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1.
Int J Mol Sci ; 22(11)2021 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-34204158

RESUMO

Breast cancer (BC) is the most predominant type of cancer among women. The aim of this study is to find new biomarkers that can help in early detection of BC, especially for those who are too young to be screened using mammography as per guidelines. Using microRNA microarray, we previously showed dysregulation of 74 microRNAs in tumors from early BC patients as compared with normal adjacent tissues, which we were interested in studying in blood circulation. In this study, we investigated the expression of 12 microRNA (miR-21/miR-155/miR-23a/miR-130a/miR-145/miR-425-5p/miR-139-5p/miR-451/miR-195/miR-125b/miR-100, and miR-182) in the plasma of 41 newly diagnosed Lebanese BC patients with early invasive ductal carcinoma as compared with 32 healthy controls. Total RNA was extracted from plasma, and expression levels of miRNA of interest were measured using RT-qPCR followed by statistical analysis; miR-21, miR-155, miR-23a, miR-130a, miR-145, miR-425-5p, and miR-139-5p were significantly upregulated and miR-451 was significantly downregulated, in the plasma of BC patients as compared with healthy controls. The positively correlated miR-23a, miR-21, and miR-130a had a high diagnostic accuracy (86%). Importantly, the combination of miR-145/miR-425-5p/miR-139-5p/miR-130a scored the highest diagnostic accuracy of 95% with AUC = 0.97 (sensitivity 97% and specificity 91%). MicroRNAs are promising non-invasive diagnostic biomarkers for early-stage BC with the panel of miR-145/miR-425-5p/miR-139-5p/miR-130a having the highest diagnostic accuracy.


Assuntos
Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , MicroRNA Circulante/sangue , MicroRNA Circulante/genética , Perfilação da Expressão Gênica , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estatísticas não Paramétricas , Adulto Jovem
2.
Lakartidningen ; 1182021 07 06.
Artigo em Sueco | MEDLINE | ID: mdl-34228808

RESUMO

Besides clinical evaluation, all patients with rectal cancer must be examined with CT of the chest and abdomen to assess the presence of metastases, pelvic MRI to stage the tumour locally, and if possible, colonoscopy to detect synchronous lesions. The recommended treatment is then discussed at an MDT conference and neoadjuvant radio- or chemoradiotherapy given according to national guidelines. A new digital rectal examination (DRE) and proctoscopy, CT and pelvic MRI should be performed around six weeks after treatment. The purpose is to detect potential new metastases and to assess tumour response after treatment. It is crucial to do a second MDT with careful MRI evaluation to detect a possible clinical complete response. If the post-treatment MRI shows a complete or near complete response, corresponding to clinical findings on DRE and endoscopy, the patient should be offered a prospective watch and wait protocol in a dedicated institution. With proper management of patients with rectal cancer, 20-25 procent may be saved from a rectal resection and the potential risk of a permanent stoma.


Assuntos
Neoplasias Retais , Quimiorradioterapia , Exame Retal Digital , Humanos , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Prospectivos , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Conduta Expectante
3.
Urologe A ; 60(7): 847-853, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34232324

RESUMO

Testicular cancer occupies a special position in several respects. Although it belongs to the group of rare tumors, which is why extensive experience in treating this tumor can not be guaranteed, interdisciplinary experts collaboration and the consequent implementation of clinical studies have resulted in standardized treatment recommendations. Because testicular cancer is one of the most curable cancers, long-term toxicity and treatment sequelae are of special importance. In the early stages, toxicity could be reduced by minimizing therapy to the extent possible, but without decreasing treatment success. Nevertheless, treatment is still controversially discussed, especially concerning treatment of stage I disease. Finally particular focus should be paid to non-germinal tumors which are even more rare, but partly also more dangerous. Therefore known facts should be made available for the broad medical community. In penile cancer, which is also a very rare tumor entity, organ-sparing surgery and consequent invasive lymph node staging are mandatory.


