bluuebunny/crossref_metadata_2025_split huggingface dataset:
O079 Predictive value for elevated platelet-derived SGPVI in venous in-stent stenosis in patients with post-thrombotic syndrome
Authors: Gwozdz AM , Black SA , Bye AP , Gibbins JM , Patel AS , Modara B , Smith A , Saha P 
Published: November 2022

Abstract

Introduction
In-stent stenosis following intervention for post-thrombotic syndrome (PTS) occurs in ∼30% of cases, despite therapeutic anticoagulation. Our aim was to investigate whether platelets are involved.

Methods
Blood was taken from case-matched patients before and after venous stenting. Flow-cytometry was used to assess platelet activation (P-selectin and/or phosphatidylserine exposure) while= functional activity was measured by plate-based aggregation and through a flow-cell model of thrombus formation. Soluble glycoprotein VI (sGPVI) was measured in plasma. Patients with in-stent stenosis requiring reintervention (&gt;50% diameter reduction) were compared with those who did not.

Results
Forty-five patients were recruited (median age: 43yrs (33–55yrs); 65% female), and 19/45 (42%) required reintervention (median time: 3wks (1day-3mths)). There was no difference in platelet activation or reactivity after stenting, but P-selectin exposure pre-stent was significantly higher in patients who developed in-stent stenosis (2.7%±0.4 vs 1.7%±0.2; P&lt;0.05). Pre-stent sGPVI levels were increased in patients who developed in-stent stenosis (18.9±3.6ng/mL vs. 7.4±0.9ng/mL; P&lt;0.01). Platelet reactivity to collagen-related peptide, a GPVI-specific platelet agonist, was reduced in patients who developed in-stent stenosis (logEC50 = -6.5M±0.3 vs -7.2M±0.2; P&lt;0.05; n=33). Pre-stent platelet accumulation (26.6AU±0.5 vs 19.0AU±8.1; P=0.04) was significantly increased in PTS patients compared with healthy controls.

Conclusion
Venous stenting does not activate platelets, but patients who developed in-stent stenosis exhibited greater levels of pre-stent platelet activation, greater loss of platelet surface GPVI in the form of sGPVI and reduction in reactivity to GPVI activation. sGPVI may have potential to risk stratify patients undergoing venous stenting and predict who requires closer surveillance.

Take-home message
Soluble GPVI may have potential to risk-stratify patients undergoing deep venous reconstruction and predict who requires closer surveillance.
O082 Patient derived renal cell carcinoma tumouroids for personalised renal cancer medicine
Authors: Bokea K , Azimi T , Stamati K , Yaghini E , Macrobert S , Cheema U , Tran M , Feber A , Loizidou M 
Published: November 2022

Abstract

Introduction
Despite the significant advancements in the therapeutic management of renal cell carcinoma (RCC), there is still a pressing need for patient-specific platforms that can predict personalised treatment response. This study aims to optimise renal cancer tumouroids: 3D in vitro models that mimic the tumour density, and incorporate primary cells isolated from RCC surgical specimens and extracellular matrix components to recapitulate the tumour microenvironment.

Methods
RCC samples were collected post-surgery (n=16), disaggregated using different methods and the isolated cells were grown in 2D and tumouroids. Cell proliferation was compared among different culture conditions by measuring ATP production. Tumouroids were also challenged with a clinically used tyrosine kinase inhibitor, pazopanib. Immunofluorescence and confocal microscopy were used to detect expression of RCC markers and whole-exome sequencing was performed to investigate tumouroids’ resemblance to the parental tumour.

Results
Patient-derived RCC tumouroids retain the expression of renal cancer associated gene markers, including mutant VHL, and protein markers, including cytokeratins and epithelial-tomesenchymal markers. A non-linear increase in proliferation was observed in the tumouroids which may be indicative of 3D organization and other cellular functions. Tumouroids’ response to pazopanib ranged from none to strong (40%) and tumouroids of higher complexity, that incorporated a stromal compartment, responded stronger than simpler tumouroids (n=3).

Conclusion
Our results indicate that RCC cells maintain their phenotype and genotype when grown as tumouroids. Future work will compare the response from tumouroids to the responses from both xenografts and the actual patients to determine the suitability of tumouroids as personalised cancer treatment platforms.

