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1.
Phys Chem Chem Phys ; 19(43): 29364-29371, 2017 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-29075691

RESUMEN

The conduction and optoelectronic properties of transparent conductive oxides can be largely modified by intentional inclusion of dopants over a very large range of concentrations. However, the simultaneous presence of structural defects results in an unpredictable complexity that prevents a clear identification of chemical and structural properties of the final samples. By exploiting the unique chemical sensitivity of Hard X-ray Photoelectron Spectra and Near Edge X-ray Absorption Fine Structure in combination with Density Functional Theory, we determine the contribution to the spectroscopic response of defects in Al-doped ZnO films. Satellite peaks in O1s and modifications at the O K-edge allow the determination of the presence of H embedded in ZnO and the very low concentration of Zn vacancies and O interstitials in undoped ZnO. Contributions coming from substitutional and (above the solubility limit) interstitial Al atoms have been clearly identified and have been related to changes in the oxide stoichiometry and increased oxygen coordination, together with small lattice distortions. In this way defects and doping in oxide films can be controlled, in order to tune their properties and improve their performances.

2.
Nanotechnology ; 26(5): 055703, 2015 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-25581391

RESUMEN

Friction characteristics of graphene deposited on different substrates have been studied by atomic force microscopy (AFM). In particular, we compared mechanically exfoliated graphene transferred over Si/SiO2 with respect to monolayer (ML) graphene grown in our laboratory by low temperature chemical vapor deposition on Ni(111) single crystal. Friction force measurements by AFM have been carried out as function of load under different environment conditions, namely vacuum (10(-5) Torr), nitrogen and air. The typical decrease of friction force with increasing number of layers has been observed on graphene over Si/SiO2 in all environment including vacuum. Continuum mechanical approximation has been used to analyze the friction versus load curves of ML graphene on Ni(111). Analysis shows that Derjaguin-Mueller-Toporov model is in good agreement with our experimental data indicating that overall behavior of the interface graphene-Ni(111) is relatively rigid respect to out of plane deformations. This result is consistent with the structural characteristics of the interface since graphene grows in registry with Ni(111) surface with covalent bonding character. Finally, the shear strength and the work of adhesion of the two systems with respect to AFM tip in vacuum have been compared. The result of this procedure indicates that shear strength and work of adhesion measured on graphene-Si/SiO2 interface are always greater than those on graphene-Ni(111) interface.

3.
Phys Chem Chem Phys ; 17(39): 26302-6, 2015 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-26387802

RESUMEN

The possibility of using exchange interactions to manipulate the spin state of an antiferromagnetic nanostructure is explored using ab initio calculations. By considering M (M = Mn, Fe, Co) mono-atomic chains supported on Cu2N islands on a Cu(001) surface as a model system, it is demonstrated that two indistinguishable Néel states of an antiferromagnetic chain can be tailored into a preferred state by the exchange interaction with a magnetic STM tip. The magnitude and direction of the anisotropy for antiferromagnetic chains can also be tuned by exchange coupling upon varying the tip-chain separation.

4.
Pancreatology ; 14(5): 425-30, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25278312

RESUMEN

Neoadjuvant treatments (chemo or chemoradiation therapy) are used for patients with locally advanced Pancreatic Ductal Adeno-Carcinoma (PDAC). FOLFIRINOX is now considered an effective treatment modality for patients with metastatic pancreatic cancer and a promising option for patients with locally advanced PDAC. Complete pathologic response after neoadjuvant therapies is anecdotic and its prognostic impact is completely unclear. We report the case of a complete pathological response after treatment with FOLFIRINOX in a patient affected by a locally advanced PDAC with a review of the literature regarding the use of FOLFIRINOX for locally advanced PDAC.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Camptotecina/análogos & derivados , Carcinoma Ductal Pancreático/tratamiento farmacológico , Neoplasias Pancreáticas/tratamiento farmacológico , Anciano , Antineoplásicos/administración & dosificación , Camptotecina/uso terapéutico , Carcinoma Ductal Pancreático/patología , Femenino , Fluorouracilo/uso terapéutico , Humanos , Leucovorina/uso terapéutico , Compuestos Organoplatinos/uso terapéutico , Neoplasias Pancreáticas/patología
5.
Phys Chem Chem Phys ; 16(35): 18848-57, 2014 Sep 21.
Artículo en Inglés | MEDLINE | ID: mdl-25079214

