RESUMO
OBJECTIVES: Pancreatic cancer (PC) is one of the most aggressive malignancies due to the high rate of metastasis. The mechanisms underlying metastasis need to be elucidated. Small extracellular vesicles (sEVs) mediate cell-to-cell communication, and cancer-derived sEVs contribute to the formation of premetastatic niches. The present study examined changes in adhesiveness by the internalization of PC-derived sEVs into vascular endothelial cells, and investigated the molecular mechanisms underlying metastasis. MATERIALS AND METHODS: Pancreatic cancer-derived sEVs were internalized into vascular endothelial cells, and changes in adhesiveness were evaluated. We evaluated the effects of sEVs on the formation of liver metastasis in vivo. We also assessed molecular changes in vascular endothelial cells by the internalization of PC-derived sEVs. RESULTS: The internalization of PC-derived sEVs into vascular endothelial cells promoted the adhesiveness of vascular endothelial cells and PC cells. Pancreatic cancer-derived sEVs contained high levels of transforming growth factor ß1 mRNA and acted as its transporter. Once PC-derived sEVs were internalized into vascular endothelial cells, the expression of fibronectin 1 increased on the cell surface, and the adhesiveness of vascular endothelial cells was enhanced. CONCLUSIONS: We investigated association between PC-derived sEVs and adhesiveness. Regulation of PC-derived sEVs has potential as a therapeutic modality to suppress the metastasis of PC.
Assuntos
Adesão Celular , Células Endoteliais , Vesículas Extracelulares , Fibronectinas , Neoplasias Pancreáticas , Fator de Crescimento Transformador beta1 , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/genética , Vesículas Extracelulares/metabolismo , Humanos , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Animais , Fibronectinas/metabolismo , Linhagem Celular Tumoral , Fator de Crescimento Transformador beta1/metabolismo , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Camundongos Nus , Comunicação Celular , Células Endoteliais da Veia Umbilical Humana/metabolismo , MasculinoRESUMO
BACKGROUND: Laparoscopic cholecystectomy (LC) is one of the most commonly undertaken procedures worldwide for cholecystolithiasis and cholecystitis. Accessory liver lobe (ALL) is a developmental anomaly defined as an excessive liver lobe composed of a normal liver parenchyma. Some ALL exist on the serosal side of the gallbladder. We herein present two cases of ALL incidentally detected during LC. CASE PRESENTATION: The first case was a 69-year-old woman diagnosed with chronic cholecystitis. LC was performed. ALL was observed anterior to the wall of the gallbladder and resected after clipping. Pathological findings revealed liver tissue with Glisson's capsule and a lobular structure in ALL. However, communication between the bile ducts of ALL and the main liver was unclear due to surgical heat degeneration. The second case was a 56-year-old woman diagnosed with acute cholecystitis. LC was performed approximately one month after the attack, and ALL attached to the wall of gallbladder. ALL was clipped and completely resected. Pathological findings showed that the bile ducts of ALL might be connected within the wall of gallbladder. CONCLUSIONS: We presented two cases of ALL attached to the gallbladder encountered during LC. Since ALL contains a normal liver parenchyma, postoperative bleeding or bile leakage may occur if it is inefficiently resected. Therefore, the complete resection of ALL is important to prevent these postoperative complications.
RESUMO
Early recurrence in patients with colorectal cancer (CRC) is associated with a poor prognosis. We aimed to identify circulating microRNAs that are biomarkers of early CRC recurrence and elucidate their functions. We identified miR-4442 as a candidate biomarker by microRNA array analysis comparing preoperative and postoperative plasma levels in patients with CRC, with and without recurrence. The association between preoperative plasma miR-4442 levels, clinicopathological features, and recurrence-free survival was analyzed in 108 patients with CRC after curative surgery. Furthermore, cell-function analyses were performed, and the involvement of miR-4442 in regulating epithelial-mesenchymal transition (EMT) was examined. Preoperatively plasma miR-4442 levels were associated with CRC recurrence and exhibited an incremental increase with earlier recurrence dates. Moreover, miR-4442 demonstrated high sensitivity and specificity as a potential biomarker for early CRC recurrence. The expression of miR-4442 in cancer tissues of patients with metastatic liver cancer from CRC was higher than in normal liver, CRC, and normal colorectal tissues. The overexpression of miR-4442 promoted the proliferative, migratory, and invasive activities of CRC cells, decreased levels of RBMS1 and E-cadherin, and increased levels of N-cadherin and Snail1. Plasma miR-4442 is a clinically useful biomarker for predicting the early recurrence of CRC. Furthermore, miR-4442 regulates EMT in CRC by directly targeting the messenger RNA of RBMS1.
