Laparoscopic Surgery for Gallbladder Neuroendocrine Carcinoma: A Case Series and Literature Review

2020 ◽  
Author(s):  
Hongwu Chu ◽  
Ying Shi ◽  
Changwei Dou ◽  
Fangqiang Wei ◽  
Chengwu Zhang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Survival Time ◽  
Postoperative Bleeding ◽  
Case Series ◽  
Bile Leakage ◽  
Postoperative Chemotherapy ◽  
Pathological Examination ◽  
Preoperative Imaging ◽  
Wall Thickening ◽  
Free Survival

Abstract Background: Gallbladder neuroendocrine carcinomas (GB-NECs) are a group of rare and heterogeneous neoplasms. There are few reports regarding laparoscopic surgery for GB-NEC cases diagnosed at advanced stage.Case presentation: Three patients, two females and one male, were admitted to our hospital. Two patients had the chief complaint of upper quadrant pain and one patient was found to have gallbladder occupation during a routine health checkup. No patient complained jaundice, weight loss, or carcinoid syndrome-related symptoms including diarrhea, edema, flushing and wheezing. Contrast-enhanced computed tomography (CT) examination showed local wall thickening of the gallbladder. In addition, one patient showed focal liver parenchymal invasion, and none of the three patients' preoperative imaging examination revealed lymph nodes (LNs) metastases. All three patients underwent laparoscopic radical cholecystectomy according to intraoperative frozen pathological examination, and they were diagnosed as GB-NEC based on postoperative pathology and immunohistochemistry. TNM stages of these patients were ⅢA (T3N0M0), ⅢB (T3N1M0) and ⅣB (T3N2M0), respectively. Chromogranin A (CgA) and synaptophysin (Syn) were positive in all cases. No patient encountered postoperative bleeding, bile leakage, abdominal abscess, gastrointestinal fistulas or pulmonary complication. Two patients underwent postoperative chemotherapy with two cycles and seven cycles of etoposide plus cisplatin, respectively. Another patient did not receive postoperative chemotherapy due to his poor general condition. The overall survival time of three patients was 4.6 months, 16.8 months and 8.5 months, respectively. All three patients presented with liver and/or bile duct recurrence after surgery with the tumor-free survival time of 2.3 months, 3.3 months and 3.0 months, respectively.Conclusion: Laparoscopic surgery may be considered as a potential treatment for advanced GB-NEC in selected patients. However, further studies are needed to investigate the tumor-free survival benefit of laparoscopic surgery, and whether expanding the resection scope could reduce postoperative recurrence.

scholarly journals Postoperative bleeding in a patient with appendiceal mucinous adenocarcinoma and liver dysfunction patient: A case-report

2021 ◽  
Author(s):  
MingKun Sun ◽  
Xiaohua Niu ◽  
Ying Tang ◽  
Wenzhong Mo ◽  
Haiyang Xin ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Liver Dysfunction ◽  
Mucinous Adenocarcinoma ◽  
Malignant Tumors ◽  
Postoperative Bleeding ◽  
Pathological Examination ◽  
Preoperative Imaging ◽  
Intraperitoneal Hyperthermic Chemotherapy ◽  
Hyperthermic Chemotherapy ◽  
Enhanced Computed Tomography

Abstract Background: Appendiceal malignant tumors are rare in the clinic, and the incidence rate of gastrointestinal tumors is only approximately 0.5%. Our aim is to describe our experience with this rare disease and to increase knowledge on the diagnosis and treatment of appendiceal malignant tumors. Case presentation: We report the case of a 69-year-old woman who was admitted to the hospital due to dyspepsia. The patient was a carrier of hepatitis B virus, and liver dysfunction was diagnosed preoperatively. Abdominal enhanced computed tomography and colonoscopy showed that the appendix was significantly enlarged and dilated, and effusion and appendicitis were observed. Mucinous adenocarcinoma and appendiceal abscesses were not excluded because of the lack of specificity, which makes it difficult to diagnose the disease before a surgery. Laparoscopic appendectomy was performed, and a rapid frozen pathological examination showed a mucinous tumor of the appendix. Intraperitoneal hyperthermic chemotherapy with cisplatin was administered. The patient had abdominal hemorrhage on the fifth day after the surgery. After active treatment, she was discharged from the hospital 19 days after the surgery.Conclusions: The diagnosis of appendiceal malignant tumors mainly depends on preoperative imaging and microscopic results,and highly suspected patients, rapid pathological examination is needed during the operation., and so on. Notably, for elderly patients with hepatitis B infection and liver dysfunction, there is a probability of postoperative bleeding.

