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Aquaculture is one of the fastest growing food industries worldwide [...].
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BACKGROUND: Thermal ablation has recently become a key therapy for the treatment of colorectal liver metastasis (CLM). However, the role of ablation in combination with resection has not yet been firmly established. We hypothesize that in patients with CLM, those who undergo liver resection with ablation (RA) have similar outcomes compared with those who undergo liver resection only. METHODS: We reviewed a multicenter international database of 906 surgical procedures for CLM from 5 high volume hepatobiliary surgical units. Patients undergoing RA (n = 63) were matched based on the number of lesions and tumor size using a 1:1 balanced propensity score analysis with those having resection only (n = 63). Our primary outcomes were overall survival (OS) and disease-free survival (DFS). RESULTS: The mean age of our cohort was 58 ± 11 years, with 43% females. With a median follow-up of 70.8 months, patients in the resection and RA group had a median OS of 45.1 and 54.8 months (p = 0.71), respectively. The median DFS was 22.7 and 14.2 months (p = 0.045), respectively. Using a multivariate Cox proportional hazards regression model, the treatment approach was not associated with OS (p = 0.94) or DFS (p = 0.059). A higher number of lesions is independently associated with worse DFS (hazard ratio: 1.12, p < 0.01). When there was disease recurrence, the region of recurrence was similar between the RA versus resection only groups (p = 0.27), but there was a shorter time to recurrence in the RA group (p = 0.002). CONCLUSION: For CLM, the treatment approach was not significantly associated with OS or DFS, while tumor biology likely played an important role. Prospective research on the quality and effectiveness of thermal ablation combined with hepatic resection is warranted.
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BACKGROUND: This study investigates the impact of margin status after colorectal liver metastasis (CLM) resection on outcomes of patients after neoadjuvant treatment versus those who underwent upfront resection. METHODS: An international collaborative database of CLM patients who underwent surgical resection was used. Proportional hazard regression models were created for single and multivariable models to assess the relationship between independent measures and median overall survival (mOS). RESULTS: R1 was associated with worse OS in the neoadjuvant group (mOS: 51.8 m for R0 vs. 26.0 m for R1; HR: 2.18). In the patients who underwent upfront surgery, R1 was not associated with OS. (mOS: 46.7 m for R0 vs. 42.6 m for R1). When patients with R1 in each group were stratified by adjuvant treatment, there was no significant difference in the neoadjuvant group, while in the upfront surgery group with R1, adjuvant treatment was associated with significant improvement in OS (mOS: 42.6 m for adjuvant vs. 25.0 m for no adjuvant treatment; HR: 0.21). CONCLUSION: R1 is associated with worse outcomes in the patients who receive neoadjuvant treatment with no significant improvement with the addition of adjuvant therapy, likely representing an aggressive tumor biology. R1 did not impact OS in patients with upfront surgery who received postoperative chemotherapy.
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Endowing perovskite quantum dots (PQDs) with circularly polarized luminescence (CPL) offers great promise for innovative chiroptical applications, but the existing strategies are inefficient in acquiring stimuli-responsive flexible chiral perovskite films with large, tunable dissymmetry factor (glum) and long-term stability. Here, we report a strategy for the design and synthesis of luminescent cholesteric liquid crystal elastomer (Lumin-CLCE) films with mechanically tunable CPL, which is enabled by liquid crystal-templated chiral self-assembly and in situ covalent cross-linking of judiciously designed photopolymerizable CsPbX3 (X=Cl, Br, I) PQD nanomonomers into the elastic polymer networks. The resulting Lumin-CLCE films showcase circularly polarized structural color in natural light and noticeable CPL with a maximum glum value of up to 1.5 under UV light. The manipulation of CPL intensity and rotation direction is achieved by controlling the self-assembled helicoidal nanostructure and the handedness of soft helices. A significant breakthrough lies in the achievement of a reversible, mechanically tunable perovskite-based CPL switch activated by biaxial stretching, which enables flexible, dynamic anti-counterfeiting labels capable of decrypting preset information in specific polarization states. This work can provide new insights for the development of advanced chiral perovskite materials and their emerging applications in information encryption, flexible 3D displays, and beyond.
