EFFICACY OF PERFUSION THERMOCHEMOTHERAPY IN GASTRIC CANCE MANAGEMENT BASED ON RESULTS OF PROSPECTIVE RANDOMIZED STUDY

2021 ◽  
pp. 87-91
Author(s):  
М.Yu. Reiitovich ◽  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Peritoneal Dissemination ◽  
Radical Surgery ◽  
Randomized Study ◽  
Progression Free Survival ◽  
Prospective Randomized Study ◽  
Free Survival ◽  
Borrmann Type

The article analyses the results of a prospective randomized study of a cohort of 154 radically operated patients with stage IIB-IIIC gastric cancer (Borrmann type 111 IV). 76 patients were administered intraoperative perfusion thermochemotherapy (HIPEC). It was noted that enhancing radical surgery procedure by complementing it with HIPEC in managing this prognostically unfavorable group of patients resulted in a decrease in the frequency of progression cases (p = 0.009), metachronous peritoneal dissemination — (p < 0.001), and 5-year cumulative carcinomatosis incidence — 70.7 ± 6.8 % to 23.6 ± 5.2 % (p < 0.001) thereby building a groundwork for improving 5-year adjusted survival rate from 27.0 ± 6.7 % to 45.1 ±6.4 % (p = 0.05), progression-free survival — from 16.3 ± 5.5 % to 42.1 ± 6.3 % (p < 0.001), and dissemination-free survival — from 19.4 ± 5.9 % to 45.2 ± 6.3 % (p = 0.001).

Intraperitoneal chemotherapy for gastric cancer with peritoneal dissemination: A single center retrospective analysis of 82 cases.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 170-170
Author(s):  
Masahiro Yoshida ◽  
Yasushi Tsuji ◽  
Syutaro Oiwa ◽  
Toshizo Takayama ◽  
Naoka Okamura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Intraperitoneal Chemotherapy ◽  
Peritoneal Dissemination ◽  
Progression Free Survival ◽  
Complete Response ◽  
Treated Group ◽  
Peritoneal Metastases ◽  
Phase Iii ◽  
Conversion Surgery

170 Background: The prognosis of gastric cancer with peritoneal metastases remains dismal. Ishigami et al. have recently published a phase III study (PHOENIX-GC) aimed at clinical efficacy of intraperitoneal paclitaxel (PTX), which established intraperitoneal chemotherapy as a decent option for gastric cancer with peritoneal dissemination. According to this report, we have used various regimens of intraperitoneal chemotherapy, adjusted mainly based on previous treatments. Methods: Data from 82 patients with gastric cancer with peritoneal metastases who underwent intraperitoneal chemotherapy in our institute from February 2012 to July 2017 were retrospectively analyzed. The progression free survival (PFS), the overall survival (OS) and the 1-year survival rate were stratified by prior treatments. Results: Of the 82 patients, 38 (46.3%) were chemotherapy-naïve. The intraperitoneal regimens were assigned mainly according to the prior treatment: intraperitoneal PTX plus S-1/PTX was the most frequent (39 cases), followed by intraperitoneal PTX plus intravenous PTX (17 cases), intraperitoneal PTX only (6 cases), and the rest. The median PFS for the chemotherapy-naïve group and the previously treated group was 6.9 and 4.1 months, and the median OS was 12.8 and 7.9 months, and the 1-year survival rate was 72.2% and 34.4%, respectively. 10 patients (12.2%) achieved conversion surgery after confirmed complete response in the peritoneal metastases. Among these 10 patients, the median survival time is 22.7 months (7.6+-47.7). Adverse events were also analyzed for each regimen, as for intraperitoneal PTX plus S-1/PTX, leukopenia, neutropenia and anemia occurred frequently. All regimens were comprehensively tolerable, and there were no treatment-related deaths. Conclusions: Intraperitoneal chemotherapy is a promising and feasible option for gastric cancer with peritoneal dissemination. There were several cases with long-term prognosis where conversion surgery was achieved.

scholarly journals Prospective Randomized Study Comparing a Single-Cuff Self-Locating Catheter with a Single-Cuff Straight Tenckhoff Catheter in Peritoneal Dialysis

2016 ◽  
Vol 36 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Juan J. Sanchez-Canel ◽  
Hector Garcia-Perez ◽  
Rafael Garcia-Calvo ◽  
Maria J. Pascual ◽  
David Casado
Keyword(s):  
Peritoneal Dialysis ◽  
Survival Rate ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Total Period ◽  
Free Survival ◽  
Tenckhoff Catheter ◽  
Variable Type ◽  
Catheter Malfunction ◽  
Significant Difference

