scholarly journals Novel Perspectives in Pseudomyxoma Peritonei Treatment

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5965
Author(s):  
Antonio Sommariva ◽  
Marco Tonello ◽  
Giulia Rigotto ◽  
Nayana Lazzari ◽  
Pierluigi Pilati ◽  
...  
Keyword(s):  
Pseudomyxoma Peritonei ◽  
Clinical Presentation ◽  
Therapeutic Option ◽  
Treatment Strategies ◽  
Mucin Production ◽  
Randomized Controlled ◽  
Improve Patient Selection ◽  
Selection For ◽  
Improve Patient

Pseudomyxoma Peritonei (PMP) is an anatomo-clinical condition characterized by the implantation of neoplastic cells on peritoneal surfaces with the production of a large amount of mucin. The rarity of the disease precludes the evaluation of treatment strategies within randomized controlled trials. Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has proven to be the only therapeutic option with potential chances of cure and long-term disease control. The present review discusses the epidemiology, pathogenesis, clinical presentation and treatment of PMP, focusing on the molecular factors involved in tumor progression and mucin production that could be used, in the upcoming future, to improve patient selection for surgery and to expand the therapeutic armamentarium.

Lysability of arterial thrombi assessed by magnetic resonance imaging

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 262-265 ◽  
Author(s):  
Kozak ◽  
Mikac ◽  
Blinc ◽  
Sersa
Keyword(s):  
Magnetic Resonance ◽  
Signal Intensity ◽  
Magnetic Resonance Images ◽  
High Signal ◽  
Resonance Imaging ◽  
Gradient Echo ◽  
Catheter Directed Thrombolysis ◽  
Improve Patient Selection ◽  
Selection For ◽  
Improve Patient

Background: Intravascular thrombi change in time due to retraction and organization, which is reflected in the appearance of magnetic resonance images of clots. We have hypothesized that MRI has the potential to improve patient selection for thrombolytic treatment. The aim of our study was to analyze occlusive arterial thrombi with MRI, and to correlate the MRI parameters with the therapeutic outcome in patients with occlusive atherothrombotic disease of the superficial femoral artery who were treated with catheter-directed thrombolysis by streptokinase. Patients and methods: We included 13 patients with subacute (2 weeks to 3 months old) occlusive arterial thrombi and 4 patients with chronic (more than 6 months old) arterial occlusions. We measured the MRI signal intensity on gradient echo images of 98 axial slices of the subacute occlusive thrombi and in 45 slices of 4 chronic thrombi. Following MRI, the patients with subacute history were treated with catheter-directed thrombolysis. Results: Thrombolysis was successful in 11/13 patients. The normalized MRI signal intensity was significantly higher in the unsuccessfully treated thrombi than in the successfully treated thrombi (1.10 ± 0.08 vs. 0.72 ± 0.17, p < 0.003), but the subacute and chronic thrombi did not differ in signal intensity. Conclusions: High signal intensity of arterial thrombi on gradient echo MRI might predict resistance to thrombolytic therapy.

scholarly journals Selected Patients with Unresectable Perihilar Cholangiocarcinoma (pCCA) Derive Long-Term Benefit from Liver Transplantation

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3157
Author(s):  
Adiba I. Azad ◽  
Charles B. Rosen ◽  
Timucin Taner ◽  
Julie K. Heimbach ◽  
Gregory J. Gores
Keyword(s):  
Liver Transplantation ◽  
Sclerosing Cholangitis ◽  
De Novo ◽  
Perihilar Cholangiocarcinoma ◽  
Clinical Factors ◽  
Term Survival ◽  
Improve Patient Selection ◽  
Improve Patient ◽  
Term Benefit

Selected patients with unresectable perihilar cholangiocarcinoma (pCCA) derive long-term benefits from liver transplantation. Between 1993–2019, our group at Mayo Clinic performed 237 transplants for pCCA. With this experience, we note that two distinct patient populations comprise this group of pCCA patients: those with underlying primary sclerosing cholangitis (PSC) and those without identifiable risk factors termed sporadic or de novo pCCA. Long-term survival after transplant is better in PSC patients (74% five-year survival) than in those with de novo pCCA (58% five-year survival). Herein, we review the likely clinical factors contributing to the divergence in outcomes for these two patient populations. We also offer our insights on how further advances may improve patient selection and survival, focusing on the de novo pCCA patient population.

