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1.
Marian Gutowski Bérénice Framery Martin C. Boonstra Véronique Garambois François Quenet Karen Dumas François Scherninski Françoise Cailler Alexander L. Vahrmeijer André Pèlegrin 《Surgical oncology》2017,26(2):153-162
Purpose
Fluorescence-guided surgery (FGS) provides surgeons with new opportunities to improve real-time cancer nodule detection and tumor margin visualization. Currently, the most important challenge in this field is the development of fluorescent dyes that specifically target tumors. We developed, characterized and evaluated SGM-101, an innovative antibody-dye conjugate in which the fluorochrome BM104, which has an absorbance band centered at 700 nm, is coupled to a chimeric monoclonal antibody (mAb) against carcinoembryonic antigen (CEA).Methods
The dye to mAb ratio, binding to CEA and photobleaching of SGM-101 were determined. FGS was performed and results analyzed using different mouse models of human digestive tumors.Results
SGM-101 allowed the detection of tumor nodules in three different colon cancer models: LS174T human colorectal adenocarcinoma cell-induced peritoneal carcinomatosis (PC) and liver metastases, and orthotopic grafts of HT29 human colorectal adenocarcinoma cells. In the PC model, submillimeter-sized nodules were detected during SGM-101-based FGS and SGM-101 predictive positive values ranged from 99.04% to 90.24% for tumor nodules >10 mg and nodules <1 mg, respectively. Similarly, in the orthotopic model of pancreatic cancer using BxPC3 (pancreas adenocarcinoma) cells, SGM-101 could clearly delineate tumors in vivo with a tumor-to-background ratio of 3.5, and penetrated in tumor nodules, as demonstrated by histological analysis. Free BM105 dye (BM104 with an activated ester for conjugation to the antibody) and an irrelevant conjugate did not induce any NIR fluorescence.Conclusion
These preclinical data indicate that SGM-101 is an attractive candidate for FGS of CEA-expressing tumors and is currently assessed in clinical trials. 相似文献2.
Helen J.S. Jones Chris Cunningham Gary A. Nicholson Roel Hompes 《European journal of surgical oncology》2018,44(1):15-23
Objectives
To establish outcomes after completion and salvage surgery following local excision in literature published since 2005, to inform decision-making when offering local excision.Background
Local excision of early rectal cancer aims to offer cure while maintaining quality of life through organ preservation. However, some patients will require radical surgery, prompted by unexpected poor pathology or local recurrence. Consistent definition and reporting of these scenarios is poor. We propose the term “salvage surgery” for recurrence after local excision and “completion surgery” for poor pathology.Methods
Electronic databases were searched in February 2016. Studies since 2005 describing outcomes for radical surgery following local excision of rectal cancer were included. Pooled and average values were obtained.Results
A total of 23 studies included 262 completion and 165 salvage operations. Most completion operations were done within 4 weeks; local recurrence rate was 5% and overall disease recurrence rate was 14%.The majority of salvage operations for local recurrence were within 15 months of local excision, often following adjuvant treatment. Re-do local excision was used in 15%; APR was the most common radical procedure. Further local recurrence was uncommon (3%) but overall disease recurrence rate was 13%. Estimated 5-year survival was in the order of 50%.Heterogeneity was high among the studies.Conclusions
Patients undergoing local excision must be informed of risks and expected outcomes, but better data on completion and salvage surgery are required to achieve this.Systematic review registration number
CRD42014014758. 相似文献3.
Britt ten Wolde Frits J.H. van den Wildenberg Fatih Polat Johannes H.W. de Wilt Luc J.A. Strobbe 《Clinical breast cancer》2018,18(5):e1023-e1026
Background
The aim of this study was to investigate whether gentamicin-collagen (GC) sponges can lower the incidence of seroma and surgical site infections following breast cancer surgery.Patients and Methods
A retrospective cohort study was performed. Two consecutive cohorts of patients who underwent a mastectomy with or without an axillary lymph node dissection were compared. The first cohort was treated conventionally (n = 38), the second cohort received GC sponges (n = 39). Endpoints were the incidence of clinical significant seroma (CSS) and surgical site infections (SSI), the mean number of aspirations, and the mean aspirated volume.Results
GC sponges lowered the CSS incidence from 73.7% to 38.5% (P = .002). The mean number of aspirations and the mean aspirated volume were not affected. SSI incidence was 15.8% in the conventional cohort compared with 7.7% in the GC cohort (P = .23).Conclusion
Application of GC sponges significantly lowered the incidence of CSS. The incidence of SSI was halved, although this was not significant. 相似文献4.
