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Palliative surgery

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https://www.readbyqxmd.com/read/27909972/can-we-estimate-short-and-intermediate-term-survival-in-patients-undergoing-surgery-for-metastatic-bone-disease
#1
Jonathan A Forsberg, Rikard Wedin, Patrick J Boland, John H Healey
BACKGROUND: Objective means of estimating survival can be used to guide surgical decision-making and to risk-stratify patients for clinical trials. Although a free, online tool ( www.pathfx.org ) can estimate 3- and 12-month survival, recent work, including a survey of the Musculoskeletal Tumor Society, indicated that estimates at 1 and 6 months after surgery also would be helpful. Longer estimates help justify the need for more durable and expensive reconstructive options, and very short estimates could help identify those who will not survive 1 month and should not undergo surgery...
December 1, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27908501/prospective-evaluation-of-surgical-palliative-care-immersion-training-for-general-surgery-residents
#2
Mustafa Raoof, Lisa O'Neill, Leigh Neumayer, Mindy Fain, Robert Krouse
BACKGROUND: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. STUDY DESIGN: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework...
November 27, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27904933/-metastatic-disease-in-long-bones-review-of-surgical-treatment-options
#3
Franz Liska, Philipp Schmitz, Norbert Harrasser, Peter Prodinger, Hans Rechl, Rüdiger von Eisenhart-Rothe
Surgery in metastatic bone disease is currently the most frequent type of surgery in orthopedic oncology. Improved survival rates and an increasing incidence of bone metastasis have led to an increase in complications caused by metastatic disease, such as pathological fractures or hardware failure after operative treatment. Although surgery of metastatic lesions remains a palliative therapy concept, because of sufficient therapy for the primary carcinomas, tumor-specific-oriented follow-up protocols and a variation in the prognosis for the individual entities, an individually adapted treatment strategy is necessary...
November 30, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27903668/malignant-pleural-mesothelioma-an-update-on-investigation-diagnosis-and-treatment
#4
Anna C Bibby, Selina Tsim, Nikolaos Kanellakis, Hannah Ball, Denis C Talbot, Kevin G Blyth, Nick A Maskell, Ioannis Psallidas
Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#5
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27898747/-review-of-medical-or-combined-treatment-of-local-or-locally-advanced-oesophageal-cancer
#6
Tünde Nagy, Gábor Rubovszky
More than 800 oesophageal tumours are diagnosed each year in Hungary. The disease is characterized by high mortality. The curative treatment traditionally surgical, although the study results of recent decades pointed out that patient outcome can be improved with the proper application of radio- and chemotherapy. The diverse study designs, the low number of recruited patients and the sometimes conflicting results make the determination of optimal treatment difficult. The aim of this work is to facilitate the choice of treatment modality with the best outcome, especially with the view of medical oncologists...
November 29, 2016: Magyar Onkologia
https://www.readbyqxmd.com/read/27895410/collision-tumor-of-hepatocellular-carcinoma-and-neuroendocrine-carcinoma-involving-the-liver-case-report-and-review-of-the-literature
#7
Gyu Ho Choi, Sun Young Ann, Soon Il Lee, Suk Bae Kim, Il Han Song
Primary hepatic neuroendocrine carcinoma (NEC) with concurrent occurrence of hepatocellular carcinoma (HCC) of the liver is very rare. Only 8 cases have been reported in the literature. Concurrent occurrence of HCC and NEC in the liver is classified as combined type or collision type by histological distributional patterns; only 2 cases have been reported. Herein, we report a case of collision type concurrent occurrence of HCC and NEC, in which primary hepatic NEC was in only a small portion of the nodule, which is different from the 2 previously reported cases...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27893189/a-first-population-based-long-term-outcome-study-in-adults-with-repaired-tetralogy-of-fallot-in-malta
#8
Maryanne Caruana, Victor Grech
OBJECTIVES: To determine overall and reintervention-free survival for repaired Maltese tetralogy of Fallot patients and to investigate the potential impact of gender, age at repair, genetic syndromes, previous palliation, and type of repair on these outcomes. DESIGN: All 130 tetralogy of Fallot patients born before the end of 1997 included in the local database were extracted. Surgical repair type, age at repair and operative survival were analyzed among the 103/130 repaired patients...
