Vulvar abscess: a retrospective review

Vulvar abscesses can progress to cause significant illness requiring disfiguring surgical debridement, broad spectrum antibiotics, and require hospitalization. A retrospective review of de-identified charts of 13 patients admitted for inpatient care for vulvar abscesses from 2004-2009 at West Virginia University Hospitals was conducted. Risk factors for vulvar abscess in these patients included obesity and diabetes. Body mass index (BMI) is directly proportionate to the size of the abscess and increased risk of intensive care unit admission. Most patients did not seek medical care prior to hospital admission. Polymicrobial infections were common, and methicillin resistant Staphylococcus aureus was seen in two cases. The presence of multiple risk factors increased the length of hospitalization. Clinicians should be aware of these risk factors and initiate aggressive therapy for patients with elevated BMI or multiple risk factors.     

Vulvar Paget's disease. Clinicopathological review of 14 cases

The clinicopathological course of 14 cases of vulvar Paget's disease is presented. Clinical presentation, age at diagnosis, duration of symptoms, associated and underlying malignancies, treatment and follow-up are reviewed. Survival by invasiveness and surgical management are compared. The use of conservative therapy where appropriate is advocated.     

Nutrition and cancer: a review

The issue about the aetiology of malignancies on the whole remains mysterious. There have been strong suggestion that, amongst other things, certain forms of cancer may be diet related. This has led to drastic changes in food consumption patterns in some parts of the Western world. The world over, certain types of cancers have been shown to be on the increase and the changing patterns of food consumption have occasionally been blamed. This paper reviews current thoughts in the relationship between cancer and nutrition.     

Short-course versus long-course neoadjuvant radiotherapy for lower rectal cancer: a systematic review

Objective  

To analyse the efficacy of short-course (SCRT) versus long-course radiotherapy/chemoradiation (LCRT) as a neoadjuvant modality for the management of lower rectal cancer (LRC).     

Penile cancer: a local case series and literature review

INTRODUCTION

Penile cancer is an uncommon disease affecting only about one in 100,000 men worldwide in a year. The diagnosis of the condition is frequently delayed, and the disease and its treatment frequently result in significant morbidity in patients.

METHODS

We herein describe seven cases of penile tumours: six cases of squamous cell carcinomas and one case of B-cell lymphoma that presented to our hospital’s urology department between March 2011 and October 2012. We reviewed the literature to discuss the clinical presentation, natural history and current management of penile cancer.

RESULTS

The patients were followed up for 1–24 months. They were managed according to their disease stage and lymph node status. Four out of seven patients showed disease progression during the follow-up period.

CONCLUSION

The accurate staging of inguinal nodes in cases of low-risk disease is important to prescribe appropriate surgery for the inguinal nodes. Aggressive management of inguinal and pelvic lymph nodes remains the cornerstone in the treatment of high-risk disease cases.     

Gene therapy in head and neck cancer: a review

Gene therapy for cancer is a rapidly evolving field with head and neck squamous cell cancer being one of the more frequently targeted cancer types. The number of clinical trials in the UK is growing and there is already a commercially available agent in China. Various gene therapy strategies along with delivery mechanisms for targeting head and neck cancer are reviewed.     

Vulvar basal cell carcinoma misdiagnosed for 4 years

Vulvar basal cell carcinoma is a rare cutaneous neoplasm occurring mainly in white postmenopausal females. It can be misdiagnosed due to its nonspecific physical appearance. Here, we report a 59-year-old white female who had vulvar basal cell carcinoma misdiagnosed for 4 years.     

艾迪注射液治疗非小细胞肺癌系统评价

目的：评价艾迪注射液治疗非小细胞肺癌的有效性和临床研究质量。 方法：检索PubMed（1980～2008年）、Cochrane中心对照试验注册资料库（Cochrane Central Register of Controlled Trials,CENTRAL）2008年第3期、EMBASE（1984～2004年）、CancerLit（1996～2003年）、中国生物医学文献数据库（CBMdisc1980～2008年）、中国学术期刊网专题全文数据库（中国知网1980～2008年）、中文科技期刊全文数据库（重庆维普1980～2008年）、万方数据库（1980～2008年）,并根据文献中的参考文献进行文献追溯。手工检索四川大学医学图书馆部分相关期刊,纳入随机对照试验。使用国际Cochrane中心推荐的方法进行文献质量评价,并用RevMan5．0软件进行统计分析。 结果：共纳入14篇研究,且均为低质量研究。14项研究显示,在改善瘤体变化方面,艾迪注射液联合^60Co与单独应用^60Co比较,差异有统计学意义（P=0．0002）,相对危险度（relative risk,RR）为1．93,95％可信区间（confidence interval,CI）[1．36,2．72];艾迪注射液联合长春瑞滨和顺铂（navelbine and platinol,NP）与单用NP比较,差异亦有统计学意义（P=0．04）,RR=1．18,95％CI[1．00,1．38]。但艾迪注射液联合依托泊苷和顺铂（etoposideand and platinol,EP）、紫杉醇制剂和顺铂（taxinoland and platinol,TP）以及伽玛刀与单用EP、TP和伽玛刀比较,差异均无统计学意义（P=0．60,P=0．16,P=0．34）,其RR和95％CI分别为1．17[0．65,2．09],1．27[0．91,1．78]和1．08[0．92,1．26]。6项研究证实艾迪注射液联合NP或伽玛刀能够改善患者的生活质量。6项研究显示艾迪注射液具有保护骨髓造血功能的作用。3项研究显示可提高免疫功能。3项研究显示艾迪注射液未能提高1年及以上生存率。 结论：艾迪注射液对非小细胞肺癌可能具有一定的辅助治疗作用,但不排除与纳入文献质量较低,各种治疗方案纳入研究数量少和发表偏倚有关,尚需大样本多中心随机对照临床试验进一步证实其临床疗效。     

The role of surgery for pancreatic cancer: a 12-year review of patient outcome

Introduction

Pancreatic cancer has a poor prognosis with <5% alive at 5 years, despite active surgical treatment. The study aim was to review patients undergoing pancreatic resection and assess the effect of clinical and pathological parameters on survival.

