Combined surgeries for retroperitoneal tumors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23579-e23579
Author(s):  
Oleg I. Kit ◽  
Oksana V. Katelnitskaya ◽  
Andrey A. Maslov ◽  
Yuriy A. Gevorkyan ◽  
Evgeniy N. Kolesnikov ◽  
...  
Keyword(s):  
Blood Vessel ◽  
Malignant Tumors ◽  
Vena Cava ◽  
Poor Response ◽  
Early Postoperative Period ◽  
Tumor Diameter ◽  
Major Blood Vessel ◽  
Major Vessel ◽  
Retroperitoneal Tumors ◽  
Vessel Involvement

e23579 Background: Retroperitoneal tumors are rare heterogeneous malignant tumors. Due to their poor response to chemoradiotherapy, surgery is the main treatment option. Currently, there is little data on treatment outcomes in patients who underwent en block resection of retroperitoneal tumors and major vessels. Our purpose was to analyze surgical and oncological results in patients with retroperitoneal tumors and major blood vessel involvement. Methods: 27 patients received surgery for retroperitoneal tumors with major vessel resection in 2015-2019. Results: The mean tumor diameter was 17 cm (11-39 cm). The most frequent histological types were moderately differentiated liposarcoma (33.4%), well differentiated (18.5%), poorly differentiated sarcoma (18.5%), pleomorphic liposarcoma (22.2%), leiomyosarcoma (7.4%). Resection of the suprarenal inferior vena cava (IVC) with prosthetics was performed in 4 cases, resection of its renal segment with renal vein reimplantation - 1, resection of the infrarenal IVC with prosthetics - 8. PTFE prostheses were used as a conduit in all cases. Marginal excision of the suprarenal IVC was performed in one patient, that of the infrarenal IVC - in 5 patients; resection of the infrarenal IVC without the reconstruction - in one case. The iliac venous segment resection was required in 6 patients, in one case – with the iliac arterial segment resection and prosthetics. Macroscopic complete resection (R0-R1) was achieved in 92.6%. The postoperative morbidity was 25.9%, with no fatal outcomes. Despite the anticoagulant therapy, the frequency of thrombosis of the venous reconstruction area in the early postoperative period (1 month) was 7.4%. The median relapse-free survival was 14 months; the median overall survival was not achieved. Conclusions: Combined surgeries with simultaneous removal of retroperitoneal tumor and angioplasty demonstrate an acceptable level of morbidity and mortality. Radical removal of tumors with major blood vessel involvement allows increasing the survival in patients often considered inoperable.

scholarly journals Unclear Retroperitoneal Tumors, an Interdisciplinary Challenge – A Case Report and Review of the Literature

2021 ◽  
Author(s):  
Benno Traub ◽  
Benedikt Haggemüller ◽  
Lisa Baumann ◽  
Johannes Lemke ◽  
Doris Henne-Bruns ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Vena Cava ◽  
Retroperitoneal Tumors ◽  
Common Clinical Presentation ◽  
One Year ◽  
The Right ◽  
Upper Abdomen

Abstract BackgroundUnclear retroperitoneal tumors still impose major challenges for clinicians. Tumors can originate primarily from retroperitoneal tissue or secondarily invade into the retroperitoneal space. While benign lesions also occur, malignant tumors are far more common. Clinical presentation often depends on replacement or invasion of other organs and is therefore highly variable. The heterogeneous tumor composition makes a definitive preoperative diagnosis difficult. Nevertheless, surgical resection is the gold standard for treatment but often proves challenging due to frequent involvement of large retroperitoneal vessels.Case presentationWe present a case report of a 70-year old woman diagnosed with a large, unclear retroperitoneal tumor. Initial clinical symptoms were increasing dyspnea and dysphagia in our clinic. Gastroenterologic and cardiologic workup was unremarkable. Computed Tomography (CT) revealed a large retroperitoneal mass in the right upper abdomen with severe displacement of the inferior vena cava and renal veins. Without signs of irresectability, the patient was scheduled for tumor resection. The procedure was challenging due to the vessel involvement and large blood pressure alterations during tumor mobilization. The post-op pathologic workup then revealed the rare finding of a completely resected paraganglioma. The post-surgical course was uneventful. One year after diagnosis, the patient is relapse-free.CconclusionThis case impressively shows the challenges of retroperitoneal tumors and the importance of interdisciplinary work in these cases.

scholarly journals Clinical results of surgery for retroperitoneal sarcoma with major blood vessel involvement

