International journal of gastrointestinal cancer最新文献

{"title":"Long-term results after surgery for gastric cancer with or without jejunal reservoir: results of surgery for gastric cancer in Kanta-Häme central hospital in two consecutive periods without or with jejunal pouch reconstruction in 1985-1998.","authors":"Hannu Paimela,&nbsp;Saara Ketola,&nbsp;Mauri Iivonen,&nbsp;Timo Tomminen,&nbsp;Esa Könönen,&nbsp;Niku Oksala,&nbsp;Harri Mustonen","doi":"10.1385/IJGC:36:3:147","DOIUrl":"https://doi.org/10.1385/IJGC:36:3:147","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer still has a disease-specific 5-yr survival less than 30% and an overall survival of about 15%. The quality of life of patients who undergo gastrectomy is poor owing both to the severity of the disease itself and to the mutilation of the upper gastrointestinal channel after the reconstruction. Therefore, the combination of a jejunal pouch with gastrectomy has been claimed to improve the life quality and nutritional status of these patients.</p><p><strong>Aim: </strong>To assess the clinical results after surgery for gastric cancer in two consecutive periods with or without jejunal-pouch reconstruction.</p><p><strong>Methods: </strong>271 consecutive patients referred for surgery for gastric cancer in 1985-1991 (116 patients) and in 1992-1998 (155 patients) in Kanta-Häme central hospital were retrospectively analyzed regarding their disease, mode of surgery, and the immediate and long-term results. In the former observation period gastrectomy was performed with Roux-en-Y esophagojejunostomy without a reservoir, and in the latter period this procedure was combined with a jejunal reservoir. The data were collected from patient journals and from the death certificate obtained from the National Centre of Statistics in Finland.</p><p><strong>Results: </strong>During the study period the incidence of cancer in the cardia increased among the surgical patients from 13.1 to 26.7% (p <0.05). Despite this proximal migration, the cancer-specific 5-yr survival remained practically unchanged during the two study periods, 29.4% and 32.2% (NS). During the period of jejunal-pouch reconstruction there were non-significant increases of the incidences of local recurrence (from 18.9% to 26.5%), of immediate postoperative anastomotic fistulae (from 0.9% to 4.5%) as well as of the immediate mortality (from 2.6% to 3.7%) (NS for each).</p><p><strong>Conclusions: </strong>Despite proximal migration of gastric cancer and the application of a jejunal reservoir, the long-term as well as the immediate results after curative surgery (i.e., D2-gastrectomy) for gastric cancer have remained relatively unchanged. The jejunal-pouch reconstruction with the present technique after gastrectomy can therefore be safely applied.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"36 3","pages":"147-53"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/IJGC:36:3:147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26042476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery for colorectal cancer in a low-volume unit: assessment of key issues in the achievement of acceptable clinical results.","authors":"Hannu Paimela,&nbsp;Outi Lindström,&nbsp;Timo Tomminen,&nbsp;Mauri Iivonen,&nbsp;Esa Könönen,&nbsp;Pekka Kuusanmäki","doi":"10.1385/IJGC:35:3:205","DOIUrl":"https://doi.org/10.1385/IJGC:35:3:205","url":null,"abstract":"<p><strong>Background: </strong>The maintenance of modern therapeutic principles requires a proper case load to achieve acceptable surgical results. This may obligate administrative reorganization to overcome these problems and to provide an adequate level of cancer surgery.</p><p><strong>Aim: </strong>To assess the surgical results of patients coming for surgery for colorectal cancer in a low-volume non-academic unit during the past 15 yr.</p><p><strong>Methods: </strong>458 consecutive patients referred for surgery between 1988 and 2001 in Kanta-Häme Central Hospital in Finland were analyzed regarding their disease, mode of surgery, and the immediate and long-term result. The data were collected from patient journals and from the National Centre of Statistics and analyzed in two successive periods.</p><p><strong>Results: </strong>The number of patients with a localized disease (Dukes A + Dukes B) decreased during the followup from 49% to 45%. A curative procedure was achieved in 68% in the first half and in 73% in the second half of the observation period. The immediate mortality was 5% and 2% in the two periods, respectively. The corrected 5-year survival according to the Dukes Classification was 92% (A), 69% (B), 41% (C ), and 6% (D). In curative surgery for rectal cancer, the incidences of local recurrence decreased from 21% to 9% (NS) and the use of permanent colostomy from 59 to 42% (NS).