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Savio G Barreto, Benjamin Loveday, John A Windsor, Sanjay Pandanaboyana
BACKGROUND: This systematic review aimed to determine the accuracy of imaging modalities to predict resectability and R0 resection for borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC) after neoadjuvant therapy (NAT). METHODS: A systematic search of major databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Fifteen studies identified 995 patients of which 683 had BRPC and 312 LAPC...
August 17, 2018: ANZ Journal of Surgery
Alexander D Croese, Omar N Zubair, James Lonie, Alexandra F Trollope, Venkat N Vangaveti, Chrispen Mushaya, Yik-Hong Ho
BACKGROUND: With decreasing indication for abdominoperineal resection and an increase in sphincter preserving surgery, there is a growing population of patients who suffer from low anterior resection syndrome (LARS). The aim of this study is to use the LARS score to determine the prevalence of LARS at a regional centre in Australia and determine the effect of short- and long-course neoadjuvant therapy, anastomotic technique and interval from surgery will also be assessed. METHODS: Patients who had undergone an anterior resection (high, low or ultralow) at a regional centre over an 11-year period were identified...
August 17, 2018: ANZ Journal of Surgery
Tae Gyu Kim, Won Park, Hakyoung Kim, Doo Ho Choi, Hee Chul Park, Seok-Hyung Kim, Yong Beom Cho, Seong Hyen Yun, Hee Cheol Kim, Woo Yong Lee, Jeeyun Lee, Ki Mun Kang
PURPOSE: There is uncertainty over the effect of systemic inflammatory response on oncologic outcomes in patients who underwent neoadjuvant chemoradiotherapy and surgery for rectal cancer. We investigated the association between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as markers of systemic inflammation and tumor response and prognosis after treatment. METHODS: A total of 176 patients who underwent neoadjuvant chemoradiotherapy and curative surgery for rectal cancer were analyzed retrospectively...
August 17, 2018: Tumori
Tao Chen, Zhenyuan Ning, Lili Xu, Xingyu Feng, Shuai Han, Holger R Roth, Wei Xiong, Xixi Zhao, Yanfeng Hu, Hao Liu, Jiang Yu, Yu Zhang, Yong Li, Yikai Xu, Kensaku Mori, Guoxin Li
OBJECTIVE: To develop and evaluate a radiomics nomogram for differentiating the malignant risk of gastrointestinal stromal tumours (GISTs). METHODS: A total of 222 patients (primary cohort: n = 130, our centre; external validation cohort: n = 92, two other centres) with pathologically diagnosed GISTs were enrolled. A Relief algorithm was used to select the feature subset with the best distinguishing characteristics and to establish a radiomics model with a support vector machine (SVM) classifier for malignant risk differentiation...
August 16, 2018: European Radiology
N Patel, Kieran G Foley, A G Powell, J R Wheat, D Chan, P Fielding, S A Roberts, W G Lewis
PURPOSE: PET/CT is now integral to the staging pathway for potentially curable esophageal cancer (EC), primarily to identify distant metastases undetected by computed tomography. The aim of this study was to analyze the effect of PET/CT introduction on survival and assess patterns of recurrence after esophagectomy. METHODS: A longitudinal cohort of EC patients staged between 1998 and 2016 were considered for inclusion. After co-variate adjustment using propensity scoring, a cohort of 496 patients (273 pre-PET/CT and 223 post-PET/CT) who underwent esophagectomy [median age 63 years (31-80), 395 males, 425 adenocarcinomas, 71 squamous cell carcinomas, 325 neoadjuvant therapy] were included...
August 16, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Michael J O'Grady, Josephine O'Grady, Rebecca Shine, Gerard Bonnet, Tim Eglington
AIM: The quality of rectal cancer management within New Zealand provincial hospitals is largely unknown. This study was conducted to appraise and benchmark the management of rectal cancer in provincial New Zealand centres as compared to specialist tertiary centres. METHOD: Retrospective data was collected for all patients who underwent elective rectal cancer resection in six provincial New Zealand hospitals from January 2012 to December 2013. This was then compared with data from two tertiary hospitals over the same time period...
