scholarly journals SURGICAL TREATMENT OF PATIENTS WITH EXTRAORGANIC TUMORS OF THE PELVIC LOCALIZATION WITH INVASION OF THE ILIAC VESSELS

2021 ◽  
pp. 27-30
Author(s):  
I. V. Kryvorotko ◽  
A. V. Chykin ◽  
M. Ye. Tymchenko ◽  
S. O. Beresnyev ◽  
T. Z. Alexandrov
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Locally Advanced ◽  
Iliac Arteries ◽  
Advanced Tumor ◽  
Pelvic Tumors ◽  
Radical Method ◽  
End To End ◽  
Narrow Space ◽  
Locally Advanced Tumor

The aim of our study was to determine the indications for expanding the scope of operations in patients with pelvic extraorgan local formations. Materials and methods. The results of surgical treatment of 7 patients with nonorgan tumors of the pelvic localization, who underwent resection on the main vessels in connection with their involvement in the tumor process, are presented. Results and discussion. A total of 7 interventions were performed on the iliac arteries — 2 resections with an end-to-end anastomosis and 5 prostheses (one case — the aorta resection with reconstruction with a bifurcation prosthesis). Patients with pelvic extraorgan tumors are a special cohort of patients, due to the presence of several organs in a narrow space, which inevitably causes them to fit snugly to the tumor. Locally advanced tumor process in extraorganic tumors involving the main vessels of the pelvis and adjacent organs is not a reason to refuse surgery, and despite the complications, repeated recurrences and previous operations, are well tolerated by patients. This is especially important due to the lack of a real alternative to surgical treatment of this group of patients. Conclusions. Surgical intervention in the treatment of pelvic inorganic tumors involving the main vessels is the only radical method of treatment. Invasion of the main arterial and venous vessels is not a contraindication to surgery in patients with pelvic tumors. Combined angioplastic interventions allow to achieve a long without recurrent period even after cytoreductive operations.

Thymoma: From Chemotherapy to Targeted Therapy

2012 ◽  
pp. 475-479
Author(s):  
Nicolas Girard
Keyword(s):  
Targeted Therapy ◽  
Personalized Medicine ◽  
Molecular Characterization ◽  
Surgical Resection ◽  
Locally Advanced ◽  
Tumor Burden ◽  
Advanced Tumor ◽  
Druggable Targets ◽  
Locally Advanced Tumor

Overview: Thymic malignancies are rare epithelial tumors that may be aggressive and difficult to treat. Thymomas are frequently eligible for upfront surgical resection. However, nearly 30% of patients present with locally advanced tumor at time of diagnosis, and chemotherapy is then used to reduce the tumor burden—possibly allowing subsequent surgery and/or radiotherapy. Metastatic and recurrent thymic malignancies may be similarly treated with chemotherapy. More recently, the molecular characterization of thymoma led to the identification of potentially druggable targets, laying the foundation to implement personalized medicine for patients.

The role of the surgical method in the complex treatment of laryngeal cancer

2021 ◽  
Vol 70 (2) ◽  
Author(s):  
Cristina Albul ◽  
◽  
Gheorghe Tibirna ◽  
Nikolay Gorshkov ◽  
Andrei Tibirna ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Life Expectancy ◽  
Laryngeal Cancer ◽  
Surgical Intervention ◽  
Locally Advanced ◽  
Complex Treatment ◽  
Republic Of Moldova ◽  
The Republic ◽  
Anterior Posterior

As a result of studying the dynamics of the incidence of laryngeal cancer in the Republic of Moldova, in the period from 1980 to 2020. It was found that annually, a malignant tumor of the larynx, on average, about 120 patients fall ill. Over the course of 40 years, 874 patients were identified, of which more than 80% were admitted for treatment at stages 3-4 of the disease. This article studied the results of surgical treatment of 258 patients with locally advanced laryngeal cancer. Based on the characteristics of the spread of laryngeal cancer to neighboring organs and tissues, they gave us the basis to distinguish five main types of surgical intervention: upper, lower, anterior, posterior and lateral. The justification of these operations is proved by the patient’s life expectancy, which is 53.6%.

