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Javier Su& aacute rez Javier Jimenez-P& eacute rez 《World journal of gastrointestinal oncology》2016,8(1):105-112
Obstructive symptoms are present in 8% of cases at the time of initial diagnosis in cases of colorectal cancer. Emergency surgery has been classically considered the treatment of choice in these patients. However, in the majority of studies, emergency colorectal surgery is burdened with higher morbidity and mortality rates than elective surgery, and many patients require temporal colostomy which deteriorates their quality of life and becomes permanent in 10%-40% of cases. The aim of stenting by-pass to surgery is to transform emergency surgery into elective surgery in order to improve surgical results, obtain an accurate tumoral staging and detection of synchronous lesions, stabilization of comorbidities and performance of laparoscopic surgery. Immediate results were more favourable in patients who were stented concerning primary anastomosis, permanent stoma, wound infection and overall morbidity, having the higher surgical risk patients the greater benefit. However, some findings laid out the possible implication of stenting in long-term results of oncologic treatment. Perforation after stenting is related to tumoral recurrence. In studies with perforation rates above 8%, higher recurrences rates in young patients and lower disease free survival have been shown. On the other hand, after stenting the number of removed lymph nodes in the surgical specimen is larger, patients can receive adjuvant chemotherapy earlier and in a greater percentage and the number of patients who can be surgically treated with laparoscopic surgery is larger. Finally, there are no consistent studies able to demonstrate that one strategy is superior to the other in terms of oncologic benefits. At present, it would seem wise to assume a higher initial complication rate in young patients without relevant comorbidities and to accept the risk of local recurrence in old patients (> 70 years) or with high surgical risk (ASA III/IV). 相似文献
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TH Khor JKL Tuan SW Hee IWK Tham 《Journal of Medical Imaging and Radiation Oncology》2007,51(6):570-577
The aim of this is to report the results of radical radiotherapy in carcinoma of the cervix treated by high‐dose rate (HDR) intracavitary brachytherapy and external beam radiotherapy (XRT) at a single centre in Singapore. This is a retrospective analysis of 106 consecutive cases with histologically proven cervical cancer, treated by HDR brachytherapy and XRT at the Mount Elizabeth Hospital from 1990 to 1993. External beam radiotherapy to the pelvis was delivered with 6 MV photons, to 45–50.4 Gy in 1.8 Gy fractions. High‐dose‐rate brachytherapy comprised two to three applications of an intrauterine tandem with paired ovoids, to a median dose of 18 Gy to point ‘A’, carried out during XRT. All 106 patients completed treatment. Their ages ranged from 32 to 80 years (median 57 years). Most patients presented with stage II or III disease (44 and 37%, respectively) and with squamous cell carcinoma (91%). Median follow‐up time was 59 months (range 2–169 months). The 5‐year relapse‐free survival rate across all stages was 71%. The corresponding overall survival rate was 69%. Local control was achieved in 86 patients (81%); six patients had residual disease (6%), and 14 patients had local recurrence (13%). Fourteen patients developed metastatic disease (13%). On univariate analysis, tumour stage, haemoglobin level, number of brachytherapy treatments and overall treatment time were found to be prognostic factors for overall survival. Late complications were mild (Radiation Therapy Oncology Group score 1–2), except for one patient with grade 4 rectal toxicity. The complication rates were 8, 14 and 45%, respectively, for the rectum, bladder and vagina (stenosis). The use of two to three fractions of HDR intracavitary brachytherapy in addition to pelvic XRT achieves good outcomes. 相似文献
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David C. Hodgson MD MPH Eva Grunfeld MD DPhil Nadia Gunraj BSc MPH Lisa Del Giudice MSc MD 《Cancer》2010,116(14):3417-3425
BACKGROUND:
The majority of Hodgkin lymphoma (HL) patients are cured, and post‐treatment visits are a major component of their management. Little is known about the quality of follow‐up care received by these survivors.METHODS:
All patients who were diagnosed with HL in Ontario from 1992 through 2000 were identified from a population‐based cancer registry. Individual‐level linkage with physician claims was used to examine the follow‐up care received by 2071 1‐year survivors for up to 15 years after their HL diagnosis. Physician visits, imaging studies, and the use of routine and HL‐specific cancer screening tests were evaluated.RESULTS:
Most patients had visits with both a primary care provider and an oncologist in Years 2 through 5 after their HL diagnosis. In Year 5 after HL diagnosis, 31.8% of patients had at least 1 computed tomography (CT) scan, and 62.9% had a chest x‐ray. There were 5352 CT scans performed in Years 2 through 5, and 125 patients subsequently received chemotherapy within 6 months of a CT. Among the survivors who met age criteria for routine screening, 62.5% had no evidence of colorectal cancer screening during Years 2 through 15, 32.3% had no evidence of breast cancer screening, and 19.9% had no evidence of cervical cancer screening. Among young women potentially at high risk of breast cancer because of radiation therapy, 87.1% had not received the recommended breast cancer screening.CONCLUSIONS:
Radiologic surveillance of HL survivors rarely led to salvage therapy. Despite frequent physician contact, many survivors did not receive established cancer screening interventions, and the recommended early initiation of breast cancer screening among young women at high risk was not widely used. Cancer 2010. © 2010 American Cancer Society. 相似文献5.