Assuntos
MicroRNA Circulante , Neoplasias Colorretais , MicroRNAs , Humanos , Transição Epitelial-Mesenquimal/genética , Recidiva Local de Neoplasia/genética , MicroRNAs/genética , Neoplasias Colorretais/patologia , Proteínas de Ligação a DNA/metabolismo , Proteínas de Ligação a RNARESUMO
BACKGROUND: Transmediastinal radical esophagectomy (TME) is a new minimally invasive approach without thoracotomy. However, the transcervical dissection of subcarinal lymph nodes (SCLN) is challenging. The shape or narrowness of the mediastinal space, particularly around the aortic arch to the tracheal bifurcation, may increase the difficulty of this procedure. The present study aimed to clarify predictors of the difficulty of transcervical SCLN dissection. METHODS: Patients who underwent TME between 2016 and 2019 were included (n = 126). Four indicators, the cervical angle, carina distance, aorta distance, and sternum distance, were defined as indicators of mediastinal narrowness by 3D-CT. The relationships between the difficulty of transcervical SCLN dissection and clinicopathological features, including the above indicators, were investigated. RESULTS: In a univariate analysis, the cervical angle (p = 0.023), aorta distance (p = 0.002), and middle thoracic tumor (p = 0.040) correlated with difficulty. The median cervical angle and aorta distance were 15° and 33 mm in difficult cases and 19° and 43 mm in easy cases, respectively. In a multivariate analysis, the short aorta distance (odds ratio: 7.96, p = 0.002) and middle thoracic tumor (odds ratio: 3.35, p = 0.042) were independent predictive factors. CONCLUSIONS: The cervical angle, aorta distance, and middle thoracic tumor may predict the difficulty of transcervical SCLN dissection. In difficult cases, a transhiatal approach should be combined for complete SCLN dissection.
Assuntos
Neoplasias Esofágicas , Excisão de Linfonodo , Humanos , Excisão de Linfonodo/métodos , Linfonodos/cirurgia , Linfonodos/patologia , Mediastino/cirurgia , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Aorta Torácica/patologia , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/patologiaRESUMO
Esophageal cancer (EC) is the sixth leading cause of cancer-related death worldwide. Recently, neoadjuvant chemotherapy (NAC) before curative surgery has become a standard treatment for clinical stage II or III EC patients. Some EC patients receive a complete response (CR) by NAC; thus, curative surgery may be unnecessary for such patients. MicroRNA levels in plasma have the potential to be a predictor of response to NAC. In the present study, we focused on miR-192-5p, which is highly expressed in EC tissue. The purpose was to investigate the correlations between levels of plasma miR-192-5p and the response to NAC. Furthermore, molecular functions of miR-192-5p associated with chemosensitivity were examined using EC cell lines. The levels of miR-192-5p in plasma before surgery were evaluated in 113 EC patients. Sixty-nine patients received NAC. miR-192-5p levels in the CR group were significantly higher than in the other groups (p = 0.002). The downregulation of miR-192-5p in the EC cell line inhibited sensitivity to cisplatin, and the overexpression of miR-192-5p in the EC cell line promoted sensitivity to cisplatin. miR-192-5p regulated sensitivity to cisplatin by targeting ERCC3 and ERCC4. Plasma miR-192-5p could be used as a predictor of response to chemotherapy and prognosis in EC patients.