scholarly journals Laparoscopic Surgery for Intrahepatic Cholangiocarcinoma: A Focus on Oncological Outcomes

2021 ◽  
Vol 10 (13) ◽  
pp. 2828
Author(s):  
Francesca Ratti ◽  
Andrea Casadei Gardini ◽  
Federica Cipriani ◽  
Guido Fiorentini ◽  
Federica Pedica ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Intrahepatic Cholangiocarcinoma ◽  
Disease Free Survival ◽  
Resection Margins ◽  
Open Approach ◽  
Invasive Approach ◽  
Free Survival ◽  
Tertiary Referral Center ◽  
Oncological Outcomes ◽  
Disease Free

Background: The aim of the present study was to analyze the long-term outcomes of laparoscopic and open surgery for intrahepatic cholangiocarcinoma (iCCA) in a series, collected in a tertiary referral center with a high annual volume of laparoscopic activity. Methods: Between January 2004 and June 2020, 446 liver resections (LR) were performed for iCCA: of these, 179 were performed by laparoscopic surgery (LS) and 267 with the open approach. The two groups were matched through a 1:1 propensity score using covariates representative of patient and disease characteristics. The study and control groups were compared, with specific attention given to oncological outcomes (rate of R0, depth of resection margins, overall and disease-free survival, rate, and site of recurrence). Results: The number of retrieved nodes, rate, and depth of negative resection margins were comparable between the two groups. The interval time between surgery and subsequent adjuvant treatments was significantly shorter in LS patients. No differences were shown even in the comparison between the LS and the open group in terms of median disease-free and overall survival. Moreover, the disease recurrence rate was comparable between the LS and the open groups (45.2% versus 56.7%), and the recurrence pattern was similar. Conclusions: The minimally invasive approach for iCCA was once again confirmed to be associated with advantages in terms of intraoperative and short-term outcomes, but was also proven to be oncologically non-inferior to the open counterpart. In the present study, overall and disease-free survival were found to be similar between the two approaches.

Influence of Histomorphological Parameters and Ploidy on Recurrence-Free Survival Time in Early Rectal Cancer after Local Excision

1993 ◽  
Vol 10 (6) ◽  
pp. 300-305
Author(s):  
T. Böttger ◽  
A. Heinz ◽  
D. Potratz ◽  
M. Stöckle ◽  
T. Junginger
Keyword(s):  
Rectal Cancer ◽  
Survival Time ◽  
Local Excision ◽  
Recurrence Free Survival ◽  
Early Rectal Cancer ◽  
Free Survival

scholarly journals PATH-18. A MULTI-CENTER CASE SERIES OF ADULT K27M MUTATED DIFFUSE MIDLINE GLIOMAS REVEALING A POPULATION UNIQUE FROM PAEDIATRIC CASES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii167-ii168
Author(s):  
Alexander Yuile ◽  
Madhawa De Silva ◽  
Marina Kastelan ◽  
Veronica Cheung ◽  
Joanne Sy ◽  
...  
Keyword(s):  
Older Patients ◽  
Selection Criteria ◽  
Case Series ◽  
Progression Free Survival ◽  
Paediatric Population ◽  
Asia Pacific ◽  
Royal North Shore Hospital ◽  
Free Survival ◽  
Delay In Diagnosis ◽  
Presenting Symptoms

