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1.
Anticancer Res ; 41(7): 3649-3656, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34230163

RESUMO

BACKGROUND/AIM: Postoperative pancreatic fistula after distal pancreatectomy represents the most frequent procedure-related complication; however, a standard treatment is currently not available. CASE REPORT: We herein report a case of postoperative pancreatic fistula after distal pancreatectomy and splenectomy in a patient affected by a platinum-sensitive ovarian cancer recurrence. The 59-year-old patient developed a pancreatic fistula on postoperative day 4. An endoscopic transgastric double-pigtail drainage was placed on postoperative day 13. The patient was discharged after 5 days and referred to adjuvant medical treatment. A month later, computed tomography revealed complete resolution of the fistula, the drainage was removed, and the patient continued chemotherapy. She recovered uneventfully at a 3-month follow-up. CONCLUSION: EUS-guided drainage is a viable option in the management of postoperative pancreatic fistula, which can lead to a rapid resolution of peripancreatic fluid collections and to initiation of adjuvant chemotherapy with the slightest delay in ovarian cancer patients.


Assuntos
Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/terapia , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/terapia , Fístula Pancreática/cirurgia , Fístula Pancreática/terapia , Drenagem/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Pâncreas/cirurgia , Pancreatectomia/métodos , Período Pós-Operatório , Esplenectomia/métodos
2.
BMJ Case Rep ; 14(7)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34226256

RESUMO

We document a case of a 24-year-old gravida 2, para 1 (1001), on her second trimester, who was referred to the surgical oncology service for a palpable right hemiabdominal mass. She previously underwent wide excision of a retroperitoneal atypical lipomatous tumour 2 years ago. Her current case was successfully managed by a multidisciplinary team of doctors from the preoperative phase, the actual surgery up to the adjuvant treatment. She had a two-staged surgery: an elective lower-segment caesarean section at 34 weeks age of gestation for which she delivered a healthy baby girl and, 2 weeks after, she had excision of the huge retroperitoneal tumour recurrence. Histopathology revealed a 35 cm×25 cm×22 cm dedifferentiated liposarcoma, for which she was started on adjuvant systemic chemotherapy.


Assuntos
Lipossarcoma , Neoplasias Retroperitoneais , Adulto , Cesárea , Feminino , Humanos , Recém-Nascido , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgia , Gravidez , Segundo Trimestre da Gravidez , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Adulto Jovem
3.
World J Surg Oncol ; 19(1): 206, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34243773

RESUMO

BACKGROUND: The oncological outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) following neoadjuvant chemotherapy have been investigated in a few studies. Our purpose was to evaluate the oncological outcomes of LG and OG after neoadjuvant chemotherapy in patients with locally advanced gastric cancer (GC) and to determine the advantages, preferences, and ease of use of the two techniques after chemotherapy. METHODS: We conducted a retrospective chart review of all patients who underwent either OG (n = 43) or LG (n = 41). The neoadjuvant treatment regimen consisted of capecitabine plus oxaliplatin for three cycles, which was then repeated 6 to 12 weeks after the operation for four cycles. RESULTS: The hospital stay time and intraoperative blood loss in the LG group were significantly lower than those in the OG group. The mortality rate and the 3-year survival rate for patients in the LG group were comparable to those of patients in the OG group (4.6% vs. 9.7% and 68.3% vs. 58.1%, respectively). Similar trends were observed regarding the 3-year recurrence rate and metastasis. The mean survival time was 52.9 months (95% confidence interval [CI], 44.2-61.6) in the OG group compared with 43.3 (95% CI, 36.6-49.8) in the LG group. Likewise, the mean disease-free survival was 56.1 months (95% CI, 46.36-65.8) in the LG group compared with 50.9 months (95% CI, 44.6-57.2) in the OG group. CONCLUSION: LG is a feasible and safe alternative to OG for patients with locally advanced GC receiving neoadjuvant chemotherapy.


