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1.
Anticancer Res ; 40(2): 1087-1093, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014958

RESUMO

BACKGROUND: The short- and long-term outcomes of esophagectomy for esophageal cancer were fully evaluated in patients older than 75 years of age. PATIENTS AND METHODS: The present study selected patients who received esophagectomy for esophageal cancer. Patients were divided into non-elderly patients [age <75 years (non-elderly group)] and elderly patients [age ≥75 years (elderly group)]. The postoperative surgical morbidity, postoperative 30-days mortality, recurrence-free survival (RFS), and overall survival (OS) rates were evaluated between the non-elderly group and elderly group. RESULTS: One hundred twenty-two patients were evaluated in this study. Ninety-eight patients and 24 patients were classified into the non-elderly group and elderly group, respectively. The postoperative surgical complication rates in the non-elderly and elderly groups were 71.4% and 75.0%. There was not a statistically significant difference between the two groups (p=0.710). Mortality was observed in 1 patient in the elderly group (4.2%) due to cardiovascular disease. Significant differences were observed in the five-year OS and RFS rates of the elderly and non-elderly groups (55.4% vs. 29.7%, p=0.0017 and 42.2% vs. 21.2%, p=0.0334, respectively). CONCLUSION: Although the rate of postoperative surgical complications after esophagectomy for esophageal cancer was almost equal in the elderly and the non-elderly patients, significant differences were observed in the mortality and long-term outcomes of the two groups. Thus, the surgical strategy and perioperative care must be carefully planned for esophageal cancer patients older than 75 years of age.

2.
Anticancer Res ; 40(1): 405-412, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892594

RESUMO

BACKGROUND/AIM: To evaluate the outcomes of curative resection for Borrmann type IV gastric cancer through an analysis of the clinical, surgical and pathological data and through identifying which of these prognostic factors are associated with survival. PATIENTS AND METHODS: We retrospectively analyzed 2798 patients who had undergone excision of the primary lesion and 122 patients with type IV gastric cancer undergoing curative resection (R0 or 1) at Yokohama City University Hospital and Kanagawa Cancer Center between November 1995 and May 2016. RESULTS: Borrmann type IV gastric cancer had more advanced and unfavorable clinicopathological factors compared to other types. The 5-year overall survival rate was 28%, and the median survival was 21.8 months. The overall survival rate was influenced by the depth of invasion, lymph node metastasis, peritoneal lavage cytology (CY), stage and intraoperative blood loss. Of these, independent prognostic factors were intraoperative blood loss (<400 vs. ≥400 ml, risk ratio 1.64; p=0.045) and CY (0 vs. 1, risk ratio 2.25; p=0.004). CONCLUSION: The control of intraoperative bleeding had a positive impact on the survival of patients receiving curative resection for Borrmann type IV gastric cancer.


Assuntos
Perda Sanguínea Cirúrgica , Cuidados Intraoperatórios , Neoplasias Gástricas/cirurgia , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia/patologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Resultado do Tratamento
3.
Anticancer Res ; 40(1): 443-449, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892599

RESUMO

BACKGROUND: We investigated the clinical influence of anastomotic leak (AL) on 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 those with AL and those without. The risk factors for overall (OS) and recurrence-free (RFS) survival were identified. RESULTS: AL was found in 44 out of the 122 patients (36.1%). The respective OS rates at 3 and 5 years after surgery were 43.9% and 40.2% in the AL group and 63.9% and 53.2% in the non-AL group, which were significantly different (p=0.0049). In contrast, the respective RFS rates at 3 and 5 years after surgery were 44.8% and 29.8%, and 44.9% and 42.4%, which were not significantly different (p=0.2306). A multivariate analysis showed that AL was a significant independent risk factor for both poorer OS and RFS in patients who underwent curative surgery for esophageal cancer. CONCLUSION: To improve survival of patients with esophageal cancer, the surgical procedure, perioperative care and surgical strategy must be carefully planned in order to prevent AL.


