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1.
T. de Rojas S. Martínez-Álvarez S. Lerma-Lara M. Á. Díaz L. Madero M. Ramírez 《Clinical & translational oncology》2018,20(5):584-590
Purpose
Corticoid-induced osteonecrosis (ON) of femoral head can lead to severe hip joint impairment and hip replacement, with negative impact in young survivors of acute lymphoblastic leukaemia (ALL) with long life expectancy. We aim to improve quality of life in these patients with a novel approach.Methods/patients
Based on the regenerative capacities of mesenchymal stem cells (MSCs), we performed locally implanted autologous cell therapy in two adolescents suffering of bilateral femoral ON. This required a simple, minimally invasive surgical procedure.Results
Both patients experienced significant pain relief and restoration of gait kinematic values. Radiographic evaluation showed cessation of hip collapse. No toxicities/complications were observed after a 4-year follow-up.Conclusions
Our preliminary results suggest that autologous MSCs can be considered as a novel treatment for children and young adults with ON after overcoming ALL. It may avoid hip replacement and improve quality of life of leukaemia survivors.2.
J. van Bastelaar L. van Roozendaal R. Granzier G. Beets Y. Vissers 《Breast cancer research and treatment》2018,167(2):409-416
Background
Seroma formation is a common complication after mastectomy. This review aims to elucidate which surgical techniques are most effective in reducing the dead space and therefore seroma formation in patients undergoing mastectomy.Methods
A literature search was performed to identify clinical studies comparing any form of flap fixation to conventional closure technique in patients undergoing mastectomy with or without axillary clearance. Studies were eligible for inclusion if outcome was described in terms of seroma formation and/or complications of seroma formation. Studies on animal research or breast reconstruction with tissue expanders or flap harvesting (latissimus dorsi) were excluded.Results
A total of nine articles were eligible for inclusion. Five were retrospective studies and four were prospective. Retrospective and prospective studies have demonstrated the higher incidence of seroma formation in patients not undergoing mechanical flap fixation. The incidence of seroma-related complications in these studies vary. Four out of the nine studies demonstrate that patients undergoing flap fixation, need significantly fewer seroma aspirations. There are very few studies on the use of tissue glues preventing seroma formation.Conclusion
The scientific body of evidence favoring flap fixation after mastectomy is convincing. Mechanical flap fixation seems to reduce seroma formation and seroma aspiration after mastectomy. There are, however, no well-powered randomized controlled trials evaluating all aspects of seroma formation and its sequelae. Further research should elucidate whether flap fixation using sutures or tissue glue is superior.3.
Yoshihiro Sowa Toru Morihara Rie Kushida Koichi Sakaguchi Tetsuya Taguchi Toshiaki Numajiri 《Breast cancer (Tokyo, Japan)》2017,24(3):362-368
Background
Several investigators have evaluated the impaired function of the shoulder after removal of the latissimus dorsi muscle for breast reconstruction. However, a few investigators have studied whether including radiotherapy has a negative effect on functional recovery of the shoulder by a long-term follow-up after surgery. In this study, we compared objective measurements of shoulder function preoperatively and postoperatively for 3 years after latissimus dorsi muscle (LDM) flap transfer and postoperative radiotherapy (PRT).Methods
Eighteen patients who underwent unilateral transfer of a pedicled LDM flap and PRT within 2 months of breast-conserving surgery were enrolled in this study. Range of motion (ROM) and muscle strength in exhaustive shoulder movements were measured before surgery, and at 3 and 6 months, and 1 and 3 years.Results
The results of ROM measurements at 3months postsurgery showed significant decreases in both flexion and abduction by 7.1 and 9.2 % and at 3 years postsurgery by 4.7 and 5.7 %. The muscle strength measurements at 3 months postsurgery showed statistically significant decreases both in adduction and in the 2nd medial rotation by 30.7 and 25.9 % and at 3 years postsurgery by 36.4 and 20.4 %. A significant improvement in these impairments was not observed for 3 years after surgery compared with that at 3 months after surgery.Conclusion
A combination of the LDM flap procedure and PRT could be associated with a higher incidence of tissue adhesions in both flexion and abduction and muscle deficit both in adduction and in the 2nd medial rotation.4.
Aim
To explore information-seeking behaviors on links between cancers and environment.Method
Focus groups and individual semi-structured interviews realized, respectively, with individuals without and with personal cancer experience.Results
The majority of respondents reported informationscanning behaviors. Only half cancer patients searched for information regarding the links between cancers and environment.Conclusion
Little information is sought on links between cancers and environment.5.
