scholarly journals Endoscopic stenting for stenosing cancer and digestive canal structures

2021 ◽  
Vol 55 (3) ◽  
pp. 180-190
Author(s):  
Yu.M. Stepanov ◽  
O.M. Babii ◽  
B.F. Shevchenko ◽  
S.O. Tarabarov
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Mortality Rate ◽  
Digestive Tract ◽  
Median Survival ◽  
Esophageal Stricture ◽  
Stent Migration ◽  
Endoscopic Stenting ◽  
Nitinol Stents ◽  
Median Survival Rate

Background. The purpose of the work was to evaluate the effectiveness of the endoscopic stenting method in stenosing cancer and strictures of the digestive tract. Materials and methods. Since January 2015, endoscopic stenting has been performed in 12 patients using self-expanding nitinol stents with/without polymer coating manufactured by Boston Scientific, Ltd (USA) and uncoated nitinol stents manufactured by Garson (Korea). The study included 8 men (66.7 %) and 4 women (33.3 %) aged 51–80 years, (63.0 ± 4.2) years on average. Stenosing esophageal cancer was diagnosed in 5 patients, stenosing cancer of the gastric outlet — in 3, stenosing duodenal cancer — in one, esophageal stricture — in 3 people. In all patients, the indication for stenting was impaired patency of the digestive tract due to the underlying di-sease. Results. Nutrition was restored in all patients. In the group of stenosing esophageal cancer, the 30-day mortality rate was 20 %, the median survival rate was 9 months. Recurrence of dysphagia was diagnosed in one person, recanalization of the stent lumen was performed. In the group with stenosing cancer of the gastric outlet and duodenum, the 30-day mortality rate was 33.3 %, the median survival rate was 11 months. Impaired gastric emptying was detected in one patient, repeated stent-to-stent stenting was performed. In the group with esophageal stricture, one individual had stent migration, so the stent was repositioned. Conclusions. Endoscopic stenting with self-expanding nitinol stents in incu­rable patients with malignant stenoses of the esophagus, stomach, duodenum and in those with benign esophageal strictures is the surgery of choice, a safe and effective method that allows you to restore and continue natural nutrition and thereby improve the quality of life in incurable cases. Complications arising in the late period after stenting were found in 25 % of patients, and were corrected endoscopically.

scholarly journals Photodynamic therapy in the correction of disphagia in patients with esophagus cancer

2019 ◽  
Vol 12 (2) ◽  
pp. 102-106
Author(s):  
Kozlov Vasilievich Sergei ◽  
Oleg Igorevich Kaganov ◽  
Alexandr Alexandrovich Moriatov ◽  
Maria Alexandrovna Meshkova
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Photodynamic Therapy ◽  
Survival Rate ◽  
Median Survival ◽  
Comparison Group ◽  
Malignant Neoplasm ◽  
Study Group ◽  
Functional Rehabilitation ◽  
Median Survival Rate