Richard J. Cassidy Jeffrey M. Switchenko Melinda L. Yushak Nicholas Madden Mohammad K. Khan David K. Monson Jonathan J. Beitler Jerome C. Landry Karen D. Godette Theresa W. Gillespie Kirtesh R. Patel 《Surgical oncology》2018,27(4):A3-A8
Background
Scalp angiosarcomas (SA) are rare, representing <1% of soft tissue sarcomas. The optimal management of these tumors is unknown, with management based on small case series. We sought to assess the impact of different therapies on overall survival (OS), the practice patterns nationally, and identify factors associated with OS for non-metastatic scalp angiosarcomas.Methods
A prospectively maintained database was used to identify non-metastatic scalp angiosarcomas who received some form of definitive therapy. Logistics regression, Kaplan-Meier, and Cox proportional-hazard models were utilized.Results
A total of 589 patients met study entry criteria with a median follow-up of 4.2 years. The majority (482 patients, 81.8%) had upfront definitive resection and an additional 317 patients (65.8%) received postoperative radiation. Of the 107 patients who didn't have surgery, the majority (65 patients, 60.7%) received definitive radiation and 42 patients (39.3%) received radiation and chemotherapy. One-year and five-year survival estimates for patients not receiving definitive surgery were 68.0% (95%CI: 57.5–76.4) and 18.0% (95%CI: 10.2–27.5) respectively compared to 78.2% (95%CI: 74.0–81.9) and 34.1% (95%CI: 28.9–39.3) for patients receiving definitive surgery (p?<?0.01). On multivariable analysis, age ≥65 years, tumor size ≥5?cm, and not receiving definitive surgery was associated with worse OS.Conclusions
The majority of patients with non-metastatic scalp angiosarcomas had upfront definitive surgery, with a subsequent improvement in OS, including when accounting for other patient and tumor factors. Postoperative radiation was frequently given. Our large series confirmed age and tumor size as prognostic factors for this rare disease. 相似文献5.
Wasil Jastaniah Mohamed Bayoumy Abdulrahman Alsultan Saad Al Daama Walid Ballourah Faisal Al-Anzi Omar Al Shareef Reem Al Sudairy Mohammed Burhan Abrar Ibrahim Al Ghemlas 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(12):773-780
Background
The outcome of childhood acute myeloid leukemia (AML) in first relapse (rAML) remains poor. Reported overall survival (OS) rates vary between high-income developed countries and those with fewer resources. The OS of rAML in high-income developing countries (HIDCs) has not been reported.Patients and Materials
A multicenter study was performed in an HIDC. The outcome of patients with relapsed non-M3/non-Down syndrome AML was evaluated. Three-year OS was computed using the Kaplan-Meier method, and predictors of OS were analyzed using a Cox proportional hazards model.Results
A total of 88 patients with non-M3/non-Down syndrome AML diagnosed between January 2005 and December 2012 with a first relapse were identified. Their 3-year OS was 22.6% ± 5.4%. Patients with inv(16) and t(8;21) had an OS of 75.0% ± 21.7% and 36.0% ± 16.1%, respectively. Worse outcomes were associated with “other intermediate” and 11q23 rearrangement AML (OS of 9.4% ± 8.7% and 10.7% ± 9.6%, respectively). Patients experiencing time to relapse (TTR) less than 1 year had shorter OS than those with a longer TTR (14.6% ± 5.4% vs. 41.1% ± 11.5%; P = .006). The outcome of patients after stem cell transplantation (SCT) in second complete remission (CR2) was superior compared with no SCT (50.9% ± 11.2% vs. 7.7% ± 4.6%; P = .001). TTR, risk group, CR2, and SCT in CR2 were the most significant predictors for survival.Conclusions
rAML remains a clinical challenge. Genetic variability in outcomes was observed. A majority of patients with inv(16) were successfully salvaged post-relapse, whereas patients with 11q23 rearrangement had a poor prognosis. Only one-third of those with t(8;21) rAML survived. Better access to SCT in HIDCs is needed. 相似文献6.