Assuntos
Fístula Anastomótica/patologia , Neoplasias Esofágicas/patologia , Recidiva Local de Neoplasia/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Sobrevida
4.
J Anus Rectum Colon ; 3(2): 84-90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559373

RESUMO

OBJECTIVES: Raman spectroscopy yields precise information, not only regarding the secondary structure of proteins but also regarding the discrimination between normal and malignant tissues. There is, however, no standard measurement method. We evaluated the use of a miniaturized, handheld, all-in-one Raman spectrometer with a 1064-nm laser excitation source for the diagnosis of colorectal cancer. The ultimate goal is real-time, in vivo diagnosis. METHODS: Tissue samples were obtained from 20 patients who underwent surgery for colorectal cancer. The samples were irradiated with the portable Progeny™ Raman spectrometer, with which the Raman spectra were also obtained. We searched for characteristic Raman shifts and examined whether these shifts could distinguish the cancer tissues. To improve accuracy, we divided the spectra into 100 cm-1 bands and applied principal component analysis (PCA) to each range. We evaluated the contribution of each range for cancer discrimination. RESULTS: Intensities at 1261 and 1427 cm-1 differed significantly between the normal tissues and cancer tissues, but these did not efficiently discriminate the cancer tissues. However, we were able to identify the characteristic spectral range in fingerprint regions; accuracy was 85.1%. CONCLUSIONS: Use of the all-in-one type Raman spectrometer can efficiently discriminate colorectal cancer, not on the basis of the intensities at 1261 and 1427 cm-1 but rather on the basis of PCA. Thus, Raman spectroscopy performed using a handheld device has potential to become a clinically powerful tool for producing high-quality data, obtaining highly reproducible measurements, and thus accurately diagnosing colorectal cancer.

5.
In Vivo ; 33(4): 1301-1306, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31280222

RESUMO

BACKGROUND/AIM: We investigated the impact of Beppu's nomogram on colorectal liver metastasis in patients receiving perioperative chemotherapy and/or targeted therapy. PATIENTS AND METHODS: This study included 43 patients who underwent primary hepatic resection for colorectal liver metastasis at the Kanagawa Cancer Center from June 2006 to March 2011. The patients were classified as having a Beppu's nomogram score ≤9 (low-risk group) or ≥10 (high-risk group). The risk factors for the disease-free survival (DFS) were identified. RESULTS: The respective DFS rates at 1, 2, and 3 years after surgery were 72.0%, 43.3%, and 17.3% in the low-risk group and 27.8%, 16.7%, and 8.3% in the high-risk group, the difference being significant (p=0.009). The multivariate analysis showed that Beppu's nomogram score ≥10 was a significant independent risk factor for the DFS. CONCLUSION: Beppu's nomogram score was an independent prognostic factor for colorectal liver metastasis in patients receiving perioperative chemotherapy and/or targeted therapy. Thus, Beppu's nomogram might be a useful tool for predicting the risk of recurrence after hepatectomy, even in the era of newly-developed chemotherapy.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante/efeitos adversos , Quimioterapia Adjuvante/métodos , Terapia Combinada , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Estadiamento de Neoplasias , Nomogramas , Assistência Perioperatória , Resultado do Tratamento
6.
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
7.
J Cancer Res Ther ; 14(Supplement): S1129-S1134, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30539858

RESUMO

Background: The factors associated with the survival and prognosis of peritoneal cytology (CY)-positive pancreatic cancer patients who undergo curative resection followed by adjuvant chemotherapy have not been established. Patients and Methods: Both overall survival (OS) and recurrence-free survival (RFS) were examined in 23 peritoneal CY-positive pancreatic cancer patients who underwent curative resection followed by adjuvant chemotherapy between 2005 and 2015. Results: When the length of OS was evaluated using a log-rank test, significant differences were observed in the number of metastatic lymph nodes. In addition, univariate and multivariate analyses demonstrated that the number of metastatic lymph nodes was a significant independent risk factor for OS and a marginally significant risk factor for RFS. The 3-year OS rate was 20.2% in patients with ≤8 metastatic lymph nodes, and it was 0% in those with the ≥9 metastatic lymph nodes (P = 0.017). The 3-year RFS rate was 6.3% in patients with ≤8 metastatic lymph nodes, whereas it was 0% in those with ≥9 metastatic lymph nodes (P = 0.062). Conclusions: The number of metastatic lymph nodes is the most important prognostic factor for OS and RFS in peritoneal CY-positive pancreatic cancer patients who underwent curative resection followed by adjuvant chemotherapy. To improve the survival of these patients, it is necessary to establish optimal treatments.