November 28, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27890291/principles-and-applications-of-surgical-oncology-in-exotic-animals
#9
REVIEW
Michele A Steffey
The diagnosis and treatment of cancer in exotic species is a rapidly evolving area of veterinary medicine. In general, surgical excision remains pivotal in cancer treatment, although optimal outcomes are achieved when a coherent and thorough diagnostic and therapeutic plan is created prior to surgery. While surgical cure is not always achieveable, multimodal treatment plans can offer a variety of options, and palliative procedures may be used to improve quality of life. Treatment goals, whether curative intent or palliative intent, should be identified before surgery, and practitioners should endeavor to adhere to surgical principles in order to attain the best outcomes...
January 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/27889785/overcoming-cost-implications-of-mutational-analysis-in-patients-with-gastrointestinal-stromal-tumors-a-pragmatic-approach
#10
Patrick Schöffski, Agnieszka Wozniak, Oliver Schöffski, Liesbet van Eycken, Maria Debiec-Rychter
BACKGROUND: Genetic analysis of tissue derived from patients with advanced gastrointestinal stromal tumors (GISTs) is not uniformly applied on a national and international level, even though mutational data can provide clinically relevant prognostic and predictive information, especially in patients qualifying for treatment with expensive targeted agents. METHODS: The current article describes the rationale for genetic testing of GIST tissue, looks at financial implications associated with such analysis and speculates on potential cost savings introduced by routine mutational testing and tailored use of tyrosine kinase inhibitors based on genotyping...
2016: Oncology Research and Treatment
https://www.readbyqxmd.com/read/27889195/metastasectomy-in-cutaneous-melanoma
#11
REVIEW
K Lasithiotakis, O Zoras
Metastectomy remains the only treatment in malignant melanoma to offer complete pathologic response within a few days of in-hospital stay. It has been historically associated with the highest survival rates in the literature reported for patients of this stage. However, only a minority of patients are amenable to curative resection of distant metastatic disease. This patient group exhibit slow growing oligometastases as indicated by: a. Long disease free interval after treatment of their primary tumours and b...
November 13, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27888148/a-pilot-study-of-a-multimodal-treatment-paradigm-to-accelerate-drug-evaluations-in-early-stage-metastatic-prostate-cancer
#12
Matthew J O'Shaughnessy, Sean M McBride, Hebert Alberto Vargas, Karim A Touijer, Michael J Morris, Daniel C Danila, Vincent P Laudone, Bernard H Bochner, Joel Sheinfeld, Erica S Dayan, Lawrence P Bellomo, Daniel D Sjoberg, Glenn Heller, Michael J Zelefsky, James A Eastham, Peter T Scardino, Howard I Scher
OBJECTIVE: To evaluate a multimodal strategy aimed at treating all sites of disease that provides a rapid readout of success or failure in men presenting with noncastrate metastatic prostate cancers that are incurable with single modality therapy. PATIENTS AND METHODS: Twenty selected men with oligometastatic M1a (extrapelvic nodal disease) or M1b (bone disease) at diagnosis were treated using a multimodal approach that included androgen deprivation, radical prostatectomy plus pelvic lymphadenectomy (retroperitoneal lymphadenectomy in the presence of clinically positive retroperitoneal nodes), and stereotactic body radiotherapy to osseous disease and/or the primary site...
November 22, 2016: Urology
https://www.readbyqxmd.com/read/27885946/epilepsy-surgery-in-patients-with-autism
#13
Malgosia A Kokoszka, Patricia E McGoldrick, Maite La Vega-Talbott, Hillary Raynes, Christina A Palmese, Steven M Wolf, Cynthia L Harden, Saadi Ghatan
OBJECTIVE The purpose of this study was to report outcomes of epilepsy surgery in 56 consecutive patients with autism spectrum disorder. METHODS Medical records of 56 consecutive patients with autism who underwent epilepsy surgery were reviewed with regard to clinical characteristics, surgical management, postoperative seizure control, and behavioral changes. RESULTS Of the 56 patients with autism, 39 were male, 45 were severely autistic, 27 had a history of clinically significant levels of aggression and other disruptive behaviors, and 30 were considered nonverbal at baseline...
November 25, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27884196/palliative-treatment-of-pelvic-bone-tumors-using-radioiodine-125-i-brachytherapy
#14
Chongren Wang, Zhengqi Chen, Wei Sun, Yisilamu Yasin, Chuanyin Zhang, Xiaojun Ma, Jian Chen, Jiakang Shen, Yingqi Hua, Zhengdong Cai
BACKGROUND: Complete resection of pelvic bone tumors, especially recurrent and metastatic ones, is often impossible to achieve using conventional surgery. This study aimed to assess the benefits and adverse effects of computed tomography (CT)-guided radioiodine ((125)I) brachytherapy for inoperable recurrent and metastatic bone tumors of the pelvis. METHODS: This was a retrospective study of 22 patients with confirmed pelvic bone tumors (10 females and 12 males; 15-84 years; 21 with primary pelvic tumor and one with pelvic metastasis)...