Assuntos
Neoplasias Embrionárias de Células Germinativas , Neoplasias Penianas , Neoplasias Testiculares , Humanos , Excisão de Linfonodo , Masculino , Estadiamento de Neoplasias , Neoplasias Penianas/patologia , Qualidade de Vida , Encaminhamento e Consulta , Neoplasias Testiculares/patologia
5.
Isr Med Assoc J ; 23(7): 426-431, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34251125

RESUMO

BACKGROUND: Decisions on medication treatment in children dying from cancer are often complex and may result in polypharmacy and increased medication burden. There is no information on medication burden in pediatric cancer patients at the end of life (EOL). OBJECTIVES: To characterize medication burden during the last hospitalization in children dying from cancer. METHODS: We performed a retrospective cohort study based on medical records of 90 children who died from cancer in hospital between 01 January 2010 and 30 December 2018. Demographic and clinical information were collected for the last hospitalization. We compared medication burden (number of medication orders) at hospitalization and at time of death and examined whether changes in medication burden were associated with clinical and demographic parameters. RESULTS: Median medication burden was higher in leukemia/lymphoma patients (6 orders) compared to solid (4 orders) or CNS tumor patients (4 orders, P = 0.006). Overall, the median number of prescriptions per patient did not change until death (P = 0.42), while there was a significant reduction for some medication subgroups (chemotherapy [P = 0.035], steroids [P = 0.010]).Patients dying in the ICU (n=15) had a higher medication burden at death (6 orders) than patients dying on wards (3 orders, P = 0.001). There was a trend for a reduction in medication burden in patients with "Do not resuscitate" (DNR) orders (P = 0.055). CONCLUSIONS: Polypharmacy is ubiquitous among pediatric oncology patients at EOL. Disease type and DNR status may affect medication burden and deprescribing during the last hospitalization.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias , Cuidados Paliativos , Polimedicação , Esteroides/uso terapêutico , Assistência Terminal , Criança , Procedimentos Clínicos/estatística & dados numéricos , Demografia , Feminino , Pesquisa sobre Serviços de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Israel/epidemiologia , Masculino , Estadiamento de Neoplasias , Neoplasias/tratamento farmacológico , Neoplasias/mortalidade , Neoplasias/patologia , Cuidados Paliativos/métodos , Cuidados Paliativos/estatística & dados numéricos , Ordens quanto à Conduta (Ética Médica) , Assistência Terminal/métodos , Assistência Terminal/estatística & dados numéricos
8.
J Bras Pneumol ; 47(4): e20200584, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34259745

RESUMO

OBJECTIVE: EBUS-TBNA cytological sampling is routinely performed for pathological diagnosis, mediastinal staging, and molecular testing in lung cancer patients. EBUS-TBNA samples are not formally accepted for testing programmed death-ligand 1 (PD-L1) expression. The objective of the study was to compare the feasibility, reproducibility, and accuracy of PD-L1 expression assessment in cytological specimens and histological samples. METHODS: We prospectively collected histological (transbronchial forceps biopsy) and cytological (EBUS-TBNA) samples from peribronchial neoplastic lesions during an endoscopic procedure at the same target lesion for the pathological diagnosis and molecular assessment of stage IV non-small cell lung cancer (NSCLC). RESULTS: Fifteen patients underwent the procedure. Adequate cytological samples (at least 100 neoplastic cells) were obtained in 12 cases (92.3%). Assessment of PD-L1 expression was similar between histological and cytological samples (agreement rate = 92%). Sensitivity and diagnostic accuracy of EBUS-TBNA cytological specimens were 88.9% and 100%, respectively. CONCLUSIONS: The evaluation of PD-L1 expression in EBUS-TBNA cytological specimens is feasible and presents good reproducibility when compared with routine histological samples. EBUS-TBNA cytological samples could be used for the assessment of PD-L1 expression in patients with NSCLC as a minimally invasive approach in stage IV NSCLC cancer patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Antígeno B7-H1 , Carcinoma Pulmonar de Células não Pequenas/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Humanos , Neoplasias Pulmonares/patologia , Estadiamento de Neoplasias , Projetos Piloto , Estudos Prospectivos , Reprodutibilidade dos Testes
9.
World J Surg Oncol ; 19(1): 205, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238296

RESUMO

PURPOSE: To assess the value of adjuvant radiotherapy for treatment of gastric adenocarcinoma and to investigate subgroups of patients suitable for adjuvant radiotherapy. METHODS AND MATERIALS: Data from 785 patients with gastric adenocarcinoma who had undergone D1/D2 radical resection and adjuvant chemotherapy were collected, the site of first progression was determined, and the relationship between the rate of local recurrence and clinicopathologic features was analyzed. RESULTS: By the end of the follow-up period, progression was observed in 405 patients. Local recurrence was observed as the first progression in 161 cases. The local recurrence rate was significantly lower than the non-local progression rate (20.5% vs 31.5%, p=0.007). Multivariate Cox regression analysis showed a significant relationship among degree of differentiation, T stage, N stage, and rate of local recurrence. CONCLUSIONS: Not all patients with gastric carcinoma required adjuvant radiotherapy. However, patients with poorly differentiated cancer cells, advanced T stage (T3/T4), and positive lymph nodes, which included patients in the T4N1-2M0 subgroup, were recommended for adjuvant radiotherapy.


Assuntos
Adenocarcinoma , Neoplasias Gástricas , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/radioterapia , Quimioterapia Adjuvante , Gastrectomia , Humanos , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Prognóstico , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/radioterapia
10.
Urologiia ; (3): 104-109, 2021 Jun.
Artigo em Russo | MEDLINE | ID: mdl-34251110

RESUMO

PURPOSE: To investigate long-term results after radical cystectomy in patients with bladder cancer. MATERIALS AND METHODS: Since 1997 to 2020 yy. we have performed 404 radical cystectomy with different methods of derivation for patients with bladder cancer in our clinic. There were 342 (86,4%) men and 62 (13,6%) women. Laboratory study, ultrasound, X-ray, CT. MRI investigations were performed in all patients. RESULTS: Mortality rate was 2,9%. Early and late postoperative complications have occurred in 136 (33,6%) and 98 (41,8%) cases, respectively. Local recurrence has occurred in 33 (8,5%) patients. 10-years overall and cancer-specific survival were 43,4% and 47,2%, respectively. In lymph-negative patients 2-years and 5-years overall survival were 81,2% and 67,2%, respectively. In lymph positive patients 2-years and 5-years overall survival were 46,9% and 13,9%, respectively. In lymph-negative patients 2-years and 5-years cancer-specific survival were 83,6% and 70,7%, respectively. In lymph positive patients 2-years and 5-years cancer-specific survival were 51,0% and 15,1%, respectively. Overall and cancer -specific survival decreased according to increasing pT-stage and histopathologic grade. CONCLUSIONS: pT-stage (pT), lymp nodes status (pN), histopathologic grade ( pG) have a significant independent influence on overall and cancer-specific survival of bladder cancer patients after radical cystectomy.


Assuntos
Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Carcinoma de Células de Transição/patologia , Cistectomia , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
11.
Zhonghua Zhong Liu Za Zhi ; 43(6): 678-684, 2021 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-34289560

RESUMO

Objective: To summarize survival outcomes and prognostic factors in esophageal cancer (EC) patients treated with intensity-modulated radiotherapy (IMRT). Methods: A retrospective analysis was performed on the clinical and follow-up data of 1 637 patients with EC who were admitted to our hospital from January 2005 to December 2017 and met the inclusion criteria.The 5-year overall survival (OS), progression-free survival (PFS) and pattern of recurrence were analyzed. The Kaplan-Meier method was used to calculate survival rates, Log-rank test for univariate analysis and Cox method for multivariate analysis were used to detect survival difference. Results: 1-year, 3-year and 5-year OS and PFS of the entire group were 65.9% and 45.8%, 34.2% and 25.0%, 27.0% and 18.5%, respectively. Median OS and PFS were 19.4 months (95% CI=18.0-20.7 months) and 10.4 months (95% CI=9.3-11.3 months), respectively. Univariate analysis showed that the sex, KPS, tumor location, T stage, N stage, M stage, TNM stage, radiation dose and treatment modality were prognostic factors for 5-year OS and PFS of EC patients (P<0.05). Multivariate analysis indicated that the sex, KPS, TNM stage, radiation dose and treatment modality were independent prognostic factors for 5-year OS and PFS (P<0.05). Conclusions: EC patients treated with IMRT can obtain a promising survival. The sex, KPS, TNM stage, radiation dose and treatment modality are independent prognostic factors for prognosis.