Assuntos
Neoplasias Esofágicas , MicroRNAs , Humanos , Cisplatino/farmacologia , Terapia Neoadjuvante , Linhagem Celular Tumoral , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/metabolismo , MicroRNAs/metabolismo , Prognóstico , Regulação Neoplásica da Expressão Gênica , Proliferação de CélulasRESUMO
BACKGROUND/AIM: The clinical significance ofmiR-4257 in patients with colorectal cancer (CRC) remains unclear. Here, we investigated the usefulness of measuring miR-4257 levels in the plasma and cancer tissues of patients with CRC, and the function of miR-4257 in CRC cell lines. MATERIALS AND METHODS: miR-4257 levels were measured in the plasma and cancer tissues of patients with CRC using quantitative polymerase chain reaction. The relationships between miR-4257 level and clinicopathological features were examined. Proliferation, transwell, wound healing, and adhesion assays were performed using a miR-4257 mimic and inflammatory cytokines. RESULTS: Relapse-free survival was significantly lower in patients with high miR-4257 levels in the plasma and cancer tissue (p<0.001 andp=0.016, respectively). High miR-4257 expression was an independent predictive factor for recurrence (p=0.017 and p=0.028). Addition of inflammatory cytokines to CRC and normal cell lines increased the expression of miR-4257 in the cell lines and cell culture medium. Over-expression of miR-4257 in CRC cells increased malignancy, while over-expression in normal cells increased adhesion to CRC cells. The addition of inflammatory cytokines to normal cell lines enhanced adhesion to CRC cell lines. CONCLUSION: miR-4257 level in plasma and cancer tissues is a biomarker of disease recurrence in patients with CRC. Moreover, miR-4257 promoted tumour growth and was associated with cancer-induced inflammation.
Assuntos
Neoplasias Colorretais , MicroRNAs , Movimento Celular/fisiologia , Proliferação de Células/genética , Neoplasias Colorretais/patologia , Citocinas/genética , Humanos , Inflamação/genética , MicroRNAs/metabolismo , Recidiva Local de NeoplasiaRESUMO
BACKGROUND: The prognosis of gastric cancer patients with peritoneal dissemination is extremely poor and effective treatment for peritoneal dissemination has not been established. Gastric cancer-derived small extracellular vesicles play an important role in the development of a favorable microenvironment for peritoneal metastasis and progression of peritoneal dissemination. Here, we aimed to investigate the transformation of gastric cancer cells by removing gastric cancer-derived small extracellular vesicles and to develop a novel therapy for inhibiting peritoneal dissemination. METHODS: Gastric cancer cells were cultured in medium containing gastric cancer- and peritoneal mesothelium-derived small extracellular vesicles and in medium from which small extracellular vesicles were removed by ultracentrifugation. Cell function assays were performed in vitro, and the alternations in gene expression in gastric cancer cells were analyzed. The inhibitory effect of intraperitoneal lavage on peritoneal dissemination was investigated in vivo as a method to remove gastric cancer-derived small extracellular vesicles. RESULTS: Removal of gastric cancer-derived small extracellular vesicles suppressed the proliferative and migrative abilities of gastric cancer cells and the adhesion of gastric cancer cells to peritoneal mesothelial cells. It altered the expression of several genes related to the cell cycle and epithelial-mesenchymal transition pathways of gastric cancer cells, leading to the inhibition of gastric cancer cell growth and peritoneal dissemination in vivo. CONCLUSIONS: Our study provides novel insights into a novel therapy for inhibiting the peritoneal dissemination of gastric cancer by targeting gastric cancer-derived small extracellular vesicles to improve the prognosis of gastric cancer patients with peritoneal metastasis.
Assuntos
Vesículas Extracelulares , Neoplasias Peritoneais , Neoplasias Gástricas , Linhagem Celular Tumoral , Transição Epitelial-Mesenquimal , Vesículas Extracelulares/metabolismo , Vesículas Extracelulares/patologia , Humanos , Neoplasias Peritoneais/secundário , Peritônio/patologia , Neoplasias Gástricas/patologia , Microambiente TumoralRESUMO
As liver cancer (LC) is the sixth most commonly diagnosed malignancy, it is necessary to elucidate the molecular mechanisms responsible for LC progression. MicroRNAs (miRNAs/miRs) play crucial roles in tumor progression by regulating target gene expression. The present study assessed miRNA4730 expression and function in LC. The effects of miR4730 overexpression were examined in LC cell lines, and the target genes of miR4730 were evaluated using microarray analysis and TargetScan data. In addition, the association between miR4730 expression in tissue samples and the prognosis of 70 patients with LC was evaluated. miR4730 expression was suppressed in LC tissues and cell lines. miR4730 overexpression suppressed cell proliferation and cell cycle progression and promoted apoptosis. High mobility group A1 (HMGA1) was revealed as the direct target of miR4730 using luciferase reporter assay, and the inhibition of downstream integrinlinked kinase (ILK) expression and Akt or glycogen synthase kinase 3ß (GSK3ß) phosphorylation was confirmed. The lower expression of miR4730 in tissue samples was significantly associated with a worse recurrencefree survival of patients with LC. On the whole, miR4730 suppressed tumor progression by directly targeting HMGA1 and inhibiting the ILK/Akt/GSK3ß pathway. miR4730 thus has potential for use as a prognostic marker and may prove to be a therapeutic target for miRNAbased therapies.
