scholarly journals Surgical Outcomes and Comparative Analysis of Transduodenal Ampullectomy and Pancreaticoduodenectomy: A Single-Center Study

2021 ◽  
Author(s):  
Eun-Ki Min ◽  
Seung Soo Hong ◽  
Ji Su Kim ◽  
Munseok Choi ◽  
Hyeo Seong Hwang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Operation Time ◽  
Ampulla Of Vater ◽  
Perioperative Outcomes ◽  
Term Survival ◽  
Estimated Blood Loss

Abstract Background Transduodenal ampullectomy (TDA) is performed for adenoma or early cancer of the ampulla of Vater (AoV). This study aimed to analyze the short- and long-term outcomes of TDA (TDA group) when compared with conventional pancreaticoduodenectomy (PD) or pylorus-preserving pancreaticoduodenectomy (PD group). Methods Patients who underwent TDA between January 2006 and December 2019, and PD cases performed for AoV malignancy with carcinoma in-situ (Tis) (high-grade dysplasia, HGD) and T1 and T2 stage from January 2010 to December 2019 were reviewed. Results Forty-six patients underwent TDA; 21 had a benign tumor, and 25 cases with malignant tumors were compared with PD cases (n = 133). Operation time (p < 0.001), estimated blood loss (p < 0.001), length of hospital stays (p = 0.003), and overall complication rate (p < 0.001) were lower in the TDA group than in the PD group. Lymph node metastasis rates were 14.6% in pT1 and 28.9% in pT2 patients. The 5-year disease-free survival and 5-year overall survival rates for HGD/Tis and T1 tumor between the two groups were similar (TDA group vs PD group, 72.2% vs 77.7%, p = 0.550; 85.6% vs 79.2%, p = 0.816, respectively). Conclusion TDA accompanied with lymph node dissection is advisable in HGD/Tis and T1 AoV cancers in view of superior perioperative outcomes and similar long-term survival rates compared with PD.

scholarly journals A Peripheral Primitive Neuro-ectodermal Tumor (pPNET) of Larynx

2018 ◽  
Vol 26 (1) ◽  
pp. 69-72
Author(s):  
Raman Wadhera ◽  
Usha Sehrawat ◽  
Sharad Hernot ◽  
Pawan Kumar Gahlawat ◽  
Aman Jakhar
Keyword(s):  
Head And Neck ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Neck Region ◽  
Immunohistochemical Analysis ◽  
Cystic Mass ◽  
Term Survival ◽  
Head And Neck Region

Introduction Primitive neuroectodermal tumors (PNETs) are malignant tumors comprised of small round cells of neuro-ectodermal origin that affect soft tissue and bone. Though the occurrence of pPNETs in the head and neck region is rare, these are aggressive malignant tumors, and long-term survival rates following diagnosis remain poor. Case Report In the present case, a tumour was located in larynx (as globular/cystic mass of epiglottis) of the patient and was diagnosed as pPNET. Immunohistochemical analysis indicated that tumor cells were positive for CD99 and NSE, focally positive for EMA but negative for synaptophysin and chromogranin. The mass was surgically excised with negative margins. In post op period patient was planned for post-op chemotherapy and radiotherapy. Conclusion pPNETs are very rare in head and neck region. Significant advances in the neoadjuvant and adjuvant chemotherapeutic regimens, as well as improved facility in diagnosing these tumors through cytogenetic and immunohistochemical analysis improves the long-term disease-free survival.

scholarly journals Leiomyosarcoma of Prostate

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Abdeljalil Heddat ◽  
Younes Houry ◽  
Redouane Rabii
Keyword(s):  
Therapeutic Approach ◽  
Multidisciplinary Approach ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Multicenter Trial ◽  
Advanced Stage ◽  
Rare Tumor ◽  
Actuarial Survival ◽  
Term Survival

Prostate leiomyosarcoma is an extremely rare and very aggressive neoplasm that represents less than 0.1% of primary malignant tumors of the prostate. We present a patient with primary leiomyosarcoma of  prostate and examine the cases reported in the literature to discuss the clinical, diagnostic and therapeutic aspects of this rare tumor. Median survival was estimated at 17 months (95% CI 20.7–43.7 months) and the actuarial survival rates at 1, 3 and 5 years were 68%, 34% and 26%, respectively. The only predictors of long-term survival were negative surgical margins and the absence of metastatic disease at presentation. A multidisciplinary approach is necessary for the proper management of this terrible entity. Surgery with or without chemotherapy seems to be the main therapeutic method for operable leimyosarcomas, but in general there is no consensus on the best therapeutic approach. Most cases are diagnosed at an advanced stage of the disease. A global multicenter trial is needed to find therapies that would improve the prognosis.

