A5045885712- Colorectal Cancer Surgical Treatments
- Colorectal and Anal Carcinomas
- Colorectal Cancer Treatments and Studies
- Gastric Cancer Management and Outcomes
- Radiomics and Machine Learning in Medical Imaging
- Colorectal Cancer Screening and Detection
- Cancer Treatment and Pharmacology
- Genetic factors in colorectal cancer
- Anorectal Disease Treatments and Outcomes
- Cancer Genomics and Diagnostics
- Medical Imaging Techniques and Applications
- AI in cancer detection
- Cardiac, Anesthesia and Surgical Outcomes
- Lung Cancer Treatments and Mutations
- Cancer Immunotherapy and Biomarkers
- Pancreatic and Hepatic Oncology Research
- MRI in cancer diagnosis
- Esophageal Cancer Research and Treatment
- Clinical practice guidelines implementation
- Hepatocellular Carcinoma Treatment and Prognosis
- Anatomy and Medical Technology
- Laser Applications in Dentistry and Medicine
- Lymphoma Diagnosis and Treatment
- Gallbladder and Bile Duct Disorders
- Advances in Oncology and Radiotherapy
University of Leeds
2016-2025
St James's University Hospital
2015-2024
NIHR Leeds Musculoskeletal Biomedical Research Unit
2024
Lake Erie College of Osteopathic Medicine
2024
Leeds Teaching Hospitals NHS Trust
2015-2024
University of Oxford
2014-2023
Wellcome Trust
2010-2023
University of Birmingham
2022-2023
Johannes Gutenberg University Mainz
2023
University Medical Center of the Johannes Gutenberg University Mainz
2023
<h3>Importance</h3> Robotic rectal cancer surgery is gaining popularity, but limited data are available regarding safety and efficacy. <h3>Objective</h3> To compare robotic-assisted vs conventional laparoscopic for risk of conversion to open laparotomy among patients undergoing resection cancer. <h3>Design, Setting, Participants</h3> Randomized clinical trial comparing 471 with adenocarcinoma suitable curative conducted at 29 sites across 10 countries, including 40 surgeons. Recruitment was...
The plane of surgery in colonic cancer has been linked to patient outcome although the optimal extent mesenteric resection is still unclear. Surgeons Erlangen, Germany, routinely perform complete mesocolic excision (CME) with central vascular ligation (CVL) and report 5-year survivals higher than 89%. We aimed further investigate importance CME CVL for by comparison a series standard specimens.The fresh photographs 49 specimens from Erlangen 40 Leeds, United Kingdom, primary adenocarcinoma...
Purpose Over recent years, patient outcomes after colon cancer resection have not improved to the same degree as for rectal cancer. Japanese D3 and European complete mesocolic excision (CME) with central vascular ligation (CVL) are both based on sound oncologic principles. Expert surgeons using techniques report impressive compared standard surgery. We aimed independently compare physical appearances quality of specimens resected in major institutions Japan Germany. Methods A series...
Abdominoperineal excision (APE) of the rectum and anus for rectal cancer continues to have greater local recurrence poorer survival than that seen following anterior resection. Changing an extended prone perineal dissection results in a more cylindrical specimen should improve outcomes.One hundred twenty-eight specimens from patients who underwent APE was performed potentially curable primary adenocarcinoma were dissected according standard protocol Leeds Stockholm between 1997 2007 studied....
Abstract Background Abdominoperineal excision (APE) for low rectal cancer is associated with higher rates of circumferential resection margin (CRM) involvement and intraoperative perforation (IOPs) than anterior tumours. This multicentre observational study was designed to confirm that extralevator APE can improve outcomes investigated the morbidity such extensive surgery. Methods Some 176 procedures from 11 European colorectal surgeons were compared 124 standard excisions one UK centre....
Microsatellite instability (MSI) and mismatch-repair deficiency (dMMR) in colorectal tumors are used to select treatment for patients. Deep learning can detect MSI dMMR tumor samples on routine histology slides faster less expensively than molecular assays. However, clinical application of this technology requires high performance multisite validation, which have not yet been performed.
This study aimed to validate a magnetic resonance imaging (MRI) staging classification that preoperatively assessed the relationship between tumor and low rectal cancer surgical resection plane (mrLRP).Low oncological outcomes remain global challenge, evidenced by high pathological circumferential margin (pCRM) rates unacceptable variations in permanent colostomies.Between 2008 2012, prospective, observational, multicenter (MERCURY II) recruited 279 patients with adenocarcinoma 6 cm or less...