Take-home message
Renal Cell Carcinoma cells isolated from human patients maintain their phenotype and genotype when grown in biomimetic tumouroids and respond to treatment.
O087 Potential diagnostic biomarkers for congenital vascular malformations
Authors: Abu-Hanna J , Pang C , Valnarov-Boulter A , Brookes J , Lim CS , Hamilton G , Tsui J 
Published: November 2022

Abstract

Introduction
To identify potential diagnostic serum biomarkers, particularly those pertaining to the processes of inflammation and angiogenesis in patients with congenital vascular malformations (CVM).

Methods
Isolated sera from the peripheral bloods of consented healthy controls (n = 10) and patients diagnosed as having either low-flow (LF) (n = 10) or high-flow (HF) (n = 10) CVMs. Various mediators of inflammation and angiogenesis were analysed in the sera using the Inflammation 20-Plex and Angiogenesis 18-Plex Human ProcartaPlex™ Panels. Analysis was conducted via Kruskall-Wallis test and correlated with lesion volumes and visual analogue scores for pain using the Spearman rank correlation test.

Results
Compared to healthy controls, the inflammatory mediators E-selectin, IFNa, IFNg, IL1b, IL4, IL12, IL17, MIP1a, MIP1b and TNFa were elevated in the sera of LF CVM patients, whereas only MIP1a was raised in the sera of HF CVM patients. None of the angiogenic mediators were altered in the sera of patients with LF or HF CVMs. Serum IFNa, IFNg, IL4, IL12, TNFa, VEGFA, VEGFD and syndecan correlated positively with pain scores in patients with LF CVMs, whereas only IP10 did in patients with HF CVMs. Serum Ang1 and leptin correlated negatively with lesion volumes in patients with LF or HF CVMs, respectively.

Conclusion
Serum inflammatory mediators could be used to distinguish LF from HF CVMs and their expression seemed to be associated with pain severity in patients with LF CVMs. The angiogenic mediators Ang1 and leptin were associated with lesion volumes in patients with LF or HF CVMs, respectively.

Take-home message
Serum inflammatory mediators could be used to distinguish LF from HF CVMs and their expression seemed to be associated with pain severity in patients with LF CVMs. The angiogenic mediators Ang1 and leptin were associated with lesion volumes in patients with LF or HF CVMs, respectively.
O088 Systematic review and meta-analysis of survival outcomes in T2a and T2b gallbladder cancers
Authors: Alrawashdeh W. , Kamarajah S. , Gujjuri R. , Abu Hilal M. , White S. , Pandanaboyana S. 
Published: November 2022

Abstract

Background
The 8th edition of AJCC TNM staging of Gallbladder cancer subdivided T2 stage into T2a and T2b based on tumour location. This meta-analysis aimed to investigate the long-term outcomes in T2a and T2b gallbladder cancers.

Methods
Literature search of Medline, Web of science, Embase and Cochrane databases was performed. Study characteristics, survival and recurrence data were extracted for meta-analysis of effect estimates and of individual patient data.

Results
Fifteen retrospective studies (2531 patients, T2a = 1332, T2b = 199) were included in the meta-analysis. Overall survival (OS) was significantly worse in patients with T2b compared to T2a tumours (HR 2.18, 95% CI 1.67–2.86, p &lt; 0.0001). Meta-analysis of individual patient data (n = 629) showed similar results (HR 1.92, 95% CI 1.43–2.58, p &lt; 0.00001). Patients with T2b tumours had higher risk of recurrence compared to T2a (OR 3.19, 95% CI 1.40–7.28, p = 0.006) and were more likely to receive adjuvant chemotherapy (OR 1.76, 95% CI 1.12–2.84, p 0.014). Liver resection improved OS in T2b tumours (HR 2.99, CI 1.73–5.16, p &lt; 0.0001).

Conclusion
T2b gallbladder tumours have worse overall survival and increase risk of recurrence compared to T2a. Liver resection appears to improve OS in patients with T2b tumours. However, high quality multicentre data is required to confirm these results.

