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11 results on '"Larsen, Peter Norgaard"'

2. How should liver hypertrophy be stimulated? A comparison of upfront associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and portal vein embolization (PVE) with rescue possibility

Author

Sparrelid, Ernesto, Hasselgren, Kristina, Rosok, Bard Ingvald, Larsen, Peter Norgaard, Schultz, Nicolai Aagaard, Carling, Ulrik, Fallentin, Eva, Gilg, Stefan, Sandström, Per, Lindell, Gert, and Björnsson, Bergthor

Subjects
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), liver surgery, colorectal liver metastases (CRLM), portal vein embolization (PVE), Kirurgi, Surgery
Abstract

Background: The role of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in comparison to portal vein embolization (PVE) is debated. The aim of this study was to compare successful resection rates (RR) with upfront ALPPS vs. PVE with rescue ALPPS on demand and to compare the hypertrophy of the liver between ALPPS and PVE plus subsequent rescue ALPPS. Methods: A retrospective analysis of all patients treated with PVE for colorectal liver metastasis (CRLM) or ALPPS (any diagnosis, rescue ALPPS included) at five Scandinavian university hospitals during the years 2013-2016 was conducted. A Chi-square test and a Mann-Whitney U test were used to assess the difference between the groups. A successful RR was defined as liver resection without a 90-day mortality. Results: A total of 189 patients were included. Successful RR was in 84.5% of the patients with ALPPS upfront and in 73.3% of the patients with PVE and rescue ALPPS on demand (P=0.080). The hypertrophy of the future liver remnants (FLRs) with ALPPS upfront was 71% (48-97%) compared to 96% (82-113%) after PVE and rescue ALPPS (P=0.010). Conclusions: Upfront ALPPS offers a somewhat higher successful RR than PVE with rescue ALPPS on demand. The sequential combination of PVE and ALPPS leads to a higher overall degree of hypertrophy than upfront ALPPS.

Published
2021

3. Aspirin as secondary prevention in colorectal cancer liver metastasis (ASAC trial) : study protocol for a multicentre randomized placebo-controlled trial

Author

Yaqub, Sheraz, Bjornbeth, Bjorn Atle, Angelsen, Jon-Helge, Fristrup, Claus Wilki, Gronbech, Jon Erik, Hemmingsson, Oskar, Isaksson, Bengt, Juel, Ingebjorg Soterud, Larsen, Peter Norgaard, Lindell, Gert, Mortensen, Frank Viborg, Mortensen, Kim Erlend, Rizell, Magnus, Sandstrom, Per, Sandvik, Oddvar Mathias, Sparrelid, Ernesto, Taflin, Helena, Tasken, Kjetil, Yaqub, Sheraz, Bjornbeth, Bjorn Atle, Angelsen, Jon-Helge, Fristrup, Claus Wilki, Gronbech, Jon Erik, Hemmingsson, Oskar, Isaksson, Bengt, Juel, Ingebjorg Soterud, Larsen, Peter Norgaard, Lindell, Gert, Mortensen, Frank Viborg, Mortensen, Kim Erlend, Rizell, Magnus, Sandstrom, Per, Sandvik, Oddvar Mathias, Sparrelid, Ernesto, Taflin, Helena, and Tasken, Kjetil

Abstract

Background Colorectal cancer is one the most common cancers in the western world with increasing incidence. Approximately 50% of the patients develop liver metastases. Resection of liver metastases is the treatment of choice although almost half of the resected patients get recurrence in the liver. Methods The ASAC trial is a Scandinavian, multicentre, double-blinded, randomized, placebo-controlled study to determine whether adjuvant treatment with low-dose aspirin (acetylsalicylic acid (ASA)) can improve disease-free survival in patients treated for colorectal cancer liver metastases (CRCLM). Up to 800 patients operated for CRCLM will be randomized to Arm#1 ASA 160 mg once daily or Arm#2 Placebo, for a period of 3 years or until disease recurrence. The patients will be recruited at all major hepatobiliary surgical units in Norway, Sweden and Denmark and have follow-up according to standard of care and the National Guidelines. Discussion The ASAC trial will be the first clinical interventional trial to assess the potential beneficial role of ASA in recurrence of CRCLM and survival. ASA is an inexpensive, well-tolerated and easily accessible drug that will be highly potential as adjuvant drug in secondary prevention of CRCLM if the study shows a beneficial effect. We will also determine the effect of ASA as adjuvant treatment on Health-Related Quality of Life and the cost-effectiveness.

