scholarly journals Transarterial Chemoembolization With Doxorubicineluting Microspheres: Single-Center Review Of Safety Profile

2016 ◽  
Vol 26 (5) ◽  
pp. 48-53
Author(s):  
Aušra Bankauskaitė ◽  
Alvydas Česas ◽  
Algimatas Šimkaitis ◽  
Loreta Malinauskienė
Keyword(s):  
Vascular Invasion ◽  
Standard Treatment ◽  
Tumor Response ◽  
Interventional Therapy ◽  
Metastatic Carcinoma ◽  
Colorectal Metastases ◽  
Complication Rates ◽  
Single Center ◽  
First Time ◽  
Tace Procedure

Background. Since 1977 when TACE was introduced for the first time it became a standard treatment for nonresectable HCC without vascular invasion or extrahepatic disease. TACE is also performed for other indications, such as colorectal metastases, cholangiocarcinoma, neuroendocrine tumors and etc. Material/methods. the evaluation of interventional therapy with DEB-TACE of 8 patients each with unrespectable HCC, cholangiocarcinoma, neuroendocrine metastatic carcinoma. A comparison of therapy- associated complications performed. Results. We analyzed results of DEB-TACE performed in our Hospital since 2014. DEB-TACE was technically successful in all patients. A total of 21 DEB-TACE procedure was performed in 8 patients during the 2-year period. Two patients (20%) had five treatments, 1 patient (15%) had four treatments, 4 patients (50%) had two treatments and 1 (15%) had one treatment. Pain, nausea, fever and fatigue were the most common side effects following DEBTACE, with a frequency of 76%, 33%, 57% and 71% respectively. Conclusions. The current results show DEB-TACE to produce beneficial tumor response and to have exceptionally low complication rates.

scholarly journals The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases

2021 ◽  
Author(s):  
M. Runkel ◽  
T. D. Diallo ◽  
S. A. Lang ◽  
F. Bamberg ◽  
M. Benndorf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Visceral Obesity ◽  
The Body ◽  
Postoperative Outcomes ◽  
Sarcopenic Obesity ◽  
Colorectal Metastases ◽  
Complication Rates ◽  
The Impact ◽  
Body Compositions

Abstract Background The impact of body compositions on surgical results is controversially discussed. This study examined whether visceral obesity, sarcopenia or sarcopenic obesity influence the outcome after hepatic resections of synchronous colorectal liver metastases. Methods Ninety-four consecutive patients with primary hepatic resections of synchronous colorectal metastases were identified from a single center database between January 2013 and August 2018. Patient characteristics and 30-day morbidity were retrospectively analyzed. Body fat and skeletal muscle were calculated by planimetry from single-slice CT images at the level of L3. Results Fifty-nine patients (62.8%) underwent minor hepatectomies, and 35 patients underwent major resections (37.2%). Postoperative complications occurred in 60 patients (62.8%) including 35 patients with major complications (Clavien–Dindo grade III–V). The mortality was nil at 30 days and 2.1% at 90 days. The body mass index showed no influence on postoperative outcomes (p = 1.0). Visceral obesity was found in 66 patients (70.2%) and was significantly associated with overall and major complication rates (p = .002, p = .012, respectively). Sarcopenia was observed in 34 patients (36.2%) without a significant impact on morbidity (p = .461), however, with longer hospital stay. Sarcopenic obesity was found in 18 patients (19.1%) and was significantly associated with postoperative complications (p = .014). Visceral obesity, sarcopenia and sarcopenic obesity were all identified as significant risk factors for overall postoperative complications. Conclusion Visceral obesity, sarcopenic obesity and sarcopenia are independent risk factors for overall complications after resections of CRLM. Early recognition of extremes in body compositions could prompt to perioperative interventions and thus improve postoperative outcomes.

Abstract WP341: Difference in Acute Ischemic Post Thrombolytic Stroke Outcomes in Pre Comprehensive and Post Comprehensive Status: Single Center Experience

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Vishal B Jani ◽  
Achint Patel ◽  
Jillian Schurr ◽  
Erin Shell ◽  
Julie Bey ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Secondary Outcome ◽  
Rank Test ◽  
Stroke Severity ◽  
Complication Rates ◽  
Single Center ◽  
Stroke Treatment ◽  
Significant Difference ◽  
Multivariable Regression ◽  
Iv Tpa

Background: In last decade there is a significant change in stroke care especialy with newer data for ischemic stroke treatment there is a movement to obtain comprehensive stroke center certification (CSCC) to provide enhanced complex care for stroke. This study aims to assess the single center quality matrix assessment pre and post CSC status Methods: We reviewed single center cohort of IV tPA (tissue plasminogen activator) in-between year 2010 to 2014 at sparrow health system in mid Michigan region. This cohort was dichotomized in pre CSCC and post CSCC era. Stroke quality matrics data was collected for these patients. Severity of stroke was categorized in mild-moderate vs moderate-severe based on NIH stroke scale (NIHSS) scale. Primary out come for this study was any complication, which is composite end point of in-hospital mortality, and hemorrhage and secondary outcome was hospital stay. Chi square, student’s t test and wilcoxon sum rank test was used to compare both groups. Multivariable regression models were utilized to calculate odd ratios after adjusting with stroke severity. Results: Cohort of IV tPA was identified in-between year 2010 to 2014 (332 hospitalizations off which 241 were pre CSCC and 91 were Post CSCC ). In- hospital complication was lower after receiving CSCC (9.89% vs. 21.99%; p:0.011). In multivariable regression analysis the trend for in hospital complication persisted [Adjusted Odds ratio (OR):0.43–95%confidence-Interval(CI):0.20-0.93–p:0.032] but there was no significant difference in hospital stay (Median days 5 vs. 5; P:673) Conclusion: There is a clear and persistent trend of low in-hospital complication rates after acquiring CSCC quality matrics.

