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Pelvic exenteration

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BACKGROUND: Pelvic exenteration for locally recurrent rectal cancer (LRRC) is associated with variable outcomes, with the majority of data from single-centre series. This study analysed data from an international collaboration to determine robust parameters that could inform clinical decision-making. METHODS: Anonymized data on patients who had pelvic exenteration for LRRC between 2004 and 2014 were accrued from 27 specialist centres. The primary endpoint was survival...
March 12, 2018: British Journal of Surgery
Marilla Dickfos, Stephanie B M Tan, Andrew R L Stevenson, Craig A Harris, Rachel Esler, Matthew Peters, David G Taylor
BACKGROUND: Over one-third of primary rectal cancers are locally advanced at diagnosis, and local recurrence of rectal cancer occurs at a rate of 3-10% following primary curative resection. Extended resectional surgery, including pelvic exenteration, is the only proven therapy with curative potential in the treatment of these cancers along with many other pelvic malignancies. A microscopically clear resection margin (R0 resection) is the predominant prognostic factor affecting overall and disease-free survival...
March 6, 2018: ANZ Journal of Surgery
Daniel Steffens, Jane Young, Paula R Beckenkamp, James Ratcliffe, Freya Rubie, Nabila Ansari, Neil Pillinger, Michael Solomon
BACKGROUND: There is a need for evidence of the effectiveness of pre-operative exercise for patients undergoing major cancer surgery; however, recruitment to such trials can be challenging. The PrE-operative Physical Activity (PEPA) Trial will establish the feasibility and acceptability of a pre-operative exercise programme aimed to improve patient outcomes after cytoreductive surgery and pelvic exenteration. The secondary aim is to obtain pilot data on the likely difference in key outcomes (post-operative complications, length of hospital stay, post-operative functional capacity and quality of life) to inform the sample size calculation for the substantive randomised clinical trial...
February 17, 2018: Trials
Jessica Shao-Yeung Lim, Cherry E Koh, Hannah Liu, Michael J Solomon, Charlotte S H Johnstone
BACKGROUND: Pelvic exenterations are extensive surgical procedures for locally advanced or recurrent malignancies of the pelvis. However, this is often at the cost of significant morbidity due to perioperative pain, which has been poorly studied. OBJECTIVE: This study aims to review perioperative pain management in patients undergoing pelvic exenteration. DESIGN: This is a retrospective review of patients undergoing pelvic exenteration between January 2013 and December 2014...
March 2018: Diseases of the Colon and Rectum
Sandra L Kopp, William L Lanier
No abstract text is available yet for this article.
March 2018: Diseases of the Colon and Rectum
Hiroki Imamura, Kohei Murata, Yoshinori Kagawa, Rieko Okubo, Takuya Sakamoto, Atsushi Naito, Kohei Murakami, Yoshiteru Katsura, Yoshiaki Ohmura, Atsushi Takeno, Shinichi Nakatsuka, Kimihiko Ito, Yutaka Takeda, Takeshi Kato, Shigeyuki Tamura
We report a case of a woman who was suffering from post-radiochemotherapy perineum abscess concurrent with the recurrence of vaginal cancer for which total pelvic exenteration was performed. A 66-year-oldwoman presentedat our hospital with irregular genital bleeding in November 2014. A series of examinations showedthat she was suffering from vaginal cancer(cT2N0M0, cStage II ). A radiochemotherapy regimen(external irradiation 45 Gy/25 Fr, CDDP 40mg/m2, 5 course)was commencedin January 2015. In the meantime, MRI revealedsome therapeutic effect, but in October 2015, MRI indicated the enlargement of the primary tumor(PD)...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tatsuya Matsumoto, Masayoshi Nakanishi, Mahito Miyamae, Koji Takao, Tomohiko Fukunaga, Eigo Otsuji
A 63-year-old man with bloody stools, anal incompetence, and feeling of fatigue was diagnosed as having a RAS mutanttype rectal cancer with abscess and rectovesical fistula. Computed tomography revealed that the tumor had invaded the seminal vesicle, prostate, and bladder and formed an abscess. In addition, his general condition was poor. Thus, we evaluated the lesion as unresectable. His nutritional status improved, and the infection was controlled after colostomy. Then, we performed chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin(FOLFOX)plus bevacizumab...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Nobuhiro Takiguchi, Hiroaki Soda, Toru Tonooka, Atsushi Ikeda, Yoshihiro Nabeya, Isamu Hoshino, Ryotaro Teranaka, Tadamichi Denda