Relevance. In spite of successes in diagnostic and treatment of cancer, malignant neoplasm of the esophagus remain an acute problem. Cancer of the esophagus and gastroesophageal zone are the most prognostically unfavorable disease of the digestive tract. At the time of treatment, more than 70% of patients with esophageal cancer suffer from grade II – IV dysphagia, which significantly impairs the functional state and quality of life. Dysphagia indicates that 70% of the lumen of the esophagus is filled with a tumor.Purpose. Improve the results of treatment of patients with esophageal cancer with dysphagia through the use of fluorescent diagnostics and photodynamic therapy. Materials and methods. The study group included 49 patients with a diagnosis of esophageal cancer, where the disease was complicated by tumor obturation. Patients received photodynamic therapy with the use of the photogem sensitizer of hemato-porphyrin series. The comparison group included 32 patients complicated by dysphagia who received a course of radiation therapy. All patients underwent treatment and further examination at the Samara Regional Clinical Oncology Center from 2015 to 2017.Results and their discussion: In study group in 13 (26.5%) cases an increase in the lumen of the esophagus to 1 sm or more was recorded. In this case, the patient could take any food. A decrease in the degree of dysphagia was observed in 21 cases (42.8%). In 6 cases (12.2%), the tumor visually decreased in volume, but clinical improvement wasn’t observed. Positive functional results with decrease in dysphagia grade were obtained in 72 % of patients. Complete dysphagia resolution was achieved in 28 % of cases. The median survival rate was 24 weeks. In comparison group full restoration of patency was obtained in 8 cases (25%), partial - in 10 (28%). No effect was observed in 14 (43.7%) cases. Only in 8 (25%) cases an increase in the lumen of the esophagus to 1 sm or more was recorded. The median survival rate was 21 weeks.Conclusion. The result suggests a significant efficacy of photodynamic therapy compared with the results of radiation therapy. The use of photodynamic therapy allows to achieve a high degree of functional rehabilitation in patients with esophageal cancer complicated by dysphagia in the absence of serious complications.

MR-guided laser-induced thermotherapy (LITT) in liver metastases of colorectal cancer: Long-term survival data.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14131-e14131
Author(s):  
Thomas J. Vogl ◽  
Alena Dommermuth ◽  
Katrin Eichler ◽  
Stephan Zangos
Keyword(s):  
Overall Survival ◽  
Survival Analysis ◽  
Survival Rate ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Median Survival ◽  
Cox Regression ◽  
Term Survival ◽  
Median Survival Rate

e14131 Background: To evaluate retrospectively long-term survival of 594 patients with colorectal liver metastases treated with MR-guided laser-induced thermotherapy (LITT) depending on different factors. Methods: 594 patients with liver metastases from colorectal carcinoma treated with MR-guided LITT between 01/99 and 12/10 were included. For survival analysis tumor localization, TNM classification, number of metastases, diameter and volume of metastases and necrosis, lobular spread, number of treatment sessions, performance of adjuvant chemotherapy and transarterial chemoembolisation were considered. The Kaplan-Meier method was used to conduct this survival analysis. Results: Log-rank test showed statistically significant differences between survival curves, multivariate Cox-regression-analysis (p<0.05) showed prognostic factors regarding overall survival like number of metastases pre intervention, adjuvant chemotherapy, diameter of metastases, ratio of volumes of necrosis and metastases, and affected lymph nodes. Median overall survival rate at the time of first LITT was 25 months, 1-year survival: 78%, 2-year survival: 50.1%, 3-year survival: 28%; 4-year survival: 16.4%; 5-year survival: 7.8%. Numbers of metastases pre intervention: 1-2 metastases with a median survival rate of 60 months; 3-4 metastases: 45 months; ≥5 metastases: 42 months. Median survival rate for metastases <20mm in diameter 36 months; 20-30mm 27 months, 30-40mm 24 months and >40mm 21 months. Affected lymph nodes: median survival rate for patients with N0-classification 30 months, N1-classification 24 months; N2/N3/N4-classification 22 months. Conclusions: Multivariate Cox regression model provided the minimal number of significant variables with the maximal prognostic value concerning overall survival for MR-guided LITT, i.e., diameter and number of metastases and primary classification of lymph nodes.

scholarly journals Impact of minimally invasive surgery in the treatment of esophageal cancer

2014 ◽  
Vol 27 (4) ◽  
pp. 237-242 ◽  
Author(s):  
Italo BRAGHETTO M ◽  
Gonzalo CARDEMIL H ◽  
Carlos MANDIOLA B ◽  
Gonzalo MASIA L ◽  
Francesca GATTINI S.
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Mortality Rate ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Morbidity And Mortality ◽  
Type I ◽  
Minimally Invasive Techniques ◽  
Invasive Techniques

