Short-Term and Long-Term Outcomes After Gastrectomy for Gastric Cancer in Patients With Chronic Kidney Disease

Background

The incidence of chronic kidney disease (CKD) is increasing, which might be an obstacle to various aspects of gastric cancer treatment, such as perisurgical management and postsurgical follow-up. The present study aimed to evaluate the short- and long-term surgical outcomes following gastrectomy in patients with CKD.

Methods

We retrospectively analyzed surgical complications and prognosis of patients with gastric cancer. These patients were divided into three groups according to the glomerular filtration rate (GFR): 49 patients with severe CKD (GFR < 29 ml/min/1.73 m²), 128 with mild CKD (GFR 30–59), and 798 in the controls (GFR ≥ 60).

Results

The incidences of anastomotic leakage and intraabdominal abscess in the mild and severe CKD groups were higher than that in the control group. The incidences of wound infection, cardiovascular and pulmonary events, and in-hospital mortality in the severe CKD group were higher than those in the other two groups. Severe surgical complications were associated with co-morbidities other than CKD, serum albumin level, estimated blood loss, surgery duration in the mild and severe CKD group. The 3-year overall survival rates for the severe CKD, mild CKD, and control groups were 48.6, 80.9, and 85.0 %, respectively, indicating significant differences between the severe CKD group and other two groups.

Conclusions

Patients with severe CKD show an increased risk of morbidity and mortality following gastrectomy, and their prognosis is usually poor. Studies with a large cohort are essential to refine the risk stratification for gastrectomy in this high-risk population.     

Cor pulmonale due to embolization of metastatic chondrosarcoma

Summary A 25-year-old woman with acute dyspnea was found to have nodular shadows in a chest X-ray film. Multiple defects in a perfusion scan indicated pulmonary embolization. The cause of acute cor pulmonale was extensive metastatic embolization from chondrosarcoma of the calf. Embolization by metastasis as a rare occurrence resulting in acute cor pulmonale should be considered in patients with a malignant tumor.     

Long-term safety of subcutaneous immunotherapy with TO-204 in Japanese patients with house dust mite-induced allergic rhinitis and allergic bronchial asthma: Multicenter,open label clinical trial

Background

To evaluate the long-term safety of subcutaneous immunotherapy with TO-204, a standardized house dust mite (HDM) allergen extracts, we conducted a multicenter, open label clinical trial.