File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Choices of therapeutic strategies for colorectal liver metastases among expert liver surgeons: A throw of the dice?

TitleChoices of therapeutic strategies for colorectal liver metastases among expert liver surgeons: A throw of the dice?
Authors
Keywordscolorectal liver metastasis
expert liver surgeons
surgery
variability of treatment strategies
Issue Date2020
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals of Surgery, 2020, v. 272 n. 5, p. 715-722 How to Cite?
AbstractObjective: To test the degree of agreement in selecting therapeutic options for patients suffering from colorectal liver metastasis (CRLM) among surgical experts around the globe. Summary/Background: Only few areas in medicine have seen so many novel therapeutic options over the past decades as for liver tumors. Significant variations may therefore exist regarding the choices of treatment, even among experts, which may confuse both the medical community and patients. Methods: Ten cases of CRLM with different levels of complexity were presented to 43 expert liver surgeons from 23 countries and 4 continents. Experts were defined as experienced surgeons with academic contributions to the field of liver tumors. Experts provided information on their medical education and current practice in liver surgery and transplantation. Using an online platform, they chose their strategy in treating each case from defined multiple choices with added comments. Inter-rater agreement among experts and cases was calculated using free-marginal multirater kappa methodology. A similar, but adjusted survey was presented to 60 general surgeons from Asia, Europe, and North America to test their attitude in treating or referring complex patients to expert centers. Results: Thirty-eight (88%) experts completed the evaluation. Most of them are in leading positions (92%) with a median clinical experience of 25 years. Agreement on therapeutic strategies among them was none to minimal in more than half of the cases with kappa varying from 0.00 to 0.39. Many general surgeons may not refer the complex cases to expert centers, including in Europe, where they also engage in complex liver surgeries. Conclusions: Considerable inconsistencies of decision-making exist among expert surgeons when choosing a therapeutic strategy for CRLM. This might confuse both patients and referring physicians and indicate that an international high-level consensus statements and widely accepted guidelines are needed.
DescriptionPAPERS CHOSEN FOR PRESENTATION AT THE 2020 ANNUAL MEETING OF THE EUROPEAN SURGICAL ASSOCIATION
Persistent Identifierhttp://hdl.handle.net/10722/305448
ISSN
2023 Impact Factor: 7.5
2023 SCImago Journal Rankings: 2.729
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorIgnatavicius, P-
dc.contributor.authorOberkofler, CE-
dc.contributor.authorChapman, WC-
dc.contributor.authorDeMatteo, RP-
dc.contributor.authorClary, BM-
dc.contributor.authorD’Angelica, MI-
dc.contributor.authorTanabe, KK-
dc.contributor.authorHong, JC-
dc.contributor.authorAloia, TA-
dc.contributor.authorPawlik, TM-
dc.contributor.authorHernandez-Alejandro, R-
dc.contributor.authorShah, SA-
dc.contributor.authorVauthey, JN-
dc.contributor.authorTorzilli, G-
dc.contributor.authorLang, H-
dc.contributor.authorLine, PD-
dc.contributor.authorSoubrane, O-
dc.contributor.authorPinto-Marques, H-
dc.contributor.authorRobles-Campos, R-
dc.contributor.authorBoudjema, K-
dc.contributor.authorLodge, P-
dc.contributor.authorAdam, R-
dc.contributor.authorToso, C-
dc.contributor.authorSerrablo, A-
dc.contributor.authorAldrighetti, L-
dc.contributor.authorDeOliveira, ML-
dc.contributor.authorDutkowski, P-
dc.contributor.authorPetrowsky, H-
dc.contributor.authorLinecker, M-
dc.contributor.authorReiner, CS-
dc.contributor.authorBraun, J-
dc.contributor.authorAlikhanov, R-
dc.contributor.authorBarauskas, G-
dc.contributor.authorChan, ACY-
dc.contributor.authorDong, J-
dc.contributor.authorKokudo, N-
dc.contributor.authorYamamoto, M-
dc.contributor.authorKang, KJ-
dc.contributor.authorFong, Y-
dc.contributor.authorRela, M-
dc.contributor.authorDe Aretxabala, X-
dc.contributor.authorDe Santibañes, E-
dc.contributor.authorMercado, MA-
dc.contributor.authorAndriani, OC-
dc.contributor.authorTorres, OJ-
dc.contributor.authorPinna, AD-
dc.contributor.authorClavien, PA-
dc.date.accessioned2021-10-20T10:09:32Z-
dc.date.available2021-10-20T10:09:32Z-
dc.date.issued2020-
dc.identifier.citationAnnals of Surgery, 2020, v. 272 n. 5, p. 715-722-
dc.identifier.issn0003-4932-
dc.identifier.urihttp://hdl.handle.net/10722/305448-
dc.descriptionPAPERS CHOSEN FOR PRESENTATION AT THE 2020 ANNUAL MEETING OF THE EUROPEAN SURGICAL ASSOCIATION-
dc.description.abstractObjective: To test the degree of agreement in selecting therapeutic options for patients suffering from colorectal liver metastasis (CRLM) among surgical experts around the globe. Summary/Background: Only few areas in medicine have seen so many novel therapeutic options over the past decades as for liver tumors. Significant variations may therefore exist regarding the choices of treatment, even among experts, which may confuse both the medical community and patients. Methods: Ten cases of CRLM with different levels of complexity were presented to 43 expert liver surgeons from 23 countries and 4 continents. Experts were defined as experienced surgeons with academic contributions to the field of liver tumors. Experts provided information on their medical education and current practice in liver surgery and transplantation. Using an online platform, they chose their strategy in treating each case from defined multiple choices with added comments. Inter-rater agreement among experts and cases was calculated using free-marginal multirater kappa methodology. A similar, but adjusted survey was presented to 60 general surgeons from Asia, Europe, and North America to test their attitude in treating or referring complex patients to expert centers. Results: Thirty-eight (88%) experts completed the evaluation. Most of them are in leading positions (92%) with a median clinical experience of 25 years. Agreement on therapeutic strategies among them was none to minimal in more than half of the cases with kappa varying from 0.00 to 0.39. Many general surgeons may not refer the complex cases to expert centers, including in Europe, where they also engage in complex liver surgeries. Conclusions: Considerable inconsistencies of decision-making exist among expert surgeons when choosing a therapeutic strategy for CRLM. This might confuse both patients and referring physicians and indicate that an international high-level consensus statements and widely accepted guidelines are needed.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com-
dc.relation.ispartofAnnals of Surgery-
dc.rightsThis is a non-final version of an article published in final form in (provide complete journal citation)-
dc.subjectcolorectal liver metastasis-
dc.subjectexpert liver surgeons-
dc.subjectsurgery-
dc.subjectvariability of treatment strategies-
dc.titleChoices of therapeutic strategies for colorectal liver metastases among expert liver surgeons: A throw of the dice?-
dc.typeArticle-
dc.identifier.emailChan, ACY: acchan@hku.hk-
dc.identifier.authorityChan, ACY=rp00310-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/SLA.0000000000004331-
dc.identifier.pmid32833764-
dc.identifier.scopuseid_2-s2.0-85088030668-
dc.identifier.hkuros326572-
dc.identifier.volume272-
dc.identifier.issue5-
dc.identifier.spage715-
dc.identifier.epage722-
dc.identifier.isiWOS:000619410000008-
dc.publisher.placeUnited States-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats