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Palliative surgery

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https://www.readbyqxmd.com/read/28431712/salvage-operation-in-case-of-oligometastatic-disease
#1
Nicolas Duchateau, Erik Van Bouwel, Paul E Van Schil
In general, prognosis of stage IV non-small cell lung cancer is poor, and treatment is mostly palliative. However, oligometastatic disease is currently recognized as a specific entity with a better prognosis. We report a patient where combined chemoradiotherapy and salvage surgery led to extraordinary long-term survival.
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28428908/metastatic-squamous-cell-carcinoma-of-colon-from-esophageal-cancer
#2
Natasha Garg, Constance Stoehr, Yan Shi Zhao, Heather Rojas, Chung-Tsen Hsueh
BACKGROUND: Esophageal cancer including squamous cell carcinoma (SCC) and adenocarcinoma represents 4% of all cancers in the United States. Patients with esophageal cancer frequently present with locally advanced disease, and about 40% of patients have evidence of metastatic disease on presentation. Common sites of metastasis include liver, lung and bone. Here, we present a rare case of colonic metastasis from primary esophageal SCC. CASE PRESENTATION: A 60-year-old Caucasian male with a history of 20-pack-year cigarette smoking received surgery and adjuvant chemoradiotherapy for locally advanced SCC of larynx...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28424084/durable-complete-remission-with-aromatase-inhibitor-therapy-in-a-patient-with-metastatic-uterine-carcinosarcoma-with-poor-performance-status-and-coagulation-disorders-a-case-report
#3
P Martin-Romano, M Jurado, M A Idoate, L Arbea, J L Hernandez-Lizoain, D Cano, J A Paramo, S Martin-Algarra
BACKGROUND: Chemotherapy is considered the most appropriate treatment for metastatic uterine sarcoma, despite its limited efficacy. No other treatment has been conclusively proved to be a real alternative, but some reports suggest that anti-hormonal therapy could be active in a small subset of patients. We report the case of a patient with metastatic uterine carcinosarcoma with positive hormonal receptors and a complete pathological response. CASE PRESENTATION: A 54-year-old white woman presented to our emergency room with hypovolemic shock and serious vaginal bleeding...
April 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28419229/non-invasive-assessment-of-cerebral-oxygen-metabolism-following-surgery-of-congenital-heart-disease
#4
Felix Neunhoeffer, Katharina Sandner, Milena Wiest, Christoph Haller, Hanna Renk, Matthias Kumpf, Christian Schlensak, Michael Hofbeck
OBJECTIVES: Cerebral protection is a major issue in the treatment of infants with complex congenital heart disease. We tested a new device combining tissue spectrometry and laser Doppler flowmetry for non-invasive determination of cerebral oxygen metabolism following cardiac surgery in infants. METHODS: We prospectively measured regional cerebral oxygen saturation cSO 2 and microperfusion (rcFlow) in 43 infants 12-24 h following corrective ( n  = 30) or palliative surgery ( n  = 13) of congenital heart defects...
April 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28415645/peritoneal-carcinomatosis-limits-of-diagnosis-and-the-case-for-liquid-biopsy
#5
REVIEW
James R W McMullen, Matthew Selleck, Nathan R Wall, Maheswari Senthil
Peritoneal Carcinomatosis (PC) is a late stage manifestation of several gastrointestinal malignancies including appendiceal, colorectal, and gastric cancer. In PC, tumors metastasize to and deposit on the peritoneal surface and often leave patients with only palliative treatment options. For colorectal PC, median survival is approximately five months, and palliative systemic therapy is able to extend this to approximately 12 months. However, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) with a curative intent is possible in some patients with limited tumor burden...