Aleksandra Semeniuk-Wojtaś Arkadiusz Lubas Rafał Stec Tomasz Syryło Stanisław Niemczyk Cezary Szczylik 《Clinical genitourinary cancer》2018,16(3):e685-e693
Background
Inflammation plays a crucial role in cancer development. In this study, we evaluate the prognostic values of systemic inflammation markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) for the progression-free survival and overall survival in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors.Materials and Methods
PubMed and the Cochrane Library databases were searched for published studies on the effect of NLR, PLR, and CRP in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors.Results
In the meta-analysis, NLR (hazard ratio [HR], 2.01; 95% confidence interval [CI], 1.27-3.18; P = .003) and PLR (HR, 6.96; 95% CI, 5.04-9.62; P < .001) had a significant influence on progression-free survival, whereas all considered proinflammatory markers had a significant impact on overall survival: NLR (HR, 2.14; 95% CI, 1.67-2.73; P < .001), PLR (HR, 14.67; 95% CI, 11.10-19.57; P < .001), and CRP (HR, 1.96; 95% CI, 1.26-3.05; P = .003).Conclusions
Inflammation markers such as NLR, PLR, and CRP are predictors of clinical outcome and could provide additional information to individualize treatment. 相似文献7.
Christina A. Fleming Karen McCarthy Ciara Ryan Aoife McCarthy Seamus O&#x;Reilly Deirdre O&#x;Mahony Tara Jane Browne Paul Redmond Mark A. Corrigan 《Clinical breast cancer》2018,18(2):e255-e261
Background
Neoadjuvant therapy (NAT) offers a unique opportunity to assess tumor response to systemic agents. However, a discrepancy may exist between the response of the primary tumor and involved nodes. We report on the frequency of response discordance after NAT in breast cancer.Patients and Methods
All consecutive node-positive patients receiving NAT in our department from 2009 to 2014 were identified. Patient demographics, and radiologic and pathologic features were tabulated. Tumor response was estimated by magnetic resonance imaging of the breast. Lymph node (LN) response was estimated from pathologic treatment response measurements. Statistical analysis was performed.Results
A total of 108 node-positive patients treated with NAT were eligible for inclusion. Median age was 51.73 years (range, 20-87 years). All patients underwent axillary clearance, and 62% underwent mastectomy. A 40% mean reduction in tumor size was observed. Statistically, a positive correlation between tumor and LN response after NAT was observed (Spearman correlation coefficient, r = 0.46, P < .001). Complete pathologic response was observed in 17 patients (15.7%). However, 21 patients experienced complete LN response, with only 81% of these patients (n = 17) experiencing a complete response in tumor also. A complete response was observed in tumor in 20 patients, and this predicted complete nodal response in 85% of cases (n = 17). Fifteen percent of primary tumors with complete pathologic response had persistently positive LNs.Conclusion
A significant discordance exists between the primary tumor and LN response, representing a concern for the lack of response of occult regional or systemic metastases due to potential biologic heterogeneity. 相似文献8.
