scholarly journals Early radical cystectomy with negative margins in a 57-year-old female with myxoid/round cell liposarcoma of the bladder suggests prolonged overall survival

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Johannes Eduard Delport ◽  
Khanyisa Makamba
Keyword(s):  
Overall Survival ◽  
Surgical Intervention ◽  
Radical Surgery ◽  
Bladder Tumour ◽  
Eastern Cape ◽  
Round Cell ◽  
Female Population ◽  
Case Presentation ◽  
Rural Town ◽  
Common Cancer

Abstract Background Bladder cancer is the 17th most common cancer in the female population. Most bladder cancers are of urothelial origin. Sarcomas of the bladder are very uncommon. Case presentation This case concerns a 57-year-old female from a rural town in the Eastern Cape who was diagnosed with myxoid/round cell liposarcoma of the bladder. After the initial transurethral resection of the bladder tumour, she underwent an anterior exenteration with Bricker’s diversion (ileal conduit) and negative margins were achieved. Conclusions Sarcomas of the bladder are known to have a poor prognosis. Our patient is alive with good stoma function more than 24 months since her radical surgery. We are of the opinion that her favourable overall survival is attributable to early radical surgical intervention with negative margins.

scholarly journals Neo-adjuvant chemotherapy followed by surgery versus definitive chemo radiation as treatment for localized carcinoma cervix

2016 ◽  
Author(s):  
S. Singh ◽  
V. Goel ◽  
V. Talwar ◽  
S. Raina ◽  
S. Mitra ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Free Survival ◽  
Common Cancer ◽  
Group A ◽  
Group B ◽  
Disease Free

Background: Cervical cancer is ranked as the most common cancer in Indian women, second most common cancer worldwide and the leading cause of death in the developing countries. In the developing countries majority of the patients are diagnosed at locally advanced stages. The standard treatment of locally advanced cervical cancer is concomitant chemoradiation (CTRT) using platinum based chemotherapy. However, some randomized studies have shown improved results for patients receiving neoadjuvant chemotherapy (NACT) followed by surgical resection in comparison to patient receiving radiation alone. The present study was designed to compare response to the treatment and survival of and NACT followed by radical surgery (RS) with CTRT in the patients of uterine cervix of a tertiary cancer care centre. Patients and Methods: Retrospective study was performed in locally advanced/advance stage patients of cervix UTERI registered in the institute between years 2009 to 2013. Patients were included in the two groups, group A consists of 89 patients who have received NACT + RS and 67 patients in group B who have received CTRT. Clinical records were reviewed with particular reference to presenting complaint, clinical stage, response to the therapy, disease free survival and overall survival. Statistical analysis was done using SPSS version 22. Results: In the neoadjuvant group (group A) (n=89) the median age of patients was 53 years (range 31-80 years), most of the patients (70%) were presented with complaint of postmenopausal bleeding. Of the total patients, 69 (77.5%) underwent to radical surgery and 5 (8.5%) received radiotherapy after NACT. From 69 patients, who had undergone to surgery, 54 (78.3%) had also received radiation. The overall response to induction chemotherapy was 84%. In the chemo radiation group (group B) (n=65) median age was 56 years (33-75 years). Vaginal bleeding (34%) followed by postmenopausal bleeding (32%) was major presenting complaint in this group. Overall response to the complete treatment was 91%. The median follow up time was 14.3 months in group A and 12.2 months in group B. The disease free survival for NACT group was 32 months (95% CI 26.8-36.5) whereas for CTRT group it was 28 months (95% CI 23.5-33) with 12 and 13 recurrences per group (p = .226). In NACT group overall survival was 46.2 months (95% CI 44-48.3) and for CTRT group it was 38.3 months (95%CI 36.6-40) with 3 and 2 deaths per group (p=.883). Conclusion: Present study shows comparable results, with no difference in survival between both the groups. However, NACT + RS group had showed better disease free and overall survival than another group. Further studies should be performed with larger number of patients and longer duration of follow up.

