Background: The circulating DNA concentration and integrity was examined by a quantitative polymerase chain reaction (qPCR)
in the plasma from patients with gastric cancer and their diagnostic value ...for the detection of gastric cancer assessed. Patients
and Methods: Plasma samples were collected preoperatively from 53 patients with gastric cancer and 21 healthy controls. qPCR
was performed using two different primer sets for the beta-actin gene, amplifying short and long segments. DNA integrity was
calculated as the ratio of concentrations in both assays. Results: The DNA concentrations in the short and long assays of
the gastric cancer patients were significantly higher (p=0.03 and p<0.0001, respectively) than those of the control group.
The DNA integrity was also higher in cancer patients than that of the controls, however the difference was not significant
(p=0.07). Conclusion: The plasma DNA concentration assay may serve as a new diagnostic marker for the screening and monitoring
of patients with gastric cancer.
Background
Neo-adjuvant chemotherapy (NAC) followed by radical esophagectomy has been shown to prolong survival in patients with locally advanced esophageal squamous cell carcinoma (ESCC). However, ...neutropenia, one of the major adverse events due to NAC, influences the therapeutic course. The aim of this study is to clarify the relationship between neutropenia and therapeutic response in ESCC with NAC.
Methods
A total of 117 patients with clinical stage II/III ESCC who had undergone NAC followed by radical esophagectomy were retrospectively analyzed in terms of the relationship between neutropenia and clinicopathological features or outcomes.
Results
Neutropenia was the major adverse event observed in 56 % (66/117) and grade 3/4 neutropenia occurred in 29 % of patients. Grade 3/4 neutropenia correlated with a high histological response (Grade 1b–3) (
p
< 0.01). Correlative analysis identified grade 3/4 neutropenia and poor differentiation as independent predictors of a high histological response (odds ratio 5.13 and 3.25,
p
< 0.01 and
p
= 0.01, respectively). Survival analysis showed that patients with a high histological response had significantly longer survival than those with a low histological response (Grade 0–1a) (
p
= 0.03), whereas no significant differences were found for survival according to the grade of neutropenia (
p
= 0.45). In a subgroup analysis according to histological response, grade 3/4 neutropenia correlated with worse survival in patients with a low histological response (
p
= 0.05).
Conclusion
Severe neutropenia due to NAC correlates with a high histological response in ESCC. However, severe neutropenia may also result in a worse prognosis for patients with a low histological response.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background
Although systemic therapy for esophageal carcinoma has advanced dramatically over the last several decades, the consensus of treatment for cervical esophageal carcinoma (CESCC) has yet ...remained controversial.
Patients and methods
We analyzed 56 CESCC patients who underwent various therapies in our hospital between January 2000 and December 2013.
Results
Thirteen cases underwent surgery without neo-adjuvant therapy (NAT), while 20 cases underwent surgery after NAT. Definitive chemo-radiotherapy (dCRT) was administered to 23 cases. Five cases underwent salvage surgery after dCRT. Three-year overall survival rates (3-year-OS) were similar between the NAT and dCRT groups (53.3 vs. 51.5 %). These cases were divided into clinical T2/T3 and T4 cases, and a differential analysis was performed. The 3-year-OS achieved by NAT in T2/T3 cases (90.9 %) tended to be better than that by dCRT (62.5 %). In contrast, the 3-year-OS achieved by NAT in T4 cases (12.5 %) tended to be worse than that by dCRT (34.2 %). The prognosis of CESCC patients undergoing salvage surgery after dCRT was very good, with 3-year-OS of 100 % in T2/T3 cases and 66.6 % in T4 cases. A comparative analysis of postoperative complications was performed between CESCC patients undergoing surgery after neo-adjuvant chemotherapy and chemo-radiotherapy to evaluate the operative risk for CESCC patients after CRT. The rates of postoperative complications were similar between these groups.