Assuntos
Antineoplásicos/uso terapêutico , Linfonodos/patologia , Pancreatectomia , Neoplasias Pancreáticas/mortalidade , Idoso , Biópsia/métodos , Quimioterapia Adjuvante/métodos , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pâncreas/patologia , Pâncreas/cirurgia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/terapia , Lavagem Peritoneal/métodos , Prognóstico , Taxa de Sobrevida , Resultado do Tratamento
8.
Gan To Kagaku Ryoho ; 45(9): 1238-1241, 2018 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-30237362

RESUMO

Colorectal cancer(CRC)is one of the increasing cancers, and development of novel treatments is imperative for advanced CRC. In recent years, immune checkpoint inhibitors have demonstrated impressive clinical efficacy in various types of cancers, but only limited clinical responses were reported in CRC. It has been reported that such poor therapeutic effects might be possibly due to immune suppressive mechanisms other than immune checkpoints in the CRC. Therefore, comprehensive grasp of the immune environment is considered to be of significance for CRC patients. Our study aims to comprehensively assess the phenotypes and functions of various immune cells isolated from various tissues, including primary tumors and related lymph nodes, in primary CRC patients. Our preliminary results by flow cytometry analysis suggest that the immune suppression, particularly in regional lymph nodes, may be related to tumor progression. Further studies remain to be performed to more thoroughly elucidate immune suppressive mechanisms, and thereby to develop a novel immunotherapeutic strategy in the CRC.


Assuntos
Neoplasias Colorretais/imunologia , Pesquisa Médica Translacional , Relação CD4-CD8 , Neoplasias Colorretais/cirurgia , Humanos , Interferon gama/biossíntese , Fenótipo
9.
J Cancer Res Ther ; 14(Supplement): S724-S729, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30249894

RESUMO

Purpose: This study assessed whether our enhanced recovery after surgery (ERAS) program for distal pancreatectomy (DP) is safe and feasible. Patients and Methods: The subjects were patients who underwent consecutive DP between 2012 and 2014 at the Department of Gastrointestinal Surgery, Kanagawa Cancer Center. They received perioperative care according to ERAS program. All data were retrieved retrospectively. Outcome measures included postoperative mortality, morbidity, hospitalization, and 30-day readmission rate. Our ERAS program included 12 elements (4 preoperative elements, 3 intraoperative elements, and 5 postoperative elements). Results: A total of 44 patients were studied. The overall incidence of morbidity was 29.5%, the incidence of mortality was 0%, and the incidence of readmission was 0%. Four preoperative elements and 3 intraoperative elements seemed feasible. Among the 5 postoperative elements, 4 elements seemed feasible, accounting 90%< performance rate however the early removal of catheters and drain seemed not feasible. The median postoperative hospital stay was 14 days (range: 8-39 days). The median postoperative hospital stay was 13 days (range: 8-27 days) in patients without postoperative complications while the median postoperative hospital stay was 26 days (range: 14-39 days) in patients with postoperative complications. Conclusion: This study results suggested that our ERAS program is safe and feasible in patients who undergo DP. However, achieving compliance on the postoperative element, especially the removal of catcher and drain, was more challenging.


Assuntos
Neoplasias Pancreáticas/fisiopatologia , Neoplasias Pancreáticas/cirurgia , Complicações Pós-Operatórias/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pancreatectomia/efeitos adversos , Neoplasias Pancreáticas/reabilitação , Readmissão do Paciente , Assistência Perioperatória , Período Pós-Operatório , Resultado do Tratamento
10.
Gan To Kagaku Ryoho ; 45(2): 282-284, 2018 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-29483421

RESUMO

BACKGROUND: Body temperatures in elderly patients undergoing a pancreaticoduodenectomy(PD)for treatment of pancreatic cancer have not been fully evaluated. We aimed to compare body temperature during a PD between elderly(75 years old)and non-elderly patients. METHODS: This retrospective study included patients who underwent PD between April 2012 and April 2014 at the Kanasgawa Cancer Center. Patients were categorized into 2 groups: elderly patients(≥75 years of age: group A)and non-elderly patients(<75 years of age: group B). Body temperatures were compared between the groups. RESULTS: We evaluated 58 patients-14 were classified into group A, and 44 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences between patients. A comparison of body temperatures between the groups showed 36.3°C(before surgery)/36.1°C(at 1 hr)/36.3°C(at 2 hr)/36.7°C(at 3 hr)/36.8°C(at 4 hr)/37.1°C(at 5 hr)/37.4°C(at 6 hr)in group A compared to 36.2°C(before surgery)/36.2°C(at 1 hr)/36.4°C(at 2 hr)/36.6°C(at 3 hr)/ 36.9°C(at 4 hr)/37.0°C(at 5 hr)/37.3°C(at 6 hr)in group B. Results did not significantly differ between the groups. CONCLUSIONS: Our study suggests that body temperature is not affected by a patient's age.