D. S. Robertson 《Cellular oncology (Dordrecht)》2018,41(1):103-106
Purpose
Purpose of the work is to highlight a possible connection between metabolic iodine and natural tumour control.Method
Method adopted is to use information available in the literature.Result
Result indicated a means of the purpose being attained.Conclusion
Conclusion drawn is that a tumour control method derives from the relationship studied.6.
Aims
This study aims to identify the most used defense mechanisms in oncology clinicians.Method
Defenses were evaluated conducting an interview with a simulated patient in 62 nurses and 51 physicians by means of the Defense Mechanism Rating Scales for Clinician (DMRS-C).Results
Displacement (20%), rationalization (19.1%) and intellectualization (12.1%) were the most frequently observed mechanisms.Conclusion
These results underline the need to include the topic of the stress induced by the interview in clinicians during communication skills training in oncology.7.
Michael B. Rothberg Bo Hu Laura Lipold Sarah Schramm Xian Wen Jin Andrea Sikon Glen B. Taksler 《Cancer causes & control : CCC》2018,29(3):297-304
Importance
Cervical cancer screening guidelines are in evolution. Current guidelines do not differentiate recommendations based on individual patient risk.Objective
To derive and validate a tool for predicting individualized probability of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) at a single time point, based on demographic factors and medical history.Design
The study design consisted of an observational cohort with hierarchical generalized linear regression modeling.Setting
The study was conducted in a setting of 33 primary care practices from 2004 to 2010.Participants
The participants of the study were women aged ≥?30 years.Main outcome and measures
CIN2+ was the main outcome on biopsy, and the following predictors were included: age, race, marital status, insurance type, smoking history, median income based on zip code, prior human papilloma virus (HPV) results.Results
The final dataset included 99,319 women. Of these, 745 (0.75%) had CIN2+. The multivariable model had a C-statistic of 0.81. All factors but race were independently associated with CIN2+. The model categorized women as having below-average CIN2+ risk (0.15% predicted vs. 0.12% observed risk), average CIN2+ risk (0.42% predicted vs. 0.36% observed), and above-average CIN2+ risk (1.76% predicted vs. 1.85% observed). Before screening, women at below-average risk had a risk of CIN2+ well below that of women with ASCUS and HPV negative (0.12 vs. 0.20%).Conclusions and relevance
A multivariable model using data from the electronic health record was able to stratify women across a 50-fold gradient of risk for CIN2+. After further validation, use of a similar model could enable more targeted cervical cancer screening.8.
9.
Hisamitsu Zaha Norie Abe Noriko Sagawa Mikiko Unesoko 《Breast cancer research and treatment》2017,162(2):267-274
Background
There are several small case series on use of a laparoscopically harvested omental flap (LHOF) for breast reconstruction. However, the long-term oncological safety and clinical benefits of the LHOF remain uncertain, especially in use of the flap in oncoplastic breast surgery.Study design
A retrospective chart review was performed for 200 patients who underwent oncoplastic breast surgery using a LHOF at our institution from April 2002 to March 2016. Laparoscopy-associated complications, local recurrence, and cosmetic outcomes were evaluated.Results
Most of the patients underwent partial breast reconstruction immediately after breast-conserving surgery (BCS). The success rate of laparoscopic harvesting of the omental flap was 99.5%. The rate of complications was 12.0% and laparoscopy-associated complications occurred in four cases (2.0%). The rate of a positive margin was 6.5%. Two cases (1.0%) had local recurrence during a median follow-up period of 90 months. In 24 patients (12.0%), the volume of the flap was insufficient. When applied to total reconstruction, volume insufficiency occurred in 32.6% of patients. Cosmetic outcomes were mostly satisfactory. Approximately 80% of patients were rated as good or excellent by evaluation using a 4-point scale and Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software. Donor-site scars were negligible, as in laparoscopic cholecystectomy.Conclusions
The LHOF has minimal donor-site morbidity and deformity, and oncological safety is promising. There is a limit to the adaptable volume, but the LHOF is an attractive option in partial breast reconstruction after BCS.10.
Clotilde Delerce Olivia Bailly Amine Bouhamama Sophie Couchon Frank Pilleul Arnaud Thivolet Charles Mastier 《Clinical sarcoma research》2018,8(1):22
Background
Review of the first documented case of aortic wall metastasis from a limb sarcoma.Case presentation
In a 56-year-old woman with a diagnosis of a high-grade limb fibrosarcoma, an aortic metastasis was revealed by a fast growing aneurysm of the descending thoracic aorta. This was managed with an endoprosthesis.Conclusion
The presence of an aneurysm in a patient with a sarcoma with a high potential for metastasis and poor cardiovascular risk factors should alert physicians.11.