scholarly journals Prediction of Locally Advanced Urothelial Carcinoma of the Bladder Using Clinical Parameters before Radical Cystectomy - A Prospective Multicenter Study

2015 ◽  
Vol 96 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Thomas Martini ◽  
Atiqullah Aziz ◽  
Florian Roghmann ◽  
Michael Rink ◽  
Felix K. Chun ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Locally Advanced ◽  
Tumor Stage ◽  
Clinicopathological Parameters ◽  
Advanced Tumor Stage ◽  
Advanced Tumor ◽  
Carcinoma Of The Bladder ◽  
Advanced Urothelial Carcinoma ◽  
Locally Advanced Tumor

Introduction: We aimed at developing and validating a pre-cystectomy nomogram for the prediction of locally advanced urothelial carcinoma of the bladder (UCB) using clinicopathological parameters. Materials and Methods: Multicenter data from 337 patients who underwent radical cystectomy (RC) for UCB were prospectively collected and eligible for final analysis. Univariate and multivariate logistic regression models were applied to identify significant predictors of locally advanced tumor stage (pT3/4 and/or pN+) at RC. Internal validation was performed by bootstrapping. The decision curve analysis (DCA) was done to evaluate the clinical value. Results: The distribution of tumor stages pT3/4, pN+ and pT3/4 and/or pN+ at RC was 44.2, 27.6 and 50.4%, respectively. Age (odds ratio (OR) 0.980; p < 0.001), advanced clinical tumor stage (cT3 vs. cTa, cTis, cT1; OR 3.367; p < 0.001), presence of hydronephrosis (OR 1.844; p = 0.043) and advanced tumor stage T3 and/or N+ at CT imaging (OR 4.378; p < 0.001) were independent predictors for pT3/4 and/or pN+ tumor stage. The predictive accuracy of our nomogram for pT3/4 and/or pN+ at RC was 77.5%. DCA for predicting pT3/4 and/or pN+ at RC showed a clinical net benefit across all probability thresholds. Conclusion: We developed a nomogram for the prediction of locally advanced tumor stage pT3/4 and/or pN+ before RC using established clinicopathological parameters.

scholarly journals LOCALLY-ADVANCED SIGMOID CANCER WITH CARCINOMATOSIS AND MULTIPAY RECURRENCES. 15 YEARS OF OBSERVATION

2018 ◽  
pp. 57-62 ◽  
Author(s):  
S. I. Achkasov ◽  
M. S. Likhter ◽  
O. I. Sushkov ◽  
I. V. Nazarov
Keyword(s):  
Colon Cancer ◽  
Local Recurrence ◽  
Life Expectancy ◽  
Treatment Failure ◽  
Clinical Case ◽  
Locally Advanced ◽  
Advanced Tumor ◽  
Aggressive Surgical Approach ◽  
Locally Advanced Tumor ◽  
Sigmoid Cancer

Peritoneal carcinomatosis is a major reason for treatment failure. However, combination of «aggressive» surgical approach with chemotherapy allows achieving good results. In this clinical case, a locally advanced tumor was presented with large carcinomatous node in anomentum. Cytoreductive surgery with a complete cytoreduction in combination with intra-abdominal chemotherapy prevented generalization of carcinomatosis. Subsequently, the patient underwent three surgeries for repeated local recurrence of colon cancer. A 15-year period of observation of the patient suggests that this approach is promising, which significantly increases the length of patients life expectancy.

scholarly journals TREATMENT OF PATIENTS WITH COMPLICATIONS OF COLON CANCER IN CONDITIONS OF MULTIFIELD GERONTOLOGICAL HOSPITAL

2016 ◽  
Vol 175 (3) ◽  
pp. 73-78
Author(s):  
N. I. Glushkov ◽  
T. L. Gorshenin
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Locally Advanced ◽  
Acute Intestinal Obstruction ◽  
Maximal Level ◽  
Treatment Results ◽  
Advanced Tumor ◽  
Tumor Perforation ◽  
Cancer Complications ◽  
Locally Advanced Tumor