scholarly journals Calcified Prolactinoma of the Pituitary Gland: Illustrative Case Reports Highlighting Medical versus Surgical Intervention

2019 ◽  
Vol 81 (01) ◽  
pp. 022-029
Author(s):  
Sherwin Tavakol ◽  
Asma Hasan ◽  
Michelle A. Wedemeyer ◽  
Joshua Bakhsheshian ◽  
Chia-Shang J. Liu ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Standard Treatment ◽  
Tumor Response ◽  
Surgical Intervention ◽  
Case Reports ◽  
Illustrative Case ◽  
Tumor Shrinkage ◽  
Endoscopic Endonasal ◽  
Diffuse Calcification

AbstractThe presence of calcification is uncommon in pituitary adenomas, and often lends support to other diagnoses including craniopharyngioma. The majority of calcified pituitary adenomas are prolactin-secreting tumors. We report two patients with calcified macroprolactinomas, one that was treated medically with a biochemical response and partial tumor response, and one that was treated successfully via an endoscopic endonasal transsphenoidal approach. Suspected calcified prolactinomas can be initially managed medically as per standard treatment for typical prolactinomas; however, the presence of diffuse calcification may hinder tumor shrinkage. Tumors that are refractory to medical treatment can be safely managed with surgery.

scholarly journals Inhibition of FGF2-Mediated Signaling in GIST—Promising Approach for Overcoming Resistance to Imatinib

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1674
Author(s):  
Sergei Boichuk ◽  
Aigul Galembikova ◽  
Ekaterina Mikheeva ◽  
Firuza Bikinieva ◽  
Aida Aukhadieva ◽  
...  
Keyword(s):  
Tumor Response ◽  
Molecular Target ◽  
Compensatory Mechanism ◽  
Dependent Manner ◽  
First Line ◽  
Induced Apoptosis ◽  
First Time ◽  
Malignant Behavior ◽  
First Line Treatment

Inhibition of KIT-signaling is a major molecular target for gastrointestinal stromal tumor (GIST) therapy, and imatinib mesylate (IM) is known as the most effective first-line treatment option for patients with advanced, unresectable, and/or metastatic GISTs. We show here for the first time that the inhibition of KIT-signaling in GISTs induces profound changes in the cellular secretome, leading to the release of multiple chemokines, including FGF-2. IM increased migration, invasion, and colony formation of IM-resistant GISTs in an FGF2-dependent manner, whereas the use of blocking anti-FGF2 antibodies or BGJ398, a selective FGFR inhibitor, abolished these effects, thus suggesting that the activation of FGF2-mediated signaling could serve as a compensatory mechanism of KIT-signaling inhibited in GISTs. Conversely, FGF-2 rescued the growth of IM-naive GISTs treated by IM and protected them from IM-induced apoptosis, consistent with the possible involvement of FGF-2 in tumor response to IM-based therapy. Indeed, increased FGF-2 levels in serum and tumor specimens were found in IM-treated mice bearing IM-resistant GIST xenografts, whereas BGJ398 used in combination with IM effectively inhibited their growth. Similarly, increased FGF-2 expression in tumor specimens from IM-treated patients revealed the activation of FGF2-signaling in GISTs in vivo. Collectively, the continuation of IM-based therapy for IM-resistant GISTs might facilitate disease progression by promoting the malignant behavior of tumors in an FGF2-dependent manner. This provides a rationale to evaluate the effectiveness of the inhibitors of FGF-signaling for IM-resistant GISTs.

Gemcitabine, oxaliplatin and weekly high-dose 5-FU as a 24-hr-infusion in chemonaive patients with advanced or metastatic carcinoma of the gallbladder: Preliminary results of a multicenter phase II-study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4129-4129 ◽  
Author(s):  
A. D. Wagner ◽  
P. Buechner-Steudel ◽  
H. Schmalenberg ◽  
M. Moehler ◽  
O. Kuss ◽  
...  
Keyword(s):  
Survival Rate ◽  
Median Survival ◽  
Phase Ii ◽  
Tumor Response ◽  
Phase Ii Study ◽  
Metastatic Carcinoma ◽  
Phase Iii ◽  
Carcinoma Of The Gallbladder ◽  
One Year ◽  
The One