BACKGROUND: Surgical treatment of esophageal cancer is associated to a high morbidity and mortality rate. The open transthoracic or transhiatal esophagectomy are considerably invasive procedures and have been associated to high rates of complications and operative mortality. In this way, minimally invasive esophageal surgery has been suggested as an alternative to the classic procedures because would produce improvement in clinical longterm postoperative outcomes. AIM: To assess survival, mortality and morbidity results of esophagectomy due to esophageal cancer submitted to minimally invasive techniques and compare them to results published in international literature. METHOD: An observational, prospective study. Between 2003 and 2012, 69 patients were submitted to a minimally invasive esophagectomy due to cancer. It was recorded postoperative morbidity and mortality according to the Clavien-Dindo classification. The survival rate was analyzed with the Kaplan-Meier method. The number of lymph nodes obtained during the lymph node dissection, as an index of the quality of the surgical technique, was analysed. RESULTS: 63.7% of patients had minor complications (type I-II Clavien Dindo), while nine (13%) required surgical re-exploration. The most common postoperative complication corresponded to leak of the cervical anastomosis seen in 44 (63.7%) patients but without clinical repercusion, only two of them required reoperation. The mortality rate was 4.34%, and reoperation was necessary in nine (13%) cases. The average survival time was 22.59±25.38 months, with the probability of a 3-year survival rate estimated at 30%. The number of resected lymph nodes was 17.17±9.62. CONCLUSION: Minimally invasive techniques have lower morbidity and mortality rate, very satisfactory lymphnodes resection and similar long term outcomes in term of quality of life and survival compared to results observed after open surgery.

Progress report of combined chemoradiotherapy versus radiotherapy alone in patients with esophageal cancer: an intergroup study.

1997 ◽  
Vol 15 (1) ◽  
pp. 277-284 ◽  
Author(s):  
M al-Sarraf ◽  
K Martz ◽  
A Herskovic ◽  
L Leichman ◽  
J S Brindle ◽  
...  
Keyword(s):  
Weight Loss ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Side Effects ◽  
Median Survival ◽  
Locally Advanced ◽  
Survival Duration ◽  
Advanced Esophageal Cancer ◽  
Median Survival Duration ◽  
Locally Advanced Esophageal Cancer

PURPOSE The present intergroup phase III randomized study compared combined chemotherapy (CT) plus radiotherapy (RT) treatment versus RT only in patients with locally advanced esophageal cancer. MATERIALS AND METHODS Two courses of chemotherapy during 50 Gy RT followed by additional two courses of the same CT, versus 64 Gy RT alone were investigated. CT consisted of cisplatin 75 mg/m2 on day 1 [corrected] and fluorouracil (5FU) 1,000 mg/m2/d on days 1 to 4 every 4 weeks with RT and every 3 weeks post-RT. The main objective of the study was to compare overall survival between the two randomized treatment groups. Patients were stratified by tumor size, histology, and degree of weight loss. RESULTS Sixty-two assessable patients were randomized to receive RT alone, and 61 to the combined arm. Patients characteristics were as follows: squamous cell cancer, 90% versus 85%; weight loss greater than 10 lb, 61% versus 69%; and tumor size, > or = 5 cm, 82% versus 80% on the RT and CT-RT arms, respectively. Systemic side effects, which consisted of nausea, vomiting, and renal and myelosuppression, occurred more frequently on the combined arm, while local side effects were similar in both groups. With a minimum follow-up time of 5 years for all patients, the median survival duration was 14.1 months and the 5-year survival rate was 27% in the combined treatment group, while the median survival duration was 9.3 months with no patients alive at 5 years in the RT-alone group (P < .0001). Additional patients (69) were treated with the same combined therapy and were analyzed. The results of the last group confirmed all of the results obtained with combined CT-RT in the randomized trial, with a median survival duration of 17.2 months and 3-year survival rate of 30%. CONCLUSION We conclude that cisplatin and 5FU infusion given during and post-RT of 50 Gy is statistically superior to standard 64-Gy RT alone in patients with locally advanced esophageal cancer.