♦ ObjectivesPeritoneal dialysis (PD) catheters are critical to the success of the technique. However, few studies provide evidence about which design helps to reduce complications. Self-locating catheters (SLCs) are used to avoid displacement of the catheter tip. The incidence of mechanical and infectious complications and catheter survival rate were assessed in Tenckhoff PD catheters.♦ DesignThe prospective randomized study compared drainage problems in 40 incident PD patients using a single-cuff SLCs and 38 patients using a single-cuff, straight Tenckhoff catheter (TC).♦ResultsNo significant differences were observed in the number of complications in the Pre period (from the insertion of the catheter to the start of the technique); however, the number of complications was lower in the SLC group during Post ( p = 0.021) and Total period ( p = 0.048). The number of problems related to catheter malfunction for each period: Pre, Post, and Total, was significantly lower with SLCs vs TCs ( p = 0.018, p = 0.001 and p = 0.003, respectively). Problems were solved more easily with SLCs, using laxatives, with less need for fluoroscopic placement and no need for surgical replacement, as opposed to the TC group: Pre (not significant), Post ( p = 0.007), and Total ( p = 0.011). Median survival was 39.6 months (30.9 – 48.3) for SLCs and 30.1 months (22.6 – 37.5) for TCs, which is not a significant difference. However, SLCs have a higher malposition-free survival rate. Multivariate logistic regression models only included the variable “type of catheter” as a predictor of malfunction during the Pre period (odds ratio [OR] = 4.154). The Post period included the variables, “type of catheter” (OR = 7.701) and “age” (OR = 1.047), and the Total period only included the variable “type of catheter” (OR = 4.487), which indicates an increased probability of malfunction with the use of TCs vs SLCs. The variables (gender, previous intra-abdominal surgery, body mass index (BMI) and diabetes mellitus) did not add predictive value to the models ( p > 0.05).♦ ConclusionThe study confirms the hypothesis that TCs have more malfunctions and a lower malposition-free survival rate than SLCs, and TCs are considered as the highest risk factor for malfunction during all study periods.

scholarly journals Costovertebral RIB disarticulation and pleurectomy in Askin’s tumor: A mandatory approach to radical surgery in children? Case report and guiedelines to surgical treatment

2011 ◽  
Vol 58 (4) ◽  
pp. 103-106
Author(s):  
Ivan Milovic ◽  
Mila Stajevic ◽  
Igor Sehic
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Radical Surgery ◽  
Progression Free Survival ◽  
Multicenter Studies ◽  
Tumor Spread ◽  
Free Survival ◽  
Natural Barrier ◽  
Better Than

The case report of Askin?s tumor in a 16-year-old girl is focused on the still debatable surgical controversy in the treatment of PNET tumor, i.e. whether disarticulation of involved rib at the costovertabral joint should be accepted as the mandatory surgical procedure. It was concluded that the procedure, if feasible, may offer better prognosis of PNET because progression-free survival rate of patients without costovertebral junction involvement reported in multicenter studies was statistically significantly better than in patients in whom PNET has involved the costovertebral junction or bone metastases were present at the diagnosis. The cartilage is a natural barrier for tumor spread and this property should be augmented by radical surgery. Disarticulation of involved rib or ribs and pleurectomy should be routinely performed if the surgery is contemplated with proper timing between the cycles of induction chemotherapy.

scholarly journals Retrospective Cohort Study of Intraoperative Administration of Sustained-Release 5-Fluorouracil Implants in Advanced Gastric Cancer Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Ge ◽  
Ting Liu ◽  
Tianxiang Lei ◽  
Xuan Li ◽  
Kun Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Postoperative Chemotherapy ◽  
Control Group ◽  
Free Survival ◽  
Gastric Cancer Patients

Background: 5-fluorouracil (5-FU) is basically used in the field of postoperative chemotherapy of gastric cancer (GC), the goal of this study was to evaluate improvement of long-term survival rate among GC patients after the 5-FU implants treatment.Methods: The study included 145 patients with gastric cancer who received postoperative chemotherapy with 5-FU implants and had complete follow-up information. According to the sex, age and clinical stage of 5-FU implants group, 74 patients were matched as the control group at the same time. In the study, we compared the 5-year overall survival rate with progression-free survival rate in the two groups, and the drug safety for both groups during the treatment was also compared.Results: The median follow-up time was 85 months (range 60–116 months). 31 patients (21.38%) died of tumor recurrence in 5-FU implants group and 21 (28.38%) in control group. In the control group, metastatic lesions were found in the small intestine, left adrenal gland and peritoneum in three patients. The 5-year progression-free survival (PFS) rate was 79.71% in 5-FU group and 67.12% in control (p = 0.0045). The 5-year overall survival (OS) rate was 77.68% in 5-FU implants group and 64.87% in control (p = 0.0159). Both the 5-years OS and PFS rates in 5-FU group were better than control group without significant side effect.Conclusions: 5-FU implants may improve 5-years OS and PFS rates after surgery in gastric cancer patients, while good safety profile suggests it could be reliable.