Take-home message
T2b gallbladder tumours have worse overall survival and increase risk of recurrence compared to T2a. Liver resection appears to improve OS in patients with T2b tumours. However, high quality multicentre data is required to confirm these results.
O089 Relationship of metformin with the risk of pancreatic cancer in patients with diabetes and/or chronic pancreatitis: a systematic review
Authors: Mascarenhas A , Adiamah A , Lobo DN 
Published: November 2022

Abstract

Introduction
Metformin is the first-line treatment in patients with Type 2 diabetes. However, controversy exists regarding its role in reducing the risk of pancreatic cancer or improving pancreatic cancer survival in patients with Type 2 diabetes or chronic pancreatitis. This systematic review aimed to define the risk of pancreatic cancer and survival from pancreatic cancer in patients with diabetes or chronic pancreatitis receiving metformin.

Methods
Systematic searches of Medline and Cochrane Library databases were undertaken to identify studies reporting on the use of metformin and its impact on pancreatic cancer risk and/or survival in patients with diabetes or chronic pancreatitis.

Results
Thirty studies, reporting on a total of 5,969,712 patients (1,362,308 with diabetes or chronic pancreatitis, and 4,597,095 controls), were included. Eleven studies assessed the risk of developing pancreatic cancer. Of these, six found a significant reduction in the risk of developing pancreatic cancer in those taking metformin, whereas five studies found no such reduction in pancreatic cancer risk. Another 19 studies evaluated the impact of metformin on pancreatic cancer survival. Twelve of these found evidence of benefit in those receiving metformin, whereas seven found no survival benefit. Formal pooling could not be undertaken due to high statistical and clinical heterogeneity.

Conclusion
The relationship between the use of metformin and the incidence of pancreatic cancer is complex and multifactorial. However, the currently available evidence is not sufficient for definitive conclusions on this relationship.

Take-home message
Current evidence is not robust enough to recommend the use metformin as prophylaxis for pancreatic cancer or to improve survival in patients with pancreatic cancer.
O090 The Sweet approach to oesophagectomy is still a valid surgical approach seldom used in the UK
Authors: Ammar A , Paul M , El-Sharkawy A , Leeder P , Bohra A , Awad S , Iftikhar S 
Published: November 2022

Abstract

Introduction
The left thoracophrenotomy approach to oesophagectomy or Sweet Oesophagectomy (SO) for oesophageal cancer is performed by many centres worldwide but seldom used in UK, owing to concerns over extent of lymphadenectomy compared with Ivor-Lewis oesophagectomy (ILO) approach. This study aims to compare oncological and clinical outcomes following the Sweet approach with ILO.

Methods
A retrospective, single centre study was conducted, analysing all patient data following the SO approach and ILO for oesophageal cancer between August 2012 - March 2021.

Results
The total number who underwent the Sweet (SO) operation and ILO was 72 and 197 patients respectively.91.7% vs 80.2%, p=0.071 were distal oesophageal tumours. Median lymph node count were 22 and 23 respectively, p=0.980. The Sweet was associated with 69.4% circumferential, 94.4% proximal and 95.8% distal R0 resections compared with 72.6% (p=0.365, 98%(p=0.132) and 96%(p=0.330) with ILO resection, respectively. Median operative time was 169 vs. 301 minutes for Sweet and ILO respectively, p&lt;0.001. The overall complication rate was 29.2% with the Sweet and 45.7% with ILO, p=0.015, including, Anastomotic leaks 0 vs. 11, p=0.041 And return to theatre 1 vs. 22, p=0.04. The 30, 90 day and 5-year survival was 100% vs. 99%(p=0.391), 98.6% vs. 95.9% (p=0.281) & 51.4% vs. 50.3% (p=0.869), respectively.

Conclusion
The Sweet procedure was associated with comparable oncological efficacy and survival to ILO. Furthermore, was associated with significantly shorter operative time and lower complication rates, therefore should be considered in selected cases.

Take-home message
Left thoracotomy oesophagectomy remains an appropriate option with significantly better results in our centre, in the management of lower oesophageal and junctional carcinoma as compared to ILO. Having a reduced hospital stay and operative time may be more favourable in more frail patients with distal and junctional oesophageal tumours.
O091 Social deprivation and malignant progression of anal intraepithelial neoplasia
Authors: Hinchcliffe Z , Soliman F , Hargest R 
Published: November 2022

Abstract

Introduction
Social deprivation is known to be a risk factor for cervical cancer but its influence on progression rate to invasive cancer is less clear. This study aimed to investigate whether deprivation was a risk factor for high grade anal intra-epithelial neoplasia (AINIII) progression to anal squamous cell carcinoma (ASCC).

