tumor location
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2022 ◽  
Vol 17 (1) ◽  
Pierre Trémolières ◽  
Ana Gonzalez-Moya ◽  
Amaury Paumier ◽  
Martine Mege ◽  
Julien Blanchecotte ◽  

Abstract Objectives To characterise the motion of pulmonary tumours during stereotactic body radiation therapy (SBRT) and to evaluate different margins when creating the planning target volume (PTV) on a single 4D CT scan (4DCT). Methods We conducted a retrospective single-site analysis on 30 patients undergoing lung SBRT. Two 4DCTs (4DCT1 and 4DCT2) were performed on all patients. First, motion was recorded for each 4DCT in anterior–posterior (AP), superior-inferior (SI) and rightleft (RL) directions. Then, we used 3 different margins (3,4 and 5 mm) to create the PTV, from the internal target volume (ITV) of 4DCT1 only (PTV D1 + 3, PTV D1 + 4, PTV D1 + 5). We compared, using the Dice coefficient, the volumes of these 3 PTVs, to the PTV actually used for the treatment (PTVttt). Finally, new treatment plans were calculated using only these 3 PTVs. We studied the ratio of the D2%, D50% and D98% between each new plan and the plan actually used for the treatment (D2% PTVttt, D50% PTVttt, D50% ITVttt D98% PTVttt). Results 30 lesions were studied. The greatest motion was observed in the SI axis (8.8 ± 6.6 [0.4–25.8] mm). The Dice index was higher when comparing PTVttt to PTV D1 + 4 mm (0.89 ± 0.04 [0.82–0.98]). Large differences were observed when comparing plans relative to PTVttt and PTV D1 + 3 for D98% PTVttt (0.85 ± 0.24 [0.19–1.00]). and also for D98% ITVttt (0.93 ± 0.12 [0.4–1.0]).D98% PTVttt (0.85 ± 0.24 [0.19–1.00], p value = 0.003) was statistically different when comparing plans relative to PTVttt and PTV D1 + 3. No stastistically differences were observed when comparing plans relative to PTVttt and PTV D1 + 4. A difference greater than 10% relative to D98% PTVttt was found for only in one UL lesion, located under the carina. Conclusion A single 4DCT appears feasible for upper lobe lesions located above the carina, using a 4-mm margin to generate the PTV. Advance in knowledge Propostion of a personalized SBRT treatment (number of 4DCT, margins) according to tumor location (above or under the carina).

BMC Surgery ◽  
2022 ◽  
Vol 22 (1) ◽  
Peng Shu ◽  
Long Cheng ◽  
Chuan Xie ◽  
Jun Zhou ◽  
Qianjun Yu ◽  

Abstract Background We have improved and named a new reverse rolling-mat type lymph node dissection, which effectively solves the dilemma faced by the traditional lymph node dissection in hand-assisted laparoscopic D2 radical gastrectomy through the optimization of the surgical procedure. However, the relevant clinical data are still scarce. The study aims to compare the clinical effects of two surgical procedure and explore the safety and feasibility of “reverse procedure”. Study design The clinicopathological data of 195 patients who underwent hand-assisted D2 radical total gastrectomy (HALTG) in our hospital from January 2011 to September 2017 were collected. A retrospective case–control study was used to compare the clinical outcomes of the two patterns of lymph node dissection. Among them, 89 patients underwent “cabbage type” lymph node dissection and 106 patients underwent the “reverse procedure” lymph node dissection. Results There were no significant differences between the two groups of patients in terms of gender, age, tumor location, incision length, postoperative hospitalization duration, pathological classification, recent complications, long-term recurrence and metastasis. The operation time of “cabbage type” group was shorter than that of “reverse procedure” group (178.35 ± 31.52 min vs 191.25 ± 32.77 min; P = 0.006). While, in the “reverse procedure” group, intraoperative blood loss was less (249.4 ± 143.12 vs 213.58 ± 101.43; P = 0.049), and there were more numbers of lymph nodes dissected (18.04 ± 7.00 vs 32.25 ± 14.23; P < 0.001). Conclusion The pattern of reverse rolling-mat type lymph node dissection in HALTG perform well in terms of safety and feasibility.