Abstract BACKGROUND Histone mutations in the K27M gene were first described in 2014, and incorporated into the WHO CNS tumour classification system in 2016. They are typically associated with diffuse midline gliomas (DMG). Presenting symptoms vary greatly, with some experiencing significant delay in diagnosis. Median survival is only 9-12 months for these patients. Biopsy samples are small, and in some due to location, not performed. Although data is predominately based on the paediatric population, DMGs are seen in both adolescence and adults. In this multi-site retrospective study, we describe 11 adult patients with K27M DMG gliomas across two tertiary Neuro-Oncology services in Sydney, Australia. To the authors’ knowledge we present the largest known collection of adult K27M cases in the Asia-Pacific region with correlation of treatment, clinicopathologic and radiologic features with outcomes. METHODS The glioma databases of Royal North Shore Hospital (RNSH) and Royal Prince Alfred Hospital (RPAH) between January 2009 and March 2020 were interrogated to identify patients. Selection criteria included patients aged ≥ 18 years who presented with a DMG, had undergone biopsy, and had confirmed K27M via next generation sequencing. Clinicopathologic, radiologic and treatment outcomes were extracted for correlation. RESULTS Eleven patients fitting the selection criteria were identified and reported. The median age at diagnosis was 30 years and 4 were female. Five presented with hydrocephalus, the most common presenting symptoms were headaches and nausea and/or vomiting (n= 4 and n= 2 respectively). The median progression-free survival was 13 months (4-31 months) and the median overall survival was 23 months (4-59 months). CONCLUSION This case series reports the outcomes of older patients with K27M. The clinical course demonstrated suggests a divergence from paediatric biology. Ongoing studies are required to further characterise the histopathological and clinical differences of these tumours in older patients.

Management of Ovarian Endometrioma by Single Incision Laparoscopic Surgery: Case Series

2016 ◽  
Vol 23 (7) ◽  
pp. S181-S182
Author(s):  
AHF Brandão ◽  
MB Noviello ◽  
G Peret ◽  
B Lima ◽  
AS Santos-Filho
Keyword(s):  
Laparoscopic Surgery ◽  
Single Incision ◽  
Case Series ◽  
Single Incision Laparoscopic Surgery ◽  
Ovarian Endometrioma

scholarly journals NR5A2 Is One of 12 Transcription Factors Predicting Prognosis in HNSCC and Regulates Cancer Cell Proliferation in a p53-Dependent Manner

2021 ◽  
Vol 11 ◽  
Author(s):  
Kun Zhang ◽  
Ming Xiao ◽  
Xin Jin ◽  
Hongyan Jiang
Keyword(s):  
Overall Survival ◽  
Survival Time ◽  
Cancer Progression ◽  
Risk Model ◽  
Critical Role ◽  
Disease Free Survival ◽  
Dependent Manner ◽  
Loss Of Function ◽  
Free Survival ◽  
Disease Free

Head and neck squamous cell carcinoma (HNSCC) rank seventh among the most common type of malignant tumor worldwide. Various evidences suggest that transcriptional factors (TFs) play a critical role in modulating cancer progression. However, the prognostic value of TFs in HNSCC remains unclear. Here, we identified a risk model based on a 12-TF signature to predict recurrence-free survival (RFS) in patients with HNSCC. We further analyzed the ability of the 12-TF to predict the disease-free survival time and overall survival time in HNSCC, and found that only NR5A2 down-regulation was strongly associated with shortened overall survival and disease-free survival time in HNSCC. Moreover, we systemically studied the role of NR5A2 in HNSCC and found that NR5A2 regulated HNSCC cell growth in a TP53 status-dependent manner. In p53 proficient cells, NR5A2 knockdown increased the expression of TP53 and activated the p53 pathway to enhance cancer cells proliferation. In contrast, NR5A2 silencing suppressed the growth of HNSCC cells with p53 loss/deletion by inhibiting the glycolysis process. Therefore, our results suggested that NR5A2 may serve as a promising therapeutic target in HNSCC harboring loss-of-function TP53 mutations.

scholarly journals Intensive versus standard blood pressure control in type 2 diabetes: a restricted mean survival time analysis of a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050335
Author(s):  
Sandra Shi ◽  
Natalia Gouskova ◽  
Mehdi Najafzadeh ◽  
Lee-Jen Wei ◽  
Dae Hyun Kim
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Survival Time ◽  
Cardiovascular Events ◽  
Mean Difference ◽  
Event Free Survival ◽  
Free Survival ◽  
Restricted Mean Survival Time ◽  
The Mean