2006 ◽  
Vol 44 (1) ◽  
pp. 46-55 ◽  
Author(s):  
Matthias H.M. Schwarzbach ◽  
Yura Hormann ◽  
Ulf Hinz ◽  
Christine Leowardi ◽  
Dittmar Böckler ◽  
...  
Keyword(s):  
Blood Vessel ◽  
Clinical Results ◽  
Retroperitoneal Sarcoma ◽  
Major Blood Vessel ◽  
Results Of Surgery ◽  
Vessel Involvement

scholarly journals Three-stage approach to resection of left pancoast tumour with spinal and major vessel involvement

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Alison M Wallace ◽  
George D Oreopoulos ◽  
Yoga R Rampersaud ◽  
Thomas K Waddell
Keyword(s):  
Quality Of Life ◽  
Left Subclavian Artery ◽  
Neoadjuvant Chemoradiotherapy ◽  
Oncologic Outcome ◽  
Successful Outcome ◽  
Team Collaboration ◽  
Major Vessel ◽  
Vertebral Bodies ◽  
Vessel Involvement

Abstract Here we describe the successful outcome of a complex and challenging resection of a left-sided pancoast tumour involving the left subclavian artery and vertebral bodies. The resection was performed following neoadjuvant chemoradiotherapy in a multi-staged fashion involving multiple teams including thoracic surgery, plastic surgery, neurosurgery and vascular surgery. Each operation was less than 6 h, without complication, and the patient was discharged within 1 week of each procedure. This case report highlights the importance of multidisciplinary team collaboration and planning in order to achieve a successful oncologic outcome and a good quality of life following treatment of these challenging tumours. The patient had a good functional outcome and no evidence of recurrence 1.5 years later.

GCSF As a Potential Molecular Target for Overall Survival of Hepatocellular Carcinoma

2021 ◽  
Vol 24 ◽  
Author(s):  
Heng Cao ◽  
Peng Guo ◽  
Xiaohui Wu ◽  
Jiankun Li ◽  
Chenlong Ge ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Survival Analysis ◽  
Molecular Mechanisms ◽  
Malignant Tumors ◽  
Basic Research ◽  
Clinical Samples ◽  
Tumor Diameter ◽  
Overall Survival Analysis

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of digestive tract in the world. Therefore, it is important to carry out studies on the molecular mechanisms of early diagnosis and treatment of HCC to reduce mortality. Methods: Bioinformatic analysis was performed to explore the significant role of GCSF on the occurrence and development of neoplasm. Differently expressed genes (DEGs) were screened, and the significant hub genes related with GCSF were identified by the multiple algorithms of Cytoscape. Functional annotation for DEGs, pathological stage and overall survival analysis were implemented. In addition, the verification for the role of GCSF on HCC was made via the clinical samples. A total of 70 participates diagnosed as HCC were recruited from November 2014 to November 2019. The immunohistochemistry assay, qRT-PCR, receiver operating characteristic (ROC) curves, and overall survival analysis were carried out. Results: GCSF was related with the tumor size, and the expression of GCSF was up-regulated in hepatocellular carcinoma tissues. The enrichment results of GO and KEGG analysis were mainly enriched in “Inflammatory response”, “Protein binding”, “Metabolic pathways”, and “Proteasome”. The tumor diameter (P < 0.001), and survival time (P < 0.001) were significantly associated with expression of GCSF via the verification of clinical data. The univariate and multivariate Cox proportional regression analysis manifested that high expression of GCSF in patients with HCC was related to poor OS. Conclusion: The expression level of GCSF is significantly associated with the prognostic survival of HCC, and it is expected to become a new prognostic marker of HCC, providing a novel idea for future basic research as well as targeted therapy.

scholarly journals Use of Enoxaparin and Dabigatran for Thrombosis Prevention After Total Knee Replacement

2012 ◽  
Vol 19 (2) ◽  
pp. 61-64
Author(s):  
V. Yu Murylev ◽  
Y. A Rukin ◽  
P. M Elizarov ◽  
A. G Zhuchkov ◽  
D. I Terentiev
Keyword(s):  
Total Knee Replacement ◽  
Enoxaparin Sodium ◽  
Knee Replacement ◽  
Vena Cava ◽  
Preventive Measure ◽  
Early Postoperative Period ◽  
Peroral Administration ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Total Knee

Comparative analysis of dabigatran etaxilate and enoxaparin sodium use for prevention of vena cava inferior system thrombosis in patients after total knee replacement in early postoperative period was performed. In 74 patients (1 st group) dabigatran etaxilate and in 127 (2 nd group) enoxaparin sodium was used as a preventive measure. The rate of thrombosis made up 1.35% and 2.4% in the first and second groups, respectively. No significant difference in the volume of perioperative blood loss between the groups was noted. No other hemorrhagic complications were observed. It was shown that in more convenient peroral administration the dabigatran etaxilate efficacy and safety was comparable to enoxaparin sodium.

