Bjerrumherman9124
Emergency surgery for colorectal cancer (CRC) is a high-risk procedure with high morbidity and mortality rates, especially for older patients. The relationship between patient age status and long-term outcomes is unclear. We hypothesize that patient age might be associated with long-term outcomes in patients with CRC who undergo emergency surgery.
Utilizing a database of CRC patients who received emergency surgery, we examined the prognostic association of patient age.
The ≥80-years group was significantly associated with American Society of Anesthesiologists (ASA) physical status, bowel obstruction, N stage, shorter operating time, and less adjuvant chemotherapy (all p<0.03); and also, with shorter recurrence-free survival [multivariable hazard ratio, 2.79; 95% confidence interval, 1.13-7.21; p=0.026]. Selleck Cryptotanshinone ASA status and adjuvant chemotherapy were significantly associated with recurrence-free survival (all p<0.03).
Advanced age is associated with shorter recurrence-free survival in CRC patients who undergo emergency surgery.
Advanced age is associated with shorter recurrence-free survival in CRC patients who undergo emergency surgery.
We evaluated the impact of the relative dose intensity (RDI) of neoadjuvant chemotherapy (NAC) on the survival of patients with breast cancer (BC).
This randomized phase II trial included 188 patients with human epidermal growth factor receptor 2 (HER2)-negative BC treated with anthracycline followed by paclitaxel as NAC. We grouped patients using a relative dose intensity (RDI) threshold of 85% and evaluated clinicopathological features and clinical outcomes.
The 5-year overall survival rate was 91.2% and 76.3%, when RDI ≥85% and <85%, respectively (p=0.015). Age, tumor, and node status, and the RDI were significantly different on univariate analysis, but not on multivariate analysis. An exploratory subgroup analysis revealed that a low RDI was associated with low overall survival of patients with obesity, T1/2 disease, and lymph node metastases.
Maintaining the RDI of NAC is crucial for achieving the survival benefit in selected patients with HER2-negative BC.
Maintaining the RDI of NAC is crucial for achieving the survival benefit in selected patients with HER2-negative BC.
This study aimed to describe the chemotherapy effects after trifluridine/tipiracil (TFTD) and/or regorafenib treatment in colorectal cancer (CRC) patients.
Patients receiving regorafenib or TFTD for metastatic CRC during 2013-2018 were selected and divided into two groups one with additional chemotherapy after regorafenib or TFTD (CTX group) and one without additional chemotherapy (Non-CTX group). Patients were followed up from a landmark point (90 days from the last day of administration of regorafenib or TFTD). We compared overall survival (OS) between the groups.
The median OS was 7.7 months in the CTX group and 4.1 months in the non-CTX groups. Several sensitivity analyses did not negate the survival advantage detected in the CTX group.
The chemotherapy after regorafenib or TFTD was associated with prolonged OS in advanced CRC patients. Further study is required to determine appropriate treatment choice.
The chemotherapy after regorafenib or TFTD was associated with prolonged OS in advanced CRC patients. Further study is required to determine appropriate treatment choice.
We aimed to predict the prognosis of endometrial carcinoma by combining traditional histological classification with the status of tumor-infiltrating lymphocytes (TILs).
All patients with endometrial carcinoma, treated at our hospital, were classified into four categories-Category I Type I positive for TILs; category II type I negative for TILs; category III type II positive for TILs; and category IV type II negative for TILs. Prognoses were compared across all the categories. Positivity for TILs was defined as a continuously formed thick zone of TILs at the invasive front.
Multivariate analyses of progression-free and overall survival indicated that category classification was an independent prognostic factor, with hazard ratios of 3.127, 3.483, and 8.459 for progression-free survival, and 3.444, 4.374, and 11.058 for OS for patients in categories II, III, and IV, respectively.
Combining traditional histological classification with TIL status might better predict prognosis of endometrial carcinoma.
Combining traditional histological classification with TIL status might better predict prognosis of endometrial carcinoma.
This study aimed to investigate the effectiveness of knee rotationplasty (KRP) as salvage surgery for uncontrolled infection and implant failure of total knee arthroplasty (TKA) for sarcoma around the knee in adolescents and young adults (AYA).
This retrospective cohort study included 33 patients who underwent KRP and were grouped based on the treatment received initial surgery for sarcoma around the knee (n=18) or as salvage surgery (n=15). Musculoskeletal Tumor Society (MSTS) score, range of motion (ROM) and postoperative results were analyzed.
All 15 patients who underwent salvage KRP had TKA as an initial surgery. Although there were five infections in salvage KRP, which originated from the initial TKA, all cases were controllable, no implant failure occurred. MSTS score and ROM were deemed acceptable in both groups.
Salvage KRP is an effective option for uncontrolled complications of initial TKA for sarcoma around the knee.
Salvage KRP is an effective option for uncontrolled complications of initial TKA for sarcoma around the knee.
The definition of multiple oral cancers is based on the distances between the tumors. However, it is not possible to accurately predict tumor origins based only on clinical criteria.
We performed whole-exome sequencing (WES) to analyze the genetic alterations in five tumors of two patients who underwent surgery in our hospital.
In case 1, the distances between tumors on the right mandibular gingiva and buccal mucosa were more than 15 mm, leading to a clinical diagnosis of multiple primary tumors. WES revealed common mutations between tumors, suggesting that the tumors were derived from the same clone. In contrast, in case 2, the distance between tumors on the right side of the tongue was only 10 mm, but the tumors were diagnosed as double primary tumors because their mutations were completely different.