Assuntos
Laparoscopia , Neoplasias Gástricas , Gastrectomia , Humanos , Terapia Neoadjuvante , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
4.
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
5.
Gan To Kagaku Ryoho ; 48(7): 955-957, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34267035

RESUMO

The case involved a 51-year-old woman who was diagnosed with Stage Ⅰ right breast cancer(cT1, N0, M0). Partial resection of the right breast and sentinel lymph node biopsy were performed. The histological type was found to be Stage Ⅰ triple-negative medullary carcinoma with pT1c, pN0(sn), and M0. A pituitary tumor was diagnosed after discharge. After removal of the pituitary tumor, whole-breast irradiation was performed. Subsequently, chemotherapy was started. Approximately 5 months after surgery, redness and swelling of the right breast were observed. Inflammatory breast cancer recurrence could not be ruled out by imaging, and skin biopsy was performed. No malignant findings were observed, and the symptoms were considered to indicate radiation recall dermatitis caused by chemotherapy. When chemotherapy was discontinued, the redness of the right breast improved.


Assuntos
Neoplasias da Mama , Neoplasias Inflamatórias Mamárias , Radiodermatite , Axila , Neoplasias da Mama/cirurgia , Feminino , Humanos , Neoplasias Inflamatórias Mamárias/diagnóstico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Radiodermatite/diagnóstico , Radiodermatite/etiologia , Biópsia de Linfonodo Sentinela
6.
Khirurgiia (Mosk) ; (7): 36-44, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34270192

RESUMO

OBJECTIVE: To determine the indications for combined and organ-sparing surgery depending on malignancy grade of retroperitoneal liposarcoma. MATERIAL AND METHODS: A retrospective study included 190 patients with retroperitoneal liposarcoma. Influence of malignancy grade, lesion of adjacent organs and resection/excision of adjacent organs on the overall and recurrence-free survival was studied. Moreover, we analyzed the issue of kidney-sparing surgery and nephrectomy. RESULTS: Overall and recurrence-free survival were significantly worse in high grade (G2-3) compared to low-grade tumors (G1) (p=0.0001; log-rank test). Visceral invasion was revealed in 23% of patients with low-grade (G1) tumors and 53% of patients with high-grade (G2-3) neoplasms. Visceral invasion significantly impairs overall and recurrence-free survival in both low grade (G1) and high-grade (G2-3) tumors (p=0.0001; log-rank test). In case of low grade (G1) retroperitoneal liposarcoma, overall and recurrence-free survival was similar after combined surgery without histologically confirmed visceral invasion of liposarcoma and organ-sparing surgery (p=0.006; p=0.053; log-rank test). On the contrary, high grade (G2-3) tumor was followed by significantly better overall and recurrence-free survival after combined surgery without histologically confirmed visceral invasion compared to organ-sparing surgery (p=0.006; p=0.053; log-rank test). Recurrence-free survival was similar after kidney-sparing surgery and nephrectomy among patients with low-grade (G1) tumor (p=0.456; log-rank test). In case of high-grade retroperitoneal liposarcoma (G2-3), recurrence-free survival was significantly worse after kidney-sparing surgery compared to nephrectomy (p=0.039; log-rank test). CONCLUSION: Surgery is the only potentially radical treatment of patients with retroperitoneal liposarcoma. Organ-sparing including kidney-sparing surgery is advisable for low-grade liposarcoma (G1). On the contrary, organ-sparing surgery impairs long-term results and prognosis in patients with high-grade tumors (G2-3). Combined operations including nephrectomy are justified for high-grade retroperitoneal liposarcoma (G2-3).


Assuntos
Lipossarcoma , Neoplasias Retroperitoneais , Humanos , Lipossarcoma/diagnóstico , Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/cirurgia , Estudos Retrospectivos
7.
J Coll Physicians Surg Pak ; 30(7): 833-836, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271786

RESUMO

OBJECTIVE: To analyse the malignant chest wall tumors in terms of histological types and confer option for resection, stabilisation and reconstruction, along with postoperative morbidity and mortality. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Thoracic Surgery, CMH Rawalpindi, Lahore and Multan from January, 2010 to October, 2018. METHODOLOGY: Patients who had histologically proven malignant tumors of chest wall and breast with bone involvement, and required resection, stabilisation, mesh reinforcement and muscle flap reconstruction, were included. Small soft tissue tumors without bony involvement which did not require reconstruction, primary tumors of spine, pancoast tumors and lung tumors involving chest wall were excluded from the study. Record of these patients including age, gender, histopathological type, reconstruction method used, postoperative complications, mortality and recurrence were noted. Data was analysed using descriptive statistics. RESULTS: The study included 86 patients with 61 (70.9%) males and 25 (29.1%) females; age ranging from 18 to 77 years with mean age of 47.84 ± 12.9 years. Palpable mass was the most common symptom occurring in 61 (70.9%) patients. Twenty-one (24.4%) had breast tumor with chest wall invasion. In the remaining cases, most common histological type was chondrosarcoma occurring in 13 (15.1%) patients, followed by Ewing sarcoma in 12 (14%) patients. The most common complication was post-thoracotomy neuralgia (PTN), occurring in 25 (29.1%) patients. CONCLUSION: Malignant tumors of the chest wall are rare entity which can be effectively treated with chest wall resection, mesh reinforcement for stabilisation and muscle flaps for reconstruction with acceptable postoperative complications, morbidity and mortality. Key Words: Primary, Malignant, Chest wall, Tumors, Chest wall reconstruction, Stability of chest wall.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Neoplasias Torácicas , Parede Torácica , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Retalhos Cirúrgicos , Telas Cirúrgicas , Neoplasias Torácicas/cirurgia , Parede Torácica/cirurgia , Adulto Jovem
8.
World J Surg Oncol ; 19(1): 175, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34127007

RESUMO

BACKGROUND: Repeat hepatectomy and radiofrequency ablation (RFA) are widely used to treat early recurrent hepatocellular carcinoma (RHCC) located in the subcapsular region, but the optimal treatment strategy remains to be controversial. METHODS: A total of 126 RHCC patients in the subcapsular location after initial radical hepatectomy were included in this study between Dec 2014 and Jan 2018. These patients were divided into the RFA group (46 cases) and the repeat hepatectomy group (80 cases). The primary endpoints include repeat recurrence-free survival (rRFS) and overall survival (OS), and the secondary endpoint was complications. The propensity-score matching (PSM) was conducted to minimize the bias. Complications were evaluated using the Clavien-Dindo classification, and severe complications were defined as classification of complications of ≥grade 3. RESULTS: There were no significant differences in the incidence of severe complications were observed between RFA group and repeat hepatectomy group in rRFS and OS both before (1-, 2-, and 3-year rRFS rates were 65.2%, 47.5%, and 33.3% vs 72.5%, 51.2%, and 39.2%, respectively, P = 0.48; 1-, 2-, and 3-year OS rates were 93.5%, 80.2%, and 67.9% vs 93.7%, 75.8%, and 64.2%, respectively, P = 0.92) and after PSM (1-, 2-, and 3-year rRFS rates were 68.6%, 51.0%, and 34.0% vs 71.4%, 42.9%, and 32.3%, respectively, P = 0.78; 1-, 2-, and 3-year OS rates were 94.3%, 82.9%, and 71.4% vs 88.6%, 73.8%, and 59.0%, respectively, P = 0.36). Moreover, no significant differences in the incidence of severe complications were observed between the RFA group and repeat hepatectomy group. CONCLUSION: Both repeat hepatectomy and RFA are shown to be effective and safe for the treatment of RHCC located in the subcapsular region.


Assuntos
Carcinoma Hepatocelular , Ablação por Cateter , Neoplasias Hepáticas , Ablação por Radiofrequência , Carcinoma Hepatocelular/cirurgia , Hepatectomia , Humanos , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
9.
Chin Med J (Engl) ; 134(13): 1576-1583, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34133352

RESUMO

BACKGROUND: Various prediction tools have been developed to predict biochemical recurrence (BCR) after radical prostatectomy (RP); however, few of the previous prediction tools used serum prostate-specific antigen (PSA) nadir after RP and maximum tumor diameter (MTD) at the same time. In this study, a nomogram incorporating MTD and PSA nadir was developed to predict BCR-free survival (BCRFS). METHODS: A total of 337 patients who underwent RP between January 2010 and March 2017 were retrospectively enrolled in this study. The maximum diameter of the index lesion was measured on magnetic resonance imaging (MRI). Cox regression analysis was performed to evaluate independent predictors of BCR. A nomogram was subsequently developed for the prediction of BCRFS at 3 and 5 years after RP. Time-dependent receiver operating characteristic (ROC) curve and decision curve analyses were performed to identify the advantage of the new nomogram in comparison with the cancer of the prostate risk assessment post-surgical (CAPRA-S) score. RESULTS: A novel nomogram was developed to predict BCR by including PSA nadir, MTD, Gleason score, surgical margin (SM), and seminal vesicle invasion (SVI), considering these variables were significantly associated with BCR in both univariate and multivariate analyses (P < 0.05). In addition, a basic model including Gleason score, SM, and SVI was developed and used as a control to assess the incremental predictive power of the new model. The concordance index of our model was slightly higher than CAPRA-S model (0.76 vs. 0.70, P = 0.02) and it was significantly higher than that of the basic model (0.76 vs. 0.66, P = 0.001). Time-dependent ROC curve and decision curve analyses also demonstrated the advantages of the new nomogram. CONCLUSIONS: PSA nadir after RP and MTD based on MRI before surgery are independent predictors of BCR. By incorporating PSA nadir and MTD into the conventional predictive model, our newly developed nomogram significantly improved the accuracy in predicting BCRFS after RP.


Assuntos
Nomogramas , Neoplasias da Próstata , Humanos , Masculino , Gradação de Tumores , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Antígeno Prostático Específico , Prostatectomia , Neoplasias da Próstata/cirurgia , Estudos Retrospectivos , Glândulas Seminais
10.
Gan To Kagaku Ryoho ; 48(6): 833-836, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34139734

RESUMO

A 72-year-old woman underwent sigmoid colon resection plus D2 lymph node dissection in 2008, with additional resection after endoscopic mucosal resection(EMR). Histopathological examination revealed only atypical ducts in the EMR scar, with no invasion below the submucosa. No lymphatic, venous, or nerve invasions were confirmed, and oral and anal stumps and lymph node metastases were negative. She was followed up for 5 years after the surgery, and no recurrence was detected. In 2018, she visited our hospital with the chief complaint of diarrhea and constipation. Colonoscopy revealed a circumferential lesion around the anastomosis. She underwent laparoscopic low anterior resection for suspected anastomotic recurrence, which was confirmed by histopathological diagnosis. The anastomotic recurrence 10 years after surgery for SM cancer of the colon with negative lymph node metastasis and vascular factor was extremely rare. We recognized the importance of surveillance 5 years after surgery.


Assuntos
Neoplasias do Colo Sigmoide , Idoso , Anastomose Cirúrgica , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática , Recidiva Local de Neoplasia/cirurgia , Neoplasias do Colo Sigmoide/cirurgia
15.
Int. braz. j. urol ; 47(3): 484-494, May-June 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1154488

RESUMO

ABSTRACT Prostate cancer is the most common invasive cancer in men. Radical prostatectomy (RP) is a definitive treatment option, but biochemical recurrence can reach 40%. Salvage lymphadenectomy is a relatively recent approach to oligometasis and has been rapidly diffused primarily due to improvement in imaging diagnosis and results showing possibly promising therapy. A systematic literature review was performed in March 2020, according to the PRISMA statement. We excluded studies with patients with suspicion or confirmation of visceral and / or bone metastases. A total of 27 articles were included in the study. All studies evaluated were single arm, and there were no randomized studies in the literature. A total of 1,714 patients received salvage lymphadenectomy after previous treatment for localized prostate cancer. RP was the most used initial therapeutic approach, and relapses were based on PET / CT diagnosis, with Coline-11C being the most widely used radiopharmaceutical. Biochemical response rates ranged from 0% to 80%. The 5 years - Free Survival Biochemical recurrence was analyzed in 16 studies with rates of 0% up to 56.1%. The articles do not present high levels of evidence to draw strong conclusions. However, even if significant rates of biochemical recurrence are not evident in all studies, therapy directed to lymph node metastases may present good oncological results and postpone the onset of systemic therapy. The long-term impact in overall survival and quality of life, as well as the best strategies for case selection remains to be determined.


Assuntos
Humanos , Masculino , Neoplasias da Próstata/cirurgia , Qualidade de Vida , Prostatectomia , Terapia de Salvação , Excisão de Linfonodo , Linfonodos , Recidiva Local de Neoplasia/cirurgia
16.
Zhonghua Wai Ke Za Zhi ; 59(6): 447-451, 2021 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-34102726

RESUMO

Hepatocellular carcinoma(HCC) is a common malignant tumor with high morbidity and mortality in China and even in the world.Due to its tumor heterogeneity and dissemination and distant metastasis,prognosis of patients with HCC is often poor.Surgical treatment such as radical hepatectomy is still the first choice for patients with HCC in the current clinical practice.However,the high recurrence and metastasis rate after surgery still hinder the survival and prognosis of these patients.In the era of target and immunotherapy,changes of surgical treatment strategy for HCC is particularly critical.This review focuses on the definition,the feasibility and the evaluation criteria of neoadjuvant therapy for HCC,to provide a new perspective on surgical treatment for HCC.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Carcinoma Hepatocelular/cirurgia , China , Hepatectomia , Humanos , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/cirurgia , Prognóstico
17.
Ugeskr Laeger ; 183(25)2021 06 21.
Artigo em Dinamarquês | MEDLINE | ID: mdl-34169824

RESUMO

MR-guided laser interstitial thermal therapy (LITT) is a minimally invasive neurosurgical procedure, which in the last decade has gained significant momentum of the treatment of intracranial tumours and epileptic foci. In brief, LITT utilises the heat from a stereotactically placed laser catheter to selectively ablate a lesion or a structure under real-time MRI guidance, which is summarised and discussed in this review. The first LITT system gained FDA approval in 2007 and was CE-marked in 2018. In December 2020, the first patient with recurrent glioblastoma was treated at the Department of Neurosurgery at Rigshospitalet, Copenhagen.


Assuntos
Neoplasias Encefálicas , Epilepsia , Terapia a Laser , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Epilepsia/cirurgia , Humanos , Lasers , Imageamento por Ressonância Magnética , Recidiva Local de Neoplasia/cirurgia
18.
World J Surg Oncol ; 19(1): 183, 2021 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158071

RESUMO

BACKGROUND: Sentinel lymph node biopsy (SLNB) is the standard approach for the axillary region in early breast cancer patients with clinically negative nodes. The present study investigated patients with false-negative sentinel nodes in intraoperative frozen sections (FNSN) using real-world data. METHODS: A case-control study with a 1:3 ratio was conducted. FNSN was determined when sentinel nodes (SNs) were negative in frozen sections but positive for metastasis in formalin-fixed paraffin-embedded (FFPE) sections. The control was defined as having no metastasis of SNs in both frozen and FFPE sections. RESULTS: A total of 20 FNSN cases and 60 matched controls from 333 SLNB patients were enrolled between April 1, 2005, and November 31, 2009. The demographics and intrinsic subtypes of breast cancer were similar between the FNSN and control groups. The FNSN patients had larger tumor sizes on preoperative mammography (P = 0.033) and more lymphatic tumor emboli on core biopsy (P < 0.001). Four FNSN patients had metastasis in nonrelevant SNs. Another 16 FNSN patients had benign lymphoid hyperplasia of SNs in frozen sections and metastasis in the same SNs from FFPE sections. Micrometastasis was detected in seven of 16 patients, and metastases in nonrelevant SNs were recognized in two patients. All FNSN patients underwent a second operation with axillary lymph node dissection (ALND). After a median follow-up of 143 months, no FNSN patients developed breast cancer recurrence. The disease-free survival, breast cancer-specific survival, and overall survival in FNSN were not inferior to those in controls. CONCLUSIONS: Patients with a larger tumor size and more lymphatic tumor emboli have a higher incidence of FNSN. However, the outcomes of FNSN patients after completing ALND were noninferior to those without SN metastasis. ALND provides a correct staging for patients with metastasis in nonsentinel axillary lymph nodes.