RESUMEN

The modifications of the stoichiometry, morphology and surface structure of cerium oxide ultrathin films induced by thermal treatments under vacuum and oxygen partial pressure were studied using in situ X-ray photoemission spectroscopy, scanning tunnelling microscopy and low energy electron diffraction. The effect of the film nominal thickness, heating temperature and heating time on the degree of reduction of the film was investigated. The reduction is more relevant on the film surface, where different ordered surface structures were observed at different degrees of reduction for very thin films. The obtained results are discussed taking into account the dimensionality of the oxide and the effects of the proximity of the Pt substrate. After reduction it was always possible to re-oxidize the films back to their original oxidation state by thermal treatment under oxygen-rich conditions.

6.
Beilstein J Org Chem ; 10: 2513-20, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25383122

RESUMEN

The optimal conditions for regio- and stereoselective epoxide ring opening of N,N-disubstituted 1,2-epoxy-3-aminocyclopentanes by different nucleophilic reagents have been developed. The substituents on the nitrogen atom in the epoxide precursor and the orientation of the oxirane ring are crucial for the reaction outcome. Thus, treatment of (1RS,2SR,3SR)-1,2-epoxy-3-(N,N-dibenzylamino)cyclopentane (3b) with amines gave a mixture of C1 and C2 regioadducts, while the use of (1RS,2SR,3SR)-1,2-epoxy-3-(N-benzyl-N-methylamino)cyclopentane (3a) led ultimately to C1 adducts. Base-catalyzed aminolysis of epoxides 6a,b afforded mainly C1 adducts 13a,b arising from trans-diaxal opening of the epoxide ring. Using a Lewis acid catalyst, epoxides 6a,b were transformed into diaminocyclopentanols 14a,b via an alternative pathway involving the formation of aziridinium intermediate 17.

7.
Oncogene ; 43(40): 2986-2994, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39198616

RESUMEN

Trabectedin, approved for the treatment of soft tissue sarcoma (STS), interferes with cell division and genetic transcription processes. Due to its strong anti-tumor activity in only certain histotypes, several studies on trabectedin combinations are currently ongoing to improve its efficacy. In this study, we aimed to investigate novel potential therapeutic strategies to enhance the anti-tumor effect of trabectedin using integrated in silico, in vitro, and in vivo approaches. For in silico analysis, we screened two public datasets, GSEA M5190 and TCGA SARC. Fibrosarcoma, leiomyosarcoma, dedifferentiated, and myxoid liposarcoma cell lines were used for in vitro studies. For in vivo experiments, fibrosarcoma orthotopic murine model was developed. In silico analysis identified Glo1 as the only druggable target upregulated after trabectedin treatment and correlated with poor prognosis. The specific Glo1 inhibitor, S-p-bromobenzylglutathione cyclopentyl diester (BBGC), increased trabectedin cytotoxicity in STS cells, and restored drug sensitivity in myxoid liposarcoma cells resistant to trabectedin. Moreover, the combined treatment with BBGC and trabectedin had a synergistic antitumor effect in vivo without any additional toxicity to mice. Based on these results, we believe that BBGC warrants further investigation to evaluate its potential clinical use in combination with trabectedin.


Asunto(s)
Sarcoma , Trabectedina , Trabectedina/farmacología , Animales , Humanos , Ratones , Sarcoma/tratamiento farmacológico , Sarcoma/patología , Línea Celular Tumoral , Ensayos Antitumor por Modelo de Xenoinjerto , Antineoplásicos Alquilantes/farmacología , Sinergismo Farmacológico , Glutatión/metabolismo
8.
Nanotechnology ; 24(49): 495703, 2013 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-24231177

RESUMEN

Films of FePt nanoparticles (NPs) embedded in MgO were obtained by controlled co-deposition of FePt NPs pre-formed by a gas aggregation source and of Mg evaporated in an oxygen atmosphere. Assemblies of core-shell FePt@MgO NPs and films of FePt NPs embedded in MgO matrix could be obtained by varying FePt and Mg deposition rates. Transmission electron microscopy (TEM) and high resolution-TEM revealed the core-shell structure of the NPs, with an FePt core (of average diameter (d) = 4.75 nm) presenting a multitwinned icosahedral structure, and MgO partially in crystalline form. The functional effect of the MgO shell in shielding the FePt core from external oxidation was shown with XPS. Upon controlled annealing, a transition from A1 to L10 ordering could be obtained, with structural and morphological re-arrangement. The magnetic hysteresis loops obtained from alternating gradient field magnetometry at room temperature show a 'wasp-waist' shape, with small values of coercive field (Hc = 300-1400 Oe), decreasing at increasing amounts of co-deposited MgO.