March 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28413551/alveolar-soft-part-sarcoma-with-brain-metastases
#6
Vinodh Vayara Perumall, Rahmat Harun, Pulivendhan Sellamuthu, Mohd Shariman Md Shah
Metastatic tumors are the most common mass lesions in the brain. This case reports a rare form of sarcoma with metastasis to the brain. The appropriate management of a patient with metastatic alveolar soft part sarcoma to the brain is discussed. Author describes a 32-year-old gentleman diagnosed with primary tumor at gluteus and distant metastases at lower lobe of right lung and the brain. Histopathology proves diagnosis as alveolar soft part sarcoma. Craniotomy with excision of brain lesion was done. Repeated magnetic resonance imaging of the brain after 2 months showed rapidly growing new lesions...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28409374/self-expandable-metal-stent-placement-versus-emergency-resection-for-malignant-proximal-colon-obstructions
#7
Femke Julie Amelung, Werner Adriaan Draaisma, Esther Catharina Josephina Consten, Peter Derk Siersema, Frank Ter Borg
BACKGROUND: Traditionally, all patients with a malignant obstruction of the proximal colon (MOPC) are treated with emergency resection. However, recent data suggest that Self-expandable metallic stent (SEMS) placement could lower mortality and morbidity rates. This study therefore aimed to compare SEMS placement with emergency resection as treatment options for MOPC. METHODS: All consecutive patients that underwent SEMS placement for MOPC in the period 2004-2015 at our institution were identified...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28404915/prognostic-significance-of-tumor-infiltrating-immune-cells-and-pd-l1-expression-in-esophageal-squamous-cell-carcinoma
#8
Yubo Jiang, Anthony W I Lo, Angela Wong, Wenfeng Chen, Yan Wang, Li Lin, Jianming Xu
Programmed death-1 receptor (PD-1) and its ligand (PD-L1) play an integral role in regulating the immune response against cancer. This study investigated the prognostic significance of PD-L1 expression on tumor cells and tumor-infiltrating immune cells (TILs) in the tumor microenvironment in Chinese patients with esophageal squamous cell carcinoma (ESCC). Archival formalin-fixed, paraffin-embedded ESCC samples from treatment-naïve patients with ESCC after surgery or by diagnostic endoscopic biopsy were collected between 2004 and 2014...
February 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28404762/implementation-of-systemic-hedgehog-inhibitors-in-daily-practice-as-neoadjuvant-therapy
#9
REVIEW
Nikki Tang, Desiree Ratner
The most common cancer in both men and women is basal cell carcinoma (BCC). Although most primary and recurrent BCCs have high cure rates with standard therapies, advanced BCCs present a greater treatment challenge, especially in cosmetically and functionally sensitive areas. In patients unable to undergo surgery or radiation therapy, hedgehog inhibitors can be used neoadjuvantly to reduce tumor size, decreasing the extent and complexity of any subsequent surgery and providing either a cure or palliation. The goal of this review is to summarize the pharmacology, efficacy, and safety of systemic hedgehog inhibitors, as well as their role in daily practice as neoadjuvant therapy...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28402400/unplanned-cardiac-reoperations-and-interventions-during-long-term-follow-up-after-the-norwood-procedure%C3%A2
#10
Eva Sames-Dolzer, Gregor Gierlinger, Michaela Kreuzer, Julia Schrempf, Roland Gitter, Christoph Prandstetter, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Patients with hypoplastic left heart syndrome or related malformations are predominantly treated with a 3-stage palliation. Anatomic or physiologic problems can lead to unplanned additional surgical or catheter interventions during single ventricle palliation. Changes in operative technique may have an impact on the reoperation rate. METHODS: Between 1997 and 2014, 317 Norwood procedures were performed at our centre. A retrospective single centre investigation was carried out concerning incidence, timing, indication and type of unplanned interstage cardiac reoperations and catheter interventions during follow-up of Norwood patients...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28399835/optimal-treatment-and-prognostic-factors-for-esthesioneuroblastoma-retrospective-analysis-of-187-chinese-patients
#11
Le Xiong, Xiao-Li Zeng, Chang-Kuo Guo, An-Wen Liu, Long Huang
BACKGROUND: The standard treatment for esthesioneuroblastoma, a rare malignant nasal vault neoplasm, is not established. METHODS: We retrospectively assessed the clinicopathological features, prognostic factors and treatment methods for 187 patients with esthesioneuroblastoma treated in China between 1981 and 2015. Overall survival (OS) and disease-free survival (DFS) were evaluated using the Kaplan-Meier method and log-rank tests. RESULTS: Twenty-three (12...