scholarly journals Intracardiac extension of the inferior vena cavaLeiomyosarcoma with Budd-Chiari syndrome presentation: A case report

2015 ◽  
Vol 143 (1-2) ◽  
pp. 71-73
Author(s):  
Predrag Matic ◽  
Goran Vucurevic ◽  
Srdjan Babic ◽  
Slobodan Tanaskovic ◽  
Branko Lozuk ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Malignant Tumors ◽  
Vena Cava ◽  
Complete Removal ◽  
Term Result ◽  
Short Term ◽  
Short Term Result ◽  
Chiari Syndrome ◽  
Intracardiac Extension

Introduction. Leiomyosarcomas of the inferior vena cava are rare malignant tumors. A limited number of these cases have been described so far. Only few of them have intracardiac propagation and surgery is rarely undertaken for their treatment. Case Outline. We present a 52-year-old female patient in whom leiomyosarcoma of the inferior vena cava with intracardiac propagation was diagnosed. The patient underwent successful surgical treatment with complete removal of the tumor and direct suture of the inferior vena cava. No additional modalities of therapy were undertaken. Conclusion. Surgery, without radiation therapy can be a successful option for the treatment of inferior vena cava leiomyosarcoma with a good short-term result.

Retropancreatic Retroperitoneal Tumors: A 30-year Experience with 38 Cases

2013 ◽  
Vol 79 (5) ◽  
pp. 470-475
Author(s):  
Tao-Tao Zhang ◽  
Ke-Jian Guo ◽  
Gang Ma ◽  
Shao-Wei Song
Keyword(s):  
Magnetic Resonance ◽  
Surgical Management ◽  
Malignant Tumors ◽  
Pancreatic Head ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Uncinate Process ◽  
The Body ◽  
Number Of Patients ◽  
Retroperitoneal Tumors

Retropancreatic retroperitoneal tumors (RRTs) are seldom encountered in clinical practice. The lack of characteristics on clinical presentation and imaging make preoperative diagnosis difficult and surgical management remains a challenge. This retrospective report surveys the presenting diagnosis and surgical management of 38 patients with RRTs presenting at our center between August 1981 and May 2012. Six patients were misdiagnosed on the basis of computerized tomography and one each by magnetic resonance imaging and magnetic resonance cholangiopancreatography. Tumors were localized posterior to the pancreatic head and uncinate process (n = 18); posterior to the neck and body of the pancreas (n = 9); or posterior to the body and tail of the pancreas (n = 11). Thirty-three patients underwent surgical resections. Operative approaches were chosen on the basis of tumor size and localization. The tumors were mostly commonly originating from neurogenic tissue (n = 16). There were 25 benign neoplasms (65.8%), 10 malignant tumors (26.3%), and three undefined tumors. The morbidity of postsurgical complications was 21 per cent (eight of 38). The number of patients who underwent follow-up was 21, and the mean follow-up time was 35 months (range, 2 to 90 months). Three patients died during follow-up. The morbility of local recurrence was 10.5 per cent (four of 38). Definitive diagnosis of RRTs is made at laparotomy. Complete resection remains the fundamental objective of disease management. Different operative approaches should be used according to tumor localization and size.

scholarly journals The Emerging Role of Microbiota and Microbiome in Pancreatic Ductal Adenocarcinoma

Biomedicines ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. 565
Author(s):  
Sona Ciernikova ◽  
Maria Novisedlakova ◽  
Danka Cholujova ◽  
Viola Stevurkova ◽  
Michal Mego
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Malignant Tumors ◽  
Current Knowledge ◽  
Early Stage ◽  
Poor Response ◽  
Response To Therapy ◽  
Oral Microbiome ◽  
Ductal Adenocarcinoma ◽  
The Impact

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive malignant tumors due to the absence of biomarkers for early-stage detection and poor response to therapy. Since mounting evidence supports the role of microbiota composition in tumorigenesis and cancer treatment, the link between microbiome and PDAC has been described. In this review, we summarize the current knowledge regarding the impact of the gut and oral microbiome on the risk of PDAC development. Microenvironment-driven therapy and immune system interactions are also discussed. More importantly, we provide an overview of the clinical trials evaluating the microbiota role in the risk, prognosis, and treatment of patients suffering from PDAC and solid tumors. According to the research findings, immune tolerance might result from the microbiota-derived remodeling of pancreatic tumor microenvironment. Thus, microbiome profiling and targeting represent the potential trend to enhance antitumor immunity and improve the efficacy of PDAC treatment.

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