Z. Hasan R.C. Dwivedi D.A. Gunaratne S.A. Virk C.E. Palme F. Riffat 《European journal of surgical oncology》2017,43(1):42-51
Background and objectives
Management paradigms in laryngeal cancer have shifted to “organ preservation” chemoradiotherapy protocols. In the event of treatment failure, salvage total laryngectomy remains the only curative treatment option. However a comprehensive review of the complications of this procedure has not been reported.Methods
A systematic review of the literature was performed using keywords “salvage laryngectomy” to retrieve relevant publications between January 2000 and August 2015.Results
Of the 407 articles retrieved from the literature search, 50 studies encompassing 3292 patients were included. Forty-nine studies reported pharyngocutaneous fistula which occurred in 859 patients (pooled incidence 28.9%; 95% confidence intervals 25.5–32.5%). Twenty-four studies reported complications in addition to PCF and these included wound complications (infection, dehiscence and necrosis), dysphagia, bleeding, and pharyngeal and stomal stenosis.Conclusions
Overall complication rate was 67.5%, Pharyngocutaneous fistula was the commonest complication with a pooled incidence of 28.9%. 相似文献9.
Andrea Prochowski Iamurri Martina Ponziani Marco Macchini Marco Fogante Mirco Pistelli Mariagrazia De Lisa Rossana Berardi Gian Marco Giuseppetti 《Clinical breast cancer》2018,18(2):e231-e235
Introduction
The purpose of this study was to evaluate whether diagnostic performance of breast magnetic resonance imaging (MRI) for detection of multifocality and multicentricity (MFMC) of breast cancer (BC) can be influenced by different histotypes or immunophenotypes in newly diagnosed patients with breast cancer.Materials and Methods
In this institutional review board-approved retrospective study, 289 patients who underwent both preoperative breast MRI and radical or modified mastectomy in our institution because of primary BCs were selected. Patients were stratified based on the pathologic report in 2 main histotypes and 5 immunophenotypes. By matching the radiologic report with the corresponding pathologic report for each patient, breast MRI performance for detection of MFMC were obtained in each histotype and immunophenotype and subsequently compared.Results
Overall breast MRI sensitivity for MFMC detection was 88.1%, specificity was 80.0%, positive predictive value 82.1%, negative predictive value 85.8%, diagnostic accuracy 83.7%, and area under the curve 0.835. Breast MRI sensitivity for MFMC detection in triple-negative BC was 84.6% (P = .88), specificity 70.8% (P = .63), positive predictive value 61.1% (P = .02), negative predictive value 89.5% (P = .20), diagnostic accuracy 75.7% (P = .65), and area under the curve 0.777 (P = .87).Conclusion
Performance of breast MRI for the detection of MFMC are not influenced by the BC histotypes, in accordance with published literature. Conversely, the triple-negative immunophenotypes demonstrated lower performance, statistically significant only for positive predictive value (P = .02), for the detection of MFMC. 相似文献10.
Paul H. Sugarbaker 《Surgical oncology》2018,27(2):154-157
Background
Mucinous appendiceal neoplasms have a pattern of metastases that is different from the other gastrointestinal cancers. The first site for cancer dissemination is the peritoneal space surrounding the primary tumor and this is followed by increasingly extensive peritoneal spread. Invasion of the psoas and iliacus muscle is an unusual phenomenon.Method
From a prospective database of appendiceal mucinous neoplasms treated by cytoreductive surgery (CRS) and perioperative hyperthermic chemotherapy (HIPEC), patients with psoas muscle invasion were reviewed. Their clinical features and treatments were tabulated.Results
Three patients with ages 33, 60, and 63 were identified. Two patients had disease progression into the psoas muscle 33 and 95 months after CRS plus HIPEC. One had dissecting mucinous tumor into psoas, iliacus and quadratus lumborum muscle at the time of diagnosis of the appendiceal mucinous neoplasm. All three survived at least five years from their initial treatment.Conclusion
Despite the fact that mucinous tumor invasion was outside the peritoneal cavity, long term benefit from psoas muscle resection with a mucinous appendiceal neoplasm is possible and resection possibly with HIPEC should be considered. 相似文献11.