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Weili Wu Shoufang Qu Shangxian Gao Licheng Liu Jing Zhao Mengzhao Wang Junyi Zhou Huang Jie Weijun Chen 《International journal of cancer. Journal international du cancer》2013,132(12):2858-2866
PCR is a powerful platform for clinical and diagnostic applications, but challenges remain in detecting somatic mutations, as mutant cells are often mixed with more numerous wild‐type cells at the tissue‐sample sites. Here, we describe a novel method that couples PCR with restriction endonuclease digestion (designated real‐time digestion‐PCR, or RTD‐PCR) in a one‐step reaction tube for detecting somatic mutations from a minority of cells. The PCR mixture contains a thermostable restriction enzyme that digests wild‐type alleles during the PCR program, allowing selective amplification of the mutant alleles. To validate this method, we used real‐time digestion‐PCR for the specific detection of the EGFR (epidermal growth factor receptor) treatment resistance‐inducing mutation, T790M, combining with three different platforms: Sanger sequencing, TaqMan probe PCR and Sequenom MassArray. From 78 clinical samples, seven T790M mutations were consistently detected on all three platforms, indicating that RTD‐PCR may be a useful clinical tool for analyzing the T790M point mutation. 相似文献
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Hiroaki Ito Haruhiro Inoue Noriko Odaka Hitoshi Satodate Michitaka Suzuki Shumpei Mukai Yusuke Takehara Hiroyuki Kida Shin-ei Kudo 《Journal of experimental & clinical cancer research : CR》2013,32(1):2
Background
Esophagogastric junctional (EGJ) cancer occurs in the mucosa near the esophagogastric junction, and has characteristics of both esophageal and gastric malignancies; its optimal treatment strategy is controversial.Methods
We conducted a single-center retrospective cohort study of the patients who underwent curative surgery with lymphadenectomy for EGJ cancer. Tumor specimens were categorized by histology and location into four types—centered in the esophagus < 5 cm from EGJ (type E), which were subtyped as (i) squamous-cell carcinoma (SQ) or (ii) adenocarcinoma (AD); (iii) any histological tumor centered in the stomach < 5 cm from EGJ, with EGJ invasion (type Ge); (iv) any histological tumor centered in the stomach < 5 cm from EGJ, without EGJ invasion (type G)—and classified by TNM system; these were compared to patients’ clinicopathological characteristics and survival outcomes.Results
A total of 92 EGJ cancer patients were studied. Median follow-up of surviving patients was 35.5 months. Tumors were categorized as 12 type E (SQ), 6 type E (AD), 27 type Ge and 47 type G; of these 7 (58.3%), 3 (50%), 19 (70.4%) and 14 (29.8%) and 23 patients, respectively, had lymph node metastases. No patients with type E (AD) and Ge tumors had cervical lymph node metastasis; those with type G tumors had no nodal metastasis at cervical and mediastinal lymph nodes. Multivariate analysis showed that type E (AD) tumor was an independent prognostic factor.Conclusions
We should distinguish type Ge tumor from type E (AD) tumor because of the clinicopathological and prognostic differentiation. Extended gastrectomy with or without lower esophagectomy according to tumor location and lower mediastinal and abdominal lymphadenectomy are recommended for EGJ cancer.Trial registration
University Hospital Medical Information Network in Japan, UMIN000008596. 相似文献12.