Patients and methods

All patients who had undergone radical pancreatic surgery, January 1996 to December 2008, were identified from the unit database. Additional information was retrieved from the patient records. The demographic, clinical, and pathological records were recorded using Microsoft Excel. Survival was assessed using Kaplan-Meier and predictors of survival determined by multinominal logistic regression and log rank test.

Results

126 patients were identified from the database. The majority (106) had a Whipple''s procedure, 14 had a distal pancreatectomy and 6 had local periampullary excision. The average age of the Whipple''s group of patients was 61.7 years (± 11.7) with most procedures performed for malignancy (n=100). Survival was worse with adenocarcinoma compared to all other pathologies (p=0.013), while periampullary tumours had a better prognosis compared to other locations (p=0.019). Survival decreased with poorer differentiation (p=0.001), increasing pT (p<0.001) and pN stage (p<0.001). Survival was worse with perineural (p=0.04) or lymphovascular invasion (p=0.05). A microscopic postive resection margin (R1) was associated with a worse survival (p=0.007). Tumour differentiation (p=0.001) and positive nodal status (p<0.001) were found to be independent predictors of mortality.

Conclusion

Tumour differentiation and nodal status are important predictors of outcome. A positive resection margin is associated with a poorer survival.     

近十年有关肺癌治疗Meta分析的回顾

Meta分析(meta-analysis，又称汇总分析或荟萃分析)是系统评估最常用的一种方法。我们对近十年来有关肺癌治疗的Meta分析进行回顾，显示了Meta分析对临床医学的巨大影响，同时对Meta分析的优缺点进行了讨论。     

Management of oral cancer in late stages: a review.

Sixty cases of oral cancer (2 were of stage II and other 58 were of stage III and stage IV) were treated and observed over a period of 2 years. In patients of oral cancer with bone involvement and mobile cervical nodes (44 cases) local excision which included partial or hemimandibulectomy with radical neck node dissection was performed. Out of these 44 cases, 18 cases received radiotherapy pre-operatively and 26 cases postoperatively. Better results were observed in these cases. When the growth was inaccessible and/or nodes were fixed (13 cases) radiotherapy was found to be suitable. Fistula formation and reconstructive flap necrosis were common following surgery after radiotherapy. Combined modalities of treatment with pre- and postoperative radiotherapy and radical neck node dissection showed excellent results (86.4%) in majority of cases. The remaining one patient received chemotherapy and local excision was performed in 2 cases.     

Colorectal cancer screening: scientific review

Context  Screening for colorectal cancer clearly reduces colorectal cancer mortality, yet many eligible adults remain unscreened. Several screening tests are available, and various professional organizations have differing recommendations on which screening test to use. Clinicians are challenged to ensure that eligible patients undergo colorectal cancer screening and to guide patients in choosing what tests to receive. Objective  To critically assess the evidence for use of the available colorectal cancer screening tests, including fecal occult blood tests, sigmoidoscopy, colonoscopy, double-contrast barium enema, and newer tests, such as virtual colonoscopy and stool-based molecular screening. Data Sources  All relevant English-language articles were identified using PubMed (January 1966-August 2002), published meta-analyses, reference lists of key articles, and expert consultation. Data Extraction  Studies that evaluated colorectal cancer screening in healthy individuals and assessed clinical outcomes were included. Evidence from randomized controlled trials was considered to be of highest quality, followed by observational evidence. Diagnostic accuracy studies were evaluated when randomized controlled trials and observational studies were not available or did not provide adequate evidence. Studies were excluded if they did not evaluate colorectal screening tests and if they did not evaluate average-risk individuals. Data Synthesis  Randomized controlled trials have shown that fecal occult blood testing can reduce colorectal cancer incidence and mortality. Case-control studies have shown that sigmoidoscopy is associated with a reduction in mortality, and observational studies suggest colonoscopy is effective as well. Combining fecal occult blood testing and sigmoidoscopy may decrease mortality and can increase diagnostic yield. Conclusion  The recommendation that all men and women aged 50 years or older undergo screening for colorectal cancer is supported by a large body of direct and indirect evidence. At present, the available evidence does not currently support choosing one test over another.      

Colorectal cancer in Lagos: a critical review of 100 cases

This study critically analysed the clinical presentation, diagnosis, treatment and outcome in 100 patients with colorectal cancer seen over a twelve year period (1988 to 1999). Comparing our findings with those obtained three decades ago at our institution allowed for determination of time trends. There were 48 males and 52 females giving a sex ratio of approximately 1:1. On the average our patients were 10 to 15 years younger than their Caucasian counterparts and one third were 40 years in age or below. In almost two thirds (61%) of patients, the tumours were in the rectum and sigmoid colon. The tumours were resected in 58 (58%) patients, non-resectional surgery was offered to 28 patients, while 14 patients were inoperable, not fit or refused surgery. Overall 34 (34%) patients had distant metastases. The commonest (91.5%) histological type was adenocarcinoma. The postoperative complication rate was 40%, postoperative mortality was 23.3% and the crude one year survival rate was 64%. The clinicopathologic features of colorectal cancer have not changed over a period of three decades at our institution. Public enlightenment campaigns on cancer and facilities to adequately treat patients with colorectal cancer are required in our subregion.