Forms of sternal reconstruction in oncology

INTRODUCTION. Chest wall tumors represent a variety of morphological forms and variants of lesions. According to different authors, primary malignant tumors of the chest wall account for 0.2–2 % of all malignant neoplasms. Of them, soft tissue sarcomas constitute about 45 %. Metastatic tumors of the chest wall occur much more frequently and most commonly develop from malignant tumors of the mammary, prostate and thyroid glands, lungs, kidneys and ovaries.MATERIALS AND METHODS. The standard of the treatment of primary and metastatic tumors of the chest wall is combination or comprehensive therapy. In some cases, preoperative care allows to create a more favorable environment for performing surgical treatment being considered the best option for chest wall tumors. The choice of a technique for the replacement of the post-resection chest wall defect is of special importance to preserve the physiological chest volume, to restore chest rigidity, to prevent paradoxical respiration and to seal the pleural cavity.RESULTS. There are different surgical techniques for skeleton reconstruction. A wide range of materials used for a skeleton reconstruction include bone tissues obtained from patient’s own body (bone autoplasty, autografts), polymeric mesh (polypropylene, polytetrafluoroethylene (Gore-Tex), bone cement (polymethyl methacrylate), stainless steel and titanium constructions as well as titanium bars and rib clips (STRATOS). In spite of a large number of techniques for sternal reconstruction described in the literature, searching for new materials and ways of their usage appears relevant.CONCLUSION. Our clinical case studies demonstrate that modern reconstructive techniques combined with careful surgical planning allow to perform radical surgery with a successful outcome preventing serious postoperative complications.

Download Full-text

Serous borderline ovarian tumors: modern possibilities of ultrasound diagnostics in monitoring the course of the disease after organ-preserving operations

Modern Oncology ◽

10.26442/18151434.2021.1.200578 ◽

2021 ◽

Vol 23 (1) ◽

pp. 106-111

Author(s):

Irina I. Davydova ◽

Marina A. Chekalova ◽

Apollon I. Karseladze ◽

Viktor V. Kuznetsov ◽

Liudmila A. Meshcheriakova ◽

...

Keyword(s):

Malignant Tumors ◽

Optimal Operation ◽

Ovarian Tumors ◽

Reproductive Age ◽

Computer Assisted ◽

Malignant Neoplasms ◽

Ultrasound Method ◽

Borderline Ovarian Tumors ◽

Ultrasound Diagnostics ◽

Wide Range

Relevance. Borderline ovarian tumors (BOT) occur mainly in women of reproductive age and account for 20% of all neoplasms of the female genital organs. Currently, there is an increase in the incidence of ВОТ. One of the reasons for the increase in morbidity is the improvement of knowledge and experience in relation to the morphological diagnosis of tumors of low malignancy potential. Nevertheless, the results of a preliminary instrumental assessment of the nature of the disease and the final diagnosis formed by histological examination are not always satisfactory, since borderline tumors are a thin layer that occupies an intermediate position between benign and malignant tumors. And, in spite of the fact that ВОТ is an independent nosological form in the histological classification, nevertheless, they have signs of both benign and malignant neoplasms. In this regard, the complexity of both instrumental and morphological diagnostics of ВOT becomes understandable, and, therefore, difficulties arise in determining the tactics of treatment, choosing the optimal operation, and the need for drug therapy. All these issues are directly related to the patients quality of life, and, most importantly, to survival. Because an incorrectly established diagnosis entails incorrect treatment and unsatisfactory results. Thus, the study of the peculiarities of ВOT diagnostics is extremely important. The ultrasound computed tomography method is simple, relatively cheap and affordable. Considering that almost all patients with ovarian neoplasms undergo this type of examination, it is extremely important and interesting to assess the role of the ultrasound method in the diagnosis of ВОТ. Moreover, at present more and more gynecological oncologists are resorting to organ-preserving surgical interventions for ВOТ. Therefore, it is especially important to study the possibility of ultrasound diagnostics in monitoring the course of the disease after breast-conserving operations, identifying recurrences of the disease in the ovary, differentiating recurrence and cystic formations of the ovaries. Aim. To determine the effectiveness of computer-assisted ultrasound diagnostics in monitoring the course of BOT after breast-conserving operations. Materials and methods. At Blokhin National Medical Research Center of Oncology carried out a retrospective and prospective analysis of 405 patients with serous BOT for the period 19702013. The age of the patients varied in a wide range, the minimum was 15, the maximum was 78 years, the median corresponded to 38 years. Before the start of treatment, the patients underwent an ultrasound examination (ultrasound) of the abdominal organs, the pelvic organs and the retroperitoneal space. The studies were carried out on expert ultrasonic systems Siemens ACUSON S2000, Hitachi ARIETTA V70 and Philips EPIQ 5. Results. We studied the capabilities of the ultrasound method for diagnosing serous BOT based on the analysis of morpho-ultrasound comparisons in patients after conservative and ultra-conservative operations. Conclusion. It has been established that ultrasound diagnostics is of decisive importance both in the initial diagnosis and in the dynamic observation of patients with conservative and ultra-conservative surgery for serous BOT. Echography makes it possible to diagnose a tumor in the ovary in 83.3% of cases and to reject the diagnosis in 86.7% of cases.