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GB Fogarty R Cassumbhoy JM Martin M Fay J Ainslie 《Journal of Medical Imaging and Radiation Oncology》2007,51(3):267-275
High‐risk skin cancer arising on the upper limb or trunk can cause axillary nodal metastases. Previous studies have shown that axillary radiotherapy improves regional control. There is little published work on technique. Technique standardization is important in quality assurance and comparison of results especially for trials. Our technique, planned with CT assistance, is presented. To assess efficacy, an audit of patients treated in our institution over a 15‐month period was conducted. Of 24 patients treated, 13 were treated with radical intent, 11 with this technique. With a follow up of over 2 years, the technique had more than a 90% (10/11) regional control in this radical group. Both of the radical patients who were not treated according to the technique had regional failure. One case of late toxicity was found, of asymptomatic lymphoedema in a radically treated patient. This technique for axillary radiotherapy for regional control of skin cancer is acceptable in terms of disease control and toxicity as validated by audit at 2 years. 相似文献
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Steffany J. Fredman Donald H. Baucom Tina M. Gremore Angela M. Castellani Theresa A. Kallman Laura S. Porter Jennifer S. Kirby E. Claire Dees Nancy Klauber‐Demore Jeffrey Peppercorn Lisa A. Carey 《Psycho-oncology》2009,18(6):667-673
Objective: Despite mounting evidence supporting the use of psychosocial interventions to promote adaptation to cancer, enrolling participants into these interventions is challenging. This is particularly salient for couple‐based interventions, and newer, more targeted recruitment strategies to increase enrollment are needed. However, there have been few published empirical studies focused specifically on recruitment‐related variables associated with enrollment into these types of interventions. To better understand how to encourage participation in couple‐based psychosocial interventions for cancer, we examined facilitating and impeding factors to enrollment into a couple‐based intervention for women with early‐stage breast cancer. Method: In this sample of 99 women diagnosed with early‐stage breast cancer, patient demographic variables and method of approaching eligible patients were examined as predictors of enrollment into a randomized controlled trial comparing couple‐based relationship enhancement with treatment as usual. Results: Results indicated that women were more likely to enroll if they were contacted at home or at a follow‐up medical appointment rather than when first diagnosed at a busy multidisciplinary clinic; they were also more likely to enroll the closer they lived to the research facility. Conclusions: In addition to decreasing participant burden, timing and setting of recruitment efforts may have important implications for enhancing participation rates in couple‐based intervention studies for cancer. Copyright © 2008 John Wiley & Sons, Ltd. 相似文献
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“The song inside”: “La canción por dentro”—Individual and dyadic impact of breast cancer for caregivers of Latina survivors
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Juliana Munoz Christina Rush Bess Flashner Ghipsel Cibrian Sandra Martinez Claudia Campos Migdalia Torres Olympia Cepeda Charlene Kuo Stacey Kaltman Lina Jandorf Kristi D. Graves 《Psycho-oncology》2017,26(10):1700-1703
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Tomohiro Kondo Junichi Matsubara Pham Nguyen Quy Keita Fukuyama Motoo Nomura Taro Funakoshi Keitaro Doi Yuichi Sakamori Masahiro Yoshioka Akira Yokoyama Masashi Tamaoki Tadayuki Kou Kenshiro Hirohashi Atsushi Yamada Yoshihiro Yamamoto Sachiko Minamiguchi Masakazu Nishigaki Takahiro Yamada Masashi Kanai Shigemi Matsumoto Manabu Muto 《Cancer science》2021,112(1):296-304
Comprehensive genomic profiling (CGP) testing by next‐generation sequencing has been introduced into clinical practice as part of precision cancer medicine to select effective targeted therapies. However, whether CGP testing at the time of first‐line chemotherapy could be clinically useful is not clear. We conducted this single‐center, prospective, observational study to investigate the feasibility of CGP testing for chemotherapy‐naïve patients with stage III/IV gastrointestinal cancer, rare cancer, and cancer of unknown primary, using the FoundationOne® companion diagnostic (F1CDx) assay. The primary outcome was the detection rate of at least one actionable/druggable cancer genomic alteration. Actionable/druggable cancer genomic alterations were determined by the F1CDx report. An institutional molecular tumor board determined the molecular‐based recommended therapies. A total of 197 patients were enrolled from October 2018 to June 2019. CGP success rate was 76.6% (151 of 197 patients), and median turnaround time was 19 days (range: 10‐329 days). Actionable and druggable cancer genomic alterations were reported in 145 (73.6%) and 124 (62.9%) patients, respectively. The highest detection rate of druggable genomic alterations in gastrointestinal cancers was 80% in colorectal cancer (48 of 60 patients). Molecular‐based recommended therapies were determined in 46 patients (23.4%). CGP testing would be a useful tool for the identification of a potentially effective first‐line chemotherapy. 相似文献
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A Predictive Score for Thrombosis Associated with Breast,Colorectal, Lung,or Ovarian Cancer: The Prospective COMPASS–Cancer‐Associated Thrombosis Study
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Grigoris T. Gerotziafas Ali Taher Hikmat Abdel‐Razeq Essam AboElnazar Alex C. Spyropoulos Salem El Shemmari Annette K. Larsen Ismail Elalamy 《The oncologist》2017,22(10):1222-1231