Neoadjuvant chemotherapy followed by radical surgery in locally advanced vulvar carcinoma: a single-institution experience

2021 ◽  
pp. 030089162110276
Author(s):  
Adorni Marco ◽  
Bazzurini Luca ◽  
Lissoni Andrea Alberto ◽  
Vecchione Francesca ◽  
Negri Serena ◽  
...  
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Partial Response ◽  
Vulvar Cancer ◽  
Elderly Women ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Complete Response ◽  
Tumor Burden ◽  
Clinical Response Rate

Background: Squamous cell carcinoma of the vulva is a rare malignancy that affects elderly women. About one-third of vulvar cancers are diagnosed in an advanced stage, requiring extensive surgery. Neoadjuvant chemotherapy (NACT) has been introduced to reduce local tumor burden. In this retrospective study, we analyze the efficacy and toxicity of NACT followed by radical surgery. Methods: Patients with locally advanced vulvar cancer (LAVC) treated at our institution with neoadjuvant platinum and paclitaxel-based chemotherapy ± ifosfamide followed by surgery at our institution were retrospectively identified. Results: Fourteen patients (93%) completed NACT with tolerable toxicities (G3–G4 toxicity: 30%). Thirteen patients (87%) underwent surgery. The overall clinical response rate on vulvar disease was 66% (20% complete response, 46% partial response), confirmed by histopathologic analysis, while on inguinal lymph nodes it was 69% (23% complete response, 46% partial response). At the pathologic examination, all patients had negative surgical margins. Three out of 9 patients (33%) with lesions infiltrating the urethral meatus and 4 patients out of 7 (57%) with anal involvement did not require urethral amputation or colostomy, respectively, after NACT. No severe postoperative complications were described. Overall survival at 5 years was 60%, and median overall survival was 76 months. Conclusion: NACT followed by surgery in locally advanced vulvar cancer is well tolerated and allows surgical modulation.

scholarly journals First reported case of penile prosthesis infection from brucellosis: case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  
Keyword(s):  
Case Report ◽  
Broad Spectrum ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Raw Milk ◽  
Prosthesis Infection ◽  
Case Presentation ◽  
First Case ◽  
Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

Is salvage radiotherapy optimal to patients with occult cervical cancer undergoing inadvertent simple hysterectomy? A propensity score-matched analysis of a nationwide clinical oncology database

2021 ◽  
Author(s):  
Yanhong Wang ◽  
Yi Ouyang ◽  
Jingjing Su ◽  
Lihua Xiao ◽  
Zhigang Bai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Radical Surgery ◽  
Figo Stage ◽  
Salvage Radiotherapy ◽  
Radiotherapy Group ◽  
Surgery Group ◽  
Group Matching

Abstract Objective We used National Cancer Institute’s Surveillance, Epidemiology and End Result database to assess the role of salvage radiotherapy for women with unanticipated cervical cancer after simple hysterectomy. Methods Patients with non-metastatic cervical cancer and meeting inclusion criteria were divided into three groups based on treatment strategy: simple hysterectomy, salvage radiotherapy after hysterectomy and radical surgery. Parallel propensity score-matched datasets were established for salvage radiotherapy group vs. simple hysterectomy group (matching ratio 1: 1), and salvage radiotherapy group vs. radical surgery group (matching ratio 1:2). The primary endpoint was the overall survival advantage of salvage radiotherapy over simple hysterectomy or radical surgery within the propensity score-matched datasets. Results In total, 2682 patients were recruited: 647 in the simple hysterectomy group, 564 in the salvage radiotherapy group and 1471 in the radical surgery group. Age, race, histology, grade, FIGO stage, insured and marital status and chemotherapy were comprised in propensity score-matched. Matching resulted in two comparison groups with neglectable differences in most variables, except for black race, FIGO stage III and chemotherapy in first matching. In the matched analysis for salvage radiotherapy vs. simple hysterectomy, the median follow-up time was 39 versus 32 months. In the matched analysis for salvage radiotherapy vs. radical surgery, the median follow-up time was 39 and 41 months, respectively. Salvage radiotherapy (HR 0.53, P = 0.046) significantly improved overall survival compared with simple hysterectomy, while salvage radiotherapy cannot achieve similar overall survival to radical surgery (HR 1.317, P = 0.045). Conclusions This is the largest study of the effect of salvage radiotherapy on overall survival in patients with unanticipated cervical cancer. Salvage radiotherapy can improve overall survival compared with hysterectomy alone, while cannot achieve comparable survival to radical surgery.

