نوع الوثيقة: | book |
| وصف الملف: | application/pdf; application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| اللغة: | English |
| العلاقة: | https://research.vu.nl/en/publications/617ed1d7-9971-4d41-a346-3535b886afbfTest |
| DOI: | 10.5463/thesis.496 |
| الإتاحة: | https://doi.org/10.5463/thesis.496Test https://research.vu.nl/en/publications/617ed1d7-9971-4d41-a346-3535b886afbfTest https://hdl.handle.net/1871.1/617ed1d7-9971-4d41-a346-3535b886afbfTest https://research.vu.nl/ws/files/290359090/167103-nooijenbnwdefdpr%20-%2065abc057c5033.pdfTest https://research.vu.nl/ws/files/290359092/cover%20thesis%20final%203%20-%2065abc32772469.pdfTest https://research.vu.nl/ws/files/290359094/tocnooijen%20-%2065bca7a39fc41.pdfTest https://research.vu.nl/ws/files/290359096/titelblad%20-%20nooijen%20-%2065536bcade521.docxTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.7619AEB4 |
| قاعدة البيانات: | BASE |
| DOI: | 10.5463/thesis.496 |
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