BackgroundRestricted mean survival time analysis offers an intuitive and robust summary of treatment effect compared with HRs.ObjectiveTo examine the effect of intensive versus standard blood pressure (BP) control on death or cardiovascular events in type 2 diabetes.DesignSecondary analysis of the Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial.Setting77 sites in the USA and Canada.Participants4733 adults with type 2 diabetes at high risk for cardiovascular events.InterventionsSystolic BP target <120 mm Hg (n=2371) versus <140 mm Hg (n=2362).MeasurementsComposite endpoint of death, non-fatal myocardial infarction or non-fatal stroke.ResultsThe mean event-free survival time over 5 years (1825 days) was similar between intensive and standard BP control (1716 vs 1714 days; mean difference, 1.3 (95% CI −18.1 to 20.7) days). However, intensive BP treatment was more beneficial for those assigned to standard glycaemic control (1725 vs 1697 days; mean difference, 28.1 (95% CI 0.4 to 55.9) days), but not for those assigned to intensive glycaemic control (1706 vs 1731 days; mean difference, −25.2 (95% CI −52.3 to 1.9) days) (p=0.008 for interaction). In subgroup analysis, the mean event-free survival time difference between intensive and standard BP treatment was −76.0 (95% CI –131.8 to –20.3) days for those with cognitive impairment and 21.8 (95% CI −24.0 to 67.5) days for those with normal cognitive function (p=0.008 for interaction). The effect was not different by age, sex and baseline cardiovascular disease status.ConclusionsIntensive BP treatment may reduce death and cardiovascular events among patients with type 2 diabetes receiving standard glycaemic treatment and without cognitive impairment.Trial registration numberNCT00000620; Post-results.

scholarly journals Efficacy of First-Third generation EGFR inhibitor combined with chemotherapy as first-line treatment for advanced lung adenocarcinoma in a real-world setting

2021 ◽  
Author(s):  
Ming-Wei Chen Ming-Wei Chen ◽  
An-Tai He . ◽  
Yi Pei .
Keyword(s):  
Lung Adenocarcinoma ◽  
Survival Time ◽  
Progression Free Survival ◽  
Egfr Mutations ◽  
Combination Group ◽  
First Line ◽  
Free Survival ◽  
Mean Survival Time ◽  
First Line Therapy ◽  
To Receive

Abstract BackgroundTo explore the optimal treatment strategy for patients who harbor sensitive EGFR mutations, a head-to-head study was performed to compare chemotherapy and gefitinib-erlotinip, osimertinib treatment in combination or with either agent alone as first-line therapy, in terms of efficacy and safety.MethodsA total of 200 untreated patients with advanced lung adenocarcinoma who harbored sensitive EGFR mutations were randomly assigned to receive gefitinib-erlotinip combined with pemetrexed and carboplatin group, gefitinib-erlotinip osimertinib combined with pemetrexed and carboplatin group, pemetrexed plus carboplatin alone group, or gefitinib-erlotinip alone group, osimertinib alone group.ResultsThe progression-free survival (PFS) of patients in the gefitinib-erlotinip combination group Mean Survival Time PFS 22.00 month,95%CI[16.29,27.70] and osimertinib gefitinib-erlotinip combination group Mean Survival Time PFS 40.00 month,95%CI[28.12,51.87]was longer than that of patients in the chemotherapy alone group PFS10,81 months, 95% CI,[ 8.99–12.64],gefitinib-erlotinip alone group PFS14.00 month.95%CI[11.98-20.01], osimertinib alone group PFS 26.66 month 95%CI[24.77-29.22].The gefitinib-erlotinip osimertinib combinational resulted in longer overall survival (OS) than chemotherapy alone (HR = 0.46, p = 0.016) or gefitinib-erlotinip alone (HR = 0.36, p = 0.01). osimertinib alone (HR = 0.26, p = 0.01).ConclusionsOur finding suggested that treatment with pemetrexed plus carboplatin combined with gefitinib-erlotinip and pemetrexed plus carboplatin combined with gefitinib-erlotinip osimertinib group could provide better survival benefits for patients with lung adenocarcinoma harboring sensitive EGFR mutations.

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