Assuntos
Neoplasias da Mama , Secções Congeladas , Axila/patologia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Estudos de Casos e Controles , Feminino , Humanos , Excisão de Linfonodo , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Prognóstico , Biópsia de Linfonodo Sentinela
19.
Rozhl Chir ; 100(4): 173-179, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34182759

RESUMO

INTRODUCTION: Pagets disease of the breast (PD) is a rare type of carcinoma that affects the skin of the nipple-areolar complex. Unresolved issues exist regarding its diagnosis and therapy. The aim of the study was to gather data on how the therapy of the disease is approached in clinical practice, and to formulate current diagnostic and therapeutic recommendations. METHODS: Retrospective evaluation of data from medical records of patients with PD who underwent surgery at our department between 2001 and 2020. The data was evaluated using basic statistical methods. RESULTS: Sixty four female patients with the mean age of 62.5 years. In 58 women, PD was confirmed before surgery, with the median of 20 weeks from initial symptoms to diagnosis. Forty seven of the patients were operated for presumed isolated PD; in 38 cases, histopathological evaluation of the specimen revealed an associated malignancy in the mammary gland. Primary breast-conserving surgery (BCS) was performed in 46 patients; surgical revision was indicated in 17 cases. In 6 patients with PD associated with non-invasive breast cancer treated by BCS without radiotherapy (RT), a local recurrence appeared in 3 cases, which is significantly more compared to the group of patients undergoing total mastectomies (p=0.032). No local recurrence appeared in 9 cases of isolated PD treated by BCS, including 6 patients without RT. The tumors associated with PD were mostly ER-negative (44/57) and HER2-positive (22/25). CONCLUSION: In cases where PD is suspected, careful clinical examination and the use of available diagnostic imaging techniques including MRI are appropriate. BCS without RT is not an adequate oncological therapy where an associated malignancy of the breast is found.


Assuntos
Neoplasias da Mama , Doença de Paget Mamária , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia Segmentar , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Doença de Paget Mamária/cirurgia , Estudos Retrospectivos
20.
Int J Hyperthermia ; 38(1): 875-886, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34078221

RESUMO

BACKGROUND & AIMS: Liver resection (LR) and radiofrequency ablation (RFA) are commonly used for the treatment of recurrent hepatocellular carcinoma (HCC), but the optimal treatment modality remains unclear. We aimed to compare the efficacy and safety of LR vs RFA for recurrent HCC. METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant studies. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes were major complications and hospital stay. RESULTS: Eighteen studies with 1991 patients with recurrent HCC were included. The pooled hazard ratio (HR) for OS demonstrated that LR had significantly better OS than RFA in recurrent HCC (HR, 0.81; 95% confidence interval [CI], 0.68-0.95). Specifically, LR was associated with higher 2-, 3- and 4-year OS rates compared with RFA. The pooled HR for DFS showed no significant difference between LR and RFA during the whole follow-up period (HR, 0.90; 95% CI, 0.76-1.07). However, LR was associated with significantly higher 2- to 5-year DFS rates compared to RFA. LR was also associated with more major complications (p < .001) and longer hospital stay (p < .001). Subgroup analyses demonstrated that LR and RFA had similar efficacy in patients with recurrent tumors less than 3 cm or patients presenting three or fewer recurrent nodules. CONCLUSION: LR could provide better long-term survival outcomes than RFA for recurrent HCC patients, while RFA has a higher safety profile. RFA can be a good alternative to LR for patients with small-sized recurrence or patients with a limited number of recurrent nodules. However, as tumor size increases, LR tends to be more efficacious.


Assuntos
Carcinoma Hepatocelular , Ablação por Cateter , Neoplasias Hepáticas , Ablação por Radiofrequência , Carcinoma Hepatocelular/cirurgia , Humanos , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/cirurgia , Resultado do Tratamento
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