Comparison of greater curvature and lesser curvature circular-stapled esophagogastrostomy after esophagectomy in patients with esophageal cancer: a prospective randomized controlled trial.

PURPOSE: Using a circular stapler to create an anastomosis for esophagogastrostomy after esophagectomy is well accepted; however, it remains uncertain if the greater curvature (GC) or lesser curvature (LC) of the gastric conduit is better for the anastomosis. We conducted this prospective study to compare the integrity of esophagogastrostomy between the esophagus and the GC or LC side of the gastric conduit. METHODS: The subjects of this study were 70 patients who underwent esophagectomy and were randomized to a "GC" group and an "LC" group (n = 35 each). The primary and secondary end points were anastomotic leakage (AL) and anastomotic stricture (AS), respectively. RESULTS: The overall AL rate was 22.1%, without a significant difference between the groups. Stump leakage developed in eight of nine patients in the GC group, whereas leakage developed at the esophagogastric anastomosis in five of six patients in the LC group. The rate of stump leakage was significantly higher than that of esophagogastric AL in the GC group. The overall AS rate was 4.4%, with a significant difference between the groups (0% in the GC group vs. 9.1% in the LC group). CONCLUSIONS: AL rates were comparable in the two groups, but the sites of leakage were significantly different.

Clinical Significance of the Histoculture Drug Response Assay in Breast Cancer.

BACKGROUND/AIM: Despite the fact that breast cancer patients are generally administered systemic chemotherapy after surgical treatment, predictive factors that allow optimization of chemotherapy are needed. The histoculture drug response assay (HDRA) is a clinically practical in vitro drug-response assay for identifying optimal anticancer agents. PATIENTS AND METHODS: Thirty-eight primary breast cancer patients who underwent surgical treatment without receiving systemic neoadjuvant therapy were analyzed. We retrospectively examined the relationships between clinicopathological factors and the HDRA results of 5 anticancer agents (mitomycin C (MMC), 5-fluorouracil (5-FU), doxorubicin hydrochloride (ADM), cisplatin (CDDP) and paclitaxel (PTX)). RESULTS: The relationships between the inhibition rates of anticancer drugs and clinicopathological factors were not significant, except for nuclear grade and venous invasion with the inhibition rate of 5-FU. We also established the threshold inhibition rate for PTX. The paclitaxel inhibition rate was significantly associated with disease-free survival (DFS). CONCLUSION: HDRA results were independent from the clinicopathological factors of breast cancer patients demonstrating that individualized treatment is needed.