Conclusion
We analyzed the treatment outcomes of CESCC patients by dividing them according to the clinical tumor invasion depth. Salvage surgery may be an effective therapy for CESCC patients and needs to be considered.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background and Aim:
No study has compared the incidence of postoperative anemia between two reconstruction methods, Billroth‐I (B‐I) and Roux‐en‐Y (R‐Y) reconstructions, after distal gastrectomy for ...gastric cancer (GC). In this study, we wished to examine the postoperative decrease in hemoglobin (Hb) as an indicator of iron‐deficiency anemia.
Methods:
We investigated a total of 119 consecutive patients who underwent distal gastrectomy with B‐I or R‐Y reconstruction for Stage I GC between 2006 and 2012. We retrospectively assessed the clinical data, including Hb results, of the first 2 years after surgery.
Results:
Compared with B‐I reconstruction, R‐Y reconstruction was performed more frequently in older patients (P = 0.017), and it was associated with a longer surgical duration (P < 0.001), a larger amount of blood loss (P = 0.031), a higher incidence of stasis (P = 0.044), and a greater decrease in Hb for the first 2 years after surgery. Univariate and multivariate analyses identified that R‐Y reconstruction was the only risk factor (P = 0.0487; odds ratio = 2.755; 95% confidence interval = 1.01–7.91) for a decrease in Hb, independent of age, tumor location, postoperative complications, and other factors. In addition, an age ≥ 75 was identified as an independent risk factor for a decrease in Hb, particularly for patients underwent R‐Y reconstruction (P = 0.033; odds ratio = 6.99; 95% confidence interval = 1.15–68.3) according to the multivariate analysis.
Conclusions:
Billroth‐I reconstruction might be preferable for the purpose of preventing a decrease in Hb in stage I GC patients, particularly in older patients.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
A 57-year-old male with lower esophageal cancer underwent subtotal esophagectomy with lymphadenectomy. The histopathological diagnosis was poorly differentiated squamous cell carcinoma, pT2N1M0 ...pStageIIB. After one course of postoperative adjuvant chemotherapy involving low-dose CDDP/5FU, a PET–CT scan obtained 12 months after surgery revealed a solitary liver metastasis in the S2 area. The patient then underwent five courses of docetaxel chemotherapy (80 mg/body, tri-weekly), and a partial response was observed. We also performed radiofrequency ablation (RFA), after which a complete response was observed. Twenty months after surgery, we detected local liver recurrence in the same position and performed additional RFA. Twenty-four months after surgery, a solitary lung metastasis was detected in the left S2 area and the patient was administered five additional courses of docetaxel therapy. Subsequently, PET–CT revealed growth of lung and liver tumors without recurrence in other areas. Twenty-nine months after surgery, we partially excised metastatic liver and lung tumors, and no subsequent recurrence has since been detected. The prognoses of patients who suffer from esophageal cancer organ recurrence are known to be extremely poor, and optimal therapeutic strategies for treating these patients have not been established. This long-term survival case suggests that multidisciplinary therapy for the treatment of liver and lung recurrence after esophagectomy is effective.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
We report a rare case of peritoneal metastasis from colon cancer being found in the bilateral sites of inguinal hernia repair. The patient was an 85-year-old man who underwent colonoscopy for a ...positive fecal occult blood test, with a subsequent diagnosis of ascending colon cancer. He had undergone mesh plug repair for bilateral inguinal hernias at another hospital 6 years previously. We performed laparoscopy-assisted right hemi-colectomy and found nodes in the bilateral scars from the inguinal hernioplasty. Biopsy confirmed that both of the nodes were peritoneal metastasis, leading to the assumption that cancer cells disseminated within the abdominal cavity had been implanted at the repair sites, although the mechanism for this was unclear. A relationship between inflammation and peritoneal metastasis has been reported; thus, we speculated that local inflammation resulting from chronic stimulus of mesh plugs and peritoneal trauma caused peritoneal metastasis at the repair sites.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