Preoperative chemotherapy has been performed for locally advanced colorectal cancer, to achieve cytoreduction, local control, and prevention of distant metastasis. The regimens of mFOLFOX6/XELOX plus bevacizumab for 3 months have been adopted to succeed curative resection for borderline resectable colorectal cancer. We examined treatment results for locally advanced colorectal cancer without distant metastasis. Thirty-four patients were examined and the mean age was 62.7 years old. The cohort comprised of 23 cases of rectal cancer and 11 of sigmoid colon cancer...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Roberto Berretta, Vito Andrea Capozzi, Giulio Sozzi, Lavinia Volpi, Valentina Ceni, Mauro Melpignano, Giovanna Giordano, Federico Marchesi, Michela Monica, Maurizio Di Serio, Matteo Riccò, Marcello Ceccaroni
PURPOSE: The aim of this retrospective study is to analyze the prognostic role and the practical implication of mesenteric lymph nodes (MLN) involvements in advanced ovarian cancer (AOC). METHODS: A total of 429 patients with AOC underwent surgery between December 2007 and May 2017. We included in the study 83 patients who had primary (PDS) or interval debulking surgery (IDS) for AOC with bowel resection. Numbers, characteristics and surgical implication of MLN involvement were considered...
January 27, 2018: Archives of Gynecology and Obstetrics
Masatoshi Nomura, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
The patient was a 47-year-old man, whose chief complaint was melena. He visited a nearby hospital, and further evaluation showed rectal cancer invading the prostate, with multiple lung and liver metastases. The clinical diagnosis was cT4b(prostate), cN1, cM1b(H2, PUL2), cStage IV . We performed colostomy in the transverse colon prior to chemotherapy. He was administered 1 course of mFOLFOX6 plus bevacizumab and 7 courses of FOLFOXIRI plus bevacizumab. The primary tumor showed PR. The liver metastases were localized and shrunken, while the lung metastases disappeared...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Pedro Marcos-Figueiredo, Diana de Sousa da Costa Moreira, Manuel Gonçalves Morim, Júlia Leite Pereira, Lurdes Silva Salgado
Vaginal cancer is a rare entity. The evidence on its management resides mostly in clinical cases or small case series. Of the histological types, the most frequent is the squamous cell carcinoma, followed by adenocarcinoma. But what to do when identifying an even more infrequent sarcoma in a premenopausal woman? In this study, we describe the case of a 53-year-old woman presenting with metrorrhagia for two months, who was evaluated after an intense episode. A necrotic and ulcerative vaginal swelling was documented and then submitted to biopsy, which revealed a vaginal sarcoma...
January 2018: Revista Brasileira de Ginecologia e Obstetrícia
Glen R Guerra, Joseph C Kong, Maria-Pia Bernardi, Robert G Ramsay, Wayne A Phillips, Satish K Warrier, A Craig Lynch, Samuel Y Ngan, Alexander G Heriot
BACKGROUND: Anal squamous cell carcinoma is a rare cancer with a high cure rate, making research into the treatment of locoregional failure difficult. OBJECTIVE: The purpose of this study was to examine factors related to local treatment failure and determine the outcomes of patients undergoing local salvage resection. DESIGN: This was a retrospective cohort study. SETTING: This study was conducted at a quaternary referral center...
February 2018: Diseases of the Colon and Rectum
Michael Höckel
No abstract text is available yet for this article.
November 2017: Gynecologic Oncology Reports
Se Ik Kim, Seungmee Lee, Chang Wook Jeong, Hee Seung Kim
OBJECTIVE: Melanomas of the vulva and vagina are rare, and surgery is the gold standard of treatment [1, 2]. Since recent studies have reported pelvic exenteration by using robotic surgical system [3, 4], we showed the surgical procedures of robot-assisted anterior pelvic exenteration (rAPE) with ileal conduit urinary diversion for vulvovaginal malignant melanoma. METHODS: A 55-year-old woman who received vaginal wall resection due to vaginal malignant melanoma 8months before was referred...