Download Full-text

Chest Wall Tumors: A Spectrum of Different Pathologies and Outcomes of Reconstruction Techniques

The Egyptian Cardiothoracic Surgeon ◽

10.35810/ects.v2i3.138 ◽

2020 ◽

Vol 2 (3) ◽

pp. 114-125

Author(s):

Mohammed Sanad ◽

Mohammed Adel Hegazy ◽

Mohammed ELshabrawy Saleh

Keyword(s):

Chest Wall ◽

Multidisciplinary Team ◽

Surgical Techniques ◽

Muscle Flap ◽

Chest Wall Resection ◽

Team Approach ◽

Direct Closure ◽

Chest Wall Tumors ◽

Multidisciplinary Team Approach

Background: Chest wall resection and further reconstruction for tumors represent a challenging concept for surgeons. Thanks to the evolving reconstruction techniques, good results were obtained after extensive resection and reconstruction. Patients and methods: This prospective cohort study was conducted at our University Hospitals throughout 5 years. A total of 43 eligible cases with chest wall tumors were included. All cases were subjected to a multidisciplinary team approach, complete history taking, physical examination, radiological evaluation, and biopsy. The details of surgical techniques, complications, and follow up parameters were included. Results: The mean age of the included cases was 29.45 years. We included a total of 24 males (55.8%). Fibromatosis was the commonest encountered pathology (27.9%), followed by chondrosarcoma (25.5%), and osteosarcoma (21%). Regarding the method of reconstruction, polypropylene mesh was used in 46.5% of cases, followed by direct closure (30.2%). Ten cases were managed by Methyl Methacrylate within the proline mesh (23.3%), while superimposed muscle flap was performed in only 2 cases (4.6%). Post-operatively, bleeding was encountered in 5 cases collectively (11.6%), while wound infection occurred in 11.6% of cases. Pulmonary complications included pneumonia (2.3%) and atelectasis (11.6%). Furthermore, chest wall instability was present in (11.6%) of cases. On follow up, recurrence was diagnosed in (9.3%) of cases (n = 4). Conclusion: Surgical intervention is very effective if tailored to every patient as per team paln. A multidisciplinary team approach is extremely important especially if an extensive demolition is required. Indeed, radical wide en-bloc resection can achieve satisfactory results provided that the extent of resection is not influenced by any anticipated reconstruction problems.

Download Full-text

Data Set for the Reporting of Ear and Temporal Bone Tumors: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2018-0415-sa ◽

2018 ◽

Vol 143 (5) ◽

pp. 593-602 ◽

Cited By ~ 5

Author(s):

Ruta Gupta ◽

Ann Sandison ◽

Bruce M. Wenig ◽

Lester D. R. Thompson

Keyword(s):

Temporal Bone ◽

International Collaboration ◽

Malignant Tumors ◽

Evidence Base ◽

Malignant Neoplasms ◽

Data Set ◽

3 Dimensional ◽

Wide Range ◽

Collaborative Efforts ◽

Cancer Reporting

The International Collaboration on Cancer Reporting (ICCR) was established to internationally unify and standardize the pathologic reporting of cancers based on collected evidence, as well as to allow systematic multi-institutional intercountry data collection to guide cancer care in the future. Such collaborative efforts are particularly essential for developing an evidence base for rare neoplasms or those with marked geographic variation in incidence, such as the tumors of the ear and the temporal bone. The ear and the temporal bone, including the external auditory canal and the middle and inner ear, with the closely associated facial nerve, internal carotid artery, and internal jugular vein, is one of the most complex anatomic structures in the head and neck. A wide range of benign and malignant neoplasms arise in this region. The management of these neoplasms involves complex surgery because of the anatomic confines, and as such, both benign and malignant tumors are included in this data set, as the oncologically equivalent management requires a multidisciplinary approach and standardized nomenclature and terminology. Surgical procedures at this site result in multifaceted 3-dimensional specimens that can be difficult to handle at macroscopic exam. A comprehensive macroscopic examination is important for identifying critical prognostic factors and often requires clinical and radiologic correlation. Histologic examination is straightforward for basal cell or squamous cell carcinoma but can be quite challenging for other neoplasms. A summary of the ICCR guidelines for ear tumors is presented, along with discussion of the salient evidence and practical issues.