Assuntos
Neoplasias Hepáticas , MicroRNAs , Linhagem Celular Tumoral , Glicogênio Sintase Quinase 3 beta/genética , Proteína HMGA1a , Humanos , Neoplasias Hepáticas/genética , MicroRNAs/genética , MicroRNAs/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismoRESUMO
Background: High-mobility group box-1 (HMGB1) is involved in the tumorigenesis and metastasis of various cancers. The present study investigated the roles of extracellular HMGB1 in the progression of gastric cancer (GC) and the therapeutic effects of recombinant human soluble thrombomodulin (rTM) targeting HMGB1. Methods: The effects of extracellular HMGB1 and rTM on GC cells were assessed using proliferation and Transwell assays. Their effects on local tumor growth and metastasis were evaluated using subcutaneous tumor and liver metastasis mouse models, respectively. Plasma HMGB1 concentrations in GC patients were measured using ELISA. The relationships between plasma HMGB1 concentrations and the prognosis and clinicopathological factors of patients were also investigated. Results: GC proliferation, migration, and invasion abilities were promoted by increases in extracellular HMGB1 concentrations and alleviated by rTM. In the subcutaneous tumor model, local tumor growth was promoted by the addition of rhHMGB1 and alleviated by rTM. Similar changes occurred in the liver metastasis model. Recurrence-free survival (p < 0.01) and overall survival (p = 0.01) were significantly worse in patients with high plasma HMGB1 concentrations. Conclusion: Plasma HMGB1 concentrations are a prognostic marker in GC patients. Extracellular HMGB1 promotes cancer progression and has potential as a novel treatment target in GC cells for rTM.
Assuntos
Proteína HMGB1/sangue , Neoplasias Hepáticas , Neoplasias Gástricas , Animais , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Camundongos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologiaRESUMO
PURPOSE: The significance of the duration of the recurrence-free survival after curative resection for colorectal cancer remains unclear. The purpose was to reveal the association between time to recurrence after surgery and the survival after recurrence. METHODS: Patients with stage II and III colorectal cancer who underwent curative resection between 2007 and 2015 were retrospectively reviewed (n = 645). Patients with recurrence after surgery (n = 133) were divided into 2 groups: early recurrence (within 13 months after surgery, n = 63) and late recurrence (more than 13 months after surgery, n = 70). The overall survival after recurrence and clinicopathological features were compared between early recurrence, late recurrence, and without recurrence groups. RESULTS: The overall survival after recurrence was significantly shorter in patients with early recurrence occurring at less than 13 months (hazard ratio: 1.70, p = 0.03). A high preoperative CA19-9 level (odds ratio [OR]: 2.38, p = 0.03), venous invasion (OR: 2.26, p = 0.03), and the absence of adjuvant chemotherapy (OR: 2.08, p = 0.04) were independently correlated with early recurrence. CONCLUSION: Early recurrence was associated with a poor prognosis after recurrence. Venous invasion correlated with early recurrence. Adjuvant chemotherapy may reduce the risk of early recurrence. These results indicate the importance of prudent surveillance and the aggressive application of adjuvant chemotherapy.
Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Recidiva Local de Neoplasia/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Tempo , Adulto JovemRESUMO
Anterior gradient 2 (AGR2) reportedly promotes tumor growth and has an unfavorable impact on survival in several cancers. However, no comprehensive functional analysis of AGR2 in esophageal squamous cell carcinoma (ESCC) has been performed. In the present study, the function and clinical significance of AGR2 were examined using ESCC cell lines and clinical samples. AGR2 was upregulated in EC tissue and ESCC cell lines. The downregulation of AGR2 suppressed cell proliferation and increased the proportion of G2/Mphase cells and phosphorylation of p53 in TP53wildtype ESCC and osteosarcoma cells. However, these changes were not observed in TP53mutant ESCC cells. In addition, immunohistochemistry results demonstrated that high AGR2 and low p53 expression levels in ESCC tissues were correlated with a worse prognosis. These results suggested that although AGR2 enhanced cell proliferation by inhibiting p53 phosphorylation in TP53wildtype ESCC, the same mechanism did not regulate cell functions in TP53mutant ESCC. Thus, AGR2 served an important role in ESCC progression and might be a useful prognostic marker in patients with TP53wildtype ESCC.
Assuntos
Progressão da Doença , Neoplasias Esofágicas/genética , Carcinoma de Células Escamosas do Esôfago/genética , Mucoproteínas/genética , Proteínas Oncogênicas/genética , Neoplasias Ósseas/genética , Neoplasias Ósseas/patologia , Linhagem Celular Tumoral , Regulação para Baixo , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Mucoproteínas/metabolismo , Proteínas Oncogênicas/metabolismo , Osteossarcoma/genética , Osteossarcoma/patologia , Fosforilação , Proteína Supressora de Tumor p53/metabolismo , Regulação para CimaRESUMO
BACKGROUND: Circular RNA is a novel endogenous non-coding RNA with a stable loop structure, and theories for its biogenesis and usefulness as a biomarker in various cancers have been proposed. The present study investigated the significance of circular FAT1 (circFAT1) as a novel biomarker in esophageal squamous cell carcinoma (ESCC). METHOD: CircFAT1 expression levels were measured in ESCC cell lines and the effects of downregulating circFAT1 on cell migration and invasion were examined using a transwell assay. The functions of miR-548g, which will be sponged by circFAT1, were assessed. Furthermore, the expression of circFAT1 was evaluated in 51 radically resected ESCC tissue samples using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The relationships between circFAT1 expression, clinicopathological factors, and patient prognosis were analyzed. RESULTS: CircFAT1 expression levels were significantly lower in tumor tissue than in adjacent non-tumorous mucosal tissue (p = 0.01). The downregulation of circFAT1 expression promoted ESCC cell migration and invasive ability, but not proliferation. The expression of miR-548g was upregulated by the downregulation of circFAT1. The overexpression of miR-548g also promoted ESCC cell migration and invasion. Recurrence-free survival (p = 0.02) and cancer-specific survival (p = 0.04) rates were significantly higher in patients with elevated circFAT1 expression levels. CONCLUSION: The expression level of circFAT1 is a novel prognostic marker in ESCC patients. New treatment strategies may be developed using the tumor suppressive functions of circFAT1.
Assuntos
Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , MicroRNAs , Caderinas/genética , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Neoplasias Esofágicas/genética , Carcinoma de Células Escamosas do Esôfago/genética , Regulação Neoplásica da Expressão Gênica , Humanos , MicroRNAs/genética , Invasividade Neoplásica , PrognósticoRESUMO
Background: The Geriatric Nutritional Risk Index (GNRI) is a nutritional measure for predicting the risk of morbidity and mortality in hospitalized patients. We evaluated the utility of the GNRI to predict the short-term and long-term outcomes after curative surgery for gastric cancer (GC). Patients and Methods: Patients who underwent curative surgery for GC between 2008 and 2016 were reviewed (n=795). We classified patients into two groups according to the GNRI (high GNRI: low and no risk; low GNRI: major and moderate risk) and compared the utility of the GNRI. Results: A low GNRI was an independent prognostic factor for poorer overall survival (hazard ratio=2.34, p<0.001). The GNRI tended to be a better prognostic indicator in elderly patients with GC. Low GNRI was associated with postoperative complications (odds ratio=2.27, p=0.002), especially in patients aged ≥75 (odds ratio=2.26, p=0.042). Conclusion: Low GNRI was associated with poor prognosis and occurrence of postoperative complications in patients with GC, especially in elderly patients.
