Hyperthermia in the treatment of recurrent abdominal desmoid tumor.

The most suitable management of recurrent abdominal desmoid tumor is still unclear. A case of recurrent huge abdominal desmoid tumor successfully treated by hyperthermia therapy is described. A 63-year-old man was operated upon for desmoid tumor in the retroperitoneum involving pancreas, posterior wall of the stomach and transverse mesocolon in 2007. In 2008, the tumor recurred and could not be resected because of the patient refused the operation. Several therapies using tamoxifen, anastrozole, imatinib mesylate and radiotherapy were all ineffective. The tumor grew bigger and bigger during a treatment period. Finally, hyperthermia treatment was applied to the tumor. The size of the recurrent desmoid tumor reduced 75% by hyperthermia treatment for 46-month. Base on this experience, we recommend hyperthermia as the treatment for patients with recurrent abdominal desmoid tumor that several therapeutic strategies did not achieve a remarkable response.

Effect of preoperative immunonutrition in patients undergoing hepatectomy; a randomized controlled trial.

No consensus has been reached concerning the effects of preoperative immunonutrition in patients undergoing hepatectomy. We evaluated the effects of immunonutrition before hepatectomy on perioperative management. This study was performed as a randomized controlled trial. Patients expected to undergo segmentectomy or more extensive hepatectomy for liver tumors were randomized to immunonutrition (IM) and control (C) groups each consisting of 13 patients. The IM group was given 750 ml of IMPACT in addition to half-size hospital meals orally from 5 days before to the day before surgery, and the C group was given conventional hospital meals. The blood level of eicosapentaenoic acid was elevated preoperatively in all patients of the IM group. The white blood cell count and interleukin 6 levels, which are indices of postoperative inflammation, were significantly lower in the IM group. As regards liver function, postoperative increases in the aspartate aminotransferase and alanine aminotransaminase levels were slightly suppressed in the IM group. No significant difference was noted in postoperative complications or duration of postoperative hospital stay. In patients undergoing hepatectomy, preoperative immunonutrition reduced inflammation and protected against liver dysfunction.