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Preoperative therapy

Alessandro Marra
Pancoast or superior pulmonary sulcus tumour is a subset of lung carcinoma that invades the structures of the thoracic inlet - first ribs, distal roots of the brachial plexus, stellate ganglion, vertebrae, and subclavian vessels. The first symptom is usually shoulder pain; consequently, most patients are initially treated for osteoarthritis. Late diagnosis is common. Success of therapy depends on an accurate staging: standard imaging with CT scan of the chest, PET-CT scan, brain MRI are needed to rule out distant metastases, endobronchial ultrasound-guided needle biopsy (EBUS-TBNA) or mediastinoscopy are mandatory for reliable nodal staging...
June 2018: Zentralblatt Für Chirurgie
Waldemar Schreiner, Sofiia Gavrychenkova, Wojciech Dudek, Sebastian Lettmaier, Ralf Rieker, Rainer Fietkau, Horia Sirbu
BACKGROUND: The outcomes of so called "salvage" resections after definitive chemoradiation vs. curative resections after neoadjuvant chemoradiation therapy (IT-resection) in patients with stage IIIA/B locally advanced non-small cell lung cancer have rarely been compared. The aim of our study was to compare perioperative results, postoperative and recurrence-free survival and to identify relevant prognostic survival factors for both therapy strategies. PATIENTS AND METHODS: Between June 2008 and May 2017, 43 patients underwent pulmonary resection following induction therapy (group 1) and 14 patients underwent salvage resection after definitive chemoradiation (group 2)...
June 2018: Zentralblatt Für Chirurgie
Bo Ram Kim, Jung Hoon Kim, Su Joa Ahn, Ijin Joo, Seo-Youn Choi, Sang Joon Park, Joon Koo Han
OBJECTIVES: To assess utility of CT findings and texture analysis for predicting the resectability and prognosis in patients after neoadjuvant therapy for pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS: Among 308 patients, 45 with PDAC underwent neoadjuvant therapy (concurrent-chemoradiation-therapy, CCRT, n = 27 and chemotherapy, ChoT, n = 18) before surgery were included. All underwent baseline and preoperative CT. Two reviewers assessed CT findings and resectability...
June 21, 2018: European Radiology
N D Cosgrove, D K Mullady
Endoscopy has an important role in the pre- and post-treatment staging of esophageal cancer. Complete pathologic response following neoadjuvant chemoradiation therapy occurs in approximately 25% of patients. However, the ability to accurately detect this preoperatively with currently available endoscopic modalities is limited such that the default pathway is for fit patients to proceed with surgical resection. This article discusses the available endoscopic modalities (primarily Esophagogastroduodenoscopy [EGD] with mucosal biopsies and endoscopic ultrasonography with or without fine needle aspiration) used for post-treatment staging of esophageal cancer...
June 19, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Masafumi Otsuka, Tomohiko Kamasako, Toshihiro Uemura, Nobushige Takeshita, Tetsuo Shinozaki, Masayuki Kobayashi, Atsushi Komaru, Satoshi Fukasawa
Background: The effectiveness of cancer control is unclear after radical prostatectomy for patients with clinical T3 prostate cancer. Methods: We retrospectively reviewed 1409 patients who underwent radical prostatectomy between April 2007 and December 2014, including 210 patients with cT3 prostate cancer. Nine patients who received neoadjuvant hormonal therapy and three patients who were lost to follow-up were excluded from the analysis. Clinical staging was performed by an experienced radiologist using preoperative magnetic resonance imaging findings...
June 19, 2018: Japanese Journal of Clinical Oncology
Sven H Loosen, Frank Tacke, Marcel Binnebosel, Catherine Leyh, Mihael Vucur, Florian Heitkamp, Wenzel Schoening, Tom F Ulmer, Patrick H Alizai, Christian Trautwein, Alexander Koch, Thomas Longerich, Christoph Roderburg, Ulf P Neumann, Tom Luedde
Background: In colorectal cancer (CRC), the liver is the most common site of metastasis. Surgical resection represents the standard therapy for patients with colorectal liver metastases (CRLM). However, 5-year survival rates after resection do not exceed 50%, and despite existing preoperative stratification algorithms it is still debated which patients benefit most from surgical treatment. The soluble urokinase plasminogen activator receptor (suPAR) has recently evolved as a promising biomarker for distinct clinical conditions...
June 5, 2018: Oncotarget
Yohtaro Sakakibara, Yoshio Taguchi, Homare Nakamura, Hidetaka Onodera, Daisuke Wakui, Tetsuya Ikeda, Yoshio Aida
OBJECTIVES: Primary meningiomas arising outside the intracranial component are rather rare and have been termed primary extradural meningiomas(PEMs). We present a case of an intraosseous-type PEM occurring at a high convexity location and discuss the clinical characteristics of PEMs. CASE: An 80-year-old woman presented with a soft and painless subcutaneous mass of approximately 10 cm in diameter in the right parietal region, which had appeared 1 year previously...
