Keywords used in these searches were “”colorectal cancer”, “”liver metastasis”, “”chemotherapy”, “”liver resection”, “”monoclonal antibody”,
“”steatohepatitis”, “”sinusoidal obstruction” and “”liver regeneration”. Databases were searched for the period January 1970 to September 2009 inclusively. In addition hand referencing of retrieved articles was performed.
Results: Modern chemotherapy BLZ945 regimens can effectively downstage initially unresectable disease such that surgical resection can be performed with the prospect of long term cure. There is insufficient evidence however to recommend its use in either the neoadjuvant or adjuvant setting in those with resectable disease from the outset.
Conclusion: Chemotherapy can be associated with significant changes to the hepatic parenchyma with subsequent increased risk of morbidity and mortality in the perioperative period. Much work needs to be done to understand
the molecular mechanisms underlying these changes to make extended resections safer in patients who are at risk. (C) 2009 Elsevier Ltd. All rights reserved.”
“Objectives: The aim was to study the incidence of joint replacements among biologic drug and disease-modifying anti-rheumatic drug (DMARD) users as well as to investigate the plausible effect of biologic treatment on survival of prostheses in patients with Rheumatoid arthritis Flavopiridol (RA).
Methods: The study P005091 in vivo population comprised 2 cohorts of patients [Register of biologic treatment in Finland (ROB-FIN) and the Central Finland RA database) from 1999 to 2010. Records of joint replacements performed in the study population
between 1980 and 2010 were retrieved from the Finnish Arthroplasty Register. Propensity score matching was used to equalize patient characteristics between biologics and DMARD users. The incidence rates of primary and revision operations were compared between the 2 treatment groups. Kaplan-Meier survival analysis was used to analyze prosthesis survival.
Results: Of the 2102 biologics and 2710 DMARD users identified from the registries, 1587 were included in both groups after the matching. Median follow-up times were 3.1 and 8.0 years, respectively. There were more primary operations per 100 patient years in the biologics (3.89, CI 95% 3.41-4.41) vs. DMARD (2.63, 2.35-2.94) group but slightly fewer revisions (0.65, 0.46-0.88 vs. 0.83, 0.68-1.01). Biologics users were more likely to receive a joint replacement to small joints (p < 0.001). The survival of the prostheses installed during or prior to follow-up was similar in both treatment groups.
Conclusions: The use of biologic drugs did not reduce the need for joint replacement surgery in patients with a similar on-medication disease activity. Despite possibly lower rate of revisions among biologic users, the durability of prostheses was not improved. (C) 2013 Elsevier Inc. All rights reserved.
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