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BACKGROUND: Subungual melanoma (SUM) is a rare tumor with historically poor outcomes. Thus, the benefit of proximal versus distal amputation in SUM remains unclear. METHODS: We performed a retrospective review of our prospectively-maintained institutional melanoma database, including SUM and non-subungual acral melanoma (AM) patients who underwent sentinel lymph node biopsy (SLNB) between 1999 and 2022. All SUMs had distal joint or proximal amputations. Primary endpoints were overall survival (OS) and recurrence free survival (RFS). Kaplan-Meier estimates, and Cox univariate and multivariate analyses were performed. Tests were repeated on propensity score matched (PSM) populations in a 2:1 ratio. RESULTS: 123 patients underwent resection with SLNB for SUM (n â= â27) and AM (n â= â96). Median follow-up was 9.2 years. Unadjusted median OS was 149.1 months for AM and 198.1 months for SUM. In the PSM comparison, median OS and RFS remained comparable between SUM and AM (149.5 months versus 198.1 months; p â= â0.612). Sentinel node positivity was associated with significantly worse overall survival outcome (Hazard Ratio 5.49; CI (1.59-18.97), p â= â0.007). In the PSM population, male sex was also associated with a significant hazard of death (HR 3.00, CI (1.03-8.71), p â= â0.043). Proximal amputations were associated with significantly worse OS (p â< â0.002) and RFS (p â< â0.01) compared to distal amputations in SUM. CONCLUSION: SUM was well-treated with distal amputations, and had better OS and RFS compared to SUM treated with proximal amputations. Sentinel lymph node status is an important prognostic factor for SUMs and AMs. SUMs can be treated similarly to AMs with comparably good long-term outcomes.
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Melanoma , Nail Diseases , Sentinel Lymph Node , Skin Neoplasms , Humans , Male , Melanoma/pathology , Sentinel Lymph Node Biopsy , Prognosis , Survival Rate , Skin Neoplasms/pathology , Sentinel Lymph Node/pathology , Retrospective Studies , Nail Diseases/pathology , Nail Diseases/surgeryABSTRACT
Healthy human skin tissue is often used as a control for comparison to diseased skin in patients with skin pathologies, including skin cancers or other inflammatory conditions such as atopic dermatitis or psoriasis. Although non-affected skin from these patients is a more appropriate choice for comparison, there is a paucity of studies examining such tissue. This lack is exacerbated by the difficulty of processing skin tissue for experimental analysis. In addition, choosing a processing protocol for skin tissue which preserves cell viability and identity while sufficiently dissociating cells for single-cell analysis is not a trivial task. Here, we compare three digestion methods for human skin tissue, evaluating the cell yield and viability for each protocol. We find that the use of a sequential dissociation method with multiple enzymatic digestion steps produces the highest cell viability. Using single-cell sequencing, we show this method results in a relative increase in the proportion of non-antigen-presenting mast cells and CD8 T cells as well as a relative decrease in the proportion of antigen-presenting mast cells and KYNU+ CD4 T cells. Overall, our findings support the use of this sequential digestion method on freshly processed human skin samples for optimal cell yield and viability.
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Dermatitis, Atopic , Skin , Humans , Skin/pathology , T-Lymphocyte Subsets/pathology , Dermatitis, Atopic/pathology , Sequence Analysis, RNA , DigestionABSTRACT
Cholesteric liquid crystal elastomers (CLCEs) that combine rubbery elasticity with structural colour from self-assembled helical nanostructures are of paramount importance for diverse applications such as biomimetic skins, adaptive optics and soft robotics. Despite great advances, it is challenging to integrate electrical sensing and colour-changing characteristics in a single CLCE system. Here, we report the design and synthesis of an ionic conductive cholesteric liquid crystal elastomer (iCLCE) through in situ Michael addition and free-radical photopolymerization of CLCE precursors on silane-functionalized polymer ionic liquid networks, in which robust covalent chemical bonding was formed at the interface. Thanks to superior mechanochromism and ionic conductivity, the resulting iCLCEs exhibit dynamic colour-changing and electrical sensing functions in a wide range upon mechanical stretching, and can be used for biomechanical monitoring during joint bending. Importantly, a capacitive elastomeric sensor can be constructed through facilely stacking iCLCEs, where the optical and electrical dual-signal reporting performance allows intuitive visual localization of pressure intensity and distribution. Moreover, proof-of-concept application of the iCLCEs has been demonstrated with human-interactive systems. The research disclosed herein can provide new insights into the development of bioinspired somatosensory materials for emerging applications in diverse fields such as human-machine interaction, prostheses and intelligent robots.
