[Predicting the Prognosis of Terminal Cancer Patients with Chemotherapy].

To determine the chemotherapy indication of terminal cancer patients, predicting the prognosis is meaningful. We intended to establish a suitable prognosis prediction index for these patients. From June 2015 to January 2016, we examined the prognosis in 7 patients who were administered chemotherapy drugs within 4 weeks before or after the prognosis calculation. Palliative prognostic index(PPI)was calculated prospectively, and prognosis in palliative care study(PiPS)was calculated prospectively or retrospectively. If patients had laboratory data within 4 days before prognosis calculation, they were assessed with PiPS-B. If patients did not have recent data, they were assessed with PiPS-A. The absolute agreement of prognosis index with actual survival was 100% in PPI, and 40.0% in PiPS. All patients who were administered chemotherapy after the PPI calculation were considered to have survived for more than 42 days. We concluded that PPI was a suitable prognosis prediction index for terminal cancer patients with chemotherapy. PPI was useful for determining the chemotherapy indication in these patients.

[A case of disseminated carcinomatosis of the bone marrow with disseminated intravascular coagulation caused by advanced colon cancer successfully treated with SOX/bevacizumab].

Our patient was a 58-year-old man who was diagnosed with a large bowel obstruction caused by ascending colon cancer, together with multiple liver metastases for which a right hemicolectomy was performed. After the operation, he developed disseminated intravascular coagulation(DIC)and severe anemia. Bone marrow biopsy findings led to a diagnosis of disseminated carcinomatosis of the bone marrow caused by colon cancer. We administered S-1+oxaliplatin(SOX) and bevacizumab( BV)chemotherapy, which improved the DIC. The patient was discharged from the hospital. After a total of six courses of chemotherapy, the carcinoma became resistant. We changed the drug regimen and his clinical condition improved. He survived for 292 days from the onset of disease.

Preoperative evaluation of malignancy in intraductal papillary mucinous neoplasms of the pancreas, especially in relation to dysplastic epithelial changes.

BACKGROUND/AIMS: Intraductal papillary mucinous neoplasms have a better prognosis than ductal adenocarcinomas of the pancreas. The aim of this study was to evaluate the malignant potential of IPMNs by their preoperative images. METHODOLOGY: Forty-three intraductal papillary mucinous neoplasms were divided into 3 duct ectatic types using preoperative images (the main duct type, the branch duct type, and the mixed type), and into 2 groups using resected specimens (the malignant group including severe dysplasia based on the WHO classification and the benign group). The diameters of the tumor, main pancreatic duct and mural nodule were measured on the images. RESULTS: Two thirds of main duct type cases were in the malignant group. For the branch duct and mixed types, the diameters of the tumor and detectable mural nodules were larger in the malignant group than in the benign group. A tumor diameter larger than 3.5cm and a mural nodule diameter larger than 6mm were risk factors for malignancy (p < 0.05). CONCLUSIONS: The main duct type, a tumor larger than 3.5cm of the branch duct or mixed type, and a mural nodule larger than 6mm were all indicators of malignancy risk.