Asunto(s)
Hierro/química , Óxido de Magnesio/química , Nanopartículas del Metal/química , Platino (Metal)/química , Cristalización , Electrónica , Gases , Magnesio/química , Magnetismo , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Nanotecnología , Oxígeno/química , Temperatura , Difracción de Rayos X
9.
Phys Rev Lett ; 107(18): 187201, 2011 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-22107667

RESUMEN

We investigate the local tunnel magnetoresistance (TMR) effect within a single Co nanoisland using spin-polarized scanning tunneling microscopy. We observe a clear spatial modulation of the TMR ratio with an amplitude of ~20% and a spacing of ~1.3 nm between maxima and minima around the Fermi level. This result can be ascribed to a spatially modulated spin polarization within the Co island due to spin-dependent quantum interference. Our combined experimental and theoretical study reveals that spin-dependent electron confinement affects all transport properties such as differential conductance, conductance, and TMR. We demonstrate that the TMR within a nanostructured magnetic tunnel junction can be controlled on a length scale of 1 nm through spin-dependent quantum interference.

10.
J Nanosci Nanotechnol ; 11(10): 9260-6, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22400334

RESUMEN

CrN-Ag nanocomposite coatings are deposited on Si(100) wafers and 20MnCr5 steel disks in a mixed Ar+N2 atmosphere by reactive magnetron sputtering. Structure, composition and morphology were investigated by Scanning Electron Microscopy (SEM), Auger Electron Spectroscopy (AES), X-ray Photoemission Spectroscopy (XPS), X-ray Diffraction (XRD) and Focused Ion Beam (FIB) cross sectional analysis. The as deposited film matrix is mainly composed by CrN phase (78%), but a relevant part (28%) is composed by Cr2N. Ag agglomerates in the CrN matrix forming elongated grains 200-400 nm wide and 50-100 nm high, which extends on the top of CrN columns. At the surface Ag aggregates into two different structures: large tetrahedral crystalline clusters, with typical dimension ranging from 200 to 500 nm, and smaller Ag nanoparticles with diameter of 15-25 nm. The annealing in N2 atmosphere up to 500 degrees C does not affect size and distribution of the Ag grains in the sub-surface region, while it induces a size increase of the bigger Ag clusters on the surface, mainly related to Ag surface diffusion and clusters coalescence. Annealing at higher temperature leads to an evident Ag out-of-bulk segregation, generating Ag depleted voids in the near-surface region, and further increasing of the Ag clusters size at the surface. Tribological tests on as deposited CrN-Ag film reveal a coefficient of friction against a steel ball reduced with respect to CrN film, probably related to the presence of Ag which acts as solid lubricant, but the coating is removed after a very short sliding distance. The poor mechanical properties of the realized Ag-based coatings are confirmed by lower hardness and Young modulus values with respect to pure CrN.

11.
J Nanosci Nanotechnol ; 11(10): 9244-50, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22400331

RESUMEN

This experimental work is oriented to give a contribution to the knowledge of the relationship among surface roughness parameters and tribological properties of lubricated surfaces; it is well known that these surface properties are strictly related, but a complete comprehension of such correlations is still far to be reached. For this purpose, a mechanical polishing procedure was optimized in order to induce different, but well controlled, morphologies on Si(100) surfaces. The use of different abrasive papers and slurries enabled the formation of a wide spectrum of topographical irregularities (from the submicro- to the nano-scale) and a broad range of surface profiles. An AFM-based morphological and topographical campaign was carried out to characterize each silicon rough surface through a set of parameters. Samples were subsequently water lubricated and tribologically characterized through ball-on-disk tribometer measurements. Indeed, the wettability of each surface was investigated by measuring the water droplet contact angle, that revealed a hydrophilic character for all the surfaces, even if no clear correlation with roughness emerged. Nevertheless, this observation brings input to the purpose, as it allows to exclude that the differences in surface profile affect lubrication. So it is possible to link the dynamic friction coefficient of rough Si samples exclusively to the opportune set of surface roughness parameters that can exhaustively describe both height amplitude variations (Ra, Rdq) and profile periodicity (Rsk, Rku, Ic) that influence asperity-asperity interactions and hydrodynamic lift in different ways. For this main reason they cannot be treated separately, but with dependent approach through which it was possible to explain even counter intuitive results: the unexpected decreasing of friction coefficient with increasing Ra is justifiable by a more consistent increasing of kurtosis Rku.

