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Yi-Hsin Liang, Chih-Hsin Wei, Wen-Hui Hsu, Yu-Yun Shao, Ya-Chin Lin, Pei-Chun Chou, Ann-Lii Cheng, Kun-Huei Yeh
PURPOSE: Do-not-resuscitate (DNR) consent is crucial in end-of-life (EOL) care for patients with advanced cancer. However, DNR consents signed by patients (DNR-P) and surrogates (DNR-S) reflect differently on patient autonomy and awareness. METHODS: This retrospective study enrolled advanced cancer patients treated at National Taiwan University Hospital, Hsin-Chu Branch between 2012 and 2014. Patients who signed DNR consent at other hospitals were excluded; the remaining patients were subsequently classified into DNR-S and DNR-P groups...
October 4, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Aslam Ejaz, Faiz Gani, Steven M Frank, Timothy M Pawlik
BACKGROUND: The surgical Apgar score (SAS) has been shown to correlate with postoperative outcomes. A key component of the SAS is estimated blood loss (EBL), which has been shown to be inaccurate and discordant with intraoperative blood transfusion. Given this, the objective of the current study was to assess the added predictive value of the including receipt of intraoperative transfusion to the SAS. METHODS: We identified 1833 patients undergoing major gastrointestinal surgery (pancreatic, hepato-biliary, and colorectal) between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tsung-Yu Tsai, Che-Chen Lin, Cheng-Yuan Peng, Wen-Hsin Huang, Wen-Pang Su, Shih-Wei Lai, Hsuan-Ju Chen, Hsueh-Chou Lai
The relationship between biliary tract inflammation (BTI) and digestive system cancers is unclear. This study aimed to evaluate the association between BTI and the risks of digestive system cancers.Using the Taiwan National Health Insurance claims data, information on a cohort of patients diagnosed with BTI (n = 4398) between 2000 and 2009 was collected. A comparison cohort of sex-, age-, and index year-matched persons without BTI (n = 17,592) was selected from the same database. The disease was defined by the ICD-9-CM...
August 2016: Medicine (Baltimore)
Chad G Ball, Elijah Dixon, Charles M Vollmer
BACKGROUND: Numerous clinical and basic science innovations have been presented at the AHPBA. The objective was to define changes in content and methodology of the scientific program over the past decade. METHODS: AHPBA abstracts from the past 10-years were reviewed by 2 investigators (volume, content, origin, methodology). RESULTS: Of 2194 total AHPBA abstracts (2005-2015), the volume per year decreased over time (2005 = 283; 2015 = 177; p < 0...
August 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Michael Camilleri, David A Katzka
BACKGROUNG & AIMS: The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs. METHODS: We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing. RESULTS: The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology...
October 2016: Clinical Gastroenterology and Hepatology
Eduardo de Souza Martins Fernandes, Felipe Tavares de Mello, Joaquim Ribeiro-Filho, Asterio Pinto do Monte-Filho, Moacir Martins Fernandes, Romulo Juventino Coelho, Monique Couto Matos, Antonio Augusto Peixoto de Souza, Orlando Jorge Martins Torres
BACKGROUND: Hepatopancreatoduodenectomy is one of the most complex abdominal operations mainly indicated in advanced biliary carcinoma. AIM: To present 10-year experience performing this operation in advanced malignant tumors. METHODS: This is a retrospective descriptive study. From 2004 to 2014, 35 hepatopancreatoduodenectomies were performed in three different institutions. The most common indication was advanced biliary carcinoma in 24 patients (68...
March 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Thomas J Vogl, Ahmed Emam, Nagy N Naguib, Katrin Eichler, Stefan Zangos
BACKGROUND: The purpose of this review is to demonstrate the clinical indications, technical developments, and outcome of liver-directed therapies in interventional oncology of non-colorectal liver metastases. METHODS: Liver-directed therapies are classified into vascular transarterial techniques such as chemoperfusion (TACP), chemoembolization (TACE), radioembolization (selective internal radiation therapy (SIRT)), and chemosaturation, as well as thermal ablation techniques like microwave ablation (MWA), radiofrequency ablation (RFA), laser-induced thermotherapy (LITT), cryotherapy, and irreversible electroporation (IRE)...