scholarly journals Long Term Survival Analysis of Hepatectomy for Neuroendocrine Tumour Liver Metastases

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Tan To Cheung ◽  
Kenneth S. H. Chok ◽  
Albert C.Y. Chan ◽  
Simon Tsang ◽  
Jeff W. C. Dai ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumour ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Operation Time ◽  
Morbidity Rate ◽  
Term Survival ◽  
One Year ◽  
Disease Free

Background.Liver is the commonest site for metastasis in patients with neuroendocrine tumour (NET). A vast majority of treatment strategies including liver directed nonsurgical therapy, liver directed surgical therapy, and nonliver directed therapy have been proposed. In this study we aim to investigate the outcome of liver resection in neuroendocrine tumour liver metastases (NELM).Method.293 patients had hepatectomy for liver metastasis in our hospital between June 1996 and December 2010. Twelve patients were diagnosed to have NET in their final pathology and their data were reviewed.Results.The median ages of the patients were 48.5 years (range 20–71 years). Eight of the patients received major hepatectomy. Four patients received minor hepatectomy. The median operation time was 418 minutes (range 195–660 minutes). The median tumor size was 8.75 cm (range 0.9–21 cm). There was no hospital mortality. The overall one-year and three-year survivals were 91.7% and 55.6%. The one-year and three-year disease-free survivals were 33.3% and 16.7%.Conclusion.Hepatectomy is an effective and safe treatment for NELM. Reasonable outcome on long term overall survival and disease-free survival can be achieved in this group of patients with a low morbidity rate.

Evolving Role of Hepatic Resection for Metastatic Urologic Malignancies

2017 ◽  
Vol 83 (6) ◽  
pp. 628-632 ◽  
Author(s):  
John B. Hamner ◽  
Mustafa Raoof ◽  
Sinziana Dumitra ◽  
Hans F. Schoellhammer ◽  
Carly Crowder ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Resection ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
R0 Resection ◽  
Term Survival ◽  
Free Survival ◽  
Urologic Malignancies ◽  
Disease Free

Liver resection for noncolorectal, nonneuroendocrine metastases remains controversial. Here, we evaluate a single institutional experience with hepatic resection for metastatic urologic malignancies. A single-institution review of patients who underwent hepatic resection for metastatic urologic tumors between the years of 2000 and 2013 was performed. Patient charts were analyzed for pathologic data and perioperative outcomes including short- and long-term morbidity, mortality, and overall and disease-free survival. Eleven patients were identified who underwent hepatic resection for metastatic urologic malignancy. The mean age was 63.5 years. All patients had an R0 resection. There were three major complications. Mean length of stay was 6.5 days and there was no 90-day mortality. Three patients have died of recurrent disease at an average of 11.2 months from resection to death. The remaining patients are still alive during a mean follow-up of 31.5 months. Five-year overall and disease-free survival was 50 and 21 months, respectively. Hepatic resection for metastatic urologic tumors is safe with low morbidity and mortality and durable long-term survival can be achieved. Liver resection for isolated hepatic disease should be considered for this rare metastatic disease to the liver.

scholarly journals A Combined “Hanging Liver Maneuver” and “Intrahepatic Extra-Glissonian Approach” for Anatomical Right Hepatectomy: Technique Standardization, Results, and Correlation With Portal Pedicle Anatomy

2021 ◽  
Vol 8 ◽  
Author(s):  
Fabio Ferrari Makdissi ◽  
Bruno Vinicius Hortences de Mattos ◽  
Jaime Arthur Pirola Kruger ◽  
Vagner Birk Jeismann ◽  
Fabricio Ferreira Coelho ◽  
...  
Keyword(s):  
Survival Rates ◽  
Anatomical Variations ◽  
Perioperative Outcomes ◽  
Right Hepatectomy ◽  
Term Survival ◽  
Oncological Patients ◽  
Glissonian Approach ◽  
Short And Long Term ◽  
The Right

Background: The hanging liver maneuver and intrahepatic extra-Glissonian approach are distinct modalities to facilitate safe anatomical liver resections. This study reports a standardized combination of these techniques focusing on safety, results and correlation with portal pedicle anatomy in oncological patients.Method: Combined hanging liver maneuver and intrahepatic extra-Glissonian approach for anatomic right hepatectomy was described stepwise. Portal pedicle anatomy was correlated with the Glissonian approach failure and complications. Clinical characteristics of patients, perioperative outcomes, short and long-term survival rates were analyzed.Results: Thirty colorectal liver metastases patients submitted to the combined approach were evaluated. Anatomical variations of the right portal pedicle were present in 26.6%. Hanging liver maneuver was feasible in 100%, and Glissonian approach in 96.7% despite portal pedicle variations. Mean operative time was 326 min. Mean blood loss was 507 ml. Mean hospital stay was 8 days. There was no 90-day operative mortality and no significant morbidity. Oncological surgical margins were free. Overall and disease-free 5-year survival were 59 and 37%.Conclusion: Regardless of frequent anatomical variations of the right portal pedicle, the hanging liver maneuver, and intrahepatic extra-Glissonian approach can be combined, being useful for anatomical right hepatectomies in a safe and reproducible way in most patients.