12.
Diagn Microbiol Infect Dis ; 100(2): 115347, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33639375

RESUMEN

OBJECTIVE: To evaluate determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection. MATERIALS AND METHODS: Hospitalized patients with SARS-CoV-2 positive nasopharyngeal RT-PCR were included in a single-center, retrospective study. Patients were divided in 2 groups according to the timing of viral clearance [≤14 days, "early clearance (EC)" and >14 days, "late clearance (LC)"]. RESULTS: 179 patients were included in the study (101 EC, 78 LC), with median age 62 years. Median time of viral shedding was 14 days (EC/LC 10 and 19 days, respectively, P < 0.0001). Univariate analyses showed that age, male gender, receiving corticosteroids, receiving tocilizumab, ICU admission, low albumin and NLR ratio were associated with late viral clearance. In the multivariable analysis, older age (P = 0.016), albumin level (P = 0.048), corticosteroids (P = 0.021), and tocilizumab (P = 0.015) were significantly associated with late viral clearance. CONCLUSIONS: Age, albumin, tocilizumab and corticosteroid treatment were independently associated with a prolonged SARS-CoV-2 RNA shedding.


Asunto(s)
COVID-19/virología , ARN Viral/metabolismo , SARS-CoV-2/metabolismo , Esparcimiento de Virus , Anciano , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo
13.
Acta Crystallogr B Struct Sci Cryst Eng Mater ; 76(Pt 6): 1045-1054, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33289716

RESUMEN

This study uses theoretically methods to investigate, for metal diiodides MI2 (M = Mg, Ca, Mn, Fe, Cd, Pb) with CdI2 (2H polytype) structure, the mutual correlation between the structure-characterizing parameters (the flatness parameter of monolayers f, the Madelung constant A, and bonding angle I-M-I) and correlation of these parameters with contributions of the Coulomb and covalent energies to cohesive energy. The energy contributions to cohesive energy are determined with the use of empirical atomic potentials. It is demonstrated that the parameters f and A, and the bonding angle I-M-I are strictly correlated and increase in the same order: FeI2 < PbI2 < MnI2 < CdI2 < MgI2 < CaI2. It is found that with an increase of parameter A and bonding angle I-M-I the relative contribution of the Coulomb energy to cohesive energy increases, whereas the relative contribution of the covalent energy decreases. For a hypothetical MX2 layered compound with the CdI2 (2H polytype) structure, composed of regular MX6 octahedra (angle X-M-X = 90°), the flatness parameter and the Madelung constant are found to be freg = 2.449 and Areg = 2.183, respectively. Correlation of the covalent energy with the type of distortion of MI6 octahedra (elongation or compression) with respect to regular configuration (angle I-M-I = 90°) is also analyzed.

14.
Nanotechnology ; 20(11): 115706, 2009 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-19420454

RESUMEN

Analytical expressions relating the trajectories of spherical nanoparticles pushed by an atomic force microscope tip to the scan pattern of the tip are derived. In the case of a raster scan path, the particles are deflected in a direction defined by the geometries of tip and particles and the spacing b between consecutive scan lines. In the case of a zigzag scan path, the particles are deflected in a range of directions around 90 degrees, also depending on the parameter b. Experimental results on gold nanoparticles manipulated on silicon surfaces in ambient conditions confirm the predictions of our model.