Download Full-text

The possibility of using tantalum oxide microparticles in phosphate glass for radiation therapy of malignant neoplasms

Pacific Medical Journal ◽

10.34215/1609-1175-2020-4-85-87 ◽

2020 ◽

pp. 85-87

Author(s):

O. S. Plotnikova ◽

V. I. Apanasevich ◽

M. A. Medkov ◽

A. A. Polezhaev ◽

V. I. Nevozhai ◽

...

Keyword(s):

Phosphate Glass ◽

Linear Accelerator ◽

Malignant Tumors ◽

Video Recording ◽

Tantalum Oxide ◽

Vertical Plane ◽

Secondary Radiation ◽

Semiconductor Diode ◽

Malignant Neoplasms ◽

Diode Detector

Objective: The creation of the medicine for a local radiomodification of tumors.Methods: The level of the secondary radiation on the surface of the phosphate glass powder with the inclusion of tantalum oxide processed by 6 MeV deceleration emission was studied. Medical linear accelerator TrueBeam (Varian, USA), and Semiconductor diode detector PDI 2.0 (Sun Nuclear Corp., USA) having the system of moving in vertical plane and the system of position video recording were used.Results: The presence of the phosphate glass (containing 20% Та2О5) on the surface gave a 63.7% increase to the secondary radiation. It’s around two thirds of the overall level.Conclusion: An opportunity to create a medicine on the basis of phosphate glass, containing tantalum oxide, for local radiomodification of malignant tumors.

Download Full-text

PROSTHESIS FOLLOWING EXCISION OF CHEST WALL TUMORS

Journal of Thoracic Surgery ◽

10.1016/s0096-5588(20)30951-x ◽

1956 ◽

Vol 31 (1) ◽

pp. 45-59

Author(s):

Bert H. Cotton ◽

George A. Paulsen ◽

Jack Dykes

Keyword(s):

Chest Wall ◽

Chest Wall Tumors

Download Full-text

Aspartame and cancer – new evidence for causation

Environmental Health ◽

10.1186/s12940-021-00725-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Philip J. Landrigan ◽

Kurt Straif

Keyword(s):

Public Health ◽

Cancer Risk ◽

Malignant Tumors ◽

Daily Intake ◽

Immunohistochemical Analysis ◽

International Agency ◽

Advisory Group ◽

Malignant Neoplasms ◽

Acceptable Daily Intake ◽

New Findings

Abstract Background Aspartame is one of the world’s most widely used artificial sweeteners and is an ingredient in more than 5000 food products globally. A particularly important use is in low-calorie beverages consumed by children and pregnant women. The Ramazzini Institute (RI) reported in 2006 and 2007 that aspartame causes dose-related increases in malignant tumors in multiple organs in rats and mice. Increased cancer risk was seen even at low exposure levels approaching the Acceptable Daily Intake (ADI). Prenatal exposures caused increased malignancies in rodent offspring at lower doses than in adults. These findings generated intense controversy focused on the accuracy of RI’s diagnoses of hematopoietic and lymphoid tissue tumors (HLTs). Critics made the claim that pulmonary lesions observed in aspartame-exposed animals were inflammatory lesions caused by Mycoplasma infection rather than malignant neoplasms. Methods To address this question, RI subjected all HLTs from aspartame-exposed animals to immunohistochemical analysis using a battery of markers and to morphological reassessment using the most recent Internationally Harmonized Nomenclature and Diagnostic (INHAND) criteria. Findings This immunohistochemical and morphological re-evaluation confirmed the original diagnoses of malignancy in 92.3% of cases. Six lesions originally diagnosed as lymphoma (8% of all HLTs) were reclassified: 3 to lymphoid hyperplasia, and 3 to chronic inflammation with fibrosis. There was no evidence of Mycoplasma infection. Interpretation These new findings confirm that aspartame is a chemical carcinogen in rodents. They confirm the very worrisome finding that prenatal exposure to aspartame increases cancer risk in rodent offspring. They validate the conclusions of the original RI studies. These findings are of great importance for public health. In light of them, we encourage all national and international public health agencies to urgently reexamine their assessments of aspartame’s health risks - especially the risks of prenatal and early postnatal exposures. We call upon food agencies to reassess Acceptable Daily Intake (ADI) levels for aspartame. We note that an Advisory Group to the International Agency for Research on Cancer has recommended high-priority reevaluation of aspartame’s carcinogenicity to humans.