WES, rather than the available clinical criteria, can clarify the clonal origins of multiple oral cancers.
WES, rather than the available clinical criteria, can clarify the clonal origins of multiple oral cancers.
This study aimed to evaluate the association of clinical characteristics with treatment outcomes to ascertain the appropriate treatment options for soft tissue sarcomas (STS) patients with brain metastasis (BM).
Medical records of STS patients with BM who were treated in our institutions were retrospectively reviewed, and analyzed to identify the factors associated with post-BM survival.
Among the 509 STS patients, BM occurred in five patients (0.98%). The median survival after BM was 1.5 months. Histological subtypes of the primary lesions in the five BM patients were two synovial sarcomas, one myxoid liposarcoma, one alveolar soft part sarcoma, and one rhabdomyosarcoma. Among the five BM patients, the post-BM survival of two patients, who underwent surgery and postoperative radiotherapy, was longer than that of the other patients (p<0.01).
Combined surgery and postoperative radiotherapy effectively managed symptoms and prolonged survival in STS patients with BM.
Combined surgery and postoperative radiotherapy effectively managed symptoms and prolonged survival in STS patients with BM.
Biomarkers for immune-related adverse events (irAEs) induced by immune checkpoint inhibitors (ICIs) are required. We encountered a patient whose skin irAE fluctuated in parallel with serum soluble interleukin-2 receptor (sIL-2R).
We examined 15 patients with cancer who received ICIs. Serum sIL-2R levels before and during ICI treatment were measured. The sIL-2R levels of preserved serum samples from another five patients who developed grade 3 irAEs were measured.
Twelve patients showed no significant changes in sIL-2R levels during ICI treatment. Baseline serum sIL-2R levels in three patients increased beyond the normal range before the second cycle. These three patients had grade ≥2 irAEs at the second cycle treatment visit, supporting our hypothesis. Furthermore, at diagnosis of irAEs, the sIL-2R levels of all preserved samples from patients with grade 3 irAEs were significantly elevated.
Serum sIL-2R is a promising biomarker for the diagnosis of irAEs.
Serum sIL-2R is a promising biomarker for the diagnosis of irAEs.
Soft pancreatic texture is a risk factor for postoperative pancreatic fistula (POPF). However, conventional evaluation of pancreatic texture is largely dependent on subjective assessment and lacks quantitative parameters. The study aimed to use ultrasonic shear wave elastography (SWE) to evaluate pancreatic stiffness to determine if the intraoperative SWE measurement could be a quantitative predictor for POPF.
Fifteen patients scheduled for pancreaticoduodenectomy were included. Both pre- and intra-operative measurement of the pancreatic SWE index (SWEI) were evaluated. Relationships between intraoperative and preoperative SWEI, pathological fibrosis of the resected pancreatic specimen, postoperative exocrine function of the remnant pancreas, and the incidence of POPF were evaluated.
The intraoperative SWEI was correlated with the preoperative SWEI, pathological fibrosis of pancreatic tissue, and pancreatic exocrine function.
Intraoperative SWE measurement of pancreatic elasticity may be useful as a quantitative method for evaluating pancreatic fibrosis and exocrine function.
Intraoperative SWE measurement of pancreatic elasticity may be useful as a quantitative method for evaluating pancreatic fibrosis and exocrine function.
To identify prognostic factors for patients with stage IV gastric cancer (GC) and a single stage IV factor before chemotherapy who underwent conversion surgery (R0 resection).
This study retrospectively analysed 32 GC patients with a single stage IV factor before chemotherapy and who underwent conversion surgery (R0 resection) between January 2001 and September 2015. The univariate and multivariate analyses were performed to identify independent prognostic factors.
The five-year survival rate was 39.6%, and the median survival time was 47.0 months. In the univariate analysis, diffuse-type according to Lauren classification was significantly associated with worse overall survival (p<0.001). In the multivariate analysis, diffuse-type was selected as an independent prognostic factor (hazard ratio=15.970, 95% confidence interval=3.804-67.043, p<0.001).
Diffuse-type may be a useful prognostic factor in GC patients with a single stage IV factor who undergo conversion surgery (R0 resection).
Diffuse-type may be a useful prognostic factor in GC patients with a single stage IV factor who undergo conversion surgery (R0 resection).
Identification of predictors of survival of patients with lower genital tract melanoma (LGTM) and evaluation of the effectiveness of immunotherapy.
Data of twenty women with LGTM were retrospectively collected. Survival outcomes were evaluated using the Kaplan-Meier method. Survival distributions were analyzed using the Log rank test.
Twenty patients with LGTM (6 vaginal/14 vulvar) were evaluated. Factors significantly affecting Five-year OS was the stage of the American Joint Committee on Cancer (AJCC 2017) (I+II 55.6% vs. III+IV 25.9%; p=0.030) and the T-Stage (I+II 100% vs. III+IV 7.5%; p=0.280). Factors negatively affecting Five-year PFS was T-Stage >II (p=0.005), AJCC stage >II (p<0.001), depth of tumor infiltration >3 mm (p=0.008), nodal involvement (p=0.013), distant disease (p=0.002), and resection margins <10 mm (p=0.024). Nine patients received immunotherapy [median duration of response (DOR)=4 months]. Three patients received immuno- and radiation therapy (median DOR of 5 months).