</p><p><strong>Conclusions: </strong>Acceptable immediate and long-term results in curative surgery for colorectal cancer can be achieved in a low-volume surgical unit. Nevertheless, owing to the low volume, the improvement of the results obligates team-based institutional specialization and careful consideration about the extensiveness of the primary procedure in case of cancer obstruction.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"35 3","pages":"205-10"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/IJGC:35:3:205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25257637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors in patients with colorectal cancer receiving adjuvant chemotherapy or chemoradiotherapy: a pooled analysis of two randomized studies.","authors":"Aristotle Bamias,&nbsp;George Basdanis,&nbsp;Ioannis Xanthakis,&nbsp;Nicholas Pavlidis,&nbsp;George Fountzilas","doi":"10.1385/IJGC:36:1:029","DOIUrl":"https://doi.org/10.1385/IJGC:36:1:029","url":null,"abstract":"<p><strong>Background: </strong>Although the TNM system is useful in predicting survival in resected colorectal cancer, heterogeneity within the same stages regarding prognosis exists. We are presenting a pooled analysis of prognostic factors from two randomized studies of adjuvant treatment conducted by the Hellenic Cooperative Oncology Group.</p><p><strong>Patients and methods: </strong>Patients with stage II or III colon (n = 279) or rectal (n = 220) cancer were included in this analysis. Following surgery, patients received: 5-fluorouracil/leucovorin (5-FU/LV) (n = 135), 5-FU/LV and interferon Alfa-2a (IFNA-2a) (n = 138), 5-FU/LV and pelvic chemoradiotherapy (n = 106), and pelvic chemoradiotherapy alone (n = 108).</p><p><strong>Results: </strong>Median follow up was 92 mo. The number of involved lymph nodes (LNs), tumor differentiation, and the presence of regional implants were independent prognostic factors for both OS and TTP, while nerve invasion was only significant for TTP. Patients were stratified into three prognostic groups (low-risk: no LNs and grade 1/2; high-risk: > 3 LNs and grade 3/4; intermediate-risk: remaining patients) with distinct differences in 5-yr survival (84.7% vs 57.6% vs 32.4%) and 5-yr TTP (81.2% vs 54.5% vs 28.6%).</p><p><strong>Conclusion: </strong>The combination of clinicopathological prognostic factors can be more informative than the traditional TNM staging system. Such stratification may be necessary in randomized trials and could be useful in deciding the most appropriate adjuvant treatment strategies.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"36 1","pages":"29-38"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/IJGC:36:1:029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25637786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase II study of capecitabine plus oxaliplatin (XELOX): a new first-line option in metastatic colorectal cancer.","authors":"Thomas Makatsoris,&nbsp;Haralabos P Kalofonos,&nbsp;Gerasimos Aravantinos,&nbsp;Christos Papadimitriou,&nbsp;Efstathios Kastritis,&nbsp;Sotirios K Rigatos,&nbsp;Nikolaos Xiros,&nbsp;Theodore Petsas,&nbsp;Theofanis Economopoulos,&nbsp;Athanassios K Sakadamis,&nbsp;George Fountzilas","doi":"10.1385/ijgc:35:2:103","DOIUrl":"https://doi.org/10.1385/ijgc:35:2:103","url":null,"abstract":"<p><strong>Background: </strong>Capecitabine and oxaliplatin are both effective and well-tolerated monotherapies for the treatment of advanced colorectal cancer (CRC). Oxaliplatin has also been shown to be very effective when combined with 5-FU/LV in the first-line setting.</p><p><strong>Aim of the study: </strong>Assess the efficacy and safety of capecitabine plus oxaliplatin (XELOX) in patients with previously untreated advanced CRC.</p><p><strong>Methods: </strong>Fifty-three patients with measurable disease received capecitabine 1,000 mg/m2 twice daily on d 1-14 and oxaliplatin 130 mg/m2 on d 1, every 3 wk. Of these, 52 were evaluable for safety and 49 for antitumor response.</p><p><strong>Results: </strong>There was a low rate of grade 1/2 adverse events; grade 3/4 events included leukopenia (10%), neutropenia (6%), thrombocytopenia (2%), nausea/vomiting (4%), and diarrhea (4%). The overall response rate was 39% (95% CI, 25-54%) and median time to disease progression was 7.8 mo.