Methods
Retrospective analysis of AINIII patients in Southeast Wales between 2000–2021. Deprivation was calculated from postcodes at time of referral, divided into five quintiles (Welsh Index of Multiple Deprivation 2019). Welsh Clinical Portal and Cancer Network Information System Cymru (CaNISC) were utilised to collect patient demographics, histopathology and clinical outcomes.

Results
Eighty-six AINIII patients were identified. Twenty-nine presented with synchronous ASCC and AINIII. Thirteen progressed to cancer (median 23 months). The proportion of patients in each deprivation quintile was calculated. The association between deprivation and incidence of ASCC at presentation (p=0.93) and AIN transformation to ASCC (p=0.65) were not statistically significant (chi-square analysis).

Conclusion
No correlation between presentation of anal ASCC or AINIII progression and social deprivation was observed. Due to small sample size, multicentre research is required to investigate this further.

Take-home message
Social deprivation was not observed to be a risk factor for anal Intra-epithelial Neoplasia III or anal cancer in our cohort. However, further research across a larger sample size is required to investigate this association further.
O093 The adrenal incidentaloma clinic: a novel and streamlined approach
Authors: Iskandar M , Chauhan V , Tunstall L , Alasttal S , Fouad M , Chadwick D , Christakis I 
Published: November 2022

Abstract

Introduction
An incidental adrenal nodule is present in 1–3% of abdominal cross-sectional imaging and pose a diagnostic dilemma for the investigating clinician. Adrenal nodules can be functional or pose a cancer risk, hence a complete adrenal hormone profile investigation is necessary.

Methods
We piloted a streamlined clinic within the endocrine surgery department for assessing adrenal incidentalomas by trained surgical care practitioners. Data was collected retrospectively for patients reviewed from March 2020 to September 2021 to evaluate its efficacy and the completion of investigations.

Results
98 new patients were seen, with an average age of 64.97 (±13.91) years. The mean time from referral to review was 37.61 (±26.07) days. The mean nodule size was 21.74 (±9.93) mm (range: 6.00–73.00 mm) and were most commonly identified on CT virtual colonoscopy (28.6%), CT abdomen and pelvis (20.4%) and Trauma CT (10.2%), with over two-thirds of referrals from colorectal services (38.9%) and Emergency Medicine (29.5%). 82.7% of patients had metanephrines tested, 79.6% for aldosterone-renin ratio and 75.5% for overnight dexamethasone suppression test following clinic attendance. 8.6% of patients had raised metanephrines, with 25.6% for aldosterone-renin ratio and 37.8% for overnight dexamethasone suppression test. 27.8% were referred on for further assessment with an adrenal CT. Three patients were operated on, one for phaeochromocytoma and two patients for metastases.

Conclusion
Preliminary results suggest this clinic provides efficient services with good completion of investigations and follow-up. It offers clinicians unfamiliar with or unable to organise adrenal investigations, a dedicated clinic, to ensure appropriate clinical assessments.

Take-home message
This dedicated incidentaloma clinic contributes to the effective use of resources in doing hormonal profiling for patients and identification of patients at risk of functional and malignant adrenal disease.
O094 Novel technique and cohort study: Stoppa approach to sciatic notch clearance in locally advanced / recurrent pelvic cancer pelvic cancer
Authors: Sahid S , Daurka J , Gibbs R , Murphy J 
Published: November 2022

Abstract

Introduction
Locally advanced / recurrent pelvic cancers (LARC) extending into the greater sciatic notch represent a significant clinical challenge. Conventional surgical resection is associated with high rates of R1/2 resection, while locoregional oncological treatments often fail to control the disease. In this study we present the first report of a modified Stoppa approach that facilitates en bloc excision of pelvic sidewall structures with LARC.

Methods
This is a retrospective review of patients who underwent surgery for LARC with the novel Stoppa approach between 2016 and 2020 in our centre.

Result
7 patients (6 female and 1 male) were identified from the institutional database with Median age of 66 (37–74). Three separate tumour types were included in the cohort: rectal adenocarcinoma - 4 (57%), anal squamous cell carcinoma - 2 (29%), and prostate adenocarcinoma - 1 (14%). 3 (42%) patients developed Clavien Dindo Class III complications (2 returned to theatre for minor flap revisions; 1 pre-sacral collection required radiological drainage). All patients lost active ipsilateral foot dorsiflexion due to planned nerve root transection. Median hospital stay was 46 days (17–114). All resections were R0.

