Subject(s)
Hypoglycemia , Insulin Antagonists , Insulin , Insulinoma , Pancreatic Neoplasms , Humans , Antibodies/immunology , Hypoglycemia/etiology , Hypoglycemia/therapy , Insulinoma/complications , Insulinoma/immunology , Insulinoma/therapy , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/immunology , Pancreatic Neoplasms/therapy , Insulin/immunology , Insulin Antagonists/immunology , Insulin Antagonists/therapeutic useABSTRACT
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is effective in select patients with peritoneal metastases of colorectal (CRC) origin. The impact of different biomarkers in predicting recurrence after CRS/HIPEC is unclear. METHODS: Retrospective review of patients who underwent CRS/HIPEC for PC of CRC origin from 03/2007-08/2017. Molecular profile of the primary tumor was obtained from pathology reports, whenever available. RESULTS: Overall, 100 patients underwent CRS/HIPEC for peritoneal metastases of CRC origin. Most patients presented high grade tumor histology (G2/G3, n = 97, 97%), and a majority showed mucinous features (n = 61, 61%). At a median follow-up of 18 months, median DFS for the overall population was 13 months (95% CI 9.6, 16.4). Data reporting at least one mutational analysis was available in 64 patients. Microsatellite stability was detected in 42/50 (84%) patients, mKRAS in 25/51 (49%), and mBRAF in 5/35 (14.3%). On Kaplan-Meier analysis, BRAF was the only mutation associated with poor DFS (16 months, CI 95% 11.7-43.3 vs. 7 months, CI 95% 2.1-11.9, p = .008). On multivariate analysis, mBRAF independently predicted earlier recurrence (p = .032). CONCLUSIONS: In this analysis, mBRAF was independently associated with earlier recurrence in patients undergoing CRS/HIPEC for CRC, leading to dismal median DFS (7 months). Strict patient selection is advisable in these patients.
Subject(s)
Colorectal Neoplasms , Hyperthermia, Induced , Peritoneal Neoplasms , Biomarkers , Chemotherapy, Cancer, Regional Perfusion , Colorectal Neoplasms/therapy , Combined Modality Therapy , Cytoreduction Surgical Procedures , Humans , Hyperthermic Intraperitoneal Chemotherapy , Neoplasm Recurrence, Local , Patient Selection , Peritoneal Neoplasms/drug therapy , Retrospective Studies , Survival RateSubject(s)
Candidiasis/drug therapy , Esophageal Neoplasms/pathology , HIV Infections/drug therapy , Neoplasm Regression, Spontaneous , Papilloma/pathology , Anti-HIV Agents/therapeutic use , Antifungal Agents/therapeutic use , Candidiasis/complications , Esophageal Diseases/complications , Esophageal Diseases/drug therapy , Esophageal Neoplasms/complications , Fluconazole/therapeutic use , HIV Infections/complications , Humans , Male , Middle Aged , Papilloma/complicationsABSTRACT
Kaposi sarcoma (KS) is a pathological endothelial growth associated with human herpes virus-8 which primarily affects the skin. In HIV-negative men who have sex with men, the clinical presentation of KS resembles the classic form limited to cutaneous or multifocal disease. In this report, we present a unique case of a healthy 61-year-old man who has sex with men with an isolated gastrointestinal KS who does not meet criteria for any of the typical KS clinical variants. Proper follow-up and regular HIV screenings are needed to evaluate the potential progression course of the disease in these patients.