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BACKGROUND: The impact of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) on quality of life (QoL) for patients taking opioids and psychotropic medications preoperatively is unclear. METHODS: This study retrospectively reviewed a CRS-HIPEC single-center prospectively maintained database for 2012-2016. Demographics and clinical data on opioids/psychotropic medication use were collected via chart review. The study collected QoL outcomes at baseline, then 3, 6, and 12 months postoperatively via the Center for Epidemiologic Studies Depression Scale (CES-D), Brief Pain Inventory, Functional Assessment of Cancer Therapy, and 36-Item Short-Form Health Survey. Differences in QoL between the groups were calculated using repeated measures analysis of variance regression. Descriptive statistics and Kaplan-Meier analyses were performed. RESULTS: Of 388 patients, 44.8% were taking opioids/psychotropic medications preoperatively. At baseline, those taking opioids/psychotropic medications preoperatively versus those not taking these medications had significantly worse QoL. By 1 year postoperatively, the QoL measures did not differ significantly except for emotional functioning (e.g., no medications vs. opioids/psychotropic medications: CES-D, 5.6 vs. 10.1). Median survival did not differ significantly (opioids/psychotropic medications vs. no medications: 52.3 vs. 60.6 months; p = 0.66). At 1 year after surgery, a greater percentage of patients were taking opioids, psychotropic medications, or both than at baseline (63.2% vs. 44.8%; p < 0.001). CONCLUSION: Despite worse baseline QoL, patients who took opioids/psychotropic medications had QoL scores 1 year postoperatively similar to the scores of those who did not except in the emotional domains. These data point to the potential utility of a timed psychosocial intervention to enhance emotional adaptation and further support the role of CRS-HIPEC in improving QoL.
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Hyperthermia, Induced , Peritoneal Neoplasms , Humans , Hyperthermic Intraperitoneal Chemotherapy , Quality of Life , Combined Modality Therapy , Cytoreduction Surgical Procedures/adverse effects , Analgesics, Opioid/therapeutic use , Retrospective Studies , Hyperthermia, Induced/adverse effects , Peritoneal Neoplasms/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Survival RateABSTRACT
INTRODUCCIÓN: Los Servicios de Salud Públicos de la Región Metropolitana (RM) cuentan con 9 camas psiquiátricas de corta estadía por 100.000 habitantes adultos, por debajo de las recomendaciones internacionales. OBJETIVO: El presente estudio evaluará la capacidad de resolución del principal Servicio de Urgencias Psiquiátricas de la RM lo que puede ser de utilidad para evaluar el impacto de la disponibilidad de camas de corta estadía en la RM. MATERIALES Y MÉTODO: Se realizó un estudio observacional retrospectivo de todas las atenciones realizadas en el Servicio de Urgencias del Instituto Psiquiátrico "Dr. José Horwitz B." entre los años 2017 y 2020 y las indicaciones de hospitalización y su resolución. Se obtuvieron Razones de Tasas de Incidencia crudas y ajustadas para la indicación de hospitalización, las efectuadas y aquellas rechazadas por falta de vacantes. RESULTADOS: Se realizaron 90.464 atenciones a 41.541 usuarios y se indicó la hospitalización al 12,5% de ellas. La hospitalización se efectúa en el 59,5% de las atenciones y 35,9% no se pueden realizar por falta de vacantes. Al comparar las Tasas de Incidencia ajustadas se observó solamente una mayor tasa de hospitalización efectuada para los usuarios de regiones (IRR = 1,27; IC95%: 1,11-1,44; valor-p < 0,001) y durante el primer semestre de 2020 (IRR = 1,49; IC95%: 1,35-1,65; valor-p < 0,001). CONCLUSIONES: La evidente demanda por las hospitalizaciones psiquiátricas y la baja disponibilidad de camas de corta estadía en la Región Metropolitana probablemente tiene consecuencias insospechadas. Su abordaje es un desafío que requiere de una planificación multinivel entre todos los actores involucrados.
