Nikolaos Andreatos

Mayo Clinic - Rochester · Department of Oncology

Background To date, only two studies have compared the outcomes of patients with liver-limited BRAF V600E-mutated colorectal liver metastases (CRLMs) managed with resection versus systemic therapy alone, and these have reported contradictory findings. Methods In this observational, international, multicentre study, patients with liver-limited BRAF...

Purpose of Review Extrapulmonary neuroendocrine carcinoma (EP-NEC) is a rare, aggressive malignancy that can arise from any organ and frequently presents with distant metastases. Advanced disease has a poor prognosis with median overall survival (OS) rarely exceeding 1 year even with systemic therapy. The management paradigm of advanced/metastatic...

This compendium was created to cover the most important subjects in the field of Neuro-Oncology, so that readers will be able to find high-yield information presented in a concise yet comprehensive format. Each chapter highlights information of critical importance by using specifically designed text boxes. In addition, to facilitate consolidation o...

Objective: To investigate the clinical implications of BRAF mutated (mutBRAF) colorectal liver metastases (CRLM). Summary background data: The clinical implications of mutBRAF status in CRLM are largely unknown. Methods: Patients undergoing resection for mutBRAF CRLM were identified from prospectively maintained registries of the collaborating...

Background: Although primary tumor sidedness (PTS) has a known prognostic role in sporadic colorectal cancer (CRC), its role in Inflammatory Bowel Disease related CRC (IBD-CRC) is largely unknown. Thus, we aimed to evaluate the prognostic role of PTS in patients with IBD-CRC. Methods: All eligible patients with surgically treated, non-metastatic...

Although the natural history of recurrence/progression in patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas has not been studied thoroughly, the three principal mechanisms have been identified: (a) presence of residual disease at the transection margin, (b) presence of intraductal/intraparenchymal metastases and (c) deve...

Background: It is debated whether primary tumor laterality (PTL) is prognostic in all patients with colorectal liver metastases (CRLM) or only those with KRAS wild-type or KRAS-mutated tumors; Methods: We systematically reviewed PubMed for studies reporting on resected CRLM originating from left-sided (LS) versus right-sided (RS) colon cancer stra...

PURPOSE The American Joint Committee on Cancer (AJCC) eighth edition schema for pancreatic ductal adenocarcinoma treats T and N stage as independent factors and uses positive lymph nodes (PLNs) to define N stage, despite data favoring lymph node ratio (LNR). We used artificial intelligence–based techniques to compare PLN with LNR and investigate in...

Objective: To validate the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging system for patients with invasive carcinomas arising in association with IPMN (IPMN-associated PDAC). Background data: Although several studies have validated AJCC systems in patients with conventional PDAC, their applicability to IPMN-associ...

Background: The prognostic implication of mutant KRAS (mKRAS) among patients with primary disease in the rectum remains unknown. Methods: From 2000 to 2018, patients undergoing hepatectomy for colorectal liver metastases at 10 collaborating international institutions with documented KRAS status were surveyed. Results: A total of 834 (65.8%) pa...

Introduction Two novel clinical risk scores (CRS) that incorporate KRAS mutation status (modified CRS (mCRS) and GAME score) were developed. However, they have not been tested in large national and international cohorts. The aim of this study was to validate the prognostic discrimination utility and determine the clinical usefulness of the two nove...

Background and Objectives Despite the long‐standing consensus on the importance of tumor size, tumor number and carcinoembryonic antigen (CEA) levels as predictors of long‐term outcomes among patients with colorectal liver metastases (CRLM), optimal prognostic cut‐offs for these variables have not been established. Methods Patients who underwent c...

Background Although the prognostic relevance of KRAS status in metastatic colorectal cancer (CRC) depends on tumor laterality, this relationship is largely unknown in non‐metastatic CRC. Methods Patients who underwent resection for non‐metastatic CRC between 2000 and 2018 were identified from institutional databases at six academic tertiary center...

Background: Although the prognostic relevance of KRAS status in metastatic colorectal cancer (CRC) depends on tumor laterality, this relationship is largely unknown in non-metastatic CRC. Methods: Patients who underwent resection for non-metastatic CRC between 2000 and 2018 were identified from institutional databases at six academic tertiary cent...

Background Combined treatment with radiotherapy (RT) and checkpoint inhibition (CPI) can theoretically increase both treatment response and toxicity. We recently reported a high rate of immune-mediated adverse events (irAEs) among patients with advanced melanoma and Merkel cell carcinoma (MCC) treated with concomitant RT and CPI. We now present sur...