scholarly journals Ovarian cancer with pleural and lung metastasis in Dr. Soetomo Hospital, Surabaya, Indonesia, in 2014-2015

2018 ◽  
Vol 26 (1) ◽  
pp. 7
Author(s):  
Fitria Khusnul Khotimah ◽  
Anna Febriani ◽  
Pungky Mulawardhana
Keyword(s):  
Ovarian Cancer ◽  
Survival Rate ◽  
Cancer Patients ◽  
Median Survival ◽  
Lung Metastasis ◽  
Survival Rates ◽  
Secondary Data ◽  
Pleural Metastasis ◽  
Histopathological Type ◽  
Median Survival Rate

Objectives: To know the characteristics of ovarian cancer patients with pleural and lung metastasis, and survival rates of ovarian cancer patients with pleural and lung metastasis in Dr. Soetomo Hospital Surabaya in 2014-2015.Materials & Methods: This was a descriptive observational study using secondary data from medical records in dr. Soetomo Hospital, Surabaya, Indonesia, in 2014 and 2015Results: Number of new patients of ovarian cancer in dr. Soe-tomo, Hospital, Surabaya in 2014 was 170 patients (14%) and 122 patients (12%) in 2015. Ovarian cancer patients most often came at the stage IIIC (33.38%) with the most histopathological type was epithelial ovarian cancer. There were 5 patients with ovarian cancer with pleural metastasis and 7 patients with lung metastasis. Pleural metastasis was 80% diagnosed at the time of ovarian cancer’s diagnosis, whereas 57.15% of lung metastasis were diag-nosed >12 months after the ovarian cancer’s diagnosis. Pleural metastasis was established by pleural fluid cytology, while lung metastasis with radiological features and/or biopsies. The most common feature of lung metastasis was nodal (71.42%). Ascites was found in 80% of ovarian cancer with pleural metastasis, but only 42.86% in lung metastasis. In 2 patients receiving NAC chemotherapy and continued by interval debulking, both had negative residues. Median survival rate in ovarian cancer with pleural metastasis was 7 months, whereas in lung metastasis was 12 months.Conclusions: Number of new patients of ovarian cancer in 2014-2015 in dr. Soetomo Hospital was on rising and was the second largest number of visits after cervical cancer. In 2014-2015, there were 5 patients with ovarian cancer and pleural metastasis and 7 patients with ovarian cancer patients and lung metastasis. Median survival rate in ovarian cancer with pleural metastasis was 7 months, whereas in lung metastasis it was 12 months.

State of the Russian Oncology Service: malignant neoplasms of the tongue C01, 02 (mortality rate in patients, median survival of patients, taking into account the stage of the disease and the histological structure of the tumor). Part II

2021 ◽  
Author(s):  
Vakhtang M. Merabishvili ◽  
Elvira N. Merabishvili ◽  
Alexander M. Shcherbakov ◽  
Alexander B. Vasiliev ◽  
Alexey F. Barsukov ◽  
...  
Keyword(s):  
Survival Rate ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Median Survival ◽  
Tongue Cancer ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
Malignant Neoplasms ◽  
Oncology Service

Malignant neoplasms of the tongue occupy 0.55% in the general structure of the cancer incidence in Russian population. No information on other parameters (the number of deaths, mortality of patients, their distribution by stages of the disease and other analytical indicators) is provided in the official reporting. The opportunity appeared only with the development of Population-based Cancer Registries (PCR) system, but this wealth of material is not used for the official reporting. Tongue cancer is a visual localization with a high mortality rate, which requires special attention. The study was conducted to investigate the state of Russian Oncology Service for tongue cancer patients with the calculations of one-year mortality rate, annual mortality rate, median survival, 1,3,5-year observed and relative survival rates, first time in Russia, at the level of the newly created Population-based Cancer Registry of the Federal District. In Russia, there has been little research on the analysis of the cancer survival rate at the population level. We have been conducting developments for all malignant tumors localizations since 2000 based on the St. Petersburg PCR database. The level of 5-year observed and relative survival rates for tongue cancer patients in Russia (St. Petersburg and the NWFD RF) has been found to be significantly lower than the EU average (Eurocare-4). To carry out this study, 5188 observations from the NWFD RF PCR database were selected. It has been established that during 4 periods of observation, the mortality rate for tongue cancer patients during the first year of observation in the NWFD RF has decreased under the C01 rubric (cancer of the base of the tongue) from 58.5 to 45.8%; and under the C02 rubric (malignant neoplasm of other and unspecified parts of tongue) from 54.5 to 42.7%. The five-year survival rate for tongue cancer patients has increased by 23.3%.