scholarly journals Osteochondroma of the pubic symphysis causing hematuria: a case report and literature review

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li-cheng Song ◽  
Qian Xu ◽  
Hui Li ◽  
Zhi-jun Li ◽  
Ya Li ◽  
...  
Keyword(s):  
Bladder Tumor ◽  
Multidisciplinary Approach ◽  
Bladder Tumour ◽  
Surgical Excision ◽  
Pubic Symphysis ◽  
Careful Analysis ◽  
Bone Neoplasm ◽  
Imaging Data ◽  
Case Presentation

Abstract Background Osteochondroma is the most common benign bone neoplasm and is sometimes referred to as osteocartilaginous exostosis. The symptoms caused by osteochondroma are rare, especially the urogenital complications. Therefore, this tumour is sometimes misdiagnosed. Case presentation This report described a 70-year-old woman with hematuria who was initially misdiagnosed with a bladder tumour in the outpatient department by a urologist. However, during cystoscopy, we found that the mass did not resemble a bladder tumor. Multidisciplinary approach with careful analysis of the imaging data suggested the diagnosis of osteochondroma. Open surgical excision of the mass was done and histology confirmed the diagnosis of benign osteochondroma. After 6 months of follow-up, the patient was still asymptomatic. Conclusions This case illustrates that hematuria is caused by not only urogenital disease but also osteochondroma. We present this case to draw the attention of clinicians to osteochondroma of the pubic symphysis.

scholarly journals Association of chemotherapy with survival in stage II colon cancer patients who received radical surgery: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhihao Lv ◽  
Yuqi Liang ◽  
Huaxi Liu ◽  
Delong Mo
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Prediction Models ◽  
Radical Surgery ◽  
Survival Rates ◽  
Stage Ii ◽  
Survival Prediction ◽  
Stage Ii Colon Cancer ◽  
Overall Survival Rates

Abstract Background It remains controversial whether patients with Stage II colon cancer would benefit from chemotherapy after radical surgery. This study aims to assess the real effectiveness of chemotherapy in patients with stage II colon cancer undergoing radical surgery and to construct survival prediction models to predict the survival benefits of chemotherapy. Methods Data for stage II colon cancer patients with radical surgery were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (1:1) was performed according to receive or not receive chemotherapy. Competitive risk regression models were used to assess colon cancer cause-specific death (CSD) and non-colon cancer cause-specific death (NCSD). Survival prediction nomograms were constructed to predict overall survival (OS) and colon cancer cause-specific survival (CSS). The predictive abilities of the constructed models were evaluated by the concordance indexes (C-indexes) and calibration curves. Results A total of 25,110 patients were identified, 21.7% received chemotherapy, and 78.3% were without chemotherapy. A total of 10,916 patients were extracted after propensity score matching. The estimated 3-year overall survival rates of chemotherapy were 0.7% higher than non- chemotherapy. The estimated 5-year and 10-year overall survival rates of non-chemotherapy were 1.3 and 2.1% higher than chemotherapy, respectively. Survival prediction models showed good discrimination (the C-indexes between 0.582 and 0.757) and excellent calibration. Conclusions Chemotherapy improves the short-term (43 months) survival benefit of stage II colon cancer patients who received radical surgery. Survival prediction models can be used to predict OS and CSS of patients receiving chemotherapy as well as OS and CSS of patients not receiving chemotherapy and to make individualized treatment recommendations for stage II colon cancer patients who received radical surgery.

scholarly journals Outcome of Acute Burn Injuries in a Tertiary Care Centre of Kathmandu Nepal