scholarly journals The effectiveness and safety of D2 plus para-aortic lymphadenectomy for resectable gastric cancer: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Shi-Hui Zou ◽  
Xi Zhong ◽  
Jia-Le Zhang ◽  
Bao-Jun Huang ◽  
Hui-Mian Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Lymph Node ◽  
Malignant Tumors ◽  
Meta Analysis ◽  
Perioperative Outcomes ◽  
Cochrane Library ◽  
Term Survival ◽  
Significant Difference ◽  
Resectable Gastric Cancer

Abstract Background Gastric cancer (GC) is among the malignant tumors of highest morbidity and mortality in the world, and has a profile of high lymph node metastasis rate. Lymph node clearance is a critical part of gastric cancer surgery, however, the extent of lymph node clearance, for example, whether to perform abdominal aortic lymph node dissection, remains considerably controversial. In this study, we performed a systematic review and meta-analysis to assess the effects of D2 plus para-aortic lymphadenectomy (PALD) on survival and postoperative complications in patients with GC. Methods An electronic search was conducted through PubMed, Embase and cochrane library. The Q test and I 2 were used to assess heterogeneity. The publication bias was evaluated via funnel plots. All statistical analyses were performed using STATA 14.0 (STATA, College Station, TX). Results 908 studies were retrieved via literature search and eight studies were finally included. There was no significant difference between D2 and D2+PALD in the 5-year survival rate after surgery (HR: 1.00, 95% CI: 0.97-1.03, P = 0.897; I 2 = 64.9%). Besides, the 30-day mortality (RR: 1.17, 95% CI: 0.66-2.10, P = 0.590; I 2 = 0.0%) and the overall risk of postoerative complications (RR: 1.15, 95% CI: 0.83-1.59, P = 0.411; I 2 = 35.5%) were comparable between D2 and D2+PALD. Conclusion Based on current literature body, compared with D2, D2+PALD does not prevail in terms of long-term survival or perioperative outcomes.

Surgical management of esophageal sarcoma: a multicenter European experience

2018 ◽  
Vol 31 (3) ◽  
Author(s):  
D Mege ◽  
L Depypere ◽  
G Piessen ◽  
A E Slaman ◽  
B P L Wijnhoven ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rates ◽  
Neoadjuvant Chemoradiotherapy ◽  
Postoperative Mortality ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
En Bloc ◽  
Term Survival

SUMMARYEsophageal sarcomas are rare and evidence in literature is scarce making their management difficult. The objective is to report surgical and oncological outcomes of esophageal sarcoma in a large multicenter European cohort. This is a retrospective multicenter study including all patients who underwent en-bloc esophagectomy for esophageal sarcoma in seven European tertiary referral centers between 1987 and 2016. The main outcomes and measures are pathological results, early and long-term outcomes. Among 10,936 esophageal resections for cancer, 21 (0.2%) patients with esophageal sarcoma were identified. The majority of tumors was located in the middle (n = 7) and distal (n = 9) third of the esophagus. Neoadjuvant chemoradiotherapy was performed in five patients. All the patients underwent en-bloc transthoracic esophagectomy (19 open, 2 minimally invasive). Postoperative mortality occurred in 1 patient (5%). One patient received adjuvant chemotherapy. Definitive pathological results were carcinosarcoma (n = 7), leiomyosarcoma (n = 5), and other types of sarcoma (n = 9). Microscopic R1 resection was present in one patient (5%) and seven patients (33%) had positive lymph nodes. Median follow-up was 16 (3–79) months in 20 of 21 patients (95%). One-, 3-, and 5-year overall survival rates were 74%, 43%, and 35%, respectively. One-, 3- and 5-years disease-free survival rates were 58%, 40%, and 33%, respectively. Median overall survival was 6 months in N+ patients vs. 37 months for N0 patients (p = 0.06). At the end of the follow-up period, nine patients had died from cancer recurrences (43%), three patients died from other reasons (14%), one patient was still alive with recurrence (5%) and the seven remaining patients were free of disease (33%). Recurrence was local (n = 3), metastatic (n = 3), or both (n = 4). In conclusion, carcinosarcoma and leiomyosarcoma were the most common esophageal sarcoma histological subtypes. Lymph node involvement was seen in one third of cases. A transthoracic en-bloc esophagectomy with radical lymphadenectomy should be the best surgical option to achieve complete resection. Long-term survival remained poor with a high local and distant recurrence rate.