November 25, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27875414/the-influence-of-histologic-subtype-in-predicting-survival-of-lung-cancer-patients-with-spinal-metastases
#15
Naresh Kumar, Kimberly-Anne Tan, Jiong Hao Tan, Aye S Zaw, Hwee Weng Dennis Hey, John Ruiz, Emily Stone
STUDY DESIGN: Retrospective analysis. SUMMARY OF BACKGROUND DATA: Recent advancements in systemic treatment of lung cancer have significantly improved the survival of patients with certain histolopathologic and molecular subtypes. Existing prognostic scores do not account for this and patients with lung cancer spinal metastases are grouped together as poor prognostic candidates, and consequently, some may be inappropriately denied palliative spine surgery. OBJECTIVE: The objective of the study was to study whether the expected survival in patients with lung cancer spinal metastases is affected by histolopathologic and molecular subtypes in the context of modern systemic therapy...
November 21, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27872935/the-social-transformation-of-singapore-medicine-through-55-years-of-the-smj
#16
Ee Heok Kua, Jade Phek Hui Kua
The Singapore Medical Journal (SMJ) has in the past 55 years reflected the phenomenal socioeconomic progress of Singapore. Publications in the pre-independent years were mainly on diseases like cholera, diphtheria, leprosy, tetanus and worm infestation. In the new millennium, the research papers included molecular genetics, health economics, obesity, Internet medicine, cancer, cosmetic surgery and palliative medicine. The annual SMA Lecture published in the SMJ provides an ethical compass for doctors to remind them of primum non nocere...
November 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27867922/palliative-resection-of-metastatic-brain-tumors-previously-treated-by-stereotactic-radiosurgery
#17
Yoo Sung Jeon, Young-Cho Koh, Sang Woo Song, Joon Cho, So Dug Lim
BACKGROUND: Therapeutic approaches to brain metastases include surgery, whole-brain radiotherapy, stereotactic radiosurgery (SRS), and combination therapy. Recently, postoperative or preoperative SRS draws more attention to reduce postoperative recurrence in brain metastases. The goal of this study is to review surgical outcome of patients who had been treated by SRS, and to discuss the effectiveness of preoperative SRS. METHODS: From 2009 to 2015, 174 patients were treated by SRS for brain metastases, and among these 50 patients underwent surgery...
October 2016: Brain Tumor Research and Treatment
https://www.readbyqxmd.com/read/27866523/-progress-on-the-therapeutic-approaches-for-malignant-tumor-%C3%A2-with-superior-vena-cava-syndrome
#18
Xiangzheng Liu, Shijie Zhang, Jian Li
Patients with thoracic malignant tumors often suffered from superior vena cava syndrome (SVCS), featured by high morbidity and mortality. Traditionally treated with palliative approaches, SVCS has been widely studied and novel therapeutic approaches have been investigated, focusing on drug therapy, interventional therapy, radiation therapy, surgery and proton therapy. In this manuscript, the progress of therapeutic approaches for SVCS is summarized.
November 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#19
REVIEW
Luca Bertolaccini, Andrea Viti, Simona Paiano, Carlo Pomari, Luca Rosario Assante, Alberto Terzi
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27862912/stenting-of-the-ductus-arteriosus-in-infants-with-functionally-univentricular-heart-disease-and-ductal-dependent-pulmonary-blood-flow-a-single-center-experience
#20
Ahmet Celebi, Ilker Kemal Yucel, Mustafa Orhan Bulut, Mehmet Kucuk, Sevket Balli
OBJECTIVE: To determine the short- and medium-term outcomes of ductal stenting (DS) in patients with functionally univentricular hearts (FUHs) and ductal-dependent pulmonary blood flow. BACKGROUND: Several studies have evaluated the outcomes of DS in a limited number of patients with FUHs. Nonetheless, there is still no consensus regarding the indications for this procedure, and no appropriate patient selection criteria have been devised. METHODS: From 2005 to 2015, cardiac catheterization for DS was performed in 68 patients with FUHs...
November 10, 2016: Catheterization and Cardiovascular Interventions
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