Vincenzo Abbate Giovanni Dell’Aversana Orabona Giovanni Salzano Paola Bonavolontà Fabio Maglitto Antonio Romano Filippo Tarabbia Mario Turri-Zanoni Federica Attanasi Alessandro Espedito Di Lauro Giorgio Iaconetta Luigi Califano 《Surgical oncology》2018,27(3):503-507
Background
Optimum management of clinically negative neck (cN0) remains controversial in early stage (T1-T2) squamous cell cancer of the oral tongue (OTSCC).The purpose of this study was to investigate the value of pre-treatment Neutrophil-to lymphocyte ratio (NLR) in predicting occult cervical metastasis in stage I and II OTSCC.Methods
We carried out a retrospective chart review on 110 patients suffering from early stage OTSCC who were surgically treated with tumour excision and elective neck dissection (END). Our cohort was divided in pN+ and pN0 groups basing on histopathological examination after elective neck dissection. For each patient pre-treatment NLR was calculated.Results
A statistically significant relationship between high levels of pre-treatment NLR and probability rate for neck occult metastases (0.000496 p-value) has been found. On our model the cut-off value was set for NLR >2.93. Above this level the probability to finding metastasis in a clinically negative neck increases exponentially.Conclusion
These preliminary results offer clinicians an easily obtainable tool to stratify patients based on risks of metastatic node in whom END could be indicated. 相似文献12.
M. Bushati K.P. Rovers A. Sommariva P.H. Sugarbaker D.L. Morris Y. Yonemura C.A. Quadros S.P. Somashekhar W. Ceelen P. Dubé Y. Li V.J. Verwaal O. Glehen P. Piso J. Spiliotis M.C.C. Teo S. González-Moreno P.H. Cashin I.H.J.T. de Hingh 《European journal of surgical oncology》2018,44(12):1942-1948
Background
At present, selected patients with resectable colorectal peritoneal metastases (CRC-PM) are increasingly treated with a combination therapy of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The aim of this study was to investigate the current worldwide practice.Methods
HIPEC experts from 19 countries were invited through the Peritoneal Surface Oncology Group International (PSOGI) to complete an online survey concerning their personal expertise and current hospital and countrywide practice.Results
It is estimated that currently more than 3800 patients with CRC-PM (synchronous and metachronous) are annually treated with CRS and HIPEC in 430 centers. Integration of CRS and HIPEC in national guidelines varies, resulting in large treatment disparities between countries. Amongst the experts, there was general agreement on issues related to indication, surgical technique and follow up but less on systemic chemotherapy or proactive strategies.Conclusion
This international survey demonstrates that CRS and HIPEC is now performed on a large scale for CRC-PM patients. Variation in treatment may result in heterogeneity in surgical and oncological outcomes, emphasising the necessity to reach consensus on several issues of this comprehensive procedure. Future initiatives directed at achieving an international consensus statement are needed. 相似文献13.
Xue-Pei Huang Tian-Tian Ye Li Zhang Rui-Feng Liu Xing-Jian Lai Liang Wang Meng Yang Bo Zhang Xiao-Yi Li Zi-Wen Liu Yu Xia Yu-Xin Jiang 《Surgical oncology》2018,27(2):172-176
Objective
To study the correlations between the sonographic features of papillary thyroid microcarcinoma (PTMC) and the presence of high-volume lymph node metastasis.Method
Medical records of 2363 PTMC patients were reviewed form October 2013 to December 2015. All the patients with lymph node metastasis identified by histopathology were included. Preoperative sonographic features, such as multifocality, tumour size, echogenicity, calcification, vascularity of papillary microcarcinoma, and capsule invasion, were recorded. Univariate and multivariate analyses were performed to investigate the relationships between sonographic features and high-volume lymph node metastasis (number of metastatic lymph nodes >5).Results
In total, 152 patients had high-volume central lymph node metastasis (6.4%, 152/2363). Multiple logistic regression analysis showed that the preoperative ultrasonic features of microcalcifications (OR?=?3.33, p?=?0.022), larger tumour size (>7?mm) (OR?=?2.802, p?<?0.001), and capsule invasion (OR?=?2.141, p?=?0.006) were independent risk factors for high-volume lymph node metastasis in the central compartment of PTMC.Conclusion
The sonographic features of primary papillary microcarcinoma of the thyroid are correlated with high-volume central lymph node metastasis. 相似文献14.