BACKGROUND: The Public Health Services at the Metropolitan Region (MR) of Chile have nine acute psychiatric beds per 100,000 inhabitants, under international recommendations. AIM: The present study will evaluate the resolution capacity of the main MR Psychiatric Emergency Room (PER), which may help assess the impact of the availability of acute beds in the MR. MATERIAL AND METHODS: A retrospective observational study of electronic patient records for all adult patients attending PER of the Psychiatric Institute "Dr. José Horwitz B." between 2017 and 2020 was analyzed. Crude and adjusted Incidence Rate Ratios were obtained for the indication of hospitalization, admissions, and those rejected due to lack of acute psychiatric beds. RESULTS: 90,464 attendances were evaluated on 41,541 patients, and hospitalization was indicated for 12.5% of them. Admissions were carried out in 59.5%, and 35.9% did not occur due to a lack of acute psychiatric beds. When comparing the adjusted Incidence Rates, only a higher hospitalization rate was observed for users from regions (IRR = 1,267; 95% CI: 1,11-1,44; p-value < 0.001) and during the first half of 2020 (IRR = 1.49; CI95%: 1.35-1.65; p-value < 0.001). CONCLUSIONS: The demand for psychiatric hospitalizations and the low availability of acute psychiatric beds in the MR probably have unsuspected consequences. The solution requires multilevel planning among all the actors involved.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Hospital Bed Capacity/statistics & numerical data , Hospitalization/statistics & numerical data , Chile/epidemiology , Retrospective Studies , Health Services Needs and Demand/statistics & numerical data , Mental Disorders/therapy , Mental Disorders/epidemiologyABSTRACT
INTRODUCTION: Treatment of advanced pancreatic adenocarcinoma remains suboptimal. Therapeutic agents with a novel mechanism of action are desperately needed; one such novel agent is CPI-613 targets. We here analyze the outcomes of 20 metastatic pancreatic cancer patients treated with CPI-613 and FOLFIRINOX in our institution and evaluate their outcomes to borderline-resectable patients treated with curative surgery. METHODS: A post hoc analysis was performed of the phase I CPI-613 trial data (NCT03504423) comparing survival outcomes to borderline-resectable cases treated with curative resection at the same institution. Survival was measured by overall survival (OS) for all study cases and disease-free survival (DFS) for resected cases with progression-free survival for CPI-613 cases. RESULTS: There were 20 patients in the CPI-613 cohort and 60 patients in the surgical cohort. Median follow-up times were 441 and 517 days for CPI-613 and resected cases, respectively. There was no difference in survival times between CPI-613 and resected cases with a mean OS of 1.8 versus 1.9 year (p = 0.779) and mean PFS/DFS of 1.4 versus 1.7 years (p = 0.512). There was also no difference in 3-year survival rates for OS (hazard ratio [HR] = 1.063, 95% confidence interval [CI] 0.302-3.744, p = 0.925) or DFS/PFS (HR = 1.462, 95% CI 0.285-7.505, p = 0.648). CONCLUSION: The first study to evaluate the survival between metastatic patients treated with CPI-613 versus borderline-resectable cases undergoing curative resection. Analysis revealed no significant differences in survival outcomes between the cohorts. Study results are suggestive that there may be potential utility with the addition of CPI-613 to potentially resectable pancreatic adenocarcinoma, although additional research with more comparable study groups are required.
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Adenocarcinoma , Pancreatic Neoplasms , Humans , Adenocarcinoma/drug therapy , Adenocarcinoma/surgery , Adenocarcinoma/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Fluorouracil/therapeutic use , Neoadjuvant Therapy/methods , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/surgery , Pancreatic Neoplasms/pathology , Pancreatic NeoplasmsABSTRACT
INTRODUCTION: There is a paucity in the literature in regard to the incidence, risk factors, and outcomes for post-operative cholangitis following hepatic resection. METHODS: Retrospective review of the ACS NSQIP main and targeted hepatectomy registries for 2012-2016. RESULTS: A total of 11,243 cases met the selection criteria. The incidence of post-operative cholangitis was 0.64% (151 cases). Multivariate analysis identified several risk factors associated with the development of post-operative cholangitis, stratified out by pre-operative and operative factors. The most significant risk factors were biliary anastomosis and pre-operative biliary stenting with odds ratios (OR) of 32.39 (95% CI 22.91-45.79, P value < 0.0001) and 18.32 (95% CI 10.51-31.94, P value < 0.0001) respectively. Cholangitis was significantly associated with post-operative bile leaks, liver failure, renal failure, organ space infections, sepsis/septic shock, need for reoperation, longer length of stay, increased readmission rates, and death. CONCLUSION: Largest analysis of post-operative cholangitis following hepatic resection. While a rare occurrence, it is associated with significantly increased risk for severe morbidity and mortality. The most significant risk factors were biliary anastomosis and stenting.