April 11, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28396928/quality-of-life-and-cost-utility-of-surgical-treatment-for-patients-with-spinal-metastases-prospective-cohort-study
#12
Shingo Miyazaki, Kenichiro Kakutani, Yoshitada Sakai, Yasuo Ejima, Koichiro Maeno, Toru Takada, Takashi Yurube, Yoshiki Terashima, Masaaki Ito, Yuji Kakiuchi, Yoshiki Takeoka, Hitomi Hara, Teruya Kawamoto, Akihiro Sakashita, Takuya Okada, Naomi Kiyota, Yoshiyuki Kizawa, Ryohei Sasaki, Toshihiro Akisue, Hironobu Minami, Ryosuke Kuroda, Kotaro Nishida
PURPOSE: Palliative surgery for patients with spinal metastasis provides good clinical outcomes. However, there have been few studies on quality of life (QOL) and cost-utility of this surgery. We aimed to elucidate QOL and cost-utility of surgical treatment for spinal metastasis. METHODS: We prospectively analyzed 47 patients with spinal metastasis from 2010 to 2014 who had a surgical indication. Thirty-one patients who desired surgery underwent spinal surgery (surgery group)...
April 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28393785/modifying-risks-to-improve-outcome-in-cardiac-surgery-an-anesthesiologist-s-perspective
#13
REVIEW
Murali Chakravarthy
Challenging times are here for cardiac surgical and anesthesia team. The interventional cardiologist seem to have closed the flow of 'good cases' coming up for any of the surgery,; successful percutaneous interventions seem to be offering reasonable results in these patients, who therefore do not knock on the doors of the surgeons any more . It is a common experience among the cardiac anesthesiologists and surgeons that the type of the cases that come by now are high risk. That may be presence of comorbidities, ongoing medical therapies, unstable angina, uncontrolled heart failure and rhythm disturbances; and in patients with ischemic heart disease, the target coronaries are far from ideal...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28392125/vaginal-vs-robotic-hysterectomy-for-patients-with-endometrial-cancer-a-comparison-of-outcomes-and-cost-of-care
#14
C C Nitschmann, F Multinu, J N Bakkum-Gamez, C L Langstraat, J A Occhino, A L Weaver, W A Cliby, A Mariani, S C Dowdy
OBJECTIVE: To compare outcomes and cost for patients with endometrial cancer undergoing vaginal hysterectomy (VH) or robotic hysterectomy (RH), with or without lymphadenectomy (LND). METHODS: Patients undergoing planned VH (and laparoscopic LND) or RH (and robotic LND) between January 2007 and November 2012 were reviewed. Patients with stage IV disease, synchronous cancer, synchronous surgery, or treated with palliative intent were excluded. Patients were objectively triaged to LND per institutional protocol based on frozen section...
April 6, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28388348/geriatric-patients-are-predisposed-to-strabismus-following-thyroid-related-orbital-decompression-surgery-a-multivariate-analysis
#15
Chris Y Wu, Alon Kahana
Geriatric patients (age ≥ 65) are prone to complications after surgery and are at risk for severe thyroid eye disease (TED). In this study, we aim to identify preoperative demographic and TED patterns associated with geriatric patients who underwent decompression surgery, to examine the effect of age on postoperative strabismus rates, and to identify factors that may contribute to postoperative strabismus in the geriatric subgroup. We retrospectively reviewed patients who underwent thyroid-related orbital decompression surgery at the Kellogg Eye Center, University of Michigan, between 1999 and 2014...
