Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 8 de 8
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Anticancer Res ; 41(10): 5097-5106, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593460

RESUMO

AIM: D3 lymph node dissection (LND) for stage II and III colon cancer has been shown to improve prognosis, however, it generally increases surgical stress. Studies have reported that the C-reactive protein/albumin ratio (CAR) may be a useful inflammatory-nutritional biomarker to predict postoperative complications and poor prognosis for with various types of cancer. Our purposes were to assess the short- and long-term outcomes of D3 LND in patients with a high preoperative CAR (≥ 0.04). PATIENTS AND METHODS: This was a retrospective cohort analysis reviewing a prospectively collected database of Yokohama City University and three affiliated hospitals. A total of 449 patients with stage II or III colon cancer with high CAR who underwent primary resection with D2 or D3 LND were identified between 2008 and 2020. The primary and secondary outcomes of interests were the 3-year recurrence-free survival and postoperative complication rates. RESULTS: After propensity matching, 230 patients were evaluated. There was no significant difference between the D3 and D2 groups in the rate of postoperative complications overall (14.8% versus 11.3%, p=0.558), however, the incidence of anastomotic leakage tended to be greater in the D3 group (9.6% versus 2.6%, p=0.050). The long-term findings showed that there was no significant difference between the two groups (3-year recurrence-free survival rate: 77.2% versus 77.2%, p=0.880). CONCLUSION: D3 LND did not improve survival outcomes for patients with colon cancer with a poor CAR in this study. D2 LND may be a treatment option for patients with stage II-III colon cancer with a high preoperative CAR.


Assuntos
Albuminas/metabolismo , Biomarcadores Tumorais/metabolismo , Proteína C-Reativa/metabolismo , Neoplasias do Colo/mortalidade , Excisão de Linfonodo/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/metabolismo , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Pontuação de Propensão , Estudos Prospectivos , Estudos Retrospectivos , Taxa de Sobrevida
2.
Anticancer Res ; 40(7): 4067-4074, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620654

RESUMO

BACKGROUND: The aim of this study was to evaluate the impact of postoperative infectious complications on long-term outcomes after curative resection of gastric cancer. PATIENTS AND METHODS: Patients who underwent curative gastrectomy with lymphadenectomy for gastric cancer at Yokohama City University and Kanagawa Cancer Center from January 2000 to August 2015 were retrospectively selected from medical records. Clinicopathological factors between patients with and without infectious complications were compared. Prognostic factors of long-term survival were analyzed by univariate and multivariate Cox proportional hazards analyses. RESULTS: A total of 2,254 patients were eligible for inclusion in the present study. Fifty-eight patients had postoperative infectious complications (IC group); 2,196 had no postoperative infectious complications (NC group). In the IC group, the median age (p=0.031), body mass index (p=0.004), American Society of Anesthesiologists physical status (p=0.006) and percentage of male patients (p<0.001) were higher in comparison to the NC group. The operation time was longer (p<0.001) and the incidence of intestinal-type histology was higher (p=0.017) in the IC group. The 5-year overall survival rates of the IC and NC groups were 59.8% and 83.2%, respectively (p<0.001). Univariate and multivariate analyses demonstrated that postoperative infectious complications were a significant risk factor for poorer overall survival (hazard ratio=2.38; 95% confidence interval=1.47-3.85, p<0.001). CONCLUSION: Perioperative management is necessary to reduce the incidence of postoperative infectious complications and improve the survival of patients after curative resection of gastric cancer.


Assuntos
Adenocarcinoma/cirurgia , Infecções/etiologia , Complicações Pós-Operatórias , Neoplasias Gástricas/cirurgia , Adenocarcinoma/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastrectomia , Humanos , Infecções/mortalidade , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias Gástricas/mortalidade , Análise de Sobrevida , Adulto Jovem
3.
Gan To Kagaku Ryoho ; 47(13): 1930-1932, 2020 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-33468756

RESUMO

A 68-year-old woman had undergone laparoscopic high anterior resection for rectal cancer. Two years postoperatively, metachronal pulmonary metastases and cerebellar metastasis were surgically resected. Three and a half years after the primary surgery, computed tomography(CT)demonstrated a nodule at the pancreatic tail. Under suspected primary pancreatic cancer or metastasis from rectal cancer, we performed distal pancreatectomy. Histological examination of the pancreatic tumor suggested a metastasis from the rectal cancer since tumor cells were negative for CK7 and positive for CK20 and CDX2 immunohistochemically. Three months after the pancreatic resection, CT demonstrated hepatic and cerebellar metastases. After subsequent chemotherapy, liver metastasis disappeared. The cerebellar metastasis shrank with radiotherapy.