Assuntos
Neoplasias Esofágicas , Radioterapia de Intensidade Modulada , Intervalo Livre de Doença , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/radioterapia , Humanos , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos
12.
Zhonghua Zhong Liu Za Zhi ; 43(6): 686-690, 2021 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-34289562

RESUMO

Objective: To investigate the effect of the neoadjuvant chemotherapy course adjustment on the patients with esophageal cancer underwent delayed operation. Methods: The clinical data of patients with esophageal cancer treated in Cancer Hospital, Chinese Academy of Medical Sciences from 2019-2020, who underwent neoadjuvant chemotherapy strategy adjustment (multiple course chemotherapy group) or not (control group), were retrospectively studied. The clinical pathological characteristics and postoperative complication of these two group were compared and analyzed. Results: The cases who underwent the interval between chemotherapy and operation more than 4 weeks in multiple course chemotherapy group and control group were 17 and 6, with significant difference (P<0.05). The average operative blood loss of these two groups were 88.6 ml and 46.1 ml, the average postoperative hospital stays were 14.7 days and 10.0 days, with significant difference (P<0.05). The incidence rate of postoperative complication in the multiple course chemotherapy group was 40.9% (9/22), not significantly different from 31.8% (7/22) of control group (P>0.05). There were no death within postoperative 7 days and 30 days in both groups. Cases with apparent tumor regression [tumor regression grade (TRG) 1 to 3] in multiple course chemotherapy group were 14, with marginal tumor regression (TRG 4 to 5) were 8, while there were 7 and 15 in the control group, respectively, with significant difference (P<0.05). After multiple neoadjuvant chemotherapy, the imaging examination of patients indicated an almost total tumor degradation and the postoperative pathology showed no residual malignant tumor tissue was observed. Conclusions: Increased neoadjuvant chemotherapy course for patients with locally advanced esophageal cancer can obtain more obvious tumor degradation response. Neoadjuvant chemotherapy adjustment according to the operation schedule is recommended.


Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Adenocarcinoma/patologia , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/cirurgia , Humanos , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Retrospectivos , Resultado do Tratamento
13.
Zhonghua Zhong Liu Za Zhi ; 43(6): 691-695, 2021 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-34289563

RESUMO

Objective: To evaluate the recurrence and progression of patients with pT1 high grade urothelial carcinoma of bladder (UCB) and glandular differentiation. Methods: We retrospectively analyzed the clinical and pathological information of 208 patients diagnosed as pT1 high grade urothelial carcinoma in the Fifth Central Hospital of Tianjin from January 2006 to February 2019.Among them, 78 cases were diagnosed as glandular differentiation (UCGD), the other 130 patients without histologic variants were served as control. The UCGD group included 62 male and 16 female, whose median age was 67 years old (range 38-81 years old). The control group contained 105 male and 25 female, whose median age was 66 years old (range 40-82 years old). Kaplan-Meier and Cox proportional hazard regression analyses were used to evaluate the predictors of oncologic outcomes. Results: The disease recurrence rate and progression rate in UCGD group were 65.4% (51/78) and 28.2% (22/78), higher than 38.5%(50/130) and 14.6%(19/130) of control group (P<0.05). The median recurrence time in UCGD group was 41 months while 55 months in the control group. The median progression time in UCGD group was 39 months while 54 months in the control group. According to the univariate analysis, largest tumor size (P=0.030), UCGD (P=0.003) and lymphovascular invasion (LVI) (P=0.032) were associated with disease recurrence. UCGD (P=0.036) and LVI (P=0.011) were associated with progression. Additionally, Cox multivariate analysis revealed that UCGD (P=0.001), LVI (P=0.038) were the independent factors of disease recurrence. UCGD (P=0.007) and LVI (P=0.037) were also found to be the independent factors of disease progression. Conclusions: Patients with T1 stage UCB and UCGD are at higher risk of disease recurrence and progression. Therefore, these patients should be followed up closely after being diagnosed and undergo individual treatment according to the situation.