Conclusion
This is the first report of a novel Stoppa approach for en bloc pelvic sidewall excision. The presented pathological resection results are promising; however, this procedure is associated with significant morbidity. Future studies will be necessary to confirm the presented oncological results and determine if the associated morbidity can be decreased.

Take-home message
Modified Stoppa technique is feasible to achieve Sciatic Notch tumour clearance in primary or recurrent locally advanced pelvic cancer. Further research needed to assess long term oncological outcome and reduce post operative morbidity.
O095 Cell-based therapies in surgery: a systematic review of the yield and composition of freshly isolated cells obtained from point-of-care devices which mechanically dissociate lipoaspirate
Authors: Liu P , Gurung B , Sochart D , Kader D , Asopa V 
Published: November 2022

Abstract

Introduction
Cell-based therapies using lipoaspirate are gaining popularity within surgical fields due to their hypothesised regenerative potential. Several point-of-care lipoaspirate-processing devices have become available to isolate cells for therapeutic use, with published evidence reporting their clinical relevance. However, few studies have analysed the composition of their minimally manipulated cellular products, information that is vital to understand the mechanisms by which these therapies may be efficacious. This review aimed to identify devices using mechanical-only processing of lipoaspirate, their cell yields, viability, phenotype and where available clinical outcomes.

Methods
MEDLINE, Embase and PubMed databases were systematically searched on 01/09/21 using relevant keywords. PRISMA guidelines were followed (PROSPERO#CRD42021282041), and level of evidence was assessed using the Oxford Centre for Evidence-Based Medicine guidelines. Information was extracted and analysed to summarise the cellular composition derived from these devices and their clinical outcomes.

Results
2895 studies were screened and a total of 15 articles (11=Level 5 evidence) fulfilled the inclusion criteria. Overall, 13 devices were identified. All the studies reported cell yield for their devices (range 0.005–21×106). 10 reported viability (range 60–98%), 11 performed immuno-phenotypic analysis of the cell-subtypes and 4 investigated clinical outcomes of their cellular products. Only 2 studies reported all four parameters.

Conclusion
Although many devices are available to mechanically process lipoaspirate, few have published peer-reviewed literature of their products’ composition. Significant heterogeneity in the reporting of these studies makes it difficult to summarise their clinical potential. This review is unable to make any recommendations on the clinical use of these devices.

Take-home message
Many point-of-care devices have become available to mechanically process lipoaspirate to form a cellular product for therapeutic use in surgery. However, few have publications on their products’ composition which is information required to understand the mechanisms by which these therapies may be efficacious.
O096 Does boron bioactive glass have a role in bone regeneration?
Authors: Awad L , Vaporidu N , Rezaei A , Jell G 
Published: November 2022

Abstract

Introduction
Bioactive glasses (BGs) provide an alternative to allogenic bone grafts. Various ions can be incorporated into the BGs structure to further influence regenerative or antimicrobial properties. Boron has recently been purposed as element that can be incorporated into BGs to promote desirable cellular regenerative response. This study aims to systematically review literature to determine the level of evidence that boron bioactive glasses (BBGs) and boron can promote desirable bone regenerative responses both in vitro and in vivo.

Methods
A systematic review of Web of Science was conducted in accordance with PRISMA guidelines. Data collected included bone cell behavioural analysis in response to boron or BBG compared to controls. Material properties of BBG (mechanical properties, degradation rate) compared to BG were compared.

Results
A total of 105 articles were included; 98 regarding BBG, and 12 articles studying the effect of boron. A higher biodegradation rate was observed in BBG compared with silicate-based BGs. BBGs have a lower compressive strength and increased fragility, as the percentage of B203 increases. 16 articles demonstrated a positive correlation with BBG and expression of OCN, VEGF, osteopontin, and RUNX2. Overall, metabolic activity of cells up to 14 days was lower in comparison to media and silicate BG.

Conclusion
BBGs have gained increased attention in the literature but the lack of heterogeneity and paucity of data does not provide convincing evidence of the effect of boron on bone regeneration and indicates the need for further quantitative research with a standardised approach to assessment.

Take-home message
Bioactive glasses can promote regeneration of bone, however the lack of heterogeneity and paucity of data regarding boron bioactive glass indicate the need for further quantitative research and standardised approach to assessment.