June 2018: No Shinkei Geka. Neurological Surgery
Cosmo Godino, Andrea Scotti, Maurizio Taramasso, Marianna Adamo, Marco Russo, Mauro Chiarito, Francesco Melillo, Alessandro Beneduce, Carlo Andrea Pivato, Luca Arrigoni, Evelina Toscano, Anna Salerno, Alberto Cappelletti, Valeria Magni, Stefano Stella, Gabriele Fragasso, Matteo Montorfano, Eustachio Agricola, Federica Ettori, Alberto Margonato, Francesco Maisano, Antonio Colombo
BACKGROUND: MitraClip implantation has evolved as a new tool for treatment of inoperable or high-risk patients with severe functional mitral regurgitation (FMR) due to dilated cardiomyopathy (DCM). Limited data are available regarding MitraClip outcomes comparing patients with ischemic and non-ischemic DCM. METHODS: From 2008 to 2016, 314 patients received MitraClip for FMR at four institutions: Brescia, Zurich and Milan. Patients were stratified according to MR aetiology in non-ischemic FMR (n = 99) and ischemic FMR (n = 215)...
June 12, 2018: International Journal of Cardiology
Daniel G Nicastri, Naomi Alpert, Bian Liu, Andrea Wolf, Emanuela Taioli, Benjamin V Tran, Raja Flores
BACKGROUND: There are no published reports on predictors of oxygen (O2 ) use after lung cancer surgery. The prospect of O2 use following lung cancer surgery may affect a patient's therapy choice. METHODS: The Surveillance, Epidemiology, and End Results -Medicare (SEER-Medicare) dataset was queried to identify patients diagnosed with primary lung cancer (stage I/II) who underwent surgical resection from 1994-2010. Patients with a second resection within 6 months of their first and those with preoperative O2 use were excluded...
June 18, 2018: Annals of Thoracic Surgery
A Yu Lubnin, A N Konovalov, N V Lasunin, T A Abramov, A Yu Bulanov, G M Galstyan, O A Polevodova, A V Moshkin, O A Gadzhieva, A A Manushkova
The article describes a rare clinical case of a patient with previously undiagnosed von Willebrand disease and basal meningioma; an intracranial neurosurgical intervention was complicated by delayed intracranial hematomas, both at the resected tumor site and distantly. The diagnosis of von Willebrand disease was established only after special hematology tests and only after surgery. Despite the use of specific therapy, the patient died due to intracranial hemorrhagic complications in the postoperative period...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Masahide Enomoto, Takeshi Kinoshita, Yasuo Kondo, Tomoaki Suzuki, Tohru Asai
We present the case of a 61-year-old patient with a history of essential thrombocythemia (ET) who was diagnosed as having aortic valve stenosis and dilatation of his ascending aorta. His aortic valve and ascending aorta were replaced under hypothermic circulatory arrest (HCA). No clear guideline exists for preoperative, perioperative, and postoperative management of cardiac surgery using HCA for ET patients. After performing risk assessment, we prescribed preoperative aspirin therapy and postoperative care was planned as usual for cardiovascular surgery in our establishment...
June 21, 2018: Annals of Thoracic and Cardiovascular Surgery
Jae Won Park, Dong Hoon Koh, Won Sik Jang, Joo Yong Lee, Kang Su Cho, Won Sik Ham, Koon Ho Rha, Woo Hee Jung, Sung Joon Hong, Young Deuk Choi
PURPOSE: Prostate cancer (PC) is a devastating and heterogeneous condition with diverse treatment options. When selecting treatments for patients with very high-risk PC, clinicians must consider patient comorbidities. We investigated the efficacy of the age-adjusted Charlson Comorbidity Index (ACCI) as a prognostic factor for patient outcomes after radical prostatectomy (RP). MATERIALS AND METHODS: We retrospectively investigated the medical records of PC patients at our institution who underwent RP from 1992 to 2010...
2018: PloS One
Yuzo Harada, Shinsuke Kazama, Teppei Morikawa, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Keisuke Hata, Hiroaki Nozawa, Soichiro Ishihara, Toshiaki Watanabe
Preoperative chemoradiotherapy (CRT) is a standard therapy for locally advanced rectal cancer; however, the response varies depending on cases. Therefore, CRT-response predictors need to be elucidated. Cancer stem cells (CSCs), comprising a small part of tumors, are associated with tumor progression and recurrence due to their self-renewal and proliferation abilities. Doublecortin-like kinase 1 (DCLK1) is one of the several putative CSC markers; however, the clinical impact of its expression in rectal cancer has not been evaluated...