Assuntos
Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
14.
Zhonghua Zhong Liu Za Zhi ; 43(7): 743-750, 2021 Jul 23.
Artigo em Chinês | MEDLINE | ID: mdl-34289567

RESUMO

The incidence and mortality of lung cancer ranked the first in China. China had 787, 000 new cases of lung cancer in 2015, and a majority of these patients with advanced lung cancer. With the development and popularization of high-resolution computed tomography, more and more early-stage lung adenocarcinomas are found in screening. The imaging finding of early-stage lung adenocarcinomas often manifests as part solid nodule (PSN) containing ground glass opacity (GGO). Although the imaging manifestation of the nodules can't accurately predict the pathologic type of nodules, the parts of solid nodule and GGO still have some pathologic indications, and the prognostic evaluation effect of the maximum diameter of PSN is superior to that of the whole nodule. With the development of the molecular radiography and molecular pathology, the relationship of imaging manifestation of the PSN and metastasis were focused on. Some PSNs with special nature are more active and rapidly progressed than the pure GGOs. While compared to the pure solid nodules, the aggressiveness of PSNs are insufficient, with lower metastatic rates of lymph node and better prognoses. Currently, international acknowledge recommends to take active intervention measure for PSNs which are highly suspected to be malignant. We focus on the diagnosis and treatment of PSNs, systemically depict their staging, follow-up, surgical treatment, gene detection and immunotherapy.


Assuntos
Adenocarcinoma de Pulmão , Neoplasias Pulmonares , Nódulo Pulmonar Solitário , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/tratamento farmacológico , Adenocarcinoma de Pulmão/patologia , China , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Linfonodos/patologia , Estadiamento de Neoplasias , Estudos Retrospectivos , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X
15.
Zhonghua Zhong Liu Za Zhi ; 43(7): 787-794, 2021 Jul 23.
Artigo em Chinês | MEDLINE | ID: mdl-34289574

RESUMO

Objective: To investigate the clinical features and prognosis of extranodal nasal-type NK/T-cell lymphoma of the extra-upper aerodigestive tract (extra-UADT NKTCL). Methods: The clinical data of 159 patients with extra-UADT NKTCL from the China Lymphoma Collaborative Group (CLCG) database between November 2001 and December 2015 were retrospectively analyzed. Kaplan-Meier survival analysis and Log-rank test were used to evaluate the prognosis. The Cox regression model is used for multi-factor analysis. Results: Extra-UADT NKTCL commonly occurs in skin and soft tissues (106/159, 66.7%) and gastrointestinal tract (31/159, 19.5%). The incidences of elevated lactate dehydrogenase (LDH) and Ann Arbor Ⅲ~Ⅳ stage were 47.8% (76/159) and 64.2% (102/159), respectively. The 3-year overall survival (OS) and progression-free survival (PFS) rates were 43.6% and 27.9%, respectively. The corresponding OS rates of primary skin/soft tissue site and gastrointestinal tract site were 41.0% and 59.4% (P=0.281), while the PFS rates were 24.8% and 48.3%, respectively (P=0.109). Combined modality treatment improved the 3-year OS of all the patients (58.4% vs 33.9%, P=0.001) and 3-year PFS (40.7% vs 20.7%, P=0.008) when compared with chemotherapy alone. LDH elevation, Ann Arbor synthesising and ≥2 junction external bits were intrusive as independent risk factors for total survival (P<0.05), LDH elevation and ≥2 junction outer bits were intrusive as independent risk factors for progressionless survival(P<0.05). The distant extranodal dissemination was the primary failure patterns. Conclusions: Extra-UADT NKTCL appears to have distinct clinical characteristics and poor outcome. Compared with chemotherapy alone, combined modality treatment may improve the prognosis of patients with extra-UADT NKTCL.


Assuntos
Linfoma Extranodal de Células T-NK , China , Humanos , Linfoma Extranodal de Células T-NK/tratamento farmacológico , Linfoma Extranodal de Células T-NK/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
16.
Zhonghua Zhong Liu Za Zhi ; 43(7): 806-809, 2021 Jul 23.
Artigo em Chinês | MEDLINE | ID: mdl-34289577

RESUMO

Objective: To investigate the risk factors of peritoneal metastasis in primary appendiceal tumor. Methods: The clinic data of 71 patients with primary appendiceal tumor admitted in the Sixth Affiliated Hospital of Sun Yat-sen University between Dec 2012 and Jan 2019 were enrolled retrospectively. Multivariate logistic regression analysis were carried out to evaluate the risk factors of appendiceal tumor with peritoneal metastasis. Results: Of the 71 patients, 33 were peritoneal metastasis (peritoneal metastasis group) and 38 were non-peritoneal metastasis (no peritoneal metastasis group). Twenty-one patients in the peritoneal metastasis group had increased preoperative cancer embryo antigen (CEA), while 3 cases in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Sixteen cases in peritoneal metastasis group had increased preoperative carbohydrate antigen 199, while only 2 cases in the non-peritoneal metastasis group, the difference was statistically significant (P<0.001). The pathological type of 30 cases in the peritoneal metastasis group was adenocarcinoma (including mucus adenocarcinoma and colon adenocarcinoma), while 12 cases of adenocarcinoma in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Twelve cases in the peritoneal metastasis group had lymph node metastasis, while 3 cases in the non-peritoneal metastasis group, the difference is statistically significant (P=0.003). Preoperative CEA elevation and pathological type is adenocarinoma were independent risk factors for peritoneal metastasis of appendiceal cancer (P<0.05). Conclusions: The propensity of peritoneal metastasis in primary appendiceal tumor is high and the outcome is poor. Patients with increased preoperative CEA, adenocarcinoma histopathology are more inclined to have peritoneal metastasis.


Assuntos
Neoplasias do Apêndice , Neoplasias Peritoneais , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/cirurgia , Humanos , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco
17.
Khirurgiia (Mosk) ; (7): 31-35, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34270191

RESUMO

OBJECTIVE: To improve the short-term postoperative outcomes in patients with thymoma stage I-II by using of thoracoscopic thymectomy (VATS TE) and to compare this technique with open (OTE) thymectomy. MATERIAL AND METHODS: A retrospective analysis included 98 patients who had undergone surgery for thymoma stage I and II for the period from January 2001 to December 2019. VATS TE (main group) was performed in 53 (54.1%) cases, OTE (control group) - in 45 (45.9%) patients. RESULTS: Duration of VATS TE and OTE was similar. VATS procedure was characterized by less intraoperative blood loss (50 vs 225 ml, p=0.000), lower pain scores and morphine consumption (p=0.000), shorter postoperative pleural drainage (1.5 vs 3.8 days, p=0.000), and postoperative hospital-stay (7.6 vs 12.7 days, p=0.000). Incidence of major complications was significantly less in the main group (9.4% vs. 1.9%, p=0.001). CONCLUSION: VATS TE is effective and safe procedure for thymoma stage I-II. Postoperative period after VATS TE is characterized by less intraoperative blood loss, incidence of complications, duration of pleural drainage and hospital-stay.


Assuntos
Timoma , Neoplasias do Timo , Humanos , Estadiamento de Neoplasias , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida , Timectomia/efeitos adversos , Timoma/diagnóstico , Timoma/cirurgia , Neoplasias do Timo/diagnóstico , Neoplasias do Timo/cirurgia , Resultado do Tratamento
18.
J Coll Physicians Surg Pak ; 30(7): 792-797, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271778

RESUMO

OBJECTIVE: To determine the diagnostic value of breast and axillary maximum standard uptake (SUVmax) values for predicting ypT0 and ypN0 separately. STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital, between May 2017 and September 2020.  Methodology: Consecutive patients with operated breast cancer (BC) after neoadjuvant chemotherapy (NAC) were evaluated. SUVmax on FDG-PET/CT after NAC at both primary tumour (postSUVmax-T) and axillary lymph nodes (postSUVmax-N) were assessed to predict the ypT0 and the ypN0, respectively.  Results: Clinically meaningful correlation was detected between postSUVmax-N with ypN0 in patients with human epidermal receptor-positive (Her2+) and triple-negative (TN) BC (in Her2+ BC: r=0.596, p <0.001, in TN BC: r=0.782, p = 0.001). The postSUVmax-N predicted ypN0 with 90.5% positive predictive value (PPV) and 85.7% negative predictive value (NPV) in patients with Her2+ and TN BC. The postSUVmax-T predicted ypT0 with 87.5% PPV and 100% NPV in patients with TN BC (AUC: 0.938, P <0.01) Conclusion: According to this study's findings, the FDG-PET/CT may be an alternative to sentinel lymph node biopsy (SNB) to protect patients from axillary lymph node dissection when the expected FNR of the SNB is high in patients with Her+ and TN BC. Key Words: Breast cancer, FDG PET/CT, Neoadjuvant therapy.