Surgery and metastases of stomach cancer in liver

2020 ◽  
pp. 21-24
Author(s):  
F. M. Dzhuraev ◽  
S. L. Gutorov ◽  
E. I. Borisova ◽  
G. G. Khakimova
Keyword(s):  
Gastric Cancer ◽  
Liver Metastases ◽  
Lymphovascular Invasion ◽  
Peritoneal Dissemination ◽  
Surgical Removal ◽  
Relapse Free Survival ◽  
Cancer Markers ◽  
Free Survival ◽  
The Poor ◽  
Isolated Liver

Liver metastases of gastric cancer determine the poor prognosis. Until now The expediency of their surgical removal has been controversial. However, according to a number of studies, the removal of potentially operable isolated liver metastases allows a significant increase of overall and relapse-free survival in some cases. The review is dedicated to the analysis of prognostic factors that allow selecting patients for surgical removal of liver metastases of gastric cancer. The main criteria are: effective perioperative chemotherapy; stage under T4, N0, absence of lymphovascular invasion, absence of peritoneal dissemination, number less than 3, size up to 4 cm, localization of metastases in one lobe, low level of cancer markers CA 19-9 and CEA.

Immediate and long-term results of the first line chemotherapy in patients with metastatic triple negative breast cancer. Final analysis of randomized study

2020 ◽  
pp. 75-80
Author(s):  
S.A. Lyalkin ◽  
◽  
L.A. Syvak ◽  
N.O. Verevkina ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Randomized Study ◽  
Progression Free Survival ◽  
First Line ◽  
Free Survival ◽  
Group 2 ◽  
Line Chemotherapy ◽  
Group 1

The objective: was to evaluate the efficacy of the first line chemotherapy in patients with metastatic triple negative breast cancer (TNBC). Materials and methods. Open randomized study was performed including 122 patients with metastatic TNBC. The efficacy and safety of the first line chemotherapy of regimens АТ (n=59) – group 1, patients received doxorubicine 60 мг/м2 and paclitaxel 175 мг/м2 and ТР (n=63) – group 2, patients received paclitaxel 175 мг/м2 and carboplatin AUC 5 were evaluated. Results. The median duration of response was 9.5 months (4.5–13.25 months) in patients received AT regimen and 8.5 months (4.7–12.25 months), in TP regimen; no statistically significant differences were observed, р=0.836. The median progression free survival was 7 months (95% CI 5–26 months) in group 1 and 7.5 months (95% CI 6–35 months) in group 2, p=0.85. Both chemotherapy regimens (AT and TP) had mild or moderate toxicity profiles (grade 1 or 2 in most patients). No significant difference in gastrointestinal toxicity was observed. The incidence of grade 3–4 neutropenia was higher in patients of group 2 (TP regimen): 42.8% versus 27% (р<0.05). Conclusions. Both regimens of chemotherapy (AT and TP) are appropriate to use in the first line setting in patients with metastatic TNBC. Key words: metastatic triple negative breast cancer, chemotherapy, progression free survival, chemotherapy toxicity.

Prospective, Randomized Study of Single Compared With Double Autologous Stem-Cell Transplantation for Multiple Myeloma: Bologna 96 Clinical Study

2007 ◽  
Vol 25 (17) ◽  
pp. 2434-2441 ◽  
Author(s):  
Michele Cavo ◽  
Patrizia Tosi ◽  
Elena Zamagni ◽  
Claudia Cellini ◽  
Paola Tacchetti ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Newly Diagnosed ◽  
Free Survival ◽  
To Receive

Purpose We performed a prospective, randomized study of single (arm A) versus double (arm B) autologous stem-cell transplantation (ASCT) for younger patients with newly diagnosed multiple myeloma (MM). Patients and Methods A total of 321 patients were enrolled onto the study and were randomly assigned to receive either a single course of high-dose melphalan at 200 mg/m2 (arm A) or melphalan at 200 mg/m2 followed, after 3 to 6 months, by melphalan at 120 mg/m2 and busulfan at 12 mg/kilogram (arm B). Results As compared with assignment to the single-transplantation group (n = 163 patients), random assignment to receive double ASCT (n = 158 patients) significantly increased the probability to attain at least a near complete response (nCR; 33% v 47%, respectively; P = .008), prolonged relapse-free survival (RFS) duration of 18 months (median, 24 v 42 months, respectively; P < .001), and significantly extended event-free survival (EFS; median, 23 v 35 months, respectively; P = .001). Administration of a second transplantation and of novel agents for treating sequential relapses in up to 50% of patients randomly assigned to receive a single ASCT likely contributed to prolong the survival duration of the whole group, whose 7-year rate (46%) was similar to that of the double-transplantation group (43%; P = .90). Transplantation-related mortality was 3% in arm A and 4% in arm B (P = .70). Conclusion In comparison with a single ASCT as up-front therapy for newly diagnosed MM, double ASCT effected superior CR or nCR rate, RFS, and EFS, but failed to significantly prolong overall survival. Benefits offered by double ASCT were particularly evident among patients who failed at least nCR after one autotransplantation.

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