2020 ◽  
Vol 42 (2) ◽  
pp. 33-36
Author(s):  
Manish Devkota ◽  
Samit Sharma ◽  
Sangam Rayamajhi ◽  
Jayan M Shrestha ◽  
Ishwar Lohani
Keyword(s):  
Low Income ◽  
Surgical Intervention ◽  
Burn Injury ◽  
Tertiary Care ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Low Income Countries ◽  
Female Population ◽  
Partial Thickness Burn ◽  
Flame Burn

Introduction Burn injuries are associated with higher morbidity and mortality especially in middle and low-income countries. The objective of the study is to assess the outcome of acute burn injuries in a tertiary care center of Kathmandu, Nepal. MethodsThis is a descriptive cross-sectional study of the clinical data of acute burn patients admitted from January 2016-December 2018. ResultsOut of 124 patients with burn injuries, there were more females (n=65, 52.4 %) than males (n=59, 47.6%). Flame burn was the most common mode of injury (n=71,57.3 %) followed by scald (n=22,17.7 %). Thirty-eight (30.6%) patients arrived to hospital on the same day of injury. The average time required to reach our hospital was 24 hours. The most frequently involved site was lower extremities (n=40, 32.26%) followed by upper extremities (n=33, 26.62%). Total body surface area (TBSA) involved in the burn injury ranges from 10% to 50% with a median of 15%. Hospital stay was 14 to 58 days with a median of 17 days. Partial thickness burn was seen in 114 (91.94%) patients whereas 10 (8.06%) patients had full thickness burn. Surgical intervention was needed in 71 (57.26%) patients. Among 71 patients, 12 patients underwent surgery twice. Fifty-two (41.94%) patients were managed conservatively. The mortality rate was 4.03%. ConclusionAdult female population is at high risk for burn injuries mostly due to flame burn. Delay in reaching care has also contributed for poor outcome of burn injuries. Majority of burn injury patients needed surgical intervention and hence improvement in surgical aspects can lead to better outcome of burn injuries.Keywords:

scholarly journals Unusual Site for a White Nodule on the Palatine Tonsil: Presentation, Differential Diagnosis, and Discussion

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwag Yagoub Aloyouny
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Fungal Infections ◽  
The Body ◽  
Palatine Tonsil ◽  
Unusual Site ◽  
Case Presentation ◽  
Lymphoepithelial Cysts ◽  
Malignant Lesions

Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.

scholarly journals Nomogram to predict overall survival for patients with pseudomyxoma peritonei of appendiceal origin: A retrospective cohort study

2020 ◽  
Author(s):  
Mingjian Bai ◽  
Shilong Wang ◽  
Ruiqing Ma ◽  
Ying Cai ◽  
Yiyan Lu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pseudomyxoma Peritonei ◽  
Roc Analysis ◽  
Prediction Models ◽  
Radical Surgery ◽  
Individual Risk ◽  
Good Discrimination ◽  
Internal Validation ◽  
Discrimination Ability ◽  
First Time

Abstract Background Pseudomyxoma peritonei (PMP) is a rare disease, the prognosis of overall survival (OS) is affected by many factors, present study aim to define independent prediction indicators and establish a nomogram for PMP patients.Methods 119 PMP patients received cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in our center for the first time were included between 01/06/2013 and 22/11/2019 . The log-rank test was used to compare the OS rate among groups, subsequently, variables with P<0.10 were subjected to multivariate Cox model for defining independent prediction indicators. Finally, the nomogram prediction models will be established and for internal validation.Results Multivariate analysis showed Sex, D-Dimer, CA125, CA19-9, PCI, and degree of radical surgery were independently associated with OS in PMP patients. A nomogram was plotted based on the independent predictive factors and undergone internal validation, ROC analysis was performed to calculate discrimination ability of the nomogram, the C-index was 0.880 (95%CI: 0.806- 0.933) and calibration plots showed good performance. Conclusions Six independent prognostic factor for predicting survival in PMP patients were difined, the nomogram has a good discrimination ability for individual risk predition, more researches are needed to verify and improve the prediction model.

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