The article analyzes treatment results of 482 patients of elderly and senile age with complicated colon cancer forms who were in the hospital for war veterans at the period from 2008 to 2014. The more frequent complication of colon cancer was an acute intestinal obstruction (76,8%). Peritumorous inflammation with abscess formation was noted in 13,5% cases, hemorrhage - in 5,6% tumor perforation - in 4,1% cases. The operations were performed by conventional methods and using endovideosurgical technologies in case of complication of colon cancer. Laparoscopic operations had less volume of intraoperative hemorrhage, lower rate of postoperative complications and reduction of the level of postoperative lethality. The rate of lethality was 31,18% after conventional operations and it consisted of 1,81% after laparoscopic surgery. Total postoperative lethality was 24,5%. The maximal level of postoperative lethality was noted in cases of colon cancer complications and it had an ultimate rate (100%) in cases of perforation of locally advanced tumor.

scholarly journals Volume of surgical intervention in renal cancer, complicated by invasion of tumoral thrombus into venous wall

2021 ◽  
Vol 88 (5-6) ◽  
pp. 28-35
Author(s):  
S. Sh. S. Boiko ◽  
V. І. Rusin ◽  
S. O. Boiko ◽  
V. V. Rusin
Keyword(s):  
Surgical Treatment ◽  
Renal Cancer ◽  
Renal Vein ◽  
Surgical Intervention ◽  
Vena Cava ◽  
Early Postoperative Period ◽  
Vena Cava Inferior ◽  
Vein Wall ◽  
Radical Method ◽  
Severe Degree

Objective. To determine the volume of surgical intervention on vena cava inferior in renal cancer, complicated by invasion of tumoral thrombus into the vein wall. Materials and methods. Into the investigation were included 147 patients, suffering renal cancer, complicated by tumoral venous thrombosis, who were treated surgically in the Zakarpattya Regional Clinical Hospital named after Andriy Novak or in the Zakarpattya Antitumoral Centre in 2005 - 2020 yrs. The patients’ age varied from 27 to 79 yrs old, their average age have constituted 58 yrs old. There were 97 (66%) men and 50 (34%) women. The null level of venous spread of tumoral thrombus was diagnosed in 55 (37.4%), І – in 32 (21.8%), ІІ – in 30 (20.4%), ІІІ – in 22 (15.0%), and IV - in 8 (5.4%) patients. The tumor was localized in right kidney in 51 (34.7%) patients. Surgical treatment in all the patients was performed - nephrectomy and various interventions on the vein. Longitudinal resection of the vein was performed in 55 (37.4%), resection with suturing of alloflap - in 5 (3.4%), circular resection with prosthesis “end-to-end” - in 4 (2.7%) patients. In the tumoral thrombus localization, including a renal vein, the uxtaosteum resection was performed in 100% of the patients. Results. Average duration of the operation was 165 (102 - 292) min, average volume of the blood loss - 780 (240 - 2250) ml. Mild and moderate postoperative complications in accordance to classification of Clavien-Dindo (Degree I - II) was registered in 38 (21.8%), and the severe (Degree ІІІ - V) - in 6 (4.1%) patients. Surgical complications of Degree III or complications, which demanded urgent relaparotomy, were not observed. In early postoperative period 1 patient died. General postoperative lethality have constituted 0.7%. In all the patients a laminar blood flow was preserved. In no one patient the prosthesis thrombosis, recurrence of the prosthesis thrombus, recurrence of tumoral venous thrombus or pulmonary thromboembolism. Conclusion. Radical method of surgical treatment of renal cancer, complicated by tumoral thrombosis of vena cava inferior, must include nephrectomy, cavatomy, thrombectomy, various variants of resection and prosthesis of the vein. In the null level of the tumoral thrombus venous spread the performance of uxtaosteum resection of renal vein is obligatory.

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