Assuntos
Neoplasias Hepáticas , Neoplasias Pulmonares , Neoplasias Pancreáticas , Neoplasias Retais , Idoso , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/cirurgia , Pancreatectomia , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Neoplasias Retais/cirurgia
4.
Gan To Kagaku Ryoho ; 47(13): 2373-2375, 2020 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-33468965

RESUMO

A 76-year-old man with a past history of liver transplantation because of liver cirrhosis visited a hospital in October 2018 because of vomiting and abdominal pain. Although the patient underwent conservative medical treatment, no improvement of the symptoms was observed, and he received consultation at our hospital. After thorough examination, and because of the policy of inpatient treatment after the diagnosis of adhesion ileus obstruction post liver transplantation surgery, intestinal decompression was performed using an ileus tube. However, there was no improvement in the symptoms even after inserting the ileus tube, and intestinal obstruction was diagnosed in November 2018. During the preoperative examination, a tumorous shadow was found in the right lung, although it became a policy of scrutiny after improvement of the bowel obstruction. During the laparotomy, a macroscopic tumor exposed on the serosal surface was observed on the anal side at 120 cm from the Treitz ligament, and this site was considered to be the blocking origin. Partial resection of the small intestine including the blockage site was performed. The pathological result revealed the diagnosis of adenosquamous carcinoma. Furthermore, immunostaining was CK7 positive, CK20 negative, TTF-1 negative, and Napsin negative, suggesting the possibility of a metastatic tumor derived from lung cancer. The postoperative course was uneventful, and the patient was discharged on postoperative day 9. On day 30 after surgery, the left pleural effusion increased and pleural effusion cytology revealed a diagnosis of primary lung adenocarcinoma Stage Ⅳ. Considering the patient's PS, it became a best supportive care(BSC)policy after consultation with the family, and it ended on postoperative day 70. Here, we report about a case diagnosed with metastatic small bowel cancer and intestinal obstruction and conduct a literature review.


Assuntos
Neoplasias do Íleo , Íleus , Neoplasias Intestinais , Obstrução Intestinal , Neoplasias do Jejuno , Idoso , Humanos , Íleus/etiologia , Íleus/cirurgia , Neoplasias Intestinais/complicações , Neoplasias Intestinais/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Masculino
5.
Gan To Kagaku Ryoho ; 46(10): 1632-1634, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31631158

RESUMO

We report a case of altered consciousness related to hyperammonemia due to FOLFIRI plus bevacizumab therapy in a patient with recurrent colorectal cancer and renal dysfunction.A 76-year-old man received third-line chemotherapy for left mediastinal lymph node metastasis.He complained of diarrhea on the evening of the same day, and mental confusion on day 3 of the first FOLFIRI therapy.He had a JCS of Ⅲ(200).The laboratory results revealed a marked hyperammonemia.5 - fluorouracil(5-FU)-induced hyperammonemia was diagnosed and the patient was ventilated and managed with branchedchain amino acid solutions, lactulose, and hemodialysis in the ICU.After hemodialysis, the blood ammonia level reduced to the normal limits, and the symptoms of encephalopathy resolved on the following day.He was discharged home on the 19th day of hospitalization.5 -FU-containing therapy should be carefully administered in patients with renal dysfunction.Herein, we report a case of 5-FU-induced hyperammonemia with literature considerations.


Assuntos
Neoplasias Colorretais , Fluoruracila/efeitos adversos , Hiperamonemia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Camptotecina , Estado de Consciência , Humanos , Hiperamonemia/induzido quimicamente , Leucovorina , Masculino , Recidiva Local de Neoplasia
6.
Gan To Kagaku Ryoho ; 46(10): 1650-1652, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31631164

RESUMO

A 77-year-old woman was taking anticoagulant medication for pulmonary hypertension. Black stools were noted in August 2018. Close abdominal ultrasonography revealed a broad-based tumor at the base of the gallbladder. Lower endoscopy showed no obvious digestive tract hemorrhage but hemorrhage from a gallbladder tumor was suspected. The resected procedure was suspected for gallbladder cancer(cT2N0M0, cStageⅡ), but dizziness 5 days before operation. The patient complained of severe anemia, and underwent laparoscopic cholecystectomy for hemorrhage control. In the macroscopic examination of the specimens, tumorous lesions and blood clots were found adhered to the bottom of the gallbladder. The histopathological diagnosis was papillary adenocarcinoma.