4129 Background: Combinations of gemcitabine (GEM)/5-FU, GEM/oxaliplatin (LOHP) or 5-FU/LOHP work synergistically in pancreatic and/or colorectal malignancies, and have non-overlapping safety profiles. This phase II-study was designed to evaluate the efficacy and safety of the triple combination GEM/LOHP/5-FU in patients (pts) with advanced or metastatic carcinoma of the gallbladder. Methods: One-stage, multicentre phase II study. Eligibility criteria: chemonaive pts with histologically proven advanced, recurrent or metastatic gallbladder carcinoma (ECOG 0–1; expected survival >3 months; measurable disease; adequate renal, hepatic and bone marrow function). According to the results of our previous phase I-study (Proc ASCO 2003, # 1298), pts were treated with GEM 900mg/m2 as a 30-min infusion, followed by LOHP 65 mg/m2 (2-hr infusion) after a 30 min rest and 5-FU 1500 mg/m2 (24-hr-infusion) on d 1, 8, every 3 weeks. Planned sample size: 35 response evaluable patients. The primary endpoint was tumor response, secondary endpoints were toxicity, median survival, the one-year-survival rate, clinical benefit and quality of life. Results: At time of abstract submission, median follow-up of 35 enrolled pts is 9.8 months. Pt. characteristics: m/f: 11/24, median age 61 (range 42–81), ECOG 0/1: 24/11 (69/31%) pts, locally advanced/metastatic disease 1/32 (3/91%) pts. Analysis of tumor response is still pending. Grade III/IV (NCI-CTC) toxicities occurred in 36/3% of 191 cycles and were: leucopenia 3/1%, neutropenia 4/1%, thrombocytopenia 4/1%, anemia 2/0%, nausea 1/0%, sensory neuropathy 4/0%, asthenia 1/0%, elevated bilirubin 2/0%, AP 4/0%, or elevated SGOT/SGPT 1/0%, edema 1/0%, infection 1/0%, dyspnoe 1/1%. Median survival of all pts is 9.9 months (95% CI: 7.5–11.5), the one-year-survival-rate is 30 % (95% CI: 16–47). Conclusions: GEM/LOHP/5-FU combination therapy is tolerated well in patients with gallbladder cancer. The promising survival data has to be confirmed in a phase III study. (Supported by grants from Eli Lilly and Company, Indianapolis, IN, USA and Sanofi-Synthelabo, Paris, France). [Table: see text]

Radiographic tumor response in pediatric patients with newly diagnosed localized (LOC) or metastatic (MET) Ewing’s sarcoma (EWS) following neoadjuvant chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20008-20008
Author(s):  
M. K. Chuk ◽  
F. M. Balis ◽  
C. Mackall ◽  
D. Hawkins ◽  
N. Avila ◽  
...  
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Local Control ◽  
Pediatric Patients ◽  
Standard Treatment ◽  
Tumor Response ◽  
Newly Diagnosed ◽  
Primary Tumors ◽  
Who Criteria ◽  
Radiographic Response

20008 Background: Standard treatment for EWS includes vincristine, doxorubicin, cyclophosphamide (VDC) alternating with ifosfamide and etoposide (IE). Using this therapy, overall survival is 70% in patients with LOC EWS and 30% in patients with MET EWS. We compared the radiographic response to VDC and IE in patients with LOC or MET EWS. Methods: We conducted a randomized trial comparing pegfilgrastim to filgrastim in patients treated with VDC (cycles 1, 2, 5, 9, 11, 13) and IE (cycles 3, 4, 6–8, 10, 12, 14). Local control with radiation or surgery was initiated after cycle 5. We assessed radiographic response after VDC (C1,2) and IE (C3,4) using 1-dimensional (RECIST) and 2-dimensional (WHO) criteria. Measurements were performed using MEDx. Results: Twenty-one patients with EWS, median age 20y (6–25y), were enrolled; 16 were evaluable for this analysis. Primary tumors were in extremity (n=5) or central axis (n=11). Eight patients had MET disease (pulmonary only, n=4). Median (range) decrease in tumor size by WHO after C4 was 61% (40–92%) for LOC and 83% (47–94%) for MET. Decrease by treatment is presented in the table . Overall responses after 4 cycles for LOC patients were 5 PR, 3 SD using RECIST, and 6 PR, 2 SD using WHO. For MET patients, overall responses were the same using RECIST and WHO, 7 PR, and 1SD. Conclusion: Patients with MET EWS responded as well as those with LOC EWS after 4 cycles of neoadjuvant chemotherapy. Similar overall response was demonstrated using RECIST or WHO. Tumor response after VDC was greater than after IE, possibly due to sequence of administration, but patients had continued tumor response with IE. [Table: see text] No significant financial relationships to disclose.

Influence of surgical margin on type of recurrence after liver resection for colorectal metastases: a single-center experience

Surgery ◽  
2008 ◽  
Vol 143 (3) ◽  
pp. 384-393 ◽  
Author(s):  
Gennaro Nuzzo ◽  
Felice Giuliante ◽  
Francesco Ardito ◽  
Maria Vellone ◽  
Ivo Giovannini ◽  
...  
Keyword(s):  
Liver Resection ◽  
Surgical Margin ◽  
Colorectal Metastases ◽  
Single Center ◽  
Single Center Experience
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