Combined treatment of patients with incompletely resected invasive thymoma: A retrospective analysis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18193-18193
Author(s):  
D. M. Kowalski ◽  
A. Janowicz-Zebrowska ◽  
M. J. Krzakowski ◽  
P. Jaskiewicz ◽  
K. Zajda ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Clinical Stage ◽  
Combined Treatment ◽  
Radical Resection ◽  
Complete Resection ◽  
Incomplete Resection ◽  
Invasive Thymoma ◽  
Type C ◽  
Single Modality

18193 Background: Although surgery remains the mainstay of therapy for invasive thymoma, complete resection is feasible in only 60% of patients (pts) and adjunctive radiotherapy (RT) or/and chemotherapy (CT) is advocated. Multidisciplinary approach with chemotherapy (CT) and radiotherapy (RT) is an option for unresectable disease. The aim of our study was to evaluate retrospectively the outcome of pts with invasive thymoma submitted to postoperative RT or combined CT and RT. Methods: Pts in our analysis underwent either radical resection followed by RT or they had incomplete resection with subsequent CT and RT. Results: Between March 1996 and September 2005, 32 (18 women; 56.3% and 14 men; 43.7%) pts with invasive thymoma were treated. Median age was 47,8 years (range, 20–75). Clinical stage I, II, III or IVA was diagnosed respectively in 3 (9.4%), 12 (37.5%), 6 (18.7%) and 11 34.4%) pts. Pathologic types of invasive thymoma were as follows: A - 4 pts (12.5%), B - 9 pts (28.1%), AB - 8 pts (25%); pathological type was not specified in 1 pts (3.1%). Type C thymoma was diagnosed in 10 pts (31.3%). Complete resection was performed in 26 pts (81.3%), whereas 1 pt (3.1%) was irradiated only and 5 pts (15.6%) were treated with CT as single modality. Cisplatin-based CT was used in all pts. Twenty pts (62.5%) were irradiated, while RT was not used in 12 pts (37.5%). Median survival time (MST) for all pts was 54.5 months (range: 2–240 months), and median time to progression (MTTP) was 27.5 months (range: 1–221 months). MST for pts on CT was 46.3 months (range: 2–156) in comparison with 54.7 months (range: 2–240) in non-CT group. MTTP for CT group was 35.2 months (range: 2–144) and 51.0 months (range: 2–221) for no CT group. Tolerance of CT was acceptable. Conclusions: Postoperative RT is effective in reducing local recurrence rate and prolonging survival in pts with invasive thymoma. The role of postoperative CT is unclear and deserves further exploration. No significant financial relationships to disclose.

Role of Ancillary Testing on Endoscopic US-Guided Fine Needle Aspiration Samples from Cystic Pancreatic Neoplasms

2019 ◽  
Vol 64 (1-2) ◽  
pp. 124-135
Author(s):  
Nirag Jhala ◽  
Piyachat Srimunta ◽  
Darshana Jhala
Keyword(s):  
Multidisciplinary Approach ◽  
Accurate Determination ◽  
Needle Aspiration ◽  
Pancreatic Cysts ◽  
Molecular Testing ◽  
Appropriate Care ◽  
Biochemical Testing ◽  
Single Modality

Pancreatic cysts are increasingly detected on imaging studies. Accurate determination of the cyst type is important to provide appropriate care for the patients. It is also very clear that not one single modality can provide adequate diagnostic information. A multidisciplinary approach is the key to the diagnosis of pancreatic cysts. In this setting, the role of ancillary testing, which includes biochemical testing (carcinoembryonic antigen and amylase levels in the cyst), molecular testing (e.g., KRAS, GNAS, VHL, and CTNB1), and/or immunohistochemical tests are very important to obtain an accurate diagnosis. This review will discuss helpful ancillary tests in common pancreatic cyst neoplasms and how to approach the diagnosis of pancreatic cysts.

Large cell lymphomas of the stomach: improved prognosis with complete resection of all intrinsic gastrointestinal disease.

1983 ◽  
Vol 1 (4) ◽  
pp. 263-269 ◽  
Author(s):  
S Paulson ◽  
R G Sheehan ◽  
M J Stone ◽  
E P Frenkel
Keyword(s):  
Cell Lymphoma ◽  
Gastrointestinal Disease ◽  
Stage Iv ◽  
Large Cell ◽  
Complete Resection ◽  
Early Surgery ◽  
Incomplete Resection ◽  
Postoperative Therapy ◽  
Large Cell Lymphoma

Thirty-seven consecutive patients with large cell lymphoma involving the stomach were evaluated between 1974 and 1980. All seven stage IE patients underwent complete resection of the stomach and all patients are alive 21-41 mo after resection. Of 18 stage IIE, 11 underwent complete resection. Two resected patients without postoperative therapy died of their disease. Six patients treated with chemotherapy are alive and well, and two of three patients treated with radiotherapy remain alive without disease. Seven patients had incomplete resection or biopsy, and only one remains alive at 34 mo. Of eight stage IV patients, four had complete resection and chemotherapy without recurrence of their disease. All four patients who were not resected have died of their disease. This study strongly supports the role of early surgery in the management of gastric large cell lymphomas.

