A five-year follow up study of stage I-IV of rectal cancer with an emphasis on epidermal growth factor over-expression.

The key pro-proliferative pathway, based on EGFR-KRAS/BRAF-myc, is seen as the main goal of personalized therapy in rectal cancer. The objective of the study is to assess the EGFR immunoreactivity in rectal cancer and to estimate its relationship with the clinical outcome, especially as a predictor of poor outcomes. Patients: applying exclusion criteria, 102 patients with stage I-IV rectal cancer, who had undergone scheduled surgery during the period 2005-2011, were included in the study. There was a follow-up study with a span of 5 years from the date of the surgery. Immunohistochemistry using EGFR (EGFR Ab10, Clone111.6) was performed to detect an overexpression of the targeted receptor. Digital analysis of positive reactions of membranes was performed utilizing VisiopharmTM. The degree of EGFR intensity (log OR 0.854, OR 2.35, 95% Cl: 1.14-4.85, p = 0.021) is a significant factor in the prognosis of death within 2 years of surgery. The OS curve showed a significant decrease after 40 months from the date of surgery in the cases where EGFR had a high expression. The ROC curve for the cancer stage, according to the UICC classification and EGFR expression, in order to predict a 2-year RFS, reached a high specificity value (ROC = 0.81, p = 0.0408). Immunohistochemical EGFR expression is inexpensive, specific and broadly available.

P21 is not a prognostic marker for rectal cancer - five-year follow up study of rectal cancer in stages I-IV.

The p21 participates in the regulation of DNA repair and replication, and modulation of apoptosis as well. After DNA damage, the p53-dependent induction of p21 results in cell cycle arrest or could trigger cell apoptosis. The objective of the study was the assessment of p21 immunoreactivity in rectal cancer and the estimation of relationships with clinical outcome especially as predictor of poor outcome. While applying the ruling in and out criteria, 102 patients were incorporated to the study, with stage I-IV rectal cancer who had undergone surgery in a planned mode during 2005-2011. The follow-up covered 5 years period from surgery date. Conventional immunohistochemistry were performed using antibody against p21 (p21WAF1 (Clone H252) to detect overexpression targeted receptor. The analysis showed no statistically significant differences in the survival curves of patients in groups with immunoreactivity of p21 protein at 0; 1; 2; 3 (p = 0.6453 in the log-rank test), also is not a significant risk factor for death (HR = 0.915, p = 0.7842) and for tumor dissemination (HR = 0.94, p = 0.9426). Our study leads to the conclusion that the probability of survival does not depend on p21 expression and do not authorize the importance of p21 immunoreactivity in the detection and monitoring of rectal cancer treatment.

Gastric gastrointestinal stromal tumor with incomplete duplication cyst - a case with possibility of neoplasia in fetal-period malformed tissues.

The coincidence of GIST and other gastric malignancies are documented well but arising GIST from congenital anomalies is still rarity in literature. To date, only a few papers have been concerned on the possibility of arising neoplasms from duplication cyst of gastrointestinal tract. There, are dominating usual cancers, neuroendocrine cancers or lymphomas but GIST has been noted only once. Here, we report a case of 73 years old female-patient with typical gastric stromal tumor comprised centrally locked an incomplete duplication cyst.

[Clinical problems of extended intestinal resections]. / Problemy kliniczne rozszerzonych zabiegów resekcyjnych jelit.

UNLABELLED: Extended intestinal resections constitute a primary surgical problem, and in numerous cases there is the necessity of programming an appropriate nutrition, including parenteral nutrition at patient's home. The aim of the work was to examine treatment problems: surgery indications, complications and the after-effects of extended intestinal resections as well as the procedure rules. MATERIALS AND METHODS: The group of 51 patients with extended intestinal resections who were subjected to treatment in the years 1988-2002. The group was comprised of 25 female patients with the average age 64.2 years (34-86) and 26 male patients at the age of 56.3 (21-72). RESULTS: Extended intestinal resections resulted from: cancer--30, ischemia (embolism, thrombosis)--12, injury--3, inflammatory bowel diseases--2, intestinal polyposis--2, diverticulosis with hemorrhages--1, toxic necrosis--1.9 deaths were recorded within the post-operative period: 7 (that is 7 of 12) due to ischemia, 1 due to cancer, 1 due to colon toxicum. The overall mortality rate was 17% (that is 9 deaths of all the 51 patients); the highest rate reached as much as 58.3% in the ischemia cases. The most frequent reason of the deaths following extended intestinal resections performed due to ischemia of intestine was: the impossibility of hemodynamic stabilization--3, the escalation of intestinal ischemia and septic shock--2, simultaneously both causes--2. The average length of time between admittance to hospital and surgical intervention was 5.1 days (0-31); the average length of stay in hospital amounted to 20.8 days (2-102). CONCLUSIONS: Extended intestinal resections were the most frequently performed due to neoplastic or vascular reasons. Such surgical interventions are fraught with a high risk of complications and deaths. Furthermore, the foregoing surgeries demand a very expensive therapeutic procedure including the post-operative parenteral nutrition.