2022 ◽  
Vol 6 (1) ◽  
pp. V12

The authors report the first cases of fluorescence-guided spinal surgery of schwannomas using near-infrared fluorescence imaging with the delayed window indocyanine (ICG) green (DWIG) technique for accurate real-time intraoperative tumor visualization. Patients with intradural spinal schwannomas received 0.5 mg/kg ICG at the beginning of surgery. After 1 hour, using the DWIG technique, near-infrared spectroscopy (NIRS) detected the spinal schwannomas, showing the exact tumor location and boundaries. DWIG with NIRS microscopy confirmed the exact location of spinal schwannomas before and after opening of the dura mater, thereby facilitating successful tumor dissection from the surrounding tissues, tumor resection, and confirmation of tumor removal. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21158

2021 ◽  
Yoshinori Fujiwara ◽  
Shunji Endo ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
Seiya Kinoshita ◽  

Abstract Background: Inflammation and nutrition are closely related to the progression of gastrointestinal malignancies. We aimed to explore the potential of preoperative inflammation-based or nutrition-based biomarkers as predictors of survival in patients with resectable esophageal squamous cell carcinoma (ESCC) using multivariate Cox analysis.Methods: We included 122 patients with resectable ESCC (stages I–IV) in the study. We assessed the inflammation-based modified Glasgow prognostic score (mGPS), nutrition-based modified controlling nutritional status (mCONUT) score, CRP(C-reactive protein),serum albumin, lymphocyte counts, and total cholesterol. The relationships of these biomarkers with overall survival (OS) and recurrence-free survival (RFS) were evaluated. Three Cox model were performed for single parameters(CRP, albumin, lymphocyte, total cholesterol), for mCONUT and mGPS,and for clinicopathological factors.Results: The cut-off values for CRP, albumin, and mCONUT measured using receiver operating characteristic (ROC) curves were 0.3, 3.5, and 4, respectively. Patients with high mGPS and high mCONUT scores were significantly associated with shorter OS and RFS (p < 0.05).Multivariate Cox analysis showed that mGPS,pStage,tumor location were independent prognostic factors both FRS and OS. Also, Cox analysis for single parameters showed that preoperative CRP, lymphocyte counts were independent prognostic factors for RFS and albumin was prognostic factor for OS.Conclusions: Preoperative inflammation-based mGPS is most reliable independent prognostic factor in patients with resectable ESCC. Suppression of preoperative inflammation can be improved nutritional status and may improve the prognosis in these patients.

Nicole M Brossier ◽  
Jennifer M Strahle ◽  
Samuel J Cler ◽  
Michael Wallendorf ◽  
David H Gutmann

Summary Tumor location has been proposed as a prognostic factor for pilocytic astrocytoma (PA), but since resection status varies by CNS location, these two variables are difficult to separate on multivariate analysis. To eliminate resection status as a confounding variable, we analyzed the outcomes of children with subtotally resected PA by brain location. We found that individuals with PA in the supratentorial midline region had an increased likelihood of multiple progression events. These children also exhibited more neurologic deficits over time compared to those with brainstem PA, frequently due to worsening vision and the acquisition of new endocrinopathies or weakness.

Akel Khaled Alyahia, Hassan Zaizafoun, Daed Dugman Akel Khaled Alyahia, Hassan Zaizafoun, Daed Dugman

Objective: The study was conducted in order to determine the epidemiological characteristics of referred patients at Tishreen University Hospital in Lattakia and who have been diagnosed with one of the types of malignant Gastrointestinal tumors and study the distribution of risk factors in these patients. Patients and Methods: An Observational Descriptive study (Cross- Sectional) conducted for the period from January 2020 to January 2021 at Tishreen University Hospital in Lattakia- Syria (in Gastrointerolog Department). The variables analyzed were age, gender, tumor location and risk factors Results: The research sample included 223 patients (127 males and 96 females). Esophageal tumors are relatively rare and most of them are of the squamous cell carcinoma type (72.8%). Stomach tumors are the second most common tumor with a percentage of (23.8%), and adenocarcinoma constituted 89% of the cases. Colon and rectal cancer represented the largest percentage (35%) of gastrointestinal tumors, and half of these tumors were in the rectum. Pancreatic cancer ranked third with 11.2% of cases. Tumors of the small intestine and gallbladder and hepatocellular carcinoma are relatively rare. Our most frequently seen risk factors were smoking in most tumors, positivity for H. pylori in 70% of gastric adenocarcinoma patients, and family history and inflammatory bowel disease in Colon tumor patients. Conclusion: Although the incidence of some gastrointestinal cancers has decreased, these cancers continue to pose major challenges to public health, especially colorectal tumors.

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