Assuntos
Temperatura Corporal , Neoplasias Pancreáticas/fisiopatologia , Pancreaticoduodenectomia , Idoso , Feminino , Humanos , Masculino , Neoplasias Pancreáticas/cirurgia
11.
Gan To Kagaku Ryoho ; 44(10): 924-925, 2017 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-29066697

RESUMO

A 72-year-old woman was referred to our hospital due to an abdominal mass. Ultrasound sonography and computed tomography revealed liver tumors in liver segments 2 and 3. The preoperative diagnosis was hepatocellular carcinoma. The patient underwent an extended left lobectomy. Histological examination of resected specimens revealed that the tumors were hepatic leiomyosarcoma. We report our experience of this hepatic leiomyosarcoma, along with the literature on this tumor type.


Assuntos
Leiomiossarcoma/cirurgia , Neoplasias Hepáticas/cirurgia , Idoso , Feminino , Hepatectomia , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Tomografia Computadorizada por Raios X
12.
Oncol Lett ; 14(2): 1505-1511, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28789372

RESUMO

The predictive roles of dihydropyrimidine dehydrogenase (DPD) in patients who undergo curative resection and adjuvant chemotherapy with S-1, which is the oral 5-fluorouracil prodrug tegafur combined with oteracil and gimeracil, remain unclear. In the present study, the clinical data from 66 consecutive patients who underwent curative resection and received adjuvant chemotherapy with S-1 for the treatment of pancreatic cancer at Kanagawa Cancer Center (Yokohama City, Japan) from April 2005 to March 2014 were retrospectively analyzed. The association between the DPD status and the survival and clinicopathological features were investigated. Of the 66 patients, 34 patients exhibited positive DPD expression (51.5%). Although a significant increase in DPD expression in male patients was observed, no significant differences were identified for other clinicopathological parameters, including tumor factor or node factor, between the DPD-positive expression group and the DPD-negative expression group. The median follow-up period of the present study was 29.2 months. There was no significant difference in the 3-year overall survival (OS) rates following surgery, which were 12.6 and 14.5% in the DPD-positive and DPD-negative expression groups, respectively (P=0.352). However, in a subgroup analysis, a significant difference in the 3-year OS rates following surgery was noted, which were 58.9 and 14.5% in the DPD-high and DPD-low expression groups, respectively (P=0.019). The intratumoral DPD expression in curatively resected pancreatic cancer patients treated with S-1 adjuvant chemotherapy was identified to not be useful as a predictive marker, whereas the level of DPD expression is a potential predictive marker. The results of the present study require confirmation in another cohort or in a prospective multicenter study.

13.
Oncol Lett ; 14(1): 599-606, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28693211

RESUMO

The predictive roles of human equilibrative nucleoside transporter 1 (hENT-1) in patients who undergo curative resection and adjuvant chemotherapy with gemcitabine alone have not been established. The present study retrospectively analyzed the clinical data from 101 consecutive patients who underwent curative resection and who received gemcitabine adjuvant chemotherapy for the treatment of pancreatic cancer at Kanagawa Cancer Center (Yokohama, Japan) between 2005 and 2014. The associations between the hENT-1 status and the survival and clinicopathological features of the patients were investigated. Of the 101 patients, 60 patients (59.4%) had high levels of hENT-1 expression. A significant association was observed between hENT-1 status and sex; however, for all the other clinicopathological parameters, including tumor and node stages, no differences were observed between the high and low hENT-1 expression groups. The median follow-up period of the present study was 67.3 months. Between the high and low hENT-1 expression groups, there was a statistically significant difference in the 5-year overall survival (OS) rates following surgery (20.6 and 8.9%, respectively; P=0.019). In addition, a significant difference was observed in the recurrence-free survival (RFS) rates at 5 years following surgery (P=0.049). hENT-1 status was one of the important predictive factors for OS and RFS in patients with pancreatic cancer who underwent curative resection followed by adjuvant chemotherapy with gemcitabine. Adjuvant chemotherapy with gemcitabine alone may be insufficient, particularly in patients with certain relevant risk factors.