15.
Biochim Biophys Acta ; 1768(10): 2459-65, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17662238

RESUMEN

Photosensitized efficacy of tetrasulfonated phthalocyanines of zinc, aluminum and nickel (ZnPcS(4), AlPcS(4) and NiPcS(4), respectively) as studied by gramicidin channel (gA) photoinactivation was compared with adsorption of the dyes on the surface of a bilayer lipid membrane as measured by the inner field compensation method. The adsorption of the negatively charged phthalocyanines on diphytanoylphosphatidylcholine (DPhPC) membranes led to formation of a negative boundary potential difference between the membrane/water interfaces. Good correlation was shown between the photodynamic activity and the membrane binding of the three metallophthalocyanines. ZnPcS(4) appeared to be the most potent of these photosensitizers, while NiPcS(4) was completely ineffective. All of these phthalocyanines displayed no binding and negligible gA photoinactivation with membranes formed of glycerol monooleate (GMO), whereas Rose Bengal exhibited significant binding and photodynamic efficacy with GMO membranes. Gramicidin photoinactivation in the presence of AlPcS(4), being insensitive to the ionic strength of the bathing solution, was inhibited by fluoride and attenuated by phosphate ions. A blue shift of the fluorescence peak position of ZnPcS(4) dissolved in ethanol was elicited by phosphate, similarly to fluoride, which was indicative of the coordination interaction of these ions with the central metal atom of the phthalocyanine macrocycle. This interaction was enhanced in the medium modeling the water-membrane interface. The results obtained imply that binding of tetrasulfonated metallophthalocyanines to phospholipid membranes is determined primarily by metal-phosphate coordination.


Asunto(s)
Indoles/farmacología , Membrana Dobles de Lípidos/metabolismo , Compuestos Organometálicos/farmacología , Fosfolípidos/metabolismo , Fármacos Fotosensibilizantes/farmacología , Indoles/química , Indoles/metabolismo , Compuestos Organometálicos/química , Compuestos Organometálicos/metabolismo , Fosfolípidos/química , Fármacos Fotosensibilizantes/metabolismo
16.
Sci Rep ; 8(1): 14118, 2018 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-30237521

RESUMEN

Several recent experiments have shown that long-range exchange interactions can determine collective magnetic ground states of nanostructures in bulk and on surfaces. The ability to generate and control entanglement in a system with long-range interaction will be of great importance for future quantum technology. An important step forward to reach this goal is the creation of entangled states for spins of distant magnetic atoms. Herein, the generation of long-distance entanglement between remote spins at large separations in bulk and on surface is studied theoretically, based on a quantum spin Hamiltonian and time-dependent Schrödinger equation for experimentally realized conditions. We demonstrate that long-distance entanglement can be generated between remote spins by using an appropriate quantum spin chain (a quantum mediator), composed by sets of antiferromagnetically coupled spin dimers. Ground state properties and quantum spin dynamics of entangled atoms are studied. We demonstrate that one can increase or suppress entanglement by adding a single spin in the mediator. The obtained result is explained by monogamy property of entanglement distribution inside a quantum spin system. We present a novel approach for non-local sensing of remote magnetic adatoms via spin entanglement.

17.
Lab Anim ; 41(1): 63-70, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17234051

RESUMEN

We compared three methods: arteriovenous anastomosis, doxorubicin administration, and combination of anastomosis and doxorubicin, with the intention of designing a simple, stable model of chronic heart failure. Twelve dogs were divided into three groups of four. One group received carotid-jugular anastomosis (Ana series), another group received anastomosis and doxorubicin injection (A/D series), and the last group received only doxorubicin (Dox series). Animals were followed for eight weeks. Fifteen different haemodynamic parameters were tracked and compared to baseline values. After eight weeks, diastolic pressure in the right atrium increased from 3.8+/-2.0 mmHg at baseline to 5.3+/-5.9 mmHg in the Ana series, to 6.3+/-3.3 mmHg in the Dox series and to 8.0+/-2.0 mmHg in the A/D series (P<0.05 A/D vs. baseline). Systolic pulmonary wedge pressure increased from 11.6+/-2.0 mmHg at baseline to 15.5+/-3.4 mmHg in the Ana series, 14.0+/-3.7 mmHg in the Dox series and 17.3+/-4.2 mmHg in the A/D series (P = NS vs. baseline). Left ventricular ejection fraction decreased from 53.9+/-10% at baseline to 36.1+/-5.6% in the Ana series (P<0.05 vs. baseline), 31.5+/-5.4% in the Dox series (P<0.05 vs. baseline) and 25.8+/-5.8% in the A/D series (P<0.001 vs. baseline, P<0.05 vs. Ana series and Dox series). In conclusion, eight weeks are not enough to produce stable heart failure using arteriovenous anastomosis alone. Doxorubicin administration alone produces a left ventricular failure. However, a combination of both of these interventions provides a more stable model of right-and left-sided heart failure.