Neoadjuvant chemotherapy (NAC) has potential advantages over standard postoperative for locally advanced colon cancer but requires formal evaluation.
Laparoscopic resection and a multimodal approach known as an enhanced recovery program (ERP) have been major changes in colorectal perioperative care that improved clinical outcomes for cancer resection. EnROL (Enhanced Recovery Open Versus Laparoscopic) is multicenter randomized controlled trial examining whether the benefits of laparoscopy still exist when open surgery optimized within ERP.
Abstract Artificial intelligence (AI) can predict the presence of molecular alterations directly from routine histopathology slides. However, training robust AI systems requires large datasets for which data collection faces practical, ethical and legal obstacles. These obstacles could be overcome with swarm learning (SL), in partners jointly train models while avoiding transfer monopolistic governance. Here, we demonstrate successful use SL large, multicentric gigapixel images over 5,000...
BackgroundRadical surgery via total mesorectal excision might not be the optimal first-line treatment for early-stage rectal cancer. An organ-preserving strategy with selective could reduce adverse effects of without substantially compromising oncological outcomes. We investigated feasibility recruiting patients to a randomised trial comparing an excision.MethodsTREC was randomised, open-label study done at 21 tertiary referral centres in UK. Eligible participants were aged 18 years or older...
Deep learning (DL) can accelerate the prediction of prognostic biomarkers from routine pathology slides in colorectal cancer (CRC). However, current approaches rely on convolutional neural networks (CNNs) and have mostly been validated small patient cohorts. Here, we develop a new transformer-based pipeline for end-to-end biomarker by combining pre-trained transformer encoder with network patch aggregation. Our approach substantially improves performance, generalizability, data efficiency,...
Microsatellite instability (MSI)/mismatch repair deficiency (dMMR) is a key genetic feature which should be tested in every patient with colorectal cancer (CRC) according to medical guidelines. Artificial intelligence (AI) methods can detect MSI/dMMR directly routine pathology slides, but the test performance has not been systematically investigated predefined thresholds.
Deep learning (DL) can predict microsatellite instability (MSI) from routine histopathology slides of colorectal cancer (CRC). However, it is unclear whether DL also other biomarkers with high performance and predictions generalize to external patient populations. Here, we acquire CRC tissue samples two large multi-centric studies. We systematically compare six different state-of-the-art architectures pathology slides, including MSI mutations in BRAF, KRAS, NRAS, PIK3CA. Using a validation...
The proportion of epithelial and stromal cells in tumours is thought to have an important role the progression malignancy. We aimed determine whether relative tumour (PoT) was related survival colorectal cancer. PoT at luminal surface measured by point counting using virtual tissue sections a series 145 cancer cases. relationship clinicopathological parameters including cancer-specific analysed. Modified receiver operating characteristic curves were used optimum cut off points dichotomise...
Colorectal cancer-specific biomarkers have been used as molecular targets for fluorescent intra-operative imaging, targeted PET/MRI, and selective cytotoxic drug delivery yet the selection of is rarely evidence-based. We evaluated sensitivities specificites four most commonly markers: carcinoembryonic antigen (CEA), tumour-associated glycoprotein-72 (TAG-72), folate receptor-α (FRα) Epithelial growth factor receptor (EGFR).Marker expression was semi-quantitatively in matched mucosal...
This study aimed to determine the prognostic significance of extramural venous invasion (EMVI) after chemoradiotherapy (CRT) by both magnetic resonance imaging (MRI) (ymrEMVI) and histopathology (ypEMVI).EMVI is a factor in rectal cancer but whether this remains so CRT preoperative unknown. Histopathological definitions EMVI are variable lead underreporting particularly CRT.All consecutive patients staged on initial MRI as EMVI-positive undergoing curative surgery between Jan 2006 2012 were...
The wide global variation in the definition of rectum has led to significant inconsistencies trial recruitment, clinical management, and outcomes. Surgical technique use preoperative treatment for a cancer sigmoid colon are radically different dependent on local definitions employed by team. A consensus is needed standardise treatment.The was conducted using Delphi with multidisciplinary colorectal experts from October, 2017 April, 2018.Eleven were used participants consensus. Magnetic...