RESUMO
Men who receive bone-targeted therapy for metastatic prostate cancer are at increased risk of osteonecrosis of the jaw (ONJ). Development of ONJ has been associated with the administration of bone-targeted therapies in association with other risk factors. ONJ can be distressing for a patient because it can cause pain, risk of jaw fracture, body image disturbance, difficultly eating, and difficulty maintaining good oral hygiene. The aim of this article is to report results of an audit of prior assessment by oral and maxillofacial surgeons (OMFS) before initiation of bone-targeted therapies and whether it may reduce the risk of ONJ in patients receiving bone-targeted therapies for advanced cancers.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/epidemiologia , Conservadores da Densidade Óssea/efeitos adversos , Neoplasias Ósseas/tratamento farmacológico , Neoplasias da Mama/patologia , Padrões de Prática em Enfermagem , Neoplasias da Próstata/patologia , Encaminhamento e Consulta , Doenças Estomatognáticas/diagnóstico , Cirurgia Bucal , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Neoplasias Ósseas/secundário , Auditoria Clínica , Denosumab/efeitos adversos , Difosfonatos/efeitos adversos , Feminino , Humanos , Imidazóis/efeitos adversos , Doenças Maxilomandibulares/induzido quimicamente , Doenças Maxilomandibulares/epidemiologia , Neoplasias Pulmonares/patologia , Masculino , Osteonecrose/induzido quimicamente , Osteonecrose/epidemiologia , Neoplasias Retais/patologia , Estudos Retrospectivos , Medição de Risco , Doenças Estomatognáticas/terapia , Extração Dentária , Ácido ZoledrônicoRESUMO
Perineal radical prostatectomy (PRP) is one of the oldest surgical procedures for prostate cancer, but its use has declined over the past 30 years. New studies show that PRP is not only minimally invasive but beneficial from an economic perspective and should not yet be abandoned in the treatment of early prostate cancer.
Assuntos
Períneo/cirurgia , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Humanos , Masculino , Prostatectomia/economia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/economiaAssuntos
Carcinoma in Situ/patologia , Carcinoma in Situ/terapia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Adulto , Quimioterapia Adjuvante , Estudos de Coortes , Terapia Combinada , Seguimentos , Humanos , Masculino , Estadiamento de Neoplasias , Observação , Orquiectomia/métodos , Radioterapia Adjuvante , Medição de Risco , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
PURPOSE: We evaluated the role of magnetic resonance imaging (MRI) in patients with renal cancer and inferior vena caval involvement with reference to its ability to characterize the extent and nature of inferior vena caval tumor extension and wall invasion. MATERIALS AND METHODS: The study included 12 consecutive patients with renal cancer and inferior vena caval involvement. All patients underwent imaging on a 1.5 Tesla MRI unit. Coronal, axial T1 and axial T2-weighted images were performed in all cases, while in 6 3-dimensional gadolinium enhanced magnetic resonance angiography and venography were also performed. Images were assessed for the extent and nature of tumor extension, that is tumor versus thrombus, and invasion of the inferior vena caval wall. Imaging results were compared with operative findings. RESULTS: On MRI the extent and nature of the inferior vena caval tumor was correctly defined in all cases. The sensitivity, specificity and accuracy of inferior vena caval wall invasion were 100%, 89% and 92%, respectively. CONCLUSIONS: In patients with renal cancer and inferior vena caval involvement MRI defines the tumor level in the inferior vena cava. It is also a sensitive technique for detecting vessel wall invasion and provides important preoperative information for surgical planning.