Brobergwhittaker9879

5% with no association with anti-VEGF therapies.The therapeutic management of simultaneous liver metastasis of colorectal cancer(SCRLM)remains controversial. Although hepatic metastasectomy is the first choice for resectable liver metastasis of colorectal cancer, radiofrequency ablation (RFA)is one of the least invasive application for patients who refuse more invasive treatment such as hepatectomy and longterm systemic chemotherapy or for whom such treatment is not suitable. We report 2 cases of SCRLM treated by surgery combined with intraoperative RFA and adjuvant chemotherapy, raising the possibility of local control in the liver for selected patients.AIM This study aimed to determine surgical outcomes in patients with gynecological cancers for whom surgery was performed by gynecologists and digestive surgeons. METHODS Seventy-three patients who underwent surgery for a gynecological malignant tumor from January 2010 to December 2014 were included in this retrospective study. Data on the definitive diagnosis, operative procedures, postoperative complications, stoma settings, length of hospital stay, and prognosis was collected for each patient. RESULTS The median age of this female-only cohort was 60 years. Emergency surgery was performed in 8(11.0%)patients. Ovarian cancer was diagnosed in 56(76.7%)patients, and among these patients, the clinical disease Stage was Ⅰ, Ⅱ, Ⅲ, and Ⅳ in 4, 4, 20, and 11 patients, respectively. Moreover, 17 patients had recurrent ovarian cancer. Intestinal resection with anastomosis was performed in 25(34.2%)patients. Stoma formation was performed in 22 (30.1%)patients, however no patient underwent stoma closure surgery in the current study. The median operative time was 252 minutes, and the median blood loss was 1,190 mL. Regarding postoperative complications, ileus, pelvic abscess, and anastomotic leakage developed in 6(8.2%), 4(5.5%), and 2(2.7%)patients, respectively. The postoperative median survival time in patients with ovarian cancer was 1,399 days. CONCLUSION These results suggest that tumor debulking, including intestinal tract resection, may contribute to the prolonged prognosis of gynecological tumors, although stoma closure is difficult to perform.BACKGROUND In Japan, pre-operative 5-FU and cisplatin(CDDP)(FP)combination therapy has been the standard neoadjuvant chemotherapy(NAC)for advanced resectable esophageal cancer(EC); furthermore, the efficacy of the docetaxel (DTX)-containing triplet regimen, FP plus DTX, has been reported. However, patients with impaired renal function should not receive high-dose CDDP. We have been developing a non-CDDP-containing triplet regimen, comprising 5-FU, DTX, and nedaplatin(NED)(UDON), on a phase Ⅰ/Ⅱtrial basis. This retrospective study aimed to investigate the safety and efficacy of NAC with UDON in advanced EC patients with impaired renal function. METHODS Five patients with advanced resectable EC with impaired renal function were enrolled in this study. Patients received NAC(5-FU, 640mg/m / 2, days 1-5; DTX, 28 mg/m2, days 1 and 15; and NED, 72mg/m2, day 1, q28, 2 courses); following this, they underwent esophagectomy. The primary endpoint was response rate, and the secondary endpoint was adverse event(AE). RESULTS The median age was 79 years (range 58-80 years). The ECOG performance status was 1/2 3/2. The main tumor locations were Ce/Ut/Mt 1/1/3 and the cStages were ⅡA/ⅢA/ⅢC 1/2/2. CX-5461 in vitro The RR(CR/PR/SD/PD 0/4/1/0)was 80%. The pathological response was grade 1a/1b 2/3. Major grade 3 or 4 AEs included neutropenia(40%), febrile neutropenia(20%), diarrhea(20%), and hyponatremia( 40%). There was no treatment-related death or reoperation. CONCLUSIONS NAC with UDON might be feasible and effective in patients with advanced resectable EC with impaired renal function, who are ineligible for high-dose CDDP administration. We are planning a phaseⅡclinical study based on the present results.We report different treatment effects between local and distant lesions based on oncotype DX in a patient with breast cancer administered neoadjuvant endocrine therapy. The patient was a 50-year-old woman. Ultrasound(US)showed a mass 16×11×11mm in diameter in the C area of her right breast. Histological examination revealed invasive ductal carcinoma positive for estrogen and progesterone receptor and negative for human epidermal growth factor receptor type 2(HER2), and a Ki-67 index of 38%. The recurrence score(RS)calculated from the core needle biopsy was 4(low-risk group)with a predicted 10-year risk of distant recurrence of 4% after 5 years of endocrine therapy. Oncotype DX showed that this patient would not benefit from chemotherapy. We administered neoadjuvant endocrine therapy. However, the tumor size increased to 26×18×15mm 1 month after treatment initiation. Therefore, right breast-conserving surgery and sentinel lymph node biopsy were performed. Histopathologically, the effect of the endocrine therapy was grade 0 and the surgical margins were negative. Even though RS was low in the breast, the effect of endocrine therapy differed between local and distant lesions such as circulating tumor cells.A 43-year-old man was referred to our hospital for examination of a pancreatic tumor. Imaging revealed a mass-like lesion with a cyst in the pancreatic tail. Histological examination by EUS-FNA showed a low grade spindle cell lesion for which laparoscopic distal pancreatectomy was performed. The neoplasm was histologically diagnosed as pancreatic leiomyosarcoma. The postoperative course was uneventful and no signs of recurrence at 8 months after the surgery. Pancreatic leiomyosarcoma is very rare. Only 7 previous cases were reported in Japan. In tumors with diameters exceeding 50 mm, bleeding and necrosis occur inside the tumor and a cyst-like form often develops, which is considered a characteristic imaging finding. Therefore, imaging is important for preoperative differential diagnosis of the disease.Chemoradiation was performed at Osaka Police Hospital's department of respiratory medicine on a 70-year-old male with small cell lung carcinoma(cT4N3M0, cStage ⅢC). Subsequent to secondary chemotherapy for multiple bone metastases that had been observed, he received care to control the disease. He arrived at the hospital complaining of epigastric pain. He got CT-scan and was referred to our department because of a suspected hematoma around the right gastroepiploic artery. He was treated conservatively because circulatory dynamics were steady and there was no indication that anemia had progressed. However, when a test laparotomy was performed the day after the start of treatment because he presented with decreased blood pressure and progressive anemia, a massive hematoma was found around the right gastroepiploic artery. The hematoma was removed, and hemostasis was performed. Based on the pathological findings of the excised specimen, he was diagnosed with abdominal metastasis of small cell lung carcinoma. This is a report on our experience and a literature review on a case of mesenteric hematoma caused by abdominal metastasis of small cell lung carcinoma.