August 17, 2018: New Zealand Medical Journal
Simon Gollins, Nicholas West, David Sebag-Montefiore, Shabbir Susnerwala, Stephen Falk, Nick Brown, Mark Saunders, Philip Quirke, Ruby Ray, Philip Parsons, Gareth Griffiths, Tim Maughan, Richard Adams, Chris Hurt
BACKGROUND: Neoadjuvant chemotherapy (NAC) allows earlier treatment of rectal cancer micro-metastases but is not standard of care. There are currently no biomarkers predicting long-term progression-free survival (PFS) benefit from NAC. PATIENTS AND METHODS: In this single arm phase II trial, patients with non-metastatic magnetic resonance imaging (MRI)-defined operable rectal adenocarcinoma at high risk of post-operative metastatic recurrence, received 8 weeks of oxaliplatin/fluorouracil NAC then short-course preoperative radiotherapy (SCPRT) before immediate surgery...
August 15, 2018: British Journal of Cancer
Courtney C Moreno, Patrick S Sullivan, Pardeep K Mittal
MRI is an integral part of the multidisciplinary treatment of rectal adenocarcinoma. Staging MRI is performed to establish TNM stage and assess for prognostic factors, including circumferential resection margin status and presence of extramural vascular invasion. The results of staging MRI determine which patients will undergo preoperative neoadjuvant chemoradiation before resection. Restaging MRI is performed to evaluate for treatment response and may identify patients with no residual visible tumor who are candidates for a "watch and wait" strategy in lieu of resection...
September 2018: Gastroenterology Clinics of North America
Hidetaka Miyashita, Kazunari Yoshida, Tomoya Soma, Kaori Kameyama, Aya Sasaki, Masanori Hisaoka, Masaki Yazawa, Hideo Morioka, Moe Takahashi, Taneaki Nakagawa, Hiromasa Kawana
BACKGROUND: Parosteal osteosarcomas are usually low-grade tumors, however, sometimes they transform to high-grade tumors, which is named dedifferentiation. This phenomenon has been reported in long bones. Recently, we encountered a patient with dedifferentiated parosteal osteosarcoma occurring in the maxilla. Here, we report a first case of dedifferentiated parosteal osteosarcoma of the head and neck region. CASE PRESENTATION: A 45-year-old Japanese woman with a refractory bone lesion in the maxilla presented to our hospital...
August 17, 2018: Journal of Medical Case Reports
Katherine S Cools, Hanna K Sanoff, Hong Jin Kim, Jen Jen Yeh, Karyn B Stitzenberg
BACKGROUND: Surgical resection provides the only potentially curative treatment of pancreatic cancer. Neoadjuvant chemotherapy and/or radiation (NAT) is used to downstage patients with borderline resectable tumors. The objective of this study was to examine the postoperative morbidity and mortality of NAT after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDA). METHODS: Using the American College of Surgeons-National Surgical Quality Improvement Project Targeted Pancreatectomy data, we identified patients who underwent a PD for PDA from 2014 to 2015...
August 16, 2018: Journal of Surgical Oncology
Matthew T Houdek, Karim Bakri, Meagan E Tibbo, Eric R Wagner, Peter S Rose, Franklin H Sim, Steven L Moran
INTRODUCTION: The vertical rectus abdominis (VRAM) flaps has been used to reliably reconstruct posterior soft tissue defects following resection of high sacral tumors, providing skin and soft tissue bulk to fill the potential space following sacral resection. Current literature examining the use of the VRAM flap for high sacral reconstruction is limited. The purpose of this study was to report our institutions outcome on the use of the VRAM flap to reconstruct a high sacral defect following an oncologic resection...
August 11, 2018: Plastic and Reconstructive Surgery
Katherine Rhoades, Betsy Smith, Michael Drew Honaker
No abstract text is available yet for this article.
July 1, 2018: American Surgeon
Sujen Jayakody, Danette Bianca Wright, Corrina Chiong, Mona Liu, Clare Bouffler, Toufic El-Khoury
BACKGROUND: Paclitaxel is a chemotherapy drug commonly used in the management of ovarian cancer. Colonic perforation is an extremely rare complication of paclitaxel administration with few case reports in the medical literature. We report a case of a patient with advanced ovarian cancer who had a rectal perforation following administration of paclitaxel. There has only been one other case report of rectal perforation in the medical literature following paclitaxel therapy. CASE PRESENTATION: A 55-year-old Caucasian woman with advanced ovarian cancer awaiting elective debulking surgery for her tumor presented to our emergency department with abdominal pain, vomiting, and diarrhea...
August 16, 2018: Journal of Medical Case Reports
Stefan Gabrielson, Alejandro Sanchez-Crespo, Fredrik Klevebro, Rimma Axelsson, Jon Albert Tsai, Ove Johansson, Magnus Nilsson
Background In most parts of the world, curatively intended treatment for esophageal cancer includes neoadjuvant therapy, either with chemoradiotherapy or chemotherapy alone, followed by esophagectomy. Currently 18F-FDG positron emission tomography/computed tomography (PET/CT) is used for preoperative disease staging, but is not well established in the evaluation of neoadjuvant treatment. Purpose To evaluate changes in PET parameters in relation to the histological primary tumor response in the surgical specimen in patients randomized to neoadjuvant chemoradiotherapy or chemotherapy...