RESUMO
AIMS: The prognosis of patients with gastric cancer and stage IV factors is poor. However, several recent studies have identified that curative surgery followed by S-1 chemotherapy for cytology positive (CY1) only patients contributed to a better prognosis. This study was designed to compare the prognosis between curative and palliative gastrectomy followed by chemotherapy in CY1 only stage IV gastric cancer. METHODS: Between 2001 and 2016, 1507 patients underwent gastrectomy for gastric cancer. Of these, 51 consecutive patients with only CY1 factor who underwent gastrectomy followed by chemotherapy were enrolled in this study. RESULTS: (1) Twenty three (45%) patients underwent curative D2 or D2+ gastrectomy, and the remaining 28 (55%) patients underwent palliative gastrectomy, followed by S-1 based or another historical recommended chemotherapy postoperatively. (2) Compared with patients undergoing palliative gastrectomy, patients undergoing curative gastrectomy had a significantly better prognosis (P = 0.042; median survival time: curative vs. palliative, 22.6 months vs. 11.8 months) and a lower incidence of recurrences (P = 0.091). Two- and five-year overall survival rates of patients following curative gastrectomy were 48.2% and 18.2%, respectively. A multivariate analysis showed that venous invasion [P = 0.006; hazard ratio (HR), 3.70 (95% CI: 1.27-9.43)] and curative gastrectomy [P < 0.005; HR, 0.28 (95% CI: 0.12-0.87)] were independent prognostic factors. CONCLUSION: Curative gastrectomy followed by chemotherapy might be justified to improve the prognosis of patients with only CY1 Stage IV gastric cancer.
Assuntos
Gastrectomia , Cuidados Paliativos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Quimioterapia Adjuvante , Feminino , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Seleção de Pacientes , Neoplasias Gástricas/mortalidade , Taxa de Sobrevida , Adulto JovemRESUMO
BACKGROUND: The 8th edition of the UICC TNM Classification was released in 2017 and introduced N3a/N3b groupings for gastric cancer. The purpose of this study was to evaluate the validity of the new classification for Stage â ¢ gastric cancer. PATIENTS AND METHODS: Clinical and pathological data on 388 patients who underwent R0 resection from January 1992 to December 2016 in our institution were retrospectively analyzed. The survival in the 7th and 8th edition stage groupings were compared. Differences in survival according to N classification were also examined in the groups with T4a tumor depth. RESULTS: 1. The 5-year overall survival(OS)probabilities for Stage â ¢A, â ¢B, and â ¢C of 7th edition were 47.6%, 55.0%, and 28.5%(p=0.0003)and the recurrence-free survival(RFS)rates were 81.1%, 79.4%, and 58.7%(p=0.0013), respectively. In contrast, the OS probabilities of the 8th edition were 50.2%, 41.3% and 30.1%(p=0.0009)and the RFS were 81.6%, 70.9% and 50.0%(p=0.0003), respectively. 2. For T4a tumor depth, the OS probabilities of N1, N2, N3a, and N3b were 48.8%, 54.0%, 27.5%, and 25.1%(p=0.0012)and the RFS were 82.7%, 81.2%, 57.0% and 48.7%(p=0.0013), respectively. CONCLUSION: The 8th edition of the UICC TNM classification may provide better accuracy than that of the 7th edition in predicting the prognosis of Stage â ¢ gastric cancer.
Assuntos
Neoplasias Gástricas , Humanos , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/diagnósticoRESUMO
Laparoscopy and endoscopy cooperative surgery(LECS)is an excellent surgical procedure to avoid excessive resection of the gastrointestinal wall and maintain its functions. However, LECS for large gastrointestinal stromal tumor(GIST)of> 50mm and/or ulcerative GIST are not recommended because of the oncological risk of peritoneal dissemination. Here, we report a case successfully treated with LECS-assisted open partial gastrectomy for a high-risk GIST with ulceration near the esophago-gastric junction.
