ABSTRACT
BACKGROUND AND OBJECTIVES: Recent studies have suggested that sidedness of origin from colorectal adenocarcinomas is a predictor of survival, however the impact of this factor in patients with resected colon cancer liver metastases (CLM) is not clear. So, in this study, we compared clinic and pathologic characteristics and long-term survival of patients with resected CLM according to the primary tumor location. METHODS: This is a retrospective analyzes of a prospective database. Patients with resected CLM from 1998 to 2012 were included. Right colon included tumors from cecum to middle transverse colon, and left colon included tumors from splenic flexure to sigmoid. RESULTS: One hundred fifty-one patients were included, 27 right colon and 124 left colon. In the latter group, there were more patients with synchronous disease (67.7 × 6.2%, P = 0.026) and a higher CEA (22.0 × 11.7 ng/mL, P = 0.001). However, K-Ras mutation was more frequent in right sided tumors (75.0 × 24.1%, P = 0.001). There was no difference in long term survival in both groups in this series even when adjusted for the confounding variables. CONCLUSION: Sidedness do not seem to be a predictor of long term survival in patients with resected colon cancer liver metastases.
Subject(s)
Colorectal Neoplasms/mortality , Liver Neoplasms/mortality , Neoplasm Recurrence, Local/mortality , Adult , Aged , Aged, 80 and over , Colorectal Neoplasms/pathology , Colorectal Neoplasms/surgery , Female , Follow-Up Studies , Hepatectomy , Humans , Liver Neoplasms/secondary , Liver Neoplasms/surgery , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Prognosis , Prospective Studies , Retrospective Studies , Survival Rate , Young AdultABSTRACT
Background: Mutations in KRAS are negative predictors of the response to anti-EGFR therapies in the treatment of metastatic colorectal cancer. Yet, the ideal tissue to test for KRAS mutation-primary or metastatic-remains unknown, as is the validity of testing only 1 area of the primary tumor. The aim of this study was to determine the heterogeneity of KRAS mutational status between areas of the primary lesion and between paired primary CRC and the corresponding lymph node (LN), liver, and lung metastasis with a high-sensitivity sequencing method. Design: DNA from 2 or 3 areas from the primary tumor and 1 area of metastatic tissue was obtained from formalin-fixed paraffin-embedded specimens from 102 metastatic CRC patients. Mutations in KRAS codons 12, 13, and 61 were analyzed by pyrosequencing. RESULTS: Ninety-one cases had DNA extracted from more than 1 area of the primary tumor. Only 1 patient showed intratumor heterogeneity, which involved KRAS mutation type, not KRAS mutational status. We examined KRAS mutations in 97 primaries and matched metastatic samples, recording 2 discordant cases, representing 2.1% of our cohort of matched samples. Conclusion:KRAS status is highly homogeneous throughout primary CRC tumor areas and consistent between the primary tumor and metastatic tissue in the same patient. Our data suggest that testing KRAS mutations in only 1 area of the primary or metastatic tissue is suitable for predicting the response to anti-EGFR treatment and guiding clinical decisions.
ABSTRACT
INTRODUCTION: Direct carotid-cavernous fistula (CCF) is a direct communication between the internal carotid artery (ICA) and the cavernous sinus. Some patients treated with detachable balloons develop pseudoaneurysms or present with a true aneurysm recanalization in the cavernous ICA with poorly known long-term radiological and clinical progression. The objective of the present study was to evaluate the long-term clinical and radiological progression of patients treated with detachable balloons. METHODS: The present study evaluated 13 patients previously treated for direct CCF by an endovascular approach. RESULTS: The follow-up period ranged between 19 and 128 months. Ophthalmological evaluation demonstrated alterations in eight patients (61.5%). All of these alterations were already present from the moment of the treatment and displayed no signs of progression. Cranial magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were performed in all patients, and 11 pseudoaneurysms were demonstrated in ten of the 11 patients in whom ICA patency had been preserved. Five patients were submitted for cerebral digital subtraction angiography (DSA) to characterize the pseudoaneurysms previously observed on MRA studies, with no significant differences in morphology, size, aneurismal neck, and number of lesions. CONCLUSION: Endovascular treatment of direct CCF with detachable balloons has been shown to be a long-term effective and stable therapeutic method. The authors found asymptomatic pseudoaneurysms in 91% of cases where the ICA patency was preserved. MRI and MRA demonstrated an accuracy similar to that of DSA in the diagnosis of pseudoaneurysms of cavernous ICA.