December 2015: Viszeralmedizin
Do-Youn Oh, Yung-Jue Bang
INTRODUCTION: Human epidermal growth factor receptor 2 (HER2) and HER3 are altered in multiple tumor types, including gastrointestinal cancer. The HER2/HER3 dimer is crucial for HER2-mediated signaling in HER2-positive tumors. HER2-targeting agents, including trastuzumab, lapatinib, trastuzumab emtansine, and pertuzumab, have been approved for the treatment of HER2-positive breast cancer, with trastuzumab also approved for the treatment of HER2-positive gastric cancer. Pertuzumab, a recombinant humanized immunoglobulin (Ig) G1 monoclonal antibody targeting HER-2, binds to the dimerization domain (extracellular domain II) of HER2, which leads to blocking of ligand-induced HER2 heterodimerization...
2016: Expert Opinion on Biological Therapy
Ivan Igaz, Peter Igaz
Beside blood-borne circulating miRNAs, miRNAs have been identified in other body fluid and excrements including stool, bile, saliva, and urine. Given the direct link of these body fluids to certain organs, their analysis for potential diagnostic miRNA markers is plausible. Several independent findings underline the potential utility of stool-derived miRNAs in the diagnosis of colorectal and pancreatic cancer. Given the difficulties in the diagnosis of cholangiocellular cancer, biliary miRNAs might be envisaged as useful markers...
2015: EXS
Xing Huang, Xin Wang, Shi-Ming Lu, Chen Chen, Jie Wang, Yan-Yan Zheng, Bin-Hui Ren, Lin Xu
Mucin4 (MUC4) is a secreted glycoprotein. Numerous studies had indicated that MUC4 was an attractive prognostic tumor biomarker. However, the results of different studies have been inconsistent. So we conducted this meta-analysis to explore the association between MUC4 expression and cancer prognosis. A systematically comprehensive search was performed through PubMed, EMBASE and CNKI (Chinese National Knowledge Infrastructure). Prognostic value of MUC4 expression in malignancy patients was evaluated by pooled hazard ratios (HRs) and their 95% confidence intervals (CIs)...
2015: International Journal of Clinical and Experimental Medicine
Marino Venerito, Riccardo Vasapolli, Theodoros Rokkas, Peter Malfertheiner
Helicobacter pylori infection is the principal trigger of gastric carcinogenesis and gastric cancer (GC) and remains the third leading cause of cancer-related death in both sexes worldwide. In a big Japanese study, the risk of developing GC in patients with peptic ulcer disease who received H. pylori eradication therapy and annual endoscopic surveillance for a mean of 9.9 years was significantly lower after successful eradication therapy compared to the group with persistent infection (0.21%/year and 0.45%/year, respectively, p = ...
September 2015: Helicobacter
Manju D Chandrasegaram, John W Chen, Timothy J Price, John Zalcberg, Katrin Sjoquist, Neil D Merrett
OBJECTIVES: Periampullary cancers (PACs) include the following 4 traditional anatomic subtypes: pancreatic, ampullary, biliary, or duodenal cancers. This review was performed to highlight recent advances in the genomic and molecular understanding of each PAC subtype and the advances in chemotherapeutic and molecular trials in these cancer subtypes. RESULTS: Recent advances have highlighted differences in the genomic and molecular features within each PAC subtype...
January 2016: Pancreas
Linjing Shu, Renhuan Huang, Songtao Wu, Zhaozhao Chen, Ke Sun, Yan Jiang, Xiaoxiao Cai
Peroxisome proliferator-activated receptor γ (PPARγ) is a versatile member of the ligand-activated nuclear hormone receptor superfamily of transcription factors, with expression in several different cell lines, especially in the digestive system. After being activated by its ligand, PPARγ can suppress the growth of oral, esophageal, gastric, colorectal, liver, biliary, and pancreatic tumor cells, suggesting that PPARγ ligand is a potential anticancer agent in PPARγ-expressing tumors. This review highlights key advances in understanding the effects of PPARγ ligands in the treatment of tumors in the digestive system...