Background
Endocrine tumours of the gastro-intestinal tract are rare and predominate in the small intestine and in the appendix, less commonly in the colon and the rectum.Aim
The aim of this study is to analyze clinical and pathologic features of an endocrine tumour of the colon and the rectum diagnosed in the Department of Pathology (Sousse, Tunisia).Methods
Five cases were diagnosed between 1992 and 2006 in our hospital unit. The medical records of the affected patients were analyzed. The pathological material was reviewed and the tumours were classified according to 2000 WHO classification.Results
The study population consisted of 2 male and 3 female patients. Their median age was 55 years. Two poorly differentiated endocrine carcinomas of the colon, and one colic and two rectal well differentiated endocrine carcinoma were identified.Conclusion
This study illustrates the importance of adequately diagnosing endocrine tumours because their treatment and prognosis are different from those of conventional carcinoma.12.
Wojciech Lubiński Stanisław Zajączek Zbigniew Sych Krzysztof Penkala Olgierd Palacz Jan Lubiński 《Hereditary cancer in clinical practice》2004,2(4):193-196
Purpose
To asses the retinal pigment epithelium (RPE) function measured by EOG testing in patients with neurofibromatosis type 1 (NF-1). Our preliminary EOG results suggested dysfunction of the RPE in individuals with NF-1. In order to confirm our initial results we performed EOG examination on a larger group of NF-1 patients.Patients
Studies were performed on 36 patients with clinically diagnosed NF-1 and compared to normal healthy controls.Methods
Standard EOG recordings were performed in accordance with the International Society for Clinical Electrophysiology of Vision (ISCEV) standards.Results
In NF-1 patients the Arden indexes of the EOG test were significantly higher primarily due to the lower values of dark troughs. Supernormal EOGs (exceeding the value of the mean + 2 SD from the control group) were present in 58% of NF-1 patients.Conclusions
Dysfunction of the RPE is a characteristic feature of individuals with NF-1.13.
Background
We recently constructed a liver index (LI) from four liver parameters, namely: blood total bilirubin, gamma glutamyl transpeptidase (GGTP), albumin, and platelet levels (a cirrhosis surrogate). We found that the scores for the liver index related significantly to a four-parameter HCC aggressiveness index (maximum tumor diameter, multifocality, percent portal vein invasion, and blood AFP levels).Aims
To validate the relationship of liver parameters to tumor aggressiveness parameters in a larger, different HCC dataset.Results
We now confirm these associations in another large HCC cohort. Furthermore, this liver index showed significant trends with the individual HCC aggressiveness parameters.Conclusions
These results provide further support for the idea that liver microenvironment, as reflected in liver function tests, may relate to HCC behavior.14.
Background
The increasing importance of molecular pathology in routine oncological diagnostics.Objective
Current recommendations, developments and future applications of molecular pathology in the clinical course of malignant melanoma, colorectal cancer and non-small cell lung cancer (NSCLC).Material and methods
The article is based on a literature review investigating clinically relevant aspects of molecular diagnostics in various databases, e.g. PubMed, the European Society of Medical Oncology (ESMO) and the World Health Organization (WHO).Results and conclusion
The translation of preclinical research and the application in clinical practice are characterized by an increasing speed. The advanced classification of malignant diseases is of high relevance in current therapeutic approaches.15.
Purpose of review
This review summarizes current immunotherapies in breast cancer, with an emphasis on immune checkpoint inhibitors and vaccines.Recent findings
Combination immunotherapy with checkpoint inhibitors and cytotoxic therapies have shown promising results. Active clinical trials are ongoing in both early stage and metastatic settings for triple negative, HER2+, and hormone-positive breast cancer patients.Summary
Ongoing challenges remain in defining biomarkers that predict response to immunotherapy, determining the optimal combination immunotherapies, and enhancing the immunogenicity of breast cancer subtypes.16.
William Paul SkeltonIV Hiral Parekh Jason S. Starr Jose Trevino Jessica Cioffi Steven Hughes Thomas J. GeorgeJr 《Journal of gastrointestinal cancer》2018,49(1):1-8
Introduction
Pancreatic cancer is often diagnosed at late stages, where disease is either locally advanced unresectable or metastatic. Despite advances, long-term survival is relatively non-existent.Discussion
This review article discusses clinical factors commonly encountered in practice that should be incorporated into the decision-making process to optimize patient outcomes, including performance status, nutrition and cachexia, pain, psychological distress, medical comorbidities, advanced age, and treatment selection.Conclusion
Identification and optimization of these clinical factors could make a meaningful impact on the patient’s quality of life.17.