Asunto(s)
Modelos Animales de Enfermedad , Perros , Insuficiencia Cardíaca/etiología , Anastomosis Quirúrgica , Animales , Presión Sanguínea , Arterias Carótidas/cirugía , Doxorrubicina/toxicidad , Ecocardiografía , Insuficiencia Cardíaca/inducido químicamente , Insuficiencia Cardíaca/fisiopatología , Venas Yugulares/cirugía , Masculino
18.
Sci Rep ; 7(1): 2759, 2017 06 05.
Artículo en Inglés | MEDLINE | ID: mdl-28584280

RESUMEN

Previous experimental studies discovered universal growth of chains and nanowires of various chemical elements on a corrugated molecular network of Cu3N on the Cu(110). Herein, performing combined ab initio and quantum Hamiltonian studies we demonstrate that such chains can be used for a fast spin switching and entanglement generation by locally applied magnetic pulses. As an example, we show that in antiferromagnetic Co chains a strong entanglement between ends of chains occurs during spin switching. A novel parity effect in spin dynamics is reported. Even-numbered chains are found to exhibit significantly faster spin switching than odd-numbered counterparts. Moreover, at certain parameters of the system the dimerization effect in the spin dynamics of the chains was found. Our studies give a clear evidence that tailoring spin dynamics and entanglement can be achieved by magnetic fields and by tuning exchange interactions in supported chains.

19.
Eur J Surg Oncol ; 32(2): 126-32, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16377120

RESUMEN

PURPOSE: Local recurrence of rectal cancer occurs in a considerable group of patients who have undergone radical treatment for primary tumour. The treatment of choice is surgical resection but the prognosis remains poor, as a negative margin excision is possible in only a small subset of patients. A review of prognostic factors for locally recurrent rectal cancer (LRRC) after surgery is presented. METHODS: We systematically reviewed the literature for reports on prognostic factors after surgical excision of LRRC. These reports were identified through a review of the Medline database from 1982 to 2004. RESULTS: This review highlights the most important prognostic factors for LRRC patients treated with surgery. Data are grouped on the basis of the prognostic factors investigated. CONCLUSIONS: R0 resection seems to be the only reliable prognostic factor; however, symptoms, pre-operative CEA doubling time, performance status and pre-operative radiotherapy can help patient selection before surgery. The results of this review provide the basis for improved outcome, aiming to assess patients who would benefit from reoperation.


Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias del Recto/diagnóstico , Neoplasias del Recto/cirugía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/epidemiología , Pronóstico , Neoplasias del Recto/epidemiología , Factores de Riesgo
20.
Surg Endosc ; 20(8): 1203-7, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16703429

RESUMEN

BACKGROUND: Neoadjuvant therapies have significantly improved local control and survival of patients with rectal cancer. Nevertheless, although a complete pathologic response can be achieved in 30% of cases, a transabdominal surgical resection is always required. This study aimed, for the first time, to test in the literature the feasibility of local excision combined with transanal endoscopic microsurgery (TEM) as a surgical option for patients treated with neoadjuvant chemoradiation. METHODS: Between July 1997 and December 2002, 30 patients with rectal cancer affected by an extraperitoneal tumor entered a protocol consisting of neoadjuvant chemoradiation followed by surgery. The surgical treatment, consisting of open surgery, local excision, or TEM, was planned according to the patient's clinical response after chemoradiation and distance from the anal verge. RESULTS: A significant clinical downstaging was observed in eight patients. Five of these patients underwent TEM, and three had local excision. Consequently, open surgery was performed for 22 patients. Histology showed six cases of complete pathologic response: three in the open surgery group and three in the transanal excision group. After a mean follow-up period of 47 months, the disease-free survival rate was 77% in the open surgery group and 100% in TEM or local excision group. CONCLUSIONS: The findings suggest the complementary feasibility of TEM and local excision after neoadjuvant chemoradiation. However, randomized trials are needed to confirm the oncologic safety of this approach.


Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo , Microcirugia , Terapia Neoadyuvante , Cuidados Preoperatorios , Proctoscopía , Neoplasias del Recto/cirugía , Anciano , Canal Anal , Quimioterapia Adyuvante , Estudios de Factibilidad , Femenino , Humanos , Masculino , Microcirugia/métodos , Persona de Mediana Edad , Estadificación de Neoplasias , Proctoscopía/métodos , Radioterapia Adyuvante , Neoplasias del Recto/tratamiento farmacológico , Neoplasias del Recto/patología , Neoplasias del Recto/radioterapia , Análisis de Supervivencia , Resultado del Tratamiento
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