Assuntos
Adenocarcinoma Papilar , Colecistectomia Laparoscópica , Neoplasias da Vesícula Biliar , Hemorragia/cirurgia , Adenocarcinoma Papilar/complicações , Adenocarcinoma Papilar/cirurgia , Idoso , Feminino , Neoplasias da Vesícula Biliar/complicações , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Ultrassonografia
7.
Gan To Kagaku Ryoho ; 46(10): 1662-1664, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31631168

RESUMO

This case involved a 42-year-old woman who had no remarkable findings in terms of case history and family history. Upper gastrointestinal series performed during a medical examination revealed ulcerative lesions in the anterior wall of the stomach body. Upper gastrointestinal endoscopy was performed, and a submucosal tumor with a maximum diameter of 50mm accompanied by an ulcerative lesion was found in the anterior wall of the lower part of the stomach. She was diagnosed with a schwannoma based on endoscopic ultrasonography-guided fine needle aspiration, and we received consultation for surgical purpose. Surgery was performed with laparoscopic partial resection of the stomach and lymph nodes in the lesser curvature of the stomach. She was discharged on the 7th day after the surgery. The postoperative pathologic findings showed no nuclear fissure or atypia with a diagnosis of a schwannoma and no lymph node metastasis. Gastric schwannoma is a rare disease that arises from Schwann cells of the Auerbach's plexus of the gastric wall muscularis and comprises 0.1-0.2% of all stomach tumors. Preoperative diagnosis is often extremely difficult, and there are reports of malignancy. Treatments and surgical methods should be carefully considered. Herein, we encountered a case of a resected giant gastric schwannoma by laparoscopic surgery, which is reported with a literature review.


Assuntos
Laparoscopia , Neurilemoma , Neoplasias Gástricas , Adulto , Endoscopia do Sistema Digestório , Feminino , Humanos , Neurilemoma/cirurgia , Neoplasias Gástricas/cirurgia
8.
Anticancer Res ; 39(5): 2671-2678, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31092467

RESUMO

BACKGROUND/AIM: Postoperative pneumonia after esophageal cancer can lead to additional pain, prolonged hospital stay, and respiratory failure. These adverse events might lead to early recurrence and/or death. We investigated the influence of postoperative pneumonia on the esophageal cancer survival and recurrence after curative surgery. PATIENTS AND METHODS: This study included 122 patients who underwent curative surgery for esophageal cancer between 2008 and 2018. The patients were classified into: i) those with postoperative pneumonia (pneumonia group) and ii) those without postoperative pneumonia (non-pneumonia group). The risk factors for the overall survival (OS) and recurrence-free survival (RFS) were identified. The rate of postoperative pneumonia was measured by the revised Uniform Pneumonia Score. RESULTS: Postoperative complications were found in 34 of the 122 patients (27.9%). The OS rate at 5 years following surgery was 28.2% in the pneumonia group and 55.1% in the non-pneumonia group (p=0.006). The RFS rate at 5 years after surgery was 18.9% in the pneumonia group and 49.2% in the non-pneumonia group (p=0.061). A multivariate analysis showed that postoperative pneumonia was a significant independent risk factor for OS. CONCLUSION: The development of postoperative pneumonia was a risk factor for a decreased overall survival in patients who underwent curative surgery for esophageal cancer. The surgical procedure, perioperative care and surgical strategy should be carefully planned in order to avoid postoperative pneumonia.


Assuntos
Neoplasias Esofágicas/epidemiologia , Recidiva Local de Neoplasia/epidemiologia , Pneumonia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Sobreviventes de Câncer , Intervalo Livre de Doença , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Pneumonia/etiologia , Pneumonia/patologia , Pneumonia/cirurgia , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/cirurgia , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...