3144 Background: Radiotherapy (RT) potentiates immune-mediated responses against tumor antigens, an effect that is enhanced by checkpoint inhibitors (CPIs) and may hold therapeutic promise. However, the mechanisms underlying this abscopal effect can theoretically increase the rate of immune-mediated adverse events (irAEs). We estimated the incidenc...

Advanced urothelial carcinoma (UC) is a very important cause of cancer-related morbidity and mortality with, until recently, only a few available therapeutic options. The treatment landscape has dramatically changed in recent years with the introduction of immune checkpoint inhibitors and the development of novel targeted agents, such as erdafitini...

Objective: Portal vein thrombosis (PVT) does not preclude liver transplantation (LT), but poor portal vein (PV) flow after LT remains a predictor of poor outcomes. Given the physiologic tendency of the hepatic artery (HA) to compensate for low PV flow via vasodilation, we investigated whether adequate HA flow would have a favorable prognostic impa...

Objective: To examine the prognostic impact of tumor laterality in colon cancer liver metastases (CLM) after stratifying by Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) mutational status. Background: Although some studies have demonstrated that patients with CLM from a right sided (RS) primary cancer fare worse, others have found equivoca...

Background: The duration of antibiotic therapy for bacteremia due to Enterobacteriaceae is not well-defined. We sought to evaluate the clinical outcomes with shorter versus longer-course treatment. Methods: We performed a systematic search of the PubMed and EMBASE databases through May 2018. Studies presenting comparative outcomes between patients...

Background: A major response to pre-hepatectomy chemotherapy has been associated with improved survival in patients who undergo resection of colorectal liver metastases (CRLM). However, the role of tumor biology, as exemplified by overall and codon-specific KRAS mutational status, in predicting response to chemotherapy is not well defined. Method...

Objective The aim of this study was to examine if the prognostic significance of margin status in hepatectomy for colorectal cancer liver metastasis (CRLM) varies for different levels of tumor burden because hepatectomy indications for CRLM have been recently expanded to include patients with a higher tumor burden in whom achieving an R0 resection...

Background/aim: Radiofrequency ablation (RFA) is thought to result in inferior prognosis than hepatic resection among patients with colorectal liver metastasis (CRLM). However, resection plus RFA may be an option for patients with a large number of tumors (≥4 liver lesions) and borderline resectability. Materials and methods: A total of 717 pati...

Background: The use of corticosteroids as adjunct treatment for community-acquired pneumonia (CAP) is associated with potential clinical benefits. The aim of this study was to evaluate the cost-effectiveness of this approach. Methods: We constructed a decision-analytic model comparing the use of corticosteroids + antibiotics with that of placebo...

Background An azoxymethane/dextran sulfate sodium (AOM/DSS) protocol has been developed for the induction in an animal model of the precancerous stages of colitis-associated carcinogenesis, by modification of the established (AOM/DSS protocol for carcinogenesis. Methods Female C57BL6 mice were treated with a single intraperitoneal dose (10 mg/kg o...

Background and Objectives In contrast with sporadic colorectal cancer liver metastases (CRLM), inflammatory bowel disease (IBD)‐related CRLM have not been studied to date. Methods Patients who underwent resection for IBD‐related and sporadic CRLM from 2000 to 2015 were identified from an international registry and matched for pertinent prognostic...

In Reply We thank Moretto et al for their interest in our study.¹ As the authors correctly suspected, only a small fraction of the patient population (7 patients) received preoperative fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI); the introduction of this regimen is a fairly recent development that is not well represented in ou...

Histone modification that occurs through the process of acetylation plays a key role in the epigenetic regulation of gene expression. The balance between histone deacetylases (HDACs) and histone acetyltransferases controls this process. Histone deacetylase inhibitors (HDACIs) can induce cancer cell cycle arrest, differentiation and cell death, redu...

Background: Antimicrobial lock solutions are a low-cost strategy that can reduce the incidence of Central Line-Associated Bloodstream Infections (CLABSI). The aim of this study was to evaluate the cost-effectiveness of antimicrobial locks for the prevention of CLABSI. Methods: We constructed a decision-analytic model comparing antimicrobial lock...

Background/objectives: Patients colonized with toxinogenic strains of Clostridium difficile have an increased risk of subsequent infection. Given the potential role of the gut microbiome in increasing the risk of C. difficile colonization, we assessed the diversity and composition of the gut microbiota among long-term care facility (LTCF) resident...

Background: While several prognostic models have been developed to predict long-term outcomes in resectable intrahepatic cholangiocarcinoma (ICC), their prognostic discrimination remains limited. The addition of tumor markers might improve the prognostic power of the classification schemas proposed by the AJCC 8th edition and the Liver Cancer Stud...