THE ROLE OF BRACHYTHERAPY IN TREATMENT FOR ESOPHAGEAL CANCER

2017 ◽  
Vol 63 (4) ◽  
pp. 660-665
Author(s):  
Yelena Tyuryaeva
Keyword(s):  
Esophageal Cancer ◽  
Critical Review ◽  
Palliative Treatment ◽  
Combined Treatment ◽  
Neoadjuvant Treatment ◽  
Early Esophageal Cancer ◽  
Separate Section ◽  
Treatment Regimens ◽  
Contradictory Data

The article is devoted to various aspects of the use of intraluminal brachytherapy (IB) in treatment for esophageal cancer (EC). A critical review of the use of IB as a component of combined radiotherapy/chemoradiotherapy in neoadjuvant treatment regimens, for definitive CRT, as well as in palliative treatment of non-operable tumors of this localization is given. The contradictory data on the effectiveness of brachytherapy with locally distributed, inoperable EC are summarized. A separate section relates to the prospects for incorporating brachytherapy into combined treatment of early esophageal cancer. Carried out analysis testifies to the necessity of standardization of summary and daily doses of irradiation depending on the indications to the IB.

Role of Natriuretic Peptide Receptor Type C in Dahl Salt-Sensitive Hypertensive Rats

Hypertension ◽  
1997 ◽  
Vol 30 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Miki Nagase ◽  
Katsuyuki Ando ◽  
Takeshi Katafuchi ◽  
Akira Kato ◽  
Shigehisa Hirose ◽  
...  
Keyword(s):  
Natriuretic Peptide ◽  
Receptor Type ◽  
Natriuretic Peptide Receptor ◽  
Hypertensive Rats ◽  
Peptide Receptor ◽  
Type C

T2 Gallbladder Cancer—Aggressive Therapy is Warranted

2016 ◽  
Vol 82 (6) ◽  
pp. 518-521 ◽  
Author(s):  
Mohd Raashid Sheikh ◽  
Houssam Osman ◽  
Susannah Cheek ◽  
Shenee Hunter ◽  
Dhiresh Rohan Jeyarajah
Keyword(s):  
Clinical Presentation ◽  
Radical Surgery ◽  
Radical Resection ◽  
Gall Bladder Cancer ◽  
Incidental Diagnosis ◽  
Radical Cholecystectomy ◽  
Node Positive ◽  
Operative Findings ◽  
Worse Prognosis

Treatment of gall bladder cancer (GBC) has traditionally been viewed with pessimism and lymph node positivity has been associated with worse prognosis. The aim of this study is to analyze the role of radical cholecystectomy in T2 tumors. All patients who underwent surgery for GBC between September 2005 and June 2014 were identified retrospectively. Data collected included clinical presentation, operative findings, and histopathological data. Twenty-five patients had incidental GBC diagnosis after cholecystectomy. Ten patients were T2 on initial cholecystectomy pathology and all underwent radical resection. Two patients were N1 on initial cholecystectomy pathology. Four were upstaged to N1 and two patients were upstaged to T3 after further surgery. Overall, 60 per cent patients with T2 disease had node positivity and 60 per cent were upstaged by further surgery. Eleven patients were diagnosed on imaging. Four of these patients were unresectable and six were either stage T3 or higher or node positive. Sixty per cent of T2 GBC was node positive and 60 per cent were upstaged with radical cholecystectomy. This finding supports the call for radical resection in patients with incidental diagnosis of T2 tumor on cholecystectomy. This study also emphasizes the role of radical surgery in accurate T staging.

scholarly journals The Role of Chemotherapy in Management of Inoperable, Metastatic and/or Recurrent Melanotic Neuroectodermal Tumor of Infancy—Own Experience and Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3872
Author(s):  
Małgorzata Styczewska ◽  
Małgorzata A. Krawczyk ◽  
Ines B. Brecht ◽  
Konrad Haug ◽  
Ewa Iżycka-Świeszewska ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pediatric Oncology ◽  
Literature Search ◽  
Web Of Science ◽  
Poor Response ◽  
Neuroectodermal Tumor ◽  
Incomplete Resection ◽  
Systematic Literature Search ◽  
Neural Crest Origin

Melanotic Neuroectodermal Tumor of Infancy (MNTI) is a very rare pediatric neoplasm of neural crest origin. In most cases, it develops in infants as a localized tumor of the maxilla, and surgery is usually curative. In less than 10% of patients with inoperable, metastatic or persistently recurring MNTI, chemotherapy (CHT) may be considered; however, its role is still unclear. The aim of our study was to assess the efficacy of CHT in children with large, inoperable, metastatic and/or recurrent MNTI. Four such infants, treated with CHT in Polish and German centers of pediatric oncology, were presented. Additionally, a systematic literature search of the PubMed/MEDLINE, Scopus and Web of Science databases was performed, yielding 38 similar cases within the last 42 years. Neoadjuvant CHT, based mainly on the protocols for neuroblastoma, was often effective, allowing for complete delayed surgery in most cases. However, the role of adjuvant CHT in preventing recurrences after incomplete resection of MNTI remains unclear. Disseminated inoperable MNTI was almost universally associated with poor response to CHT and unfavorable outcome. Further investigations to elaborate standards of management in patients with inoperable, metastatic or persistently recurring MNTIs are necessary to improve outcomes.