April 2017: Orbit
https://www.readbyqxmd.com/read/28387011/radiotherapy-in-anaplastic-thyroid-carcinoma-an-australian-experience
#16
Kevin So, Robin E Smith, Sidney R Davis
INTRODUCTION: Anaplastic thyroid cancer is a rare and fatal malignancy, associated with significant local tumour and often treatment related morbidity. We report our experience in treating this cancer over a 20-year period. METHODS: A retrospective review of prospectively collected data from a single Australian Institution (Alfred Health Radiation Oncology) was carried out on patients referred with anaplastic thyroid carcinoma between 1992 and 2013. RESULTS: Thirty patients (17 females and 13 males) were identified with a median age at presentation of 72 years...
April 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28385115/preoperative-adrenal-artery-embolization-followed-by-surgical-excision-of-giant-hypervascular-adrenal-masses-report-of-three-cases
#17
Ismail Cem Sormaz, Fatih Tunca, Arzu Poyanlı, Yasemin Giles Şenyürek
BACKGROUND: Transcatheter arterial embolization (TAE) is an effective minimally invasive adjunct to surgery for the management and/or palliation of adrenal tumors. METHODS: In this case study, we reported three patients who underwent preoperative TAE before adrenalectomy for large hypervascular adrenal tumors. All patients underwent preoperative embolization 24 h before the operation and were then followed up at the intensive care unit surgery. RESULTS: The largest diameter of the adrenal lesions ranged between 8 and 17 cm...
April 7, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28384684/an-international-collaborative-standardizing-a-comprehensive-patient-centered-outcomes-measurement-set-for-colorectal-cancer
#18
Jessica A Zerillo, Maartje G Schouwenburg, Annelotte C M van Bommel, Caleb Stowell, Jacob Lippa, Donna Bauer, Ann M Berger, Gilles Boland, Josep M Borras, Mary K Buss, Robert Cima, Eric Van Cutsem, Eino B van Duyn, Samuel R G Finlayson, Skye Hung-Chun Cheng, Corinna Langelotz, John Lloyd, Andrew C Lynch, Harvey J Mamon, Pamela K McAllister, Bruce D Minsky, Joanne Ngeow, Muhammad R Abu Hassan, Kim Ryan, Veena Shankaran, Melissa P Upton, John Zalcberg, Cornelis J van de Velde, Rob Tollenaar
Importance: Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients. Objective: The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer...
April 6, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28384630/esophageal-cancer-new-insights-into-a-heterogenous-disease
#19
Sebastian Krug, Patrick Michl
BACKGROUND: Esophageal cancer represents a heterogeneous malignancy mostly diagnosed in advanced stages. Worldwide, squamous cell carcinomas (SCCs) continue to be the most prevalent subtype; however, in the Western countries, the incidence of adenocarcinomas is increasing and will exceed that of SCC in the near future. During the last decade, several landmark trials contributed to a better understanding of the disease and emphasized the importance of multimodal treatment protocols. SUMMARY: With the introduction of perioperative or neoadjuvant approaches, the survival of both subtypes of esophageal cancer has significantly improved...
April 7, 2017: Digestion
https://www.readbyqxmd.com/read/28384214/care-of-cancer-patients-at-the-end-of-life-in-a-german-university-hospital-a-retrospective-observational-study-from-2014
#20
Burkhard Dasch, Helen Kalies, Berend Feddersen, Caecilie Ruderer, Wolfgang Hiddemann, Claudia Bausewein
BACKGROUND: Cancer care including aggressive treatment procedures during the last phase of life in patients with incurable cancer has increasingly come under scrutiny, while integrating specialist palliative care at an early stage is regarded as indication for high quality end-of-life patient care. AIM: To describe the demographic and clinical characteristics and the medical care provided at the end of life of cancer patients who died in a German university hospital...
2017: PloS One
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