Zhanlong Shen Yuanpei Lin Yingjiang Ye Kewei Jiang Qiwei Xie Zhidong Gao Shan Wang 《European journal of surgical oncology》2018,44(4):490-495
Objective
To establish predicting models of surgical complications in elderly colorectal cancer patients.Background
Surgical complications are usually critical and lethal in the elderly patients. However, none of the current models are specifically designed to predict surgical complications in elderly colorectal cancer patients.Methods
Details of 1008 cases of elderly colorectal cancer patients (age ≥ 65) were collected retrospectively from January 1998 to December 2013. Seventy-six clinicopathological variables which might affect postoperative complications in elderly patients were recorded. Multivariate stepwise logistic regression analysis was used to develop the risk model equations. The performance of the developed model was evaluated by measures of calibration (Hosmer-Lemeshow test) and discrimination (the area under the receiver-operator characteristic curve, AUC).Results
The AUC of our established Surgical Complication Score for Elderly Colorectal Cancer patients (SCSECC) model was 0.743 (sensitivity, 82.1%; specificity, 78.3%). There was no significant discrepancy between observed and predicted incidence rates of surgical complications (AUC, 0.820; P = .812). The Surgical Site Infection Score for Elderly Colorectal Cancer patients (SSISECC) model showed significantly better prediction power compared to the National Nosocomial Infections Surveillance index (NNIS) (AUC, 0.732; P ? 0.001) and Efficacy of Nosocomial Infection Control index (SENIC) (AUC; 0.686; P?0.001) models.Conclusions
The SCSECC and SSISECC models show good prediction power for postoperative surgical complication morbidity and surgical site infection in elderly colorectal cancer patients. 相似文献15.
A.C. Currie A. Brigic S. Thomas-Gibson N. Suzuki M. Moorghen J.T. Jenkins O.D. Faiz R.H. Kennedy 《European journal of surgical oncology》2017,43(11):2044-2051
Background
Previous attempts at sentinel lymph node (SLN) mapping in colon cancer have been compromised by ineffective tracers and the inclusion of advanced disease. This study evaluated the feasibility of fluorescence detection of SLNs with indocyanine green (ICG) for lymphatic mapping in T1/T2 clinically staged colonic malignancy.Methods
Consecutive patients with clinical T1/T2 stage colon cancer underwent endoscopic peritumoral submucosal injection of indocyanine green (ICG) for fluorescence detection of SLN using a near-infrared (NIR) camera. All patients underwent laparoscopic complete mesocolic excision surgery. Detection rate and sensitivity of the NIR-ICG technique were the study endpoints.Results
Thirty patients mean age = 68 years [range = 38–80], mean BMI = 26.2 (IQR = 24.7–28.6) were studied. Mesocolic sentinel nodes (median = 3/patient) were detected by fluorescence within the standard resection field in 27/30 patients. Overall, ten patients had lymph node metastases, with one of these patients having a failed SLN procedure. Of the 27 patients with completed SLN mapping, nine patients had histologically positive lymph nodes containing malignancy. 3/9 had positive SLNs with 6 false negatives. In five of these false negative patients, tumours were larger than 35 mm with four also being T3/T4.Conclusion
ICG mapping with NIR fluorescence allowed mesenteric detection of SLNs in clinical T1/T2 stage colonic cancer.16.