scholarly journals Peran Bersihan Laktat pada Kesintasan Pasien Sepsis Berat

2016 ◽  
Vol 3 (1) ◽  
pp. 38
Author(s):  
Wirawan Hambali ◽  
Lie Khie Chen ◽  
Djoko Widodo ◽  
Esthika Dewiasty ◽  
Herdiman T Pohan ◽  
...  
Keyword(s):  
Survival Rate ◽  
Mortality Rate ◽  
Regression Model ◽  
Median Survival ◽  
Cox Regression ◽  
Lactate Clearance ◽  
Hazard Ratio ◽  
Rank Test ◽  
Log Rank Test ◽  
High Lactate

Pendahuluan. Sepsis Berat merupakan masalah kesehatan dengan tingkat mortalitas yang tinggi serta insiden yang terus meningkat. Bersihan laktat menggambarkan kinetika metabolisme anaerob pasien sepsis berat dan merupakan parameter yang potensial untuk mengevaluasi kondisi penyakit dan intervensi pengobatan yang didapat pasien. Namun demikian, hubungan antara bersihan laktat terhadap terjadinya kematian pasien sepsis berat belum diketahui. Berdasarkan hal tersebut, penelitian ini dilakukan untuk mengetahui pengaruh bersihan laktat terhadap kesintasan pasien dengan sepsisberat, serta faktor-faktor perancu yang mempengaruhi hubungan tersebut.Metode. Penelitian ini merupakan penelitian kohort prospektif yang dilaksanakan di Unit Gawat Darurat dan ruang perawatan Rumah Sakit dr. Cipto Mangunkusumo (RSCM) pada bulan Maret-Mei 2011. Pasien termasuk dalam kelompok bersihan laktat tinggi bila terdapat perbedaan kadar laktat ≥10% dalam 6 jam pertama pengobatan, sedangkan perbedaan <10% termasuk ke dalam kelompok bersihan laktat rendah. Selanjutnya, dilakukan observasi terhadap terjadinya kematian dalam 10 hari pertama perawatan pada kedua kelompok. Data yang terkumpul selanjutnya dianalisis mengunakan uji statistik log-rank test, serta dicari nilai hazard ratio dengan menggunakan uji cox regression model. Selanjutnya, dilakukan analisis variabel perancu dengan menggunakan uji cox regression.Hasil. Laju kesintasan kelompok bersihan laktat tinggi dan rendah masing-masing sebesar 60,0% dan 26,7% (p=0,004). Median kesintasan yaitu 3 hari pada bersihan laktat rendah, sedangkan kematian tidak mencapai 50% pada bersihan laktat tinggi. Interkuartil I kedua kelompok berturut-turut sebesar 1 dan 4 hari. Dari analisis didapatkan hazard ratio sebesar 2,87 (IK 95%; 1,41-5,83). Pada analisis multivariat keberadaan syok sepsis, skor SOFA, penggunaan vasopresor/inotropik, transfusi dan cairan resusitasi, tidak ada yang mengubah nilai hazard ratio >10%. Oleh karena itu, tidak ada yang memenuhi syarat untuk disebut sebagai perancu.Simpulan. Pasien bersihan laktat tinggi memiliki kesintasan lebih tinggi dibandingkan pasien bersihan laktat rendah dan hubungan tersebut tidak dipengaruhi perancu. Kata Kunci: bersihan laktat, kesintasan, sepsis berat The Role of Lactate Clearance in Severe Septic Patients SurvivalIntroduction. Severe Sepsis is a major health problem that known to results high mortality rate, and still its incidents continue to rise. Lactate clearance represents kinetics alteration of anaerobic metabolism in severe septic patients that makes it to become a potential parameter to evaluate severity of one’s illness and intervention adequacy that received by the patient. However, the relationship between lactate clearance and occurrence of death in severe septic patients is still unknown.Methods. This is a prospective cohort study that conducted in Ciptomangunkusumo Hospital, from March to May 2011. Patients were categorized into high lactate clearance group if there were differences in lactate levels ≥ 10% in which occurred within the first 6 hours of the treatment, and contrary were categorized into low lactate clearance group. Occurrences of death were observed within the first 10 days. Afterward, the data were analyzed by means of survival analysis, Kapplan Meier curve were made, survival rate and median survival rate were determined, statistical test were calculated using log-rank test, and hazard ratios were calculated using Cox regression model test. Analysis of Confounder Variable was also performed using multivariate Cox regression testResults. The survival rate for high and low lactate clearance group were 60.0% vs. 26.7%, respectively (p=0,004). In low lactate clearance group the median survival was 3 days, while the mortality rate did not reach 50% in high lactate clearance group. The first Interquartile for these two groups was 1 day and 4 days, respectively. The hazard ratio that obtained from the analysis was 2.87 (95% CI, 1.41 - 5.83). On multivariate analysis the presence of septic shock, SOFA score, the use of vasopresor/inotropic, blood transfusion, fluid resuscitation didn’t change the hazard ratio value more than 10%. For that reason, these parameters were not considered as confounder.Conclusions. Patients with high lactate clearance have a better survival rate compared to patients with low lactate clearance, and its relationship is not influenced by confounder.

