RESUMO
This study assessed the accuracy of preoperative staging in patients undergoing oncological esophagectomy for adenocarcinoma and squamous cell carcinoma. All patients undergoing surgery for resectable esophageal cancer in a university hospital from 2005 to 2016 were identified from our institutional database. Patients with neoadjuvant treatment were excluded to avoid bias from down-staging effects. Routinely, all patients had an upper endoscopy with biopsy, a thoracoabdominal CT scan, an 18-FEG PET-CT, and endoscopic ultrasound. Preoperative staging was compared to histopathological staging of surgical specimen that was considered as gold standard. There were 51 patients with a median age of 65 years (IQR: 59.3-73 years) having 21 squamous cell carcinoma and 30 adenocarcinoma, respectively. T- and N-stages were correctly predicted in 26 (51%) and 37 patients (72%), respectively. Overall, 18 patients (35%) were preoperatively diagnosed with a correct T- and N-stage. There was no difference between adenocarcinoma and squamous cell carcinoma. Accuracy of the T-stage was not influenced by the smoking status. The N-stage was not correct in 7/22 smoking patients (32%) and 6/29 nonsmoking patients (21%).The N-stage was underestimated in smoking patients as 6/22 patients (27%) had a histologically confirmed N+ who were preoperatively classified as N0. In conclusion, only 35% of patients had a correct assessment. Separate T- and N-stage prediction was improved with 51% and 72%, respectively. Major efforts are needed for improvement.
Assuntos
Adenocarcinoma/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Estadiamento de Neoplasias/estatística & dados numéricos , Cuidados Pré-Operatórios/métodos , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Biópsia/métodos , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/cirurgia , Endossonografia/métodos , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago , Esofagectomia , Esôfago/diagnóstico por imagem , Esôfago/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodosRESUMO
In vitro experiments on the reduction of the solubility of human dentine in decinormal lactic acid have shown that, under the experimental conditions chosen, disodium beta-glycerophosphate was less efficient than sodium fluoride alone or in combination with ammonium metavanadate and/or ammonium molybdate.
Assuntos
Cárie Dentária/prevenção & controle , Dentina/efeitos dos fármacos , Glicerofosfatos/farmacologia , Solubilidade da Dentina/efeitos dos fármacos , Fluoretos/farmacologia , Humanos , Técnicas In Vitro , Lactatos , Molibdênio/farmacologia , Vanádio/farmacologiaRESUMO
In vitro experiments have shown that the solubility of human enamel in decinormal solutions of malic, lactic, tartaric and citric acid was in most cases reduced by treatment with a 2.5% aqueous solution of disodium beta-glycerophosphate.