scholarly journals Contribution of Aging, Obesity, and Microbiota on Tumor Immunotherapy Efficacy and Toxicity

2019 ◽  
Vol 20 (14) ◽  
pp. 3586 ◽  
Author(s):  
Regina E. M. Baiden-Amissah ◽  
Sandra Tuyaerts
Keyword(s):  
Immune Responses ◽  
Cancer Immunotherapy ◽  
Gut Microbiome ◽  
Human Cancer ◽  
Host Factors ◽  
Valuable Adjunct ◽  
Improve Patient Selection ◽  
Selection For ◽  
Improve Patient ◽  
Novel Therapeutic

Cancer immunotherapy has entered the forefront of cancer treatment, but major challenges still exist, such as the limited proportion of patients that respond to treatment and treatment-related toxicity. Therefore, biomarkers to predict which patients will benefit from therapy without major side effects are of the utmost importance. Moreover, novel therapeutic targets to increase the proportion of responding patients on a given immunotherapy or to alleviate immunotherapy-induced toxicity could be a valuable adjunct to immunotherapy treatment. Host factors such as age, obesity, and the composition of the gut microbiome have considerable effects on immune responses and, hence, could have a large impact on the outcome of immunotherapies. Moreover, since these host factors differ considerably between preclinical mouse models and human cancer patients, it might be possible that these host factors account, in part, for the observed discrepancies in outcomes between mice experiments and clinical trials. In this review, we discuss the latest data on the influence of aging, obesity, and the gut microbiome on the anti-tumor immune response and immunotherapy and propose avenues to increase our knowledge on this topic in order to improve patient selection for cancer immunotherapy treatment.

scholarly journals Algorithm-Based Screening May Improve Patient Selection for the Subcutaneous Implantable Defibrillator

2016 ◽  
Vol 2 (5) ◽  
pp. 605-614 ◽  
Author(s):  
Tom F. Brouwer ◽  
Kirsten M. Kooiman ◽  
Louise R. Olde Nordkamp ◽  
Vokko P. van Halm ◽  
Reinoud E. Knops
Keyword(s):  
Patient Selection ◽  
Implantable Defibrillator ◽  
Improve Patient Selection ◽  
Selection For ◽  
Improve Patient

scholarly journals Phase I prognostic online (PIPO): A web tool to improve patient selection for oncology early phase clinical trials

2021 ◽  
Vol 155 ◽  
pp. 168-178
Author(s):  
Ignacio Matos ◽  
Guillermo Villacampa ◽  
Cinta Hierro ◽  
Juan Martin-Liberal ◽  
Roger Berché ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Phase I ◽  
Patient Selection ◽  
Early Phase ◽  
Web Tool ◽  
Improve Patient Selection ◽  
Selection For ◽  
Early Phase Clinical Trials ◽  
Improve Patient

scholarly journals Using Risk Models to Improve Patient Selection for High-Risk Vascular Surgery

Scientifica ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-13
Author(s):  
Philip P. Goodney
Keyword(s):  
Patient Selection ◽  
Carotid Atherosclerosis ◽  
Clinical Effectiveness ◽  
Aortic Aneurysms ◽  
Risk Models ◽  
Improve Patient Selection ◽  
Potential Benefits ◽  
Selection For ◽  
Peripheral Arterial ◽  
Improve Patient

Vascular surgeons frequently perform procedures aimed at limiting death, stroke, or amputation on patients who present with diseases such as aortic aneurysms, carotid atherosclerosis, and peripheral arterial occlusive disease. However, now more than ever surgeons must balance the potential benefits associated with these interventions with the risks of physiologic insult for these elderly patients, who often have significant comorbidity burdens and the potential for costly complications. In this paper, we highlight how regional and national datasets can help surgeons identify which patients are most likely to benefit from vascular operations and which patients are most likely to suffer complications in the postoperative period. By using these guidelines to improve patient selection, our risk models can help patients, physicians, and policymakers improve the clinical effectiveness of surgical and endovascular treatments for vascular disease.

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