POSSIBLE ROLE OF 5α-ANDROSTANE-3α,17β-DIOL IN THE CONTROL OF FOLLICLE-STIMULATING HORMONE SECRETION IN THE IMMATURE FEMALE RAT

1982 ◽  
Vol 92 (1) ◽  
pp. 37-42 ◽  
Author(s):  
H. M. A. MEIJS-ROELOFS ◽  
P. KRAMER ◽  
L. GRIBLING-HEGGE
Keyword(s):  
Inhibitory Action ◽  
Combined Treatment ◽  
Hormone Secretion ◽  
Inhibitory Effect ◽  
Ovariectomized Rats ◽  
Female Rat ◽  
Immature Rat ◽  
Rat Strain ◽  
Intact Rats

A possible role of 5α-androstane-3α,17β-diol (3α-androstanediol) in the control of FSH secretion was studied at various ages in ovariectomized rats. In the rat strain used, vaginal opening, coincident with first ovulation, generally occurs between 37 and 42 days of age. If 3α-androstanediol alone was given as an ovarian substitute, an inhibitory effect on FSH release was evident with all three doses tested (50, 100, 300 μg/100 g body wt) between 13 and 30 days of age; at 33–35 days of age only the 300 μg dose caused some inhibition of FSH release. Results were more complex if 3α-androstanediol was given in combined treatment with oestradiol and progesterone. Given with progesterone, 3α-androstanediol showed a synergistic inhibitory action on FSH release between 20 and 30 days of age. However, when 3α-androstanediol was combined with oestradiol a clear decrease in effect, as compared to the effect of oestradiol alone, was found between 20 and 30 days of age. Also the effect of combined oestradiol and progesterone treatment was greater than the effect of combined treatment with oestradiol, progesterone and 3α-androstanediol. At all ages after day 20 none of the steroid combinations tested was capable of maintaining FSH levels in ovariectomized rats similar to those in intact rats. It is concluded that 3α-androstanediol might play a role in the control of FSH secretion in the immature rat, but after day 20 the potentially inhibitory action of 3α-androstanediol on FSH secretion is limited in the presence of oestradiol.

Facilitating Change in Anorexia Nervosa: The Role of Occupational Therapy

1992 ◽  
Vol 55 (9) ◽  
pp. 334-339 ◽  
Author(s):  
Priscilla Harries
Keyword(s):  
Anorexia Nervosa ◽  
Occupational Therapy ◽  
Multidisciplinary Approach ◽  
Projective Art

Patients with anorexia nervosa benefit from a multidisciplinary approach. This article gives a brief description of, first, the illness and its treatment and, secondly, the occupational therapy techniques used at the Maudsley Unit. It then demonstrates the progress of patients through examples of projective art.

scholarly journals Nutritional Optic Neuropathies: State of the Art and Emerging Evidences

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2653
Author(s):  
Matilde Roda ◽  
Natalie di Geronimo ◽  
Marco Pellegrini ◽  
Costantino Schiavi
Keyword(s):  
Bariatric Surgery ◽  
Optic Neuropathy ◽  
Multidisciplinary Approach ◽  
State Of The Art ◽  
Signs And Symptoms ◽  
Therapeutic Strategies ◽  
Scientific Interest ◽  
Optic Nerve Atrophy ◽  
Prompt Diagnosis

Nutritional optic neuropathy is a cause of bilateral, symmetrical, and progressive visual impairment with loss of central visual acuity and contrast sensitivity, dyschromatopsia, and a central or centrocecal scotoma. The clinical features are not pathognomonic, since hereditary and toxic forms share similar signs and symptoms. It is becoming increasingly common due to the widespread of bariatric surgery and strict vegetarian or vegan diets, so even the scientific interest has recently increased. In particular, recent studies have focused on possible pathogenetic mechanisms, and on novel diagnostic and therapeutic strategies in order to prevent the onset, make a prompt diagnosis and an accurate nutritional supplementation, and to avoid irreversible optic nerve atrophy. Nowadays, there is clear evidence of the role of cobalamin, folic acid, thiamine, and copper, whereas further studies are needed to define the role of niacin, riboflavin, and pyridoxine. This review aims to summarize the etiology, diagnosis, and treatment of nutritional optic neuropathy, and it is addressed not only to ophthalmologists, but to all physicians who could come in contact with a patient with a possible nutritional optic neuropathy, being a fundamental multidisciplinary approach.

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