Assuntos
Neoplasias da Mama , Terapia Neoadjuvante , Axila/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Feminino , Fluordesoxiglucose F18 , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons
19.
J Coll Physicians Surg Pak ; 30(7): 798-804, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271779

RESUMO

OBJECTIVE:  To determine the relationship between resected specimen length and tumor location, the number of LN harvested (LNh), and the positive LN ratio (LNR) in colon cancer. STUDY DESIGN: A descriptive study. Place & Duration of Study: Department of General Surgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, between January 2009 and December 2019. METHODOLOGY: Colon specimens resected for colon cancer were evaluated retrospectively, in terms of tumor location, type of surgery, resected colon length, LNh and the number of metastatic LN, based on hospital records. Chi-square test, Kruskal-Wallis along with Dunn-Bonferroni post hoc tests were applied. The lymph node ratio (LNR) (= ratio of LN+  to LNh), the number of lymph nodes per unit distance (LNh/cm), the ratio of LNR to length of specimen (LNR/cm) were evaluated. RESULTS: The rate of ≥12 LNh in 644 colon cancer patients was 81.4%. The length of colon specimen and the number of harvested lymph nodes (LNh) were higher in patients, who underwent subtotal colectomy (StC), compared to patients who underwent right and left hemicolectomy (RhC and LhC, p<0.001). Inadequate LNh was more common in LhC patients (p<0.001). The ratio of the number of LNh to the length of the resected specimen (LNh/cm) was higher in RhC and LhC patients than StC patients (p<0.001). LNR and LNR/cm were higher in LhC patients, though mean specimen length was shorter in LhC patients (p<0.05). The number of LNh had a direct proportion with the resected specimen length; however, the LNh/cm and LNR/cm ratios decreased in >50 cm length specimen patients (p<0.001). CONCLUSION: Central LN dissection and vascular high ligation, according to tumor site are more efficient than the length of the resected specimen for an adequate LN dissection in colon cancers. Key Words: Colon cancer, Harvested lymph node,  Specimen length, Adequate dissection.


Assuntos
Neoplasias do Colo , Excisão de Linfonodo , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Humanos , Linfonodos/patologia , Linfonodos/cirurgia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Turquia
20.
J Coll Physicians Surg Pak ; 30(7): 805-810, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271780

RESUMO

OBJECTIVE: To investigate the association between the ratio of negative/positive lymph nodes (RNP) and other clinic pathological parameters. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY:  Faculty of Medicine, Cumhuriyet University, Sivas, Turkey, from February 2008 to December 2019. METHODOLOGY: Consecutive 119 patients with gastric adenocarcinoma, who underwent gastrectomy and D2 lymph node dissection, were included. RNP, other clinicopathological parameters such as tumour grade, type and lymphovascular invasion (LVI) were analysed, as their prognostic impact was investigated. RESULTS: RNP was an independent prognostic factor for overall survival (p = 0.003) and was significantly associated with poor survival (p <0.001). Advanced pathologic T and N stage, presence of perineural invasion (PNI), presence of LVI, high tumour grade, and diffuse-type as per Louren's classification, and the number of the negative lymph nodes were also significantly associated with poor survival (all p <0.05). Although pathologic N stage (p <0.01), PNI (p <0.01), LVI (p <0.01), tumour type as per Louren's classification (p <0.01), tumour grade (p <0.01) and the number of negative lymph nodes (p <0.01) were significantly associated with overall survival in univariate analyses; only gender (p = 0.025), gastrectomy type (p = 0.037), PNI (p = 0.028), tumour type (p = 0.006), and number of  negative lymph nodes (p = 0.003) were meaningfully associated with survival in a multivariate analysis. CONCLUSION: The ratio of negative/positive lymph nodes can be used as an independent prognostic marker in patients with gastric cancer, who undergo curative resection, as an alternative prognostic marker to the pathologic N stage. Key Words: Stomach neoplasms, Lymph node ratio, Prognosis, Gastrectomy, Lymph nodes.


Assuntos
Adenocarcinoma , Neoplasias Gástricas , Adenocarcinoma/cirurgia , Gastrectomia , Humanos , Excisão de Linfonodo , Razão entre Linfonodos , Linfonodos/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Taxa de Sobrevida , Turquia/epidemiologia
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