February 2018: Gynecologic Oncology
Kazuyoshi Kato, Kohei Omatsu, Maki Matoda, Hidetaka Nomura, Sanshiro Okamoto, Hiroyuki Kanao, Kuniko Utsugi, Nobuhiro Takeshima
OBJECTIVE: The aim of this study was to investigate the clinical usefulness of the placement of a transanal drainage tube (TDT) to prevent anastomotic leakage after a modified posterior pelvic exenteration (MPPE) for the treatment of primary ovarian cancer. METHODS: We performed a retrospective review of all the consecutive patients who had undergone an MPPE for primary ovarian, tubal, or peritoneal cancer between October 2012 and November 2016 at our institution...
December 13, 2017: International Journal of Gynecological Cancer
Alvaro Garcia-Granero, Sebastiano Biondo, Eloy Espin-Basany, Ana González-Castillo, Silvia Valverde, Loris Trenti, Antonio Gil-Moreno, Esther Kreisler
INTRODUCTION: Pelvic exenteration (PE) offers the best chance of cure for locally advanced primary or recurrent pelvic organ malignancies invading adjacent organs. The aims of this study were to analyse results for any pelvic exenteration that includes rectal resection and the analysis of results of fecal and urinary reconstruction. METHOD: From January 2000 to April 2014, 111 PE with rectal resection for any pelvic cancer were analysed retrospectively at two national tertiary referral centers...
December 8, 2017: Cirugía Española
Christos Kontovounisios, Paris Tekkis
Advanced primary and recurrent colorectal cancer can be successfully treated by experienced, dedicated centers delivering good outcomes with low mortality and morbidity. Development and implementation of a comprehensive referral pathway is to be encouraged. Multidisciplinary team management is essential in the management of this complex group of patients and is associated with significantly more complete preoperative evaluation and more accurate provision of patient information, as well as improved access to the most appropriate individualized management plan...
November 2017: Clinics in Colon and Rectal Surgery
E Schloericke, M Zimmermann, C Benecke, T Laubert, R Meyer, H-P Bruch, R Bouchard, T Keck, M Hoffmann
BACKGROUND: Patients with rectovaginal fistulas have a significantly reduced quality of life. Therefore, surgical therapy is often needed even in palliative cases. The aim of the present study was to perform an analysis of the results of the different treatment options available today. METHODS: We performed a retrospective analysis of patients who underwent treatment for rectovaginal fistulas at the Department of Surgery, University of Schleswig-Holstein, Campus Luebeck and the Department of Surgery, WKK Heide, between January 2000 and September 2016...
December 2017: Techniques in Coloproctology
A Martinez, T Filleron, P Rouanet, P Méeus, E Lambaudie, J M Classe, F Foucher, F Narducci, S Gouy, F Guyon, F Marchal, E Jouve, P E Colombo, A Mourregot, M Rivoire, N Chopin, G Houvenaeghel, I Jaffre, J Leveque, V Lavoue, E Leblanc, P Morice, E Stoeckle, J L Verheaghe, D Querleu, G Ferron
BACKGROUND: Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent. METHODS: A French multicentric prospective study was performed by including patients who underwent pelvic exenteration...
November 20, 2017: Annals of Surgical Oncology
M H Eleanor Koay, Colin J R Stewart
Extravascular migratory metastasis (EVMM), also known as pericytic mimicry or angiotropism, is a mechanism of angiocentric tumor spread that has been investigated mainly in cutaneous malignant melanoma where it has been associated with an increased risk of metastasis. In EVMM, the tumor cells spread along the external (ablumenal) aspect of vessels without breaching the endothelium, a process that is therefore distinct from the more widely recognized intraluminal invasion. Although EVMM has also been reported in a limited range of other tumor types, to our knowledge it has not been described in squamous cell carcinoma (SCC)...
November 14, 2017: International Journal of Gynecological Pathology
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