14.
BMC Surg ; 17(1): 29, 2017 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-28327119

RESUMO

BACKGROUND: The short-term outcomes of laparoscopic-assisted surgery for colorectal cancer (LAC) have not been fully evaluated in elderly patients. The aim of this study was to compare the short term surgical outcomes of LAC between the patients older than 75 years and those with non-elderly patients. METHODS: This retrospective multi-institutional study selected patients who underwent LAC between April 2013 and March 2014 at Yokohama City University Hospital and its related general hospitals. The patients were categorized into two groups: elderly patients (>75 years of age: group A) and non-elderly patients (<75 years of age: group B). Surgical outcomes and post operative complications were compared between the two groups. RESULTS: A total of 237 patients were evaluated in the present study. Eighty-four patients were classified into group A, and 153 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences except for the ASA score. When comparing the surgical outcomes between group A and group B, the rate of conversion to open procedure (3.6% vs 5.2%, P = 0.750), median operation time (232 min vs 232 min, P = 0.320), median blood loss (20 ml vs 12 ml, P = 0.350). The differences were not significantly different in the surgical outcomes. The incidences of > grade 2 post operative surgical complications were similar between two groups ((19.0% vs 15.7%, p = 0.587). No mortality was observed in this study. The length of postoperative hospital stay was also similar (10 days vs 10 days, p = 0.350). CONCLUSIONS: The present study suggested that LAC is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for colon cancer surgery.


Assuntos
Neoplasias Colorretais/cirurgia , Laparoscopia/efeitos adversos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Laparoscopia/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
15.
Gan To Kagaku Ryoho ; 43(10): 1289-1291, 2016 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-27760963

RESUMO

A 74-year-old man with IgG4-related cholangitis had been treated with steroids for 1 year. In the outpatient clinic, elevated levels of the tumor marker CA19-9 and serum IgG4 were observed. Abdominal enhanced CT showed a 20mm hypovascular tumor in the pancreatic head. ERCP showed narrowingof the main pancreatic duct in the pancreatic head with slight caudal dilation and stricture of the lower common bile duct. We made a diagnosis of pancreatic cancer, and the patient underwent pancreaticoduodenectomy. Pathological examination of the resected tissue revealed a well-differentiated adenocarcinoma surrounded by autoimmune pancreatitis, characteristic of lymphoplasmacytic sclerosingpancreatitis. He is receiving adjuvant chemotherapy with S-1 in the outpatient clinic.


Assuntos
Adenocarcinoma/etiologia , Doenças Autoimunes/complicações , Neoplasias Pancreáticas/etiologia , Pancreatite/complicações , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/cirurgia , Idoso , Antimetabólitos Antineoplásicos/uso terapêutico , Doenças Autoimunes/imunologia , Antígeno CA-19-9/sangue , Quimioterapia Adjuvante , Combinação de Medicamentos , Humanos , Imunoglobulina G/sangue , Masculino , Ácido Oxônico/uso terapêutico , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Pancreatite/imunologia , Tegafur/uso terapêutico , Resultado do Tratamento
16.
Anticancer Res ; 36(5): 2497-503, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27127164

RESUMO

BACKGROUND: We investigated the impact of the surgical Apgar score (SAS) on survival in patients with pancreatic cancer and recurrence after curative surgery followed by adjuvant chemotherapy. PATIENTS AND METHODS: This study included 103 patients who underwent curative surgery for pancreatic cancer between 2005 and 2014. Patients with a SAS of 0-4 were classified into the low SAS group, while those with a SAS of 5-10 were classified into the high SAS group. The risk factors for overall (OS) and recurrence-free (RFS) survival were identified. RESULTS: The OS rates at 3 and 5 years after surgery were 23.0% and 14.4%, respectively, in the low-SAS group and 32.3% and 21.4%, respectively, in the high-SAS group, which was a statistically significant difference (p=0.039). The RFS rates at 3 and 5 years after surgery were 13.1% and 13.1%, respectively, in the low-SAS group and 21.4% and 19.2%, respectively, in the high-SAS group, which was a marginally significant difference (p=0.100). Multivariate analysis demonstrated that the SAS was a significant independent risk factor for OS and a marginally significant risk factor for RFS. CONCLUSION: The SAS was a risk factor for OS in patients who underwent curative surgery followed by adjuvant chemotherapy for pancreatic cancer. The surgical procedure, perioperative care and surgical strategy should be carefully planned to improve survival.