August 15, 2018: Acta Radiologica
Jitesh B Shewale, Kyle G Mitchell, David B Nelson, Anthony P Conley, David C Rice, Mara B Antonoff, Wayne L Hofstetter, Garrett L Walsh, Stephen G Swisher, Jack A Roth, Reza J Mehran, Ara A Vaporciyan, Annikka Weissferdt, Boris Sepesi
BACKGROUND AND OBJECTIVES: Chest wall sarcomas are rare and may demonstrate heterogeneous features. Surgery remains the mainstay of treatment with chemotherapy and radiotherapy used as adjuncts. Herein, we report outcomes of a large cohort of patients with primary chest wall sarcoma who underwent resection. METHODS: Records of 121 patients who underwent resection for primary chest wall sarcoma between 1998 and 2013 were reviewed. A thoracic pathologist reexamined all tumors and categorized them according to grade...
August 15, 2018: Journal of Surgical Oncology
Justin T Matulay, Ashish M Kamat
Bladder cancer is a heterogeneous disease that poses unique challenges to the treating clinician. It can be limited to a relatively indolent papillary tumor with low potential for progression beyond this stage to muscle-invasive disease prone to distant metastasis. The former is best treated as conservatively as possible, whereas the latter requires aggressive surgical intervention with adjuvant therapies in order to provide the best clinical outcomes. Risk stratification traditionally uses clinicopathologic features of the disease to provide prognostic information that assists in choosing the best therapy for each individual patient...
2018: F1000Research
Elizabeth V Connor, Erica M Newlin, J Eric Jelovsek, Mariam M AlHilli
OBJECTIVE: To externally validate a model predicting non-home discharge in women undergoing primary cytoreductive surgery (CRS) for epithelial ovarian cancer (EOC). METHODS: Women undergoing primary CRS via laparotomy for EOC at three tertiary medical centers in an academic health system from January 2010 to December 2015 were included. Patients were excluded if they received neoadjuvant chemotherapy, had a non-epithelial malignancy, were not undergoing primary cytoreduction, or lacked documented model components...
August 11, 2018: Gynecologic Oncology
Jing Wang, Hongyu Gao, Guohui Liu, Lina Gu, Chang Yang, Fengmin Zhang, Tianbo Liu
We explored the correlation of tumor necrosis factor α-induced protein 8 (TNFAIP8) with platinum resistance in ovarian cancers (OCs) treated with neoadjuvant chemotherapy (NACT). We observed a significant trend of decreased TNFAIP8 expression after NACT (P=.042), and the extent of decreased TNFAIP8 expression following NACT was positively associated with response to NACT (P=.013). Interestingly, in patients treated with NACT, the extent of decreased TNFAIP8 expression following NACT in tumor (change in immunohistochemistry [ΔIHC] score≤-1 vs...
August 11, 2018: Human Pathology
Domenico Rubello, Maria Cristina Marzola, Patrick M Colletti
Published experiences related to the prognostic relevance of negative or positive FDG PET/CT in patients treated for ovarian cancer for progression-free survival and overall survival are typically heterogeneous retrospective analyses. Several points have been well defined, these are as follows: (a) there is a correlation between FDG tumor uptake and prognosis; (b) ovarian cancer patients treated by neoadjuvant or adjuvant chemotherapy can be divided into responders with reduction in tumor FDG uptake during and after treatment and nonresponders where tumor FDG uptake remains stable or increases after treatment;...
August 13, 2018: Clinical Nuclear Medicine
S Mine, M Watanabe, K Kumagai, A Okamura, K Yamashita, M Hayami, M Yuda, Y Imamura, N Ishizuka
BACKGROUND: Treatment of supraclavicular nodes remains controversial among patients with oesophageal squamous cell carcinoma. This study assessed the outcomes of patients who underwent oesophagectomy with or without supraclavicular lymphadenectomy after neoadjuvant treatment. METHODS: This was a single-centre retrospective cohort study. Patients with oesophageal squamous cell carcinoma and clinically negative supraclavicular nodes who underwent oesophagectomy after neoadjuvant treatment between January 2005 and December 2015 were included...
August 14, 2018: British Journal of Surgery
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