Asaf Shvero Ofer Nativ Yasmin Abu-Ghanem Dorit Zilberman Bahouth Zaher Max Levitt Eddie Fridman Orith Portnoy Jacob Ramon Zohar A. Dotan 《Clinical genitourinary cancer》2018,16(3):e613-e617
Background
Partial nephrectomy (PN) for clinical stage T3 tumors is controversial. Radical nephrectomy (RN) has been associated with a greater rate of chronic kidney disease, an increased risk of cardiovascular disease, and increased mortality compared with PN. We present our long-term 2-center experience with PN for stage pT3a tumors and compare the oncologic outcomes with those of similar patients treated with RN.Materials and Methods
We reviewed the data from all patients who had undergone nephrectomy for renal cell carcinoma from 1987 to 2015 in 2 medical centers. The study included 134 patients with pathologic stage T3a tumors, of whom 48 and 86 underwent PN and RN, respectively. We compared the 2 groups (PN and RN) using univariate and multivariate analyses.Results
The tumors of all patients with pathologic stage T3a who had undergone PN had been pathologically upstaged from clinical stage T1 or T2. Univariate and multivariate analyses revealed tumor size was significantly different statistically between the study groups (median, 7.0 cm in RN group vs. 4.0 cm in PN group; P < .001). Surgery type was not a predictor of local recurrence (P = .978), metastatic progression (P = .972), death from renal cancer (P = .626), or death from all causes (P = .974) at the 5-year follow-up point.Conclusion
The results of the present study have shown similar oncologic outcomes between 48 patients with stage pT3a renal cancer who underwent PN and 86 patients who underwent RN. Although PN was not performed on clinical T3a tumors, our findings suggest that PN can also be considered for these tumors and, thus, avoid the long-term complications of RN. However, strict follow-up protocols are mandatory. 相似文献17.
Hawk Kim SooHyun Kim Hyeoung-Joon Kim Yeo-Kyeoung Kim Jae-Yong Kwak Ho-Young Yhim Sung-Hyun Kim Young Rok Do Sukjoong Oh Sung-Eun Lee Saengsuree Jootar Jiu Wei Cui Dong-Wook Kim 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(10):e391-e399
Introduction
BCR-ABL1 mutations require consideration during second-line tyrosine kinase inhibitor selection for patients with chronic myeloid leukemia (CML). The present retrospective analysis compared the frequency of BCR-ABL1 mutations in Asian and white patients in whom imatinib therapy had failed.Patients and Methods
A nonstudy cohort (76 Asian patients from community clinical practices) and 2 study cohorts (29 Asian and 352 white patients from dasatinib phase II and III clinical trials) were identified.Results
In the nonstudy cohort, 80 mutations were identified; the most frequent was T315I (15%), followed by phosphate-binding loop mutations E255K (11%), G250E (10%), and Y253H (10%). Asian patients had a greater proportion of T315I and phosphate-binding loop mutations compared with the white patients. The nonstudy cohort was less likely to have multiple mutations compared with either study cohort. Single mutations highly resistant to dasatinib, nilotinib, and bosutinib were more frequent in the Asian than in the white cohorts.Conclusion
These results suggest that mutational analysis findings will be invaluable for choosing an appropriate second-line tyrosine kinase inhibitor in Asia. 相似文献18.
Paul H. Sugarbaker 《European journal of surgical oncology》2018,44(7):1083-1086
Background
The hepatic bridge forms a tunnel of liver parenchyma that may obscure peritoneal metastases associated with the round ligament. Visualization and then resection of nodules associated with this structure is necessary.Materials and methods
The incidence of a hepatic bridge and the extent that it covered the round ligament was determined in consecutive patients. Extent of coverage of the round ligament by the hepatic bridge was determined: Class 1 indicates up to one-third of the round ligament obscured, Class 2 up to two-thirds and Class 3 more than two-thirds.Results
In 102 patients in whom the round ligament of the liver could be completely visualized, 50 had a hepatic bridge. Class 1 was 22 (44%) of the bridges, Class 2 was 16 (32%) and Class 3 was 12 (24%). A hepatic bridge was more frequently present in 28 of 45 male patients (62%) vs. 22 of 57 female patients (38%).Conclusions
Approximately one-half of our patients having cytoreductive surgery for peritoneal metastases were observed to have a hepatic bridge. Up to 56% of these patients have Class 2 or 3 hepatic bridge and may require division of the hepatic bridge to completely visualize the contents of the tunnel created by this structure. 相似文献19.
S.C. Hawkins I. Brown P. King M. El-Gammal K. Stepp S. Widdison M. Barta N. Jackson R. English S. Ahmad P. Drew 《European journal of surgical oncology》2017,43(1):62-67