Assuntos
Tumores do Estroma Gastrointestinal , Laparoscopia , Neoplasias Gástricas , Gastrectomia , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Neoplasias Gástricas/cirurgia , Resultado do Tratamento , ÚlceraRESUMO
Anastomotic recurrence in 6 colorectal cancer cases during the postoperative surveillance between 2008 and 2015 was evaluated retrospectively. Five cases had undergone DST anastomosis for sigmoidectomy and proctectomy. They had a pathological tendency to have T3 tumor and deeper, positive lymph node metastases and positive lymphatic and vascular invasion. There were 2 cases with the anastomotic recurrence diagnosis 6 to 8 months after the primary tumor resection while 4 resected cases had recurrent tumor depth of T3, though 3 cases were diagnosed 1 year after the primary tumor resection. Anastomotic recurrence should be considered a few months after primary tumor resection.
Assuntos
Neoplasias Colorretais/diagnóstico , Idoso , Anastomose Cirúrgica , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos RetrospectivosRESUMO
BACKGROUND/AIM: The self-expandable metallic stent (SEMS) is an excellent non-invasive tool for emergent bowel obstruction. This study was designed to evaluate the clinical usefulness of the SEMS for avoiding perioperative complications. PATIENTS AND METHODS: We analyzed a total of 47 consecutive patients who had a bowel obstruction due to colorectal cancer at initial diagnosis between 2012 and 2017 from hospital records. RESULTS: Perioperative complications occurred in 30% (14/47) of patients. Univariate and multivariate logistic regression analyses identified an age of more than 75 years [p=0.037, OR=6.84 (95% CI=1.11-41.6)] and the absence of an SEMS treatment [p=0.028, OR=18.5 (95% CI=1.36-250.0)] as independent risk factors for perioperative complications. Pneumonia (12.7% (6/47)) was the most common complication. There were no pneumonia patients (0% (0/15)) who were treated with the SEMS. In contrast to patients with the non-SEMS treatment, 18.7% (6/32) of all patients and 35.7% (5/14) of elderly patients had pneumonia. CONCLUSION: The SEMS is a safe and effective treatment for avoiding perioperative complications, particularly pneumonia, and may be a crucial strategy in elderly patients with acute obstruction due to colorectal cancer.
Assuntos
Neoplasias Colorretais/cirurgia , Obstrução Intestinal/cirurgia , Metais/química , Stents , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/complicações , Feminino , Humanos , Obstrução Intestinal/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Período Perioperatório , Pneumonia/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Resultado do TratamentoRESUMO
Re-laparotomy with resection of the mesh after abdominal incisional hernia repair may cause recurrence of the hernia and infection of the mesh. In the present study, we performed laparoscopic distal gastrectomy(LDG)for early gastric cancer without the resection of the mesh in such a case. A 82-year-old man who had undergone abdominal vascular replacement, cholecystectomy, abdominal incisional hernia repair with the mesh, sigmoidectomy had local recurrence of gastric cancer after endoscopic submucosal resection. We diagnosed as cStage IA and performed LDG without resection of the mesh. He had no recurrence of hernia nor infection of the mesh. Minimizing damage to the abdominal wall by laparoscopic surgery can prevent them.
Assuntos
Abdome/cirurgia , Hérnia Ventral/cirurgia , Laparoscopia , Neoplasias Gástricas/cirurgia , Idoso de 80 Anos ou mais , Gastrectomia , Hérnia Ventral/complicações , Humanos , Laparoscopia/instrumentação , Laparoscopia/métodos , Laparotomia , Masculino , Neoplasias Gástricas/complicações , Telas CirúrgicasRESUMO
The patient was a 68-year-old man who underwent Hartmann's procedure for a fistula due to rectal cancer in August 2012. The cancer was tub2>tub1, pSE, pN2, pH2, pM1(intrapulmonary metastasis), stage IV. The patient received 5 courses of FOLFOX and bevacizumab as adjuvant chemotherapy. In December 2012, the patient was seen by Otolaryngology for hoarseness. A neck examination revealed induration of the left lobe of the thyroid, and FNA biopsy strongly suggested metastasis of rectal cancer to the thyroid. FDG-PET was performed and revealed extensive accumulation of FDG at the same site. The patient was diagnosed with thyroid metastasis of rectal cancer and underwent a left thyroid lobectomy and lymph node dissection in January 2013. Histopathology confirmed the thyroid metastasis of rectal cancer. Thyroid metastasis of rectal cancer is extremely rare: there are 11 such cases in the Japanese literature, including the case encountered by the current authors. This case is reported here, along with a discussion of some of the literature.