scholarly journals Efficacy and safety of endoscopic submucosal dissection for superficial cancer of the cervical esophagus

2017 ◽  
Vol 05 (08) ◽  
pp. E736-E741 ◽  
Author(s):  
Toshiro Iizuka ◽  
Daisuke Kikuchi ◽  
Shu Hoteya ◽  
Yoshiaki Kajiyama ◽  
Mitsuru Kaise
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Local Recurrence ◽  
Esophageal Stricture ◽  
Cervical Esophagus ◽  
Control Group ◽  
R0 Resection ◽  
Case Group ◽  
Resection Rate ◽  
Superficial Cancer

Abstract Background and study aims Cervical esophageal cancer (CEC) is a less common form of cancer and often locally advanced at the time of diagnosis; thus, survival rates for patients with CEC remain poor. However, no reports exist on results of endoscopic submucosal dissection (ESD) for superficial cancer at the cervical esophagus. The aim of this retrospective study was to elucidate the clinicopathological features and clinical outcomes of ESD for superficial CEC. Patients and methods ESD was performed on 891 lesions (in 662 patients) for superficial esophageal cancer from January 2008 to December 2015. Of these, 45 lesions (45 patients) were enrolled in the case group (CEC), and 405 lesions (375 patients) were enrolled in the control group (superficial cancer in the middle thoracic esophagus). The safety of ESD, including R0 resection rate and adverse events, and the efficacy, such as the local recurrence rate and overall survival rate, were evaluated. Results The R0 resection rate was 91.1 % in the case group and 96 % in the control group. The rate of esophageal stricture was significantly higher in the case group (20 %) than in the control group (6.6 %). There was no local recurrence, and the 3-year survival rate was 88.4 % in the case group and 96.7 % in the control group. Conclusions ESD for superficial cancer in the cervical esophagus was achieved safely, and successful local control was also confirmed. However, the esophageal stricture after ESD was more frequent.

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