Subject(s)
Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/therapy , Balloon Occlusion/methods , Carotid Arteries/abnormalities , Carotid Arteries/pathology , Cavernous Sinus/abnormalities , Cavernous Sinus/pathology , Magnetic Resonance Angiography , Adult , Female , Humans , Male , Middle Aged , Treatment Outcome , Young AdultABSTRACT
The goal of this work was to evaluate the effects of the pesticides abamectin, carbaryl, fenitrothion, methidathion, sulphur and trichlorfon on eggs of two Chrysoperla externa (Hagen) populations, as well as on the subsequent developmental stages and reproduction capacity of this green lacewing. Pesticide exposure and distilled water (control) were accomplished using a Potter's tower. None of the evaluated pesticides affected the egg viability of the C. externa populations studied, but abamectin and carbaryl caused significant mortality of other developmental stages of the predator. Sex ratio and reproduction capacity of females originated from treated eggs were unaffected. However, egg viability of C. externa from Bento Gonçalves, RS, Brazil, was reduced by sulphur. Considering to the total effect (E) of each pesticide, trichlorfon, fenitrothion, methidathion and abamectin were harmless to both C. externa populations (Bento Gonçalves and Vacaria), when applied on eggs, whereas carbaryl was slightly harmful. On the other hand, the fungicide sulphur was slightly harmful to C. externa from Bento Gonçalves, but harmless to those from Vacaria.
Subject(s)
Insect Control , Insecta , Malus , Pesticides/toxicity , Animals , Malus/parasitology , Ovum/drug effects , Time FactorsABSTRACT
Os efeitos dos pesticidas abamectim, carbaril, fenitrotiom, metidatiom, enxofre e triclorfom foram avaliados sobre a fase de ovo de duas populações de Chrysoperla externa (Hagen), bem como sobre as fases subsequentes do desenvolvimento e reprodução do predador. A pulverização dos pesticidas e de água destilada (testemunha) sobre ovos de C. externa foi realizada por meio de torre de Potter. Nenhum dos pesticidas avaliados reduziu a viabilidade de ovos tratados, independente da população de C. externa estudada. Para as demais fases de desenvolvimento, apenas carbaril causou mortalidade acumulada significativa de ambas as populações quando em comparação aos demais pesticidas. A razão sexual dos adultos obtidos não foi afetada por nenhum dos compostos. Nenhum dos pesticidas afetou negativamente a capacidade de oviposição de fêmeas de C. externa oriundas de ovos tratados. No entanto, enxofre reduziu a viabilidade de ovos depositados por fêmeas da população de Bento Gonçalves. Considerando-se o efeito total (E) de cada pesticida, triclorfom, fenitrotiom, metidatiom e abamectim foram inócuos a ambas as populações de C. externa quando aplicados sobre seus ovos, enquanto carbaril foi considerado levemente prejudicial; o fungicida enxofre, por outro lado, foi considerado levemente prejudicial à população de Bento Gonçalves, e inócuo aos insetos da população de Vacaria.
The goal of this work was to evaluate the effects of the pesticides abamectin, carbaryl, fenitrothion, methidathion, sulphur and trichlorfon on eggs of two Chrysoperla externa (Hagen) populations, as well as on the subsequent developmental stages and reproduction capacity of this green lacewing. Pesticide exposure and distilled water (control) were accomplished using a Potter's tower. None of the evaluated pesticides affected the egg viability of the C. externa populations studied, but abamectin and carbaryl caused significant mortality of other developmental stages of the predator. Sex ratio and reproduction capacity of females originated from treated eggs were unaffected. However, egg viability of C. externa from Bento Gonçalves, RS, Brazil, was reduced by sulphur. Considering to the total effect (E) of each pesticide, trichlorfon, fenitrothion, methidathion and abamectin were harmless to both C. externa populations (Bento Gonçalves and Vacaria), when applied on eggs, whereas carbaryl was slightly harmful. On the other hand, the fungicide sulphur was slightly harmful to C. externa from Bento Gonçalves, but harmless to those from Vacaria.