Bloodstream infections are associated with considerable morbidity and health care costs. Molecular rapid diagnostic tests (mRDTs) are a promising complement to conventional laboratory methods for the diagnosis of bloodstream infections and may reduce the time to effective therapy among patients with bloodstream infections. The concurrent implementa...

Importance BRAF mutations are reportedly associated with aggressive tumor biology. However, in contrast with primary colorectal cancer, the association of V600E and non-V600E BRAF mutations with survival and recurrence after resection of colorectal liver metastases (CRLM) has not been well studied. Objective To investigate the prognostic associati...

Background: While previously believed to be mutually exclusive, concomitant mutation of Kirsten rat sarcoma viral oncogene homolog (KRAS)- and V-raf murine sarcoma b-viral oncogene homolog B1 (BRAF)-mutated colorectal carcinoma (CRC), has been described in rare instances and been associated with advanced-stage disease. The present case series is t...

Background This study sought to develop a clinical risk score for resectable colorectal liver metastasis (CRLM) by combining clinicopathological and clinically available biological indicators, including KRAS. Methods A cohort of patients who underwent resection for CRLM at the Johns Hopkins Hospital (JHH) was analysed to identify independent predi...

Colorectal liver metastases (CRLM) present an important clinical challenge in both surgical and medical oncology. Despite improvements in management, survival among patients undergoing resection of CRLM is still very variable and there is a paucity of clinical trial data and reliable biomarkers that could guide prognostic forecasts, treatment selec...

Background: Varying definitions of resection margin clearance are currently employed among patients with colorectal cancer liver metastases (CRLM). Specifically, a microscopically positive margin (R1) has alternatively been equated with an involved margin (margin width = 0 mm) or a margin width < 1 mm. Consequently, patients with a margin width of...

Objectives: To investigate the association of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection with socioeconomic factors and antibiotic prescriptions at the county level. Methods: MRSA bloodstream infection rates were extracted from the Medicare Hospital Compare database. Data on socioeconomic factors and antibiotic pres...

Objective: Endometrial cancer is increasingly prevalent in western societies and affects mainly postmenopausal women; notably incidence rates have been rising by 1.9% per year on average since 2005. Although the early-stage endometrial cancer can be effectively managed with surgery, more advanced stages of the disease require multimodality treatme...

Histone modification that occurs through the process of acetylation plays a key role in the epigenetic regulation of gene expression. The balance between histone deacetylases (HDACs) and histone acetyltransferases controls this process. Histone deacetylase inhibitors (HDACIs) can induce cancer cell cycle arrest, differentiation and cell death, redu...

Background: Preoperative hepatitis C virus (HCV) viral load is known to predict long-term outcomes after hepatectomy for HCV-related hepatocellular carcinoma (HCC). This study sought to examine the hypothesis that postoperative and preoperative HCV viral-load have similar prognostic implications, as well as determine a target viral-load that will...

220 Background: Microsatellite instability (MSI) is associated with favorable prognosis and distinct response to chemotherapy and immunotherapy for non-metastatic colorectal cancer (CRC). However, studies suggest that MSI may have minimal prognostic impact for widely metastatic CRC. Whether MSI is prognostic for the subset of patients with resectab...

Objective: To evaluate the changing impact of genetic and clinicopathologic factors on conditional overall survival (CS) over time in patients with resectable colorectal liver metastasis. Background: CS estimates account for the changing likelihood of survival over time and may reveal the changing impact of prognostic factors as time accrues fro...

Non-small cell lung cancer constitutes the most common type of lung cancer, accounting for 85-90% of lung cancer, and is a leading cause of cancer-related death. Despite the progress during the past years, poor prognosis remains a challenge and requires further research and development of novel antitumor treatment. Recently, the role of histone dea...

Background: While reduction of portal venous (PV) blood flow has been described in animal models of intra-abdominal hypertension, reports on compensatory changes in hepatic arterial (HA) flow, known as the hepatic arterial buffer response are controversial. Materials and methods: Pneumoperitoneum with helium was induced in 13 piglets. Hemodynami...

In recent years, a growing amount of research has begun to focus on the oral microbiome due to its links with health and systemic disease. The oral microbiome has numerous advantages that make it particularly useful for clinical studies, including non-invasive collection, temporal stability, and lower complexity relative to other niches, such as th...

Background: Accurate prediction of prognosis for patients with intrahepatic cholangiocarcinoma(ICC) remains a challenge. We sought to define a preoperative risk tool to predict long-term survival following resection of ICC. Methods: Patients who underwent hepatectomy for ICC at one of 16 major hepatobilliary centers between 1990-2015 were identi...