Assuntos
Neoplasias Pancreáticas/patologia , Pancreaticoduodenectomia , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Terapia Combinada , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Complicações Pós-Operatórias , Prognóstico , Fatores de Risco , Taxa de Sobrevida , Adulto Jovem
17.
Gan To Kagaku Ryoho ; 43(12): 1521-1522, 2016 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-28133043

RESUMO

PURPOSE: This study aimed to evaluate the safety and feasibility of pancreatic surgery for pancreatic cancer in elderly patients. PATIENTS AND METHODS: In total, 9 patients underwent pancreatic surgery for pancreatic cancer between April 2005 and March 2014. The surgical complications were evaluated by Clavien-Dindo classification. RESULTS: The median operating time was 420(range: 354-503)min and the median blood loss was 640(range: 350-1,170)mL. Grade 2 or higher complications were observed in 3 patients. Pancreatic fistula(Grade 3b)was observed in 1 patient, delirium was observed(Grade 2)in 1 patient, and portal vein thrombosis(Grade 2)was observed in 1 patient. No surgical mortality was observed. DISCUSSION: Our results suggest that pancreatic surgery is a safe and feasible treatment for pancreatic cancer in elderly patients.


Assuntos
Pancreatectomia , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Complicações Pós-Operatórias , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pancreatectomia/efeitos adversos , Pancreaticoduodenectomia/efeitos adversos , Resultado do Tratamento
18.
Gan To Kagaku Ryoho ; 43(12): 1644-1646, 2016 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-28133085

RESUMO

BACKGROUND: The aim of this study was to evaluate the safety of laparoscopic-assisted colorectomy(LAC)for elderly patients more than 70 years old. METHODS: The outcomes of 131 patients more than 70 years old who underwent LAC between April 2013 and March 2014 were retrospectively analyzed.Morbidity and mortality were evaluated using the Clavien-Dindo classification. RESULTS: Postoperative complications exceeding Grade II in the Clavien-Dindo classification were found in 20 patients(15.3%).No mortalities were observed in this study. CONCLUSIONS: LAC can be performed safely for elderly patients older than 70 years.


Assuntos
Colectomia , Neoplasias Colorretais/cirurgia , Idoso , Idoso de 80 Anos ou mais , Colectomia/efeitos adversos , Feminino , Humanos , Laparoscopia , Masculino , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento
19.
Gan To Kagaku Ryoho ; 43(12): 2359-2361, 2016 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-28133321

RESUMO

We report a case of duodenal liposarcoma. A 62-year-old man presented with an abdominal tumor. Abdominal CT scan and MRI showed a tumor in the wall of the duodenum. Pancreaticoduodenectomy was performed. The final pathological diagnosis was mixed-type liposarcoma. Twenty-one months after the 1st surgery, the patient presented with locoregional recurrence and tumor resection was performed. However, 12 months after the 2nd operation, the patient again presented with locoregional recurrence and further surgery is planned.


Assuntos
Neoplasias Duodenais/patologia , Lipossarcoma , Neoplasias Duodenais/cirurgia , Humanos , Lipossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Pancreaticoduodenectomia , Recidiva
20.
Gan To Kagaku Ryoho ; 42(12): 1482-4, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26805070

RESUMO

BACKGROUND: By remarkable progress of chemotherapy for pancreatic cancer, we sometimes achieve resection of initially unresectable pancreatic cancer after chemotherapy. Otherwise, the safety and feasibility of radical pancreatic resection after chemotherapy is not still clear. In this report, we evaluated the safety and feasibility of conversion surgery for initially unresectable pancreatic cancer in our center. PATIENTS AND METHODS: Between 2009 and 2014, approximately 500 patients were diagnosed with unresectable pancreatic cancer and received chemotherapy, and after chemotherapy, 10 patients were found to have resectable tumors on computed tomography. We evaluated surgical complications using the Clavien-Dindo classification. Clinicopathological data were reviewed by using UICC, seventh edition, and the chemotherapeutic effect was measured by using Evans classification. RESULTS: The mean age of patients was 68 years, with 4 men and 6 women. The preoperative chemotherapy regimens were S-1 chemotherapy in 2 patients, gemcitabine in 5 patients, and gemcitabine plus S-1 chemotherapy in 3 patients. Nine patients underwent pancreatoduodenectomy, and 1 underwent distal pancreatosplenectomy. The mean operative time was 527.5 minutes, and the mean estimated blood loss was 875 mL. Surgery-related morbidity more than Grade 2 based on Clavien-Dindo classification occurred in 6 patients. Mortality was 0%. CONCLUSION: Our study suggests that conversion surgery for initially unresectable pancreatic cancer is safe and feasible.


Assuntos
Antineoplásicos/uso terapêutico , Terapia Neoadjuvante , Neoplasias Pancreáticas/tratamento farmacológico , Idoso , Antineoplásicos/efeitos adversos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Complicações Pós-Operatórias , Resultado do Tratamento
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