2016: Current Stem Cell Research & Therapy
Giuseppe Aprile, Francesco Leone, Riccardo Giampieri, Mariaelena Casagrande, Donatella Marino, Luca Faloppi, Stefano Cascinu, Gianpiero Fasola, Mario Scartozzi
The 2015 Gastrointestinal Cancers Symposium (San Francisco, CA, USA; January 15-17) is the world-class conference co-sponsored by the American Society of Clinical Oncology, the American Society for Radiation Oncology, the American Gastroenterological Association Institute, and the Society of Surgical Oncology, in which the most innovative research results in digestive tract oncology are presented and discussed. In its twelfth edition, the meeting has provided new insights focusing on the underpinning biology and clinical management of gastrointestinal malignancies...
2015: OncoTargets and Therapy
Emmanuel Melloul, Nicolas Demartines
In 2014, surgical management of complex digestive pathology requires a multimodal approach. The association of chemotherapy combined with surgery allows obtaining promising 5 years survival, particularly for borderline adenocarcinoma of the head of the pancreas or for liver metastasis. The incremental use of cytoreductive surgery associated with hyperthermic intraperitoneal chemotherapy provides a clear benefit in long-term survival for selected patients with primary or secondary peritoneal carcinomatosis. Finally, the use of Enhanced recovery pathways (ERAS) after surgery is now validated in colorectal surgery, and the preliminary results in hepato-biliary and pancreatic surgery are very promising...
January 14, 2015: Revue Médicale Suisse
Daniela Molena, Benedetto Mungo, Miloslawa Stem, Richard L Feinberg, Anne O Lidor
BACKGROUND: The effectiveness of the CMS nonpayment policy for certain hospital-acquired conditions (HAC) is debated, since their preventability is questionable in several groups of patients. This study aimed to determine the rate of the three most common HAC in major surgical resections for cancer: surgical site infection (SSI), urinary tract infection (UTI), and venous thromboembolism (VTE). Additionally, the association of HAC with patients' characteristics and their effect on post-operative outcomes were investigated...
January 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ola Wallengren, Britt-Marie Iresjö, Kent Lundholm, Ingvar Bosaeus
PURPOSE: Muscle mass depletion is associated with adverse outcomes in cancer patients. There is limited information on the impact of age, sex, tumor type, and inflammation on muscle loss in the end of life of cancer patients. METHODS: Muscle depletion and loss of muscle in the last 2 years of life was estimated in 471 cancer patients from 779 dual-energy X-ray absorptiometry scans. A linear mixed model was used to estimate the impact of age, sex, tumor type, and inflammation...
January 2015: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Se-Jin Baek, Seon-Hahn Kim
Since its introduction, robotic surgery has been rapidly adopted to the extent that it has already assumed an important position in the field of general surgery. This rapid progress is quantitative as well as qualitative. In this review, we focus on the relatively common procedures to which robotic surgery has been applied in several fields of general surgery, including gastric, colorectal, hepato-biliary-pancreatic, and endocrine surgery, and we discuss the results to date and future possibilities. In addition, the advantages and limitations of the current robotic system are reviewed, and the advanced technologies and instruments to be applied in the near future are introduced...
May 2014: Asian Journal of Endoscopic Surgery
F Cauchy, S Benoist, S Gaujoux, J-M Régimbeau, C Mariette, D Fuks
GOAL: The aim of this study was to objectively analyze the characteristics of abstracts submitted to the annual joint congress of the SFCD (French Society of Digestive Surgery) and the ACBHT (Association of Hepato-biliary Surgery and Transplantation), in order to identify factors associated with acceptance for presentation at the Congress and of subsequent publication in a scientific journal. MATERIAL AND METHODS: All abstracts submitted between 2005 and 2012 were retrospectively reviewed...
June 2014: Journal of Visceral Surgery
Farshid Ejtehadi, Nikolaos A Chatzizacharias, Rebecca J Brais, Nigel R Hall, Edmund M Godfrey, Emmanuel Huguet, Raaj K Praseedom, Asif Jah
Pancreato-biliary malignancies often present with locally advanced or metastatic disease. Surgery is the mainstay of treatment although less than 20% of tumours are suitable for resection at presentation. Common sites for metastases are liver, lungs, lymph nodes and peritoneal cavity. Metastatic disease carries poor prognosis, with median survival of less than 3 mo. We report two cases where metastases from pancreato-biliary cancers were identified in the colon and anal canal. In both cases specific immunohistochemical staining was utilised in the diagnosis...
April 7, 2014: World Journal of Gastroenterology: WJG
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