June 2018: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Hong Yan, Furong Wang, Lin Xiang, Wei Zhu, Cheng Liang
RATIONALE: Diffuse giant cell tumors of the tendon sheath (GCT-TS) in the temporomandibular joint (TMJ) are extremely rare. PATIENT CONCERNS: We reported the imaging appearance and the pathological findings of 2 male cases with diffuse GCT-TS in the TMJ (52 years for the case 1 and 50 years for the case 2) who complain of the hearing disorders of left ear when presenting to our hospital. DIAGNOSIS: Preoperative computerized tomography (CT) scan revealed an irregular mass in the left temporal fossa with the sizes of approximately 5...
June 2018: Medicine (Baltimore)
Kazuhiro Shirozu, Naoyuki Fujimura, Yuji Karashima, Mizuko Ikeda, Hidehisa Kitada, Yasuhiro Okabe, Kei Kurihara, Tomoko Henzan, Sumio Hoka
BACKGROUND: ABO-incompatible living-donor kidney transplantation (LDKT) requires immunotherapy and plasma exchange therapy (PEX). PEX with albumin replacement fluid reportedly decreases fibrinogen levels. However, no reports have described the effects of PEX with albumin replacement fluid on blood coagulation parameters and blood loss during the perioperative period. Therefore, we investigated the effects of preoperative PEX on blood coagulation parameters and blood loss during the perioperative period in patients undergoing ABO-incompatible LDKT as measured by rotational thromboelastometry (ROTEM®)...
June 19, 2018: BMC Anesthesiology
Rongrui Tang, Jiantao Shi, Xuegang Li, Yongjie Zou, Long Wang, Yujie Chen, Rubin Yan, Boyuan Gao, Hua Feng
OBJECTIVE: To investigate the effects of atorvastatin on the surgical treatment of patients with chronic subdural hematoma (CSDH). METHODS: Our retrospective study included 245 consecutive adult patients undergoing burr hole craniotomy of CSDH. Data included baseline characteristics and recurrence, postoperative complications, and mortality. A univariate and multivariate regression model analyzed the association between administration of atorvastatin perioperatively and recurrence rates...
June 16, 2018: World Neurosurgery
P Collinet, X Fritel, C Revel-Delhom, M Ballester, P A Bolze, B Borghese, N Bornsztein, J Boujenah, T Brillac, N Chabbert-Buffet, C Chauffour, N Clary, J Cohen, C Decanter, A Denouël, G Dubernard, A Fauconnier, H Fernandez, T Gauthier, F Golfier, C Huchon, G Legendre, J Loriau, E Mathieu-d'Argent, B Merlot, J Niro, P Panel, P Paparel, C A Philip, S Ploteau, C Poncelet, B Rabischong, H Roman, C Rubod, P Santulli, M Sauvan, I Thomassin-Naggara, A Torre, J M Wattier, C Yazbeck, N Bourdel, M Canis
First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Recommended first-line hormonal therapies for the management of endometriosisrelated pain are combined hormonal contraceptives (CHCs) or the 52mg levonorgestrel-releasing intrauterine system (IUS)...
June 16, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Go Shinke, Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Yutaka Takeda, Masahiro Tanemura, Masaki Mori, Yuichiro Doki
Current therapies for pancreatic ductal cancer (PDAC) do not sufficiently control distant metastasis. Thus, new therapeutic targets are urgently needed. Numerous studies have suggested that the epithelial-mesenchymal transition (EMT) is pivotal for metastasis of carcinomas. The fact that the EMT is reversible suggests the possibility that it is induced by an epigenetic mechanism. In this study, we aimed to investigate the role of histone deacetylase 1 (HDAC1), which is an epigenetic mechanism on distant metastasis of PDAC...
June 19, 2018: Cancer Science
Tatiana Sequeira Gross, Shiho Naito, Niklas Neumann, Johannes Petersen, Thomas Kuntze, Hermann Reichenspurner, Yskert von Kodolitsch, Evaldas Girdauskas
Background: Studies have demonstrated that statin therapy decreases the growth rate of abdominal aneurysms. However, the effect of statin therapy on the proximal aortic disease has not been sufficiently elucidated. Aim: We aimed to analyze the association between statin treatment and the severity of proximal aortopathy in patients with aortic valve disease. Design: Cross-sectional study. Methods: We prospectively identified 458 patients who were referred for aortic valve surgery from 2008 to 2014...
June 18, 2018: QJM: Monthly Journal of the Association of Physicians
Tatsunori Mitake, Takanobu Nishizuka, Masahiro Tatebe, Hitoshi Hirata
This multicenter cross-sectional study aimed to determine the differences in distribution and fracture pattern between low-energy and high-energy groups in distal humeral fractures in Japan. Retrospectively, 133 patients (48 males, 85 females) with distal humeral fractures were enrolled in this study. The age, sex, fracture classification, injury mechanism, preoperative therapy for osteoporosis, and nature of soft-tissue injury were recorded for all patients. The Mann-Whitney U test and chi-square test or Fisher's exact test were used for non-normally distributed variables and categorical variables, respectively, to compare differences between the two groups...
May 2018: Nagoya Journal of Medical Science
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