Jawahar R. Talsania Umakant B. Shah Ajay I. Shah Naveen K. Singh 《Indian journal of otolaryngology and head and neck surgery》2009,61(1):22-25
Introduction
Oral submucous fibrosis (OSMF) in later stages invariably leads to trismus due to retromolar fibrosis and buccal mucosa involvement. Medical treatment has limited role once trismus is established. Various surgical methods have been used with varying success to relieve trismus. We used diode laser to relieve trismus. All patients were diagnosed to have OSMF with trismus. The results are quite encouraging.Study design
Prospective clinical study. This study involved 8 patients between the years 2002 and 2006.Objective
To evaluate the efficacy of laser to reduce trismus in OSMFMethods
Laser with follow-up physiotherapyConclusion
Diode laser gave good result in all our patients. Diode laser is a less expensive and alternative method in group III and group IVA cases in whom bilateral temporalis myotomy and coronoidectomy are considered to be the only solution.This technique has less morbidity and is suitable for Asian population as it requires less hospital stay and less followup as compared to other surgical methods.18.
Donato Casella Claudio Calabrese Lorenzo Orzalesi Ilaria Gaggelli Lorenzo Cecconi Caterina Santi Roberto Murgo Stefano Rinaldi Lea Regolo Claudio Amanti Manuela Roncella Margherita Serra Graziano Meneghini Massimiliano Bortolini Vittorio Altomare Carlo Cabula Francesca Catalano Alfredo Cirilli Francesco Caruso Maria Grazia Lazzaretti Icro Meattini Lorenzo Livi Luigi Cataliotti Marco Bernini 《Breast cancer (Tokyo, Japan)》2017,24(3):451-457
Background
Reconstruction options following nipple-sparing mastectomy (NSM) are diverse and not yet investigated with level IA evidence. The analysis of surgical and oncological outcomes of NSM from the Italian National Registry shows its safety and wide acceptance both for prophylactic and therapeutic cases. A further in-depth analysis of the reconstructive approaches with their trend over time and their failures is the aim of this study.Methods
Data extraction from the National Database was performed restricting cases to the 2009–2014 period. Different reconstruction procedures were analyzed in terms of their distribution over time and with respect to specific indications. A 1-year minimum follow-up was conducted to assess reconstructive unsuccessful events. Univariate and multivariate analyses were performed to investigate the causes of both prosthetic and autologous failures.Results
913 patients, for a total of 1006 procedures, are included in the analysis. A prosthetic only reconstruction is accomplished in 92.2 % of cases, while pure autologous tissues are employed in 4.2 % and a hybrid (prosthetic plus autologous) in 3.6 %. Direct-to-implant (DTI) reaches 48.7 % of all reconstructions in the year 2014. Prophylactic NSMs have a DTI reconstruction in 35.6 % of cases and an autologous tissue flap in 12.9 % of cases. Failures are 2.7 % overall: 0 % in pure autologous flaps and 9.1 % in hybrid cases. Significant risk factors for failures are diabetes and the previous radiation therapy on the operated breast.Conclusions
Reconstruction following NSM is mostly prosthetic in Italy, with DTI gaining large acceptance over time. Failures are low and occurring in diabetic and irradiated patients at the multivariate analysis.19.
Background
An abdominal advancement flap (AAF) is a flap that pulls the elevated abdominal skin up, creating the shape of the inferior portion of the breast by making a neo-inframammary fold. We used an AAF combined with volume displacement techniques to fill the defect left after breast-conserving surgery (BCS).Methods
Forty-one small- to medium-sized breast patients whose resection area included the lower portion of the breast underwent this procedure from October 2010 to December 2014. We evaluated efficacy of this procedure.Results
The excision volume ranged from 10 to 35 %. Complications after surgery were observed in two patients (partial necrosis of the nipple-areola complex and partial necrosis of the breast skin in one patient each). There was no fat necrosis of the flap in any of the patients. The cosmetic results were found to be excellent in 7 cases, good in 23, fair in 9 and poor in 2. In 11 cases with an unacceptable outcome, 9 cases were in the inner portion. In patients with the tumor in the inner portion, the proportion of unacceptable cases was 50 %. In the cases other than the inner portion, the proportion of unacceptable cases was 8.7 % (p < 0.01). In the cases with larger breasts, unacceptable cases were more frequently observed (p < 0.05).Conclusions
We believe that an AAF combined with volume displacement techniques may be useful following BCS in the lower portion of a small- to medium-sized breast, except in cases where the tumors is located in the inner potion.20.
Yaqiong Sun Jie Wu Hui Cai Shuyang Wang Qiaolan Liu William J. Blot Xiao Ou Shu Qiuyin Cai 《Cancer causes & control : CCC》2016,27(6):831-835