Published
2021
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4. Response to Comment on 'When Innovation Is Not Enough'

Author

Sandstrom, Per, Larsson, Anna Lindhoff, Bjornsson, Bergthor, Rosok, Bard Ingvald, Sparrelid, Ernesto, Larsen, Peter Norgaard, Schultz, Nicolai A., Bjornbeth, Bjorn Atle, Lindell, Gert, Isaksson, Bengt, Rizell, Magnus, Sandstrom, Per, Larsson, Anna Lindhoff, Bjornsson, Bergthor, Rosok, Bard Ingvald, Sparrelid, Ernesto, Larsen, Peter Norgaard, Schultz, Nicolai A., Bjornbeth, Bjorn Atle, Lindell, Gert, Isaksson, Bengt, and Rizell, Magnus

Published
2019
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5. Response to the Comment on 'Should We Have a Little More Patience With the Conventional 2-Stage Hepatectomy?'

Author

Sandström, Per, Røsok, Bård I., Sparrelid, Ernesto, Lindell, Gert, Larsen, Peter Norgaard, Larsson, Anna Lindhoff, Schultz, Nicolai A., Bjørnbeth, Bjorn A., Isaksson, Bengt, Rizell, Magnus, Björnsson, Bergthor, Sandström, Per, Røsok, Bård I., Sparrelid, Ernesto, Lindell, Gert, Larsen, Peter Norgaard, Larsson, Anna Lindhoff, Schultz, Nicolai A., Bjørnbeth, Bjorn A., Isaksson, Bengt, Rizell, Magnus, and Björnsson, Bergthor

Published
2019
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6. Response to 'ALPPS Versus Conventional Two-stage Hepatectomy in Patients With Advanced Colorectal Liver Metastases'

Author

Sandström, Per, Rosok, Bard I., Sparrelid, Ernesto, Larsen, Peter Norgaard, Larsson, Anna Lindhoff, Lindell, Gert, Schultz, Nicolai A., Bjornbeth, Bjorn A., Isaksson, Bengt, Rizell, M., Bjornsson, Bergthor, Sandström, Per, Rosok, Bard I., Sparrelid, Ernesto, Larsen, Peter Norgaard, Larsson, Anna Lindhoff, Lindell, Gert, Schultz, Nicolai A., Bjornbeth, Bjorn A., Isaksson, Bengt, Rizell, M., and Bjornsson, Bergthor

Published
2019
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7. Response 'Unresectable Colorectal Liver Metastases : When Definitions Matter to Appropriately Assess Extreme Liver Resection Techniques'

Author

Sandström, Per, Rosok, Bard I., Sparrelid, Ernesto, Lindell, Gert, Larsen, Peter Norgaard, Larsson, Anna Lindhoff, Schultz, Nicolai A., Isaksson, Bengt, Rizell, Magnus, Bjornsson, Bergthor, Sandström, Per, Rosok, Bard I., Sparrelid, Ernesto, Lindell, Gert, Larsen, Peter Norgaard, Larsson, Anna Lindhoff, Schultz, Nicolai A., Isaksson, Bengt, Rizell, Magnus, and Bjornsson, Bergthor

Published
2018
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11. Retransplantation of the liver in adults: long-term outcome and prognostic modeling.

Author

Yamauchi Y, Wettergren A, Yamashita Y, Mikami K, Hyodo M, Larsen PN, Rasmussen A, Shirakusa T, and Kirkegaard P

Subjects
Adult, Female, Humans, Japan epidemiology, Male, Prognosis, Reoperation mortality, Survival Analysis, Treatment Outcome, Liver Transplantation mortality
Abstract

Background/aims: The purpose of this study was to assess the outcome of liver retransplantation in adults at our institution and identify the subset of patients in which the outcome was too poor to justify retransplantation., Methodology: Over a 12-year period, we performed 346 liver transplantations in 305 adult patients, and of these, 41 (11.8%) were retransplantations. Survival data were stratified and multivariate analysis was conducted to identify variables associated with poor outcome after retransplantation., Results: The 90-day, 1-year, and 5-year survival rates after liver retransplantation were 65.9%, 62.6%, and 48.2%, respectively. These rates were significantly inferior compared to those following single liver transplantation. Major adverse events affecting patient survival after retransplantation occurred within the first 90 days after surgery. Three independent prognostic variables of patient survival after retransplantation were identified: preoperative coagulation factor, total bilirubin, and the need for preoperative dialysis. Using these variables, we defined a simplified mathematical model available at the time of decision of retransplantation., Conclusions: The present study indicated three important prognostic factors associated with a poor outcome after retransplantation. Based on our newly developed scoring-system estimating patient survival, we suggest that retransplantation must be indicated before the deterioration of more than two organs. These findings should assist in the decision process for liver retransplantation in adult patients.

Published
2007

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