Download Full-text

Proteomic Analysis of Zeb1 Interactome in Breast Carcinoma Cells

Molecules ◽

10.3390/molecules26113143 ◽

2021 ◽

Vol 26 (11) ◽

pp. 3143

Author(s):

Sergey E. Parfenyev ◽

Sergey V. Shabelnikov ◽

Danila Y. Pozdnyakov ◽

Olga O. Gnedina ◽

Leonid S. Adonin ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Cells ◽

Epithelial To Mesenchymal Transition ◽

Critical Role ◽

Malignant Neoplasm ◽

Malignant Neoplasms ◽

Breast Cancer Patients ◽

Survival Prognosis ◽

Mesenchymal Transition ◽

Wide Range

Breast cancer is the most frequently diagnosed malignant neoplasm and the second leading cause of cancer death among women. Epithelial-to-mesenchymal Transition (EMT) plays a critical role in the organism development, providing cell migration and tissue formation. However, its erroneous activation in malignancies can serve as the basis for the dissemination of cancer cells and metastasis. The Zeb1 transcription factor, which regulates the EMT activation, has been shown to play an essential role in malignant transformation. This factor is involved in many signaling pathways that influence a wide range of cellular functions via interacting with many proteins that affect its transcriptional functions. Importantly, the interactome of Zeb1 depends on the cellular context. Here, using the inducible expression of Zeb1 in epithelial breast cancer cells, we identified a substantial list of novel potential Zeb1 interaction partners, including proteins involved in the formation of malignant neoplasms, such as ATP-dependent RNA helicase DDX17and a component of the NURD repressor complex, CTBP2. We confirmed the presence of the selected interactors by immunoblotting with specific antibodies. Further, we demonstrated that co-expression of Zeb1 and CTBP2 in breast cancer patients correlated with the poor survival prognosis, thus signifying the functionality of the Zeb1–CTBP2 interaction.

Download Full-text

Risk of Metastatic Ovarian Involvement in Nongynecologic Malignancies

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182332cd1 ◽

2012 ◽

Vol 22 (1) ◽

pp. 3-8 ◽

Cited By ~ 4

Author(s):

Kidong Kim ◽

Soo Youn Cho ◽

Sang-Il Park ◽

Hye Jin Kang ◽

Beob-Jong Kim ◽

...

Keyword(s):

Overall Survival ◽

Malignant Tumors ◽

Rank Test ◽

Benign Tumors ◽

Binary Logistic Regression Analysis ◽

Fisher Exact Test ◽

Tumor Type ◽

Metastatic Tumors ◽

Number Of Patients ◽

Adnexal Tumors

ObjectiveThe objectives were to evaluate the risk of malignant adnexal tumors in women with nongynecologic malignancies and to identify variables associated with the risk of malignant adnexal tumors.MethodsThe eligibility criteria included the diagnosis of a nongynecologic malignancy and adnexal tumors, which were resected or subjected to biopsy at our institute between 1999 and 2010. The risk of malignant adnexal tumors was assessed by dividing the number of patients with metastatic tumors to the adnexa or primary adnexal cancers by the total number of patients. The association of clinicopathologic variables with the risk of malignant adnexal tumors was evaluated using the Fisher exact test and binary logistic regression analysis. In patients with metastatic tumors to the adnexa, the association of clinicopathologic variables with overall survival after adnexal surgery was examined using the log-rank test.ResultsIn 166 patients with adnexal tumors, 41 benign tumors, 113 metastatic tumors to the adnexa, and 12 primary adnexal cancers were diagnosed. Age older than 46 years, a tumor type associated with a high risk for malignant adnexal tumors, and bilateral tumors significantly increased the risk of malignant adnexal tumors. The overall survival of the patients with stomach cancer was significantly worse than the patients with colorectal or breast cancers.ConclusionOne hundred twenty-five of the 166 patients with nongynecologic malignancies who had adnexal tumors managed surgically were shown to have malignant tumors, and most of the tumors were metastatic from primary sites. The risk of malignant adnexal tumors was associated with age, nongynecologic malignancy, and bilaterality.

Download Full-text