Background Mismanagement of asymptomatic patients with positive urine cultures (referred to as asymptomatic bacteriuria [ASB] in the literature) promotes antimicrobial resistance and results in unnecessary antimicrobial-related adverse events and increased health care costs. Methods We conducted a systematic review and meta-analysis of studies tha...

Objective: To examine the impact of surgical margin width on survival following R0 hepatic resection for colorectal metastases (CRLM). Summary of background data: Although negative resection margin is considered of paramount importance for the prognosis of patients with colorectal liver metastases, optimal resection margin width remains controve...

Background/aim: Epithelioid angiomyolipoma of the liver is a rare benign mesenchymal tumor that usually presents in adult female patients. It most frequently occurs in the kidney, with the liver being the second most common site of involvement. Angiomyolipoma belongs to a family of tumors arising from perivascular epithelioid cells, but in rare ca...

OBJECTIVE: Malformations of the lymphatic system are recognized as benign congenital tumors that affect infant and children in the perinatal era. In children, these abnormalities usually found in the neck and the axillary region, but they can present in other parts of the body such as mediastinum, pelvis, retroperitoneum as well as in solid organs...

Purpose: Tumor location (right-sided vs. left-sided) is known to exert a significant influence on the prognosis of primary colorectal cancer (CRC). Given the genetic continuity between primary and metastatic lesions, we aimed to summarize the existing literature on the prognostic implications of primary tumor site as well as to examine the respons...

Background/aim: Malignant melanoma is the most aggressive type of skin cancer, with increasing frequency and mortality. Melanoma is characterized by rapid proliferation and metastases. Malignant transformation of normal melanocytes is associated with imbalance between oncogenes' action and tumor suppressor genes. Mutations or inactivation of these...

Background Gonorrhea is the second most commonly reported identifiable disease in the United States (U.S.). Importantly, more than 25% of gonorrheal infections demonstrate antibiotic resistance, leading the Centers for Disease Control and Prevention (CDC) to classify gonorrhea as an “urgent threat”. Methods We examined the association of gonorrhea...

Objectives: To estimate the colonization rate by extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) among residents of Long Term Care facilities (LTCFs) and to identify pertinent risk factors. Methods: A systematic search of PubMed and EMBASE databases for studies published up to May, 2016 that provided raw data for gastroin...

Background and objectives: While preoperative treatment is frequently administered to CRLM patients, the impact of chemotherapy, with or without bevacizumab, on liver regeneration remains controversial. Methods: The early and late regeneration indexes were defined as the relative increase in liver volume (RLV) within 2 and 9 months from surgery....

Background: Although the prognostic role of surgical margin status after resection of colorectal liver metastasis (CRLM) has been previously examined, controversy still surrounds the importance of surgical margin status in patients with multiple tumors. Methods: Patients who underwent curative-intent surgery for CRLM from 2000 to 2015 and who pr...

Background Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) are an increasing cause of resistant infections among patients with malignancy. Methods We sought to estimate the prevalence of bloodstream infections (BSIs) caused by ESBL-PE in this population, and examine regional and temporal differences. We searched the PubMed...

Background: Solid pseudopapillary tumors (SPTs) of the pancreas are a rare occurrence, not exceeding 1-2% of all exocrine pancreatic tumors. SPT was first described in 1959 as "papillary tumor of the pancreas, benign or malignant" and affects mainly young women, in their second or third decade of age. These tumors are of low malignant potential, un...

Objective: To investigate the potential clinical advantage of anatomical resection versus nonanatomical resection for colorectal liver metastases, according to KRAS mutational status. Background: KRAS-mutated colorectal liver metastases (CRLM) are known to be more aggressive than KRAS wild-type tumors. Although nonanatomical liver resections hav...

Background Although experimental data strongly support the pro-tumorigenic role of postoperative liver regeneration, this hypothesis has not been clinically investigated. We aimed to examine the impact of liver regeneration determined by volumetric imaging on recurrence following resection of colorectal liver metastasis (CRLM). Methods Resected li...

Background: Recently, a tumor-burden "metro ticket" score (TBS) based on final pathology was proposed to predict outcome following resection of colorectal liver metastasis (CRLM). We sought to validate the TBS prognostic tool using preoperative radiologic cross-sectional imaging. Methods: Imaging TBS was defined on a Cartesian plane that incorpo...

Background Despite reports questioning its efficacy, cefepime remains a first-line option in febrile neutropenia. We aimed to reevaluate the role of cefepime in this setting. Methods We searched the PubMed and EMBASE databases to identify randomized comparisons of a) cefepime vs. alternative monotherapy, or b) cefepime plus aminoglycoside vs. alte...