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Biliary Tract Diseases , Cholangitis , Humans , Liver/surgery , Cholangitis/epidemiology , Cholangitis/etiology , Cholangitis/surgery , Risk Factors , Hepatectomy/adverse effects , Biliary Tract Diseases/surgery , Retrospective Studies , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/surgeryABSTRACT
Chameleon skin is naturally adaptive and can sense environmental changes and transform sensing into bioelectrical and optical signals by manipulating ion transduction and photonic nanostructures. The increasing interest in mimicking biological skins has considerably promoted the development of advanced photonic materials with an increasing ionic conductivity. Herein, we report the judicious design and fabrication of a bioinspired mechanochromic chiral nematic nanostructured film with good ionic conductivity by infiltrating fluorine-rich ionic liquids (FILs) into a swollen self-assembled cellulose nanocrystal (CNC) film with helical nanoarchitectures. Notably, the introduction of 2-hydroxyethyl acrylate considerably enhances the compatibility of hydrophobic FILs and hydrophilic CNCs. The resulting FIL-CNC nanostructured films exhibited excellent mechanochromism, good ionic conductivity, and outstanding optical/electrical dual-signal sensing performance when used as a bioinspired ionic skin for real-time monitoring of human motions. Owing to the integration of FILs, the underwater stability of the chiral liquid crystal nanostructures of CNCs was significantly enhanced. Notably, underwater contact/contactless sensing modes and encrypted information transmission have been achieved with the FIL-CNC nanostructured film. This study can offer great insights for the advancement of biomimetic multifunctional artificial skins and emerging interactive devices, which can find important applications in wearable iontronics, human-machine interactions, and intelligent robots.
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Nanoparticles , Nanostructures , Humans , Nanostructures/chemistry , Nanoparticles/chemistry , Cellulose/chemistry , Hydrophobic and Hydrophilic InteractionsABSTRACT
Bicalutamide is a selective androgen receptor antagonist. To date, it has been used orally with good efficacy results, but not in mesotherapy. In our center, we assessed whether patients undergoing bicalutamide mesotherapy showed positive responses and tolerated the local administration of bicalutamide. Six premenopausal women, with a mean age of 35.7 years and clinical diagnosis of Olsen Grade II or III female androgenetic alopecia accompanied by significant seborrhea were treated with 1 ml bicalutamide 0.5% mesotherapy. Three monthly sessions were performed. A subtle improvement in hair density was described after the third session. The overall satisfaction of the patients with the treatment was 6.3, on a scale of 1-10. Premenopausal women require several therapeutic approaches to combat severe androgenetic alopecia. Our data showed that bicalutamide mesotherapy was well tolerated and welcomed by the patients; we, therefore, provide a new tool for the management of this pathology.
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In the normal lung, the dominant cable is an elastic "line element" composed of elastin fibers bound to a protein scaffold. The cable line element maintains alveolar geometry by balancing surface forces within the alveolus and changes in lung volume with exercise. Recent work in the postnatal rat lung has suggested that the process of cable development is self-organized in the extracellular matrix. Early in postnatal development, a blanket of tropoelastin (TE) spheres appear in the primitive lung. Within 7 to 10 days, the TE spheres are incorporated into a distributed protein scaffold creating the mature cable line element. To study the process of extracellular assembly, we used cellular automata (CA) simulations. CA simulations demonstrated that the intermediate step of tropoelastin self-aggregation into TE spheres enhanced the efficiency of cable formation more than 5-fold. Similarly, the rate of tropoelastin production had a direct impact on the efficiency of scaffold binding. The binding affinity of the tropoelastin to the protein scaffold, potentially reflecting heritable traits, also had a significant impact on cable development. In contrast, the spatial distribution of TE monomer production, increased Brownian motion and variations in scaffold geometry did not significantly impact simulations of cable development. We conclude that CA simulations are useful in exploring the impact of concentration, geometry, and movement on the fundamental process of elastogenesis.
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Lung , Tropoelastin , Animals , Rats , Tropoelastin/metabolism , Lung/metabolism , Extracellular Matrix/metabolismABSTRACT
Wireless actuation of electrically driven soft actuators is of paramount importance for the development of bioinspired soft robotics without physical connection or on-board batteries. Here, we demonstrate untethered electrothermal liquid crystal elastomer (LCE) actuators based on emerging wireless power transfer (WPT) technology. We first design and fabricate electrothermal LCE-based soft actuators that consist of an active LCE layer, a conductive liquid metal-filled polyacrylic acid (LM-PA) layer, and a passive polyimide layer. LM can function not only as an electrothermal transducer to endow resulting soft actuators with electrothermal responsiveness but also as an embedded sensor to track the resistance changes. Various shape-morphing and locomotive modes such as directional bending, chiral helical deformation, and inchworm-inspired crawling can be facilely obtained through appropriately controlling the molecular alignment direction of monodomain LCEs, and the reversible shape-deformation behaviors of resulting soft actuators can be monitored in real-time through resistance changes. Interestingly, untethered electrothermal LCE-based soft actuators have been achieved by designing a closed conductive LM circuit within the actuators and combining it with inductive-coupling WPT technology. When the resulting soft actuator approaches a commercially available wireless power supply system, an induced electromotive force can be generated within the closed LM circuit, which results in Joule heating and wireless actuation. As proof-of-concept illustrations, wirelessly driven soft actuators that can exhibit programmable shape-morphing behaviors are demonstrated. The research disclosed herein can provide insights into the development of bioinspired somatosensory soft actuators, battery-free wireless soft robots, and beyond.
