Palliative surgery for advanced gastric cancer: A pilot study of 10 years experience in a tertiary referral center before and after centralization of surgical care

2017 ◽  
Vol 72 ◽  
pp. S83
Author(s):  
E. De Wijkerslooth ◽  
H. Topal ◽  
J. Tegels ◽  
T. Hoofwijk ◽  
K. Hulsewe ◽  
...  
PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248010
Author(s):  
Markus Schranz ◽  
Michael Georgopoulos ◽  
Stefan Sacu ◽  
Adrian Reumueller ◽  
Gregor S. Reiter ◽  
...  

Purpose To assess the influence of the SARS-CoV-2 lockdown in spring on frequency, severity and quality of care of rhegmatogeneous retinal detachments (RRD) in a tertiary referral center in Vienna, Austria. Methods Single center, consecutive case series with historical controls. Patients presenting with primary RRD during the first Austrian SARS-CoV-2 lockdown (March 16th–May 3rd 2020) and a corresponding control group consisting of the same time period of the preceding 3 years. Results The mean number of patients with RD in the reference group (RG) was 22 (± 1) and in the lockdown group (LG) 15. Median total delay, defined as onset of symptoms until surgery, in the RG was 5 (lower quartile: 3.0; upper quartile: 8.0) compared to 7 (3.0; 12.0) days in the LG, (p = 0.740). During the lockdown 67% of patients were referred from an external ophthalmologist compared to 52% in the RG, (p = 0.395). 34% of patients in the RG presented with an attached macula compared to 33% in the LG (p = 0.597). PVR was present in 49% of cases in the RG compared to 73% in the LG. Single surgery success (SSS) rates were lower in the LG (73.3%) compared to the RG (85.3%), (p = 0.275). Conclusion Patients with RRD during the SARS-CoV-2 lockdown presented and were treated within acceptable time limits, showed the same macula-on ratios but a higher PVR rate and a tendency towards worse SSS rates compared to the time period of the preceding 3 years.


2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Harry Papasozomenos ◽  
Nandita Guha-Thakurta ◽  
Rory R. Mayer ◽  
Jeffrey S. Weinberg ◽  
Morris D. Groves ◽  
...  

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 412-412
Author(s):  
Hiroaki Tanaka ◽  
Takuya Mori ◽  
Kenjiro Kimura ◽  
Kazuya Muguruma ◽  
Kosei Hirakawa ◽  
...  

412 Background: Conversion surgery for unresectable advanced gastric cancer has been increasing with the development of chemotherapy. Adjuvant chemotherapy regimens after conversion surgery have not been standardized. The main mechanism of nivolumab is augmentation of antitumor immune response of tumor infiltrating cytotoxic T cells (CTL) to cancer cells, and it has recently been reported that nivolumab therapy before and after chemotherapy is effective in other carcinomas. We previously reported that tertiary lymphoid architecture (TLS) correlates with tumor-infiltrating T cells and is associated with a better prognosis in untreated patients. The purpose of this study was to investigate the relationship between the presence of TLS in the primary tumor and prognosis in patients with gastric cancer who underwent conversion therapy. Methods: We evaluated 52 patients with advanced gastric cancer including 17 patients underwent conversion surgery and 35 patients underwent palliative surgery without prior chemotherapy in our department from 2009 to 2017. The local immune environment and presence of TLS was evaluated by immunohistochemical staining. Results: Intratumoral TLS occurred in 20% of patients with advanced cancer who did not receive chemotherapy before surgery and in 52% of patients who received conversion surgery. And the prognosis of patients with the presence of TLS was better than no TLS. Intratumoral CD8 T-cell infiltration was slightly associated presence of TLS. We had a case in which nivolumab was highly effective and converted to conversion surgery, and a case in which nivolumab was highly effective in patients with recurrence after conversion surgery. TLS was observed in the vicinity of the tumor in these patients. Conclusions: The prognosis was good in the case in which intratumoral TLS was present after conversion surgery. These results suggest that the adjuvant nivolumab therapy may improve the outcome of patients underwent conversion surgery for advanced gastric cancer. These results suggest that peri-tumor TLS is a predictor of nivolumab efficacy in adjuvant therapy after conversion surgery.


2021 ◽  
Vol 222 ◽  
pp. 368-372 ◽  
Author(s):  
Hasenin Al-khersan ◽  
Meghana A. Kalavar ◽  
Rebecca Tanenbaum ◽  
Thomas A. Lazzarini ◽  
Nimesh A. Patel ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christoph Ehlken ◽  
Constantin von Medem ◽  
Maya Lüdemann ◽  
Anna Maria Kirsch ◽  
Johann Baptist Roider

Abstract Background During the first wave of the COVID-19 pandemic, the need of treatment of urgent ophthalmological diseases and the possible risk of a SARS-CoV-2 infection had to be weighed against each other. In this questionnaire study, we aimed to analyze potential barriers and patients’ health beliefs during and after the lockdown early 2020 in a tertiary referral center in Kiel, Germany. Methods Patients admitted for the treatment of urgent ophthalmic diseases between March 1st, 2020, and June 3rd, 2020, were asked to participate in a questionnaire study. After informed consent was obtained, patients were interviewed using a standardized questionnaire which addressed aspects of their medical history, their health beliefs concerning the COVID-19 pandemic and barriers on their way to the treatment center. The study group was subdivided into two subgroups, depending on the occurrence of their symptoms, before and after the lockdown was ended on April 20th, 2020. Results Ninety-three patients were included, 43 in subgroup A (before April 20th) and 50 in subgroup B (April 20th or later). Retinal disorders were the most common causes for admission (approximately 60%).. Only 8 patients (8.6%) experienced a delay between their decision to visit a doctor until the actual examination. Every fourth patient was afraid of a COVID-19 infection, and expected a higher likelihood for an infection at the hospital. Patients with comorbidities tended to be more likely to be afraid of an infection (correlation coefficient 0.183, p = 0.0785) and were significantly more likely to be concerned about problems with organizing follow-up care (corr. Coefficient 0.222, p = 0.0328). Higher age was negatively correlated with fear of infection (corr. Coefficient − 0.218, p-value 0.034). Conclusion In this questionnaire study, only a minority of patients indicated a delay in treatment, regardless of whether symptoms occurred before or after the lockdown before April 20th, 2020. While patients with comorbidities were more concerned about infection and problems during follow-up care, patients of higher age – who have a higher mortality – were less afraid. Protection of high-risk groups should be prioritized during the SARS-CoV-2 pandemic. Trial registration The study was registered as DRKS00021630 at the DRKS (Deutsches Register Klinischer Studien) before the conduction of the study on May 5th, 2020.


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