scholarly journals The effectiveness and safety of D2 plus para-aortic lymphadenectomy for resectable gastric cancer: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Shi-Hui Zou ◽  
Xi Zhong ◽  
Jia-Le Zhang ◽  
Bao-Jun Huang ◽  
Hui-Mian Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Lymph Node ◽  
Postoperative Complications ◽  
Malignant Tumors ◽  
Meta Analysis ◽  
Perioperative Outcomes ◽  
Cochrane Library ◽  
Term Survival ◽  
Significant Difference

Abstract Background: Gastric cancer (GC) is among the malignant tumors of highest morbidity and mortality in the world, and has a profile of high lymph node metastasis rate. Lymph node clearance is a critical part of gastric cancer surgery, however, the extent of lymph node clearance, for example, whether to perform abdominal aortic lymph node dissection, remains considerably controversial. In this study, we performed a systematic review and meta-analysis to assess the effects of D2 plus para-aortic lymphadenectomy (PALD) on survival and postoperative complications in patients with GC.Methods: An electronic search was conducted through PubMed, Embase and cochrane library. The Q test and I2 were used to assess heterogeneity. The publication bias was evaluated via funnel plots. All statistical analyses were performed using STATA 14.0 (STATA, College Station, TX).Results: 908 studies were retrieved via literature search and eight studies were finally included. There was no significant difference between D2 and D2+PALD in the 5-year survival rate after surgery (HR: 1.00, 95% CI: 0.97-1.03, P = 0.897; I2 = 64.9%). Besides, the 30-day mortality (RR: 1.17, 95% CI: 0.66-2.10, P = 0.590; I2 = 0.0%) and the overall risk of postoperative complications (RR: 1.15, 95% CI: 0.83-1.59, P = 0.411; I2 = 35.5%) were comparable between D2 and D2+PALD.Conclusion: Based on current literature body, compared with D2, D2+PALD does not prevail in terms of long-term survival or perioperative outcomes.

Greater negative lymph node count predicts favorable survival of patients with breast cancer in the setting of neoadjuvant chemotherapy and mastectomy

2019 ◽  
Vol 15 (32) ◽  
pp. 3701-3709 ◽  
Author(s):  
Xin Wang ◽  
Zhenzhen Yin ◽  
Daquan Wang ◽  
Jiaqi Zhang ◽  
Shuai Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Free Survival ◽  
Lymph Node Count ◽  
Disease Free

Aim: Adequate lymph node evaluation is recommended in patients with malignant tumors. However, the role of negative lymph nodes (NLNs) remains unclear in breast cancer (BC), especially in patients who have received neoadjuvant chemotherapy and mastectomy. Materials & methods: A total of 435 patients were included in the analysis. On multivariate analysis, NLN count was an independent predictor of 5 year disease-free survival and 5 year overall survival. Results: Patients with NLN count <10 showed significantly worse 5 year disease-free survival than those with NLN count ≥10 (34.8 and 78.2%; p = 0.000); the corresponding 5 year overall survival rates were also significantly different (52.0 and 82.7%; p = 0.000). Conclusion: This is the first study that confirms the relationship between NLN count and prognosis of patients in the setting of neoadjuvant chemotherapy and mastectomy. More NLNs imply better prognosis.

scholarly journals Ensuring Quality in Thyroid Cancer Surgery

2017 ◽  
Vol 13 (01) ◽  
pp. 22
Author(s):  
Maria F Bates ◽  
Kristin L Long ◽  
Rebecca S Sippel ◽  
◽  
◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Survival Rates ◽  
Surgical Care ◽  
High Volume ◽  
Term Survival ◽  
Lymph Node Yield ◽  
Ultrasound Evaluation

Thyroid cancer incidence is increasing worldwide. Though long-term survival rates are excellent, recurrence remains a significant problem, which highlights potential areas of needed improvement, including the surgical care of these patients. This review paper identifies tools and markers that can be used to improve surgical quality in thyroid cancer. Preoperative surgical planning starts with an adequate ultrasound evaluation of the cervical lymph node basins. Postoperatively, thyroglobulin and radioactive iodine uptake scans can track adequacy of resection. In addition, lymph node yield and lymph node ratios serve as indirect markers for assessing the quality of lymph node dissections. Current research also suggests that high-volume surgeons have improved oncological outcomes. Surgeons can use these tools and information to follow and potentially improve the care provided to patients.

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