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Radiative cooling materials that can dynamically control solar transmittance and emit thermal radiation into cold outer space are critical for smart thermal management and sustainable energy-efficient buildings. This work reports the judicious design and scalable fabrication of biosynthetic bacterial cellulose (BC)-based radiative cooling (Bio-RC) materials with switchable solar transmittance, which are developed by entangling silica microspheres with continuously secreted cellulose nanofibers during in situ cultivation. Theresulting film shows a high solar reflection (95.3%) that can be facilely switched between an opaque state and a transparent state upon wetting. Interestingly, the Bio-RC film exhibits a high mid-infrared emissivity (93.4%) and an average sub-ambient temperature drop of ≈3.7 °C at noon. When integrating with a commercially available semi-transparent solar cell, the switchable solar transmittance of Bio-RC film enables an enhancement of solar power conversion efficiency (opaque state: 0.92%, transparent state: 0.57%, bare solar cell: 0.33%). As a proof-of-concept illustration, an energy-efficient model house with its roof built with Bio-RC-integrated semi-transparent solar cell is demonstrated. This research can shine new light on the design and emerging applications of advanced radiative cooling materials.
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In nature, many plants have evolved diverse flight mechanisms to disperse seeds by wind and propagate their genetic information. Inspired by the flight mechanism of the dandelion seeds, we demonstrate light-driven dandelion-inspired microfliers based on ultralight and super-sensitive tubular-shaped bimorph soft actuator. Like dandelion seeds in nature, the falling velocity of the as-proposed microflier in air can be facilely controlled by tailoring the degree of deformation of the "pappus" under different light irradiations. Importantly, the resulting microflier is able to achieve a mid-air flight above a light source with a sustained flight time of ~8.9 s and a maximum flight height of ~350 mm thanks to the unique dandelion-like 3D structures. Unexpectedly, the resulting microflier is found to exhibit light-driven upward flight accompanied by autorotating motion, and the rotation mode can be customized in either a clockwise or counterclockwise direction by engineering the shape programmability of bimorph soft actuator films. The research disclosed herein can offer new insights into the development of untethered and energy-efficient artificial aerial vehicles that are of paramount significance for many applications from environmental monitoring and wireless communication to future solar sail and robotic spacecraft.
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INTRODUCTION: Complete resection of colorectal liver metastasis (CLM) improves long-term survival in colorectal cancer. However, there is limited recent data on conditional survival (CS) as postoperative survival milestones are achieved post-hepatectomy. METHODS: A retrospective analysis was performed on the penta-institutional Colorectal Liver Operative Metastasis International Collaborative (COLOMIC), with 906 consecutive CLM hepatectomy cases. CS was calculated using Bayes' theorem and Kaplan-Meier analysis. Additional CS analyses were performed on additional clinicopathologic risk factors, including colon cancer laterality, KRAS mutation status, and extrahepatic disease. RESULTS: The 5-year CS was 40.6%, 45.3%, 52.8%, and 65.3% at 0, 1, 2, and 3 years postoperatively, with significant improvements each year (p < 0.005). CS was not significantly different between right-sided and left-sided colorectal cancers by 3 years postoperatively. Patients with KRAS mutations had worse CS at all timepoints (p < 0.001). Extrahepatic disease was a poor prognostic factor for OS and CS (p < 0.001). However, CS for patients with KRAS mutations or extrahepatic disease improved significantly as 2-year, postoperative survival was achieved (p < 0.05). CONCLUSIONS: Five-year CS after hepatectomy for CLM improved with each passing year of survival postoperatively. Although extrahepatic disease and KRAS mutations are poor prognostic factors for OS, these populations still had improved CS after 2 years postoperatively.