</p><p><strong>Conclusions: </strong>XELOX is an active and well-tolerated first-line treatment for advanced CRC. Randomized phase III studies are ongoing to compare XELOX with FOLFOX in view of the comparable efficacy and safety but superior convenience of XELOX therapy.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"35 2","pages":"103-9"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/ijgc:35:2:103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25270210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant chemoradiotherapy for adenocarcinoma of the pancreas: analysis of histopathology and outcome.","authors":"Aaron R Sasson,&nbsp;R Wesley Wetherington,&nbsp;John P Hoffman,&nbsp;Eric A Ross,&nbsp;Harry Cooper,&nbsp;Neal J Meropol,&nbsp;Gary Freedman,&nbsp;James F Pingpank,&nbsp;Burton L Eisenberg","doi":"10.1385/IJGC:34:2-3:121","DOIUrl":"https://doi.org/10.1385/IJGC:34:2-3:121","url":null,"abstract":"<p><p>To examine the histopathologic effect of neoadjuvant therapy and its impact on survival in patients with carcinoma of the pancreas, we retrospectively reviewed the records of 116 patients who underwent resections for pancreatic cancer from 1987 to 2000. Median follow-up of surviving patients was 19 mo(range 4-150 mo). Preoperative chemotherapy was administered in 61 patients (53%) and consisted of 5-fluorouracil/mitomycin C in 35 patients and gemcitabine in 26 patients, given concurrently with external beam radiation (5040 cGy). All resections were performed with curative intent (98 Whipples, 11 total, 6 distal, and 1 central pancreatectomy). Histopathologic examination included an estimation of the amount of fibrosis present in the tumor specimen (expressed as the percentage of fibrosis identified relative to the amount of neoplastic cells present). The mean fibrosis level for the series was 56% (range 5% to 100%). The administration of neoadjuvant therapy resulted in greater fibrosis (73%) than no preoperative treatment (38%) (p = 0.0001). Higher mean fibrosis levels were observed in patients with negative lymph nodes (p = 0.0006) and negative margins (p = 0.05). Factors associated with improved survival(log rank test) included: negative margins (p = 0.001), negative lymph nodes (p = 0.03), and use of neoadjuvant therapy (p = 0.03). Median survival in the neoadjuvant group was 23 mo vs 16 mo without preoperative therapy (p = 0.03). In conclusion, the use of neoadjuvant therapy resulted in a greater degree of fibrosis in the specimen. Patients with negative margins and negative lymph nodes had a greater amount of fibrosis present, and these were significant predictors of improved outcome. Although retrospective,this series suggests an improvement in survival in patients treated with neoadjuvant therapy.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"34 2-3","pages":"121-8"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/IJGC:34:2-3:121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gallbladder cystadenoma and common bile duct obstruction.","authors":"Seth A Spector,&nbsp;Vania E Fernandez,&nbsp;Stephen E Vernon,&nbsp;Brian Dunkin,&nbsp;Alan S Livingstone","doi":"10.1385/IJGC:34:2-3:151","DOIUrl":"https://doi.org/10.1385/IJGC:34:2-3:151","url":null,"abstract":"<p><p>Cystadenomas are usually found in the extra-hepatic bile ducts in conjunction with multilocular cysts in the liver. Cystadenoma of the gallbladder itself is a rare finding, cited only once in the literature as the cause of extrinsic obstruction of the common bile duct (5). In this report, we describe the endoscopic retrograde cholangiopancreaticographic (ERCP) detection of intrinsic obstruction of the cystic duct and common bile duct by such a tumor in a 47-yr-old woman.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"34 2-3","pages":"151-5"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/IJGC:34:2-3:151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24676539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous metastasis at a surgical drain site after the resection of pancreatic cancer.","authors":"Shawn D St Peter,&nbsp;Cuong C Nguyen,&nbsp;David C Mulligan,&nbsp;Adyr A Moss","doi":"10.1385/ijgc:33:2-3:111","DOIUrl":"https://doi.org/10.1385/ijgc:33:2-3:111","url":null,"abstract":"<p><p>The aggressive nature of pancreatic cancer makes surgical control of disease an arduous challenge. Tumor seeding during resection is a feared complication during operations performed for this disease. Recurrence within the peritoneal cavity commonly occurs after resection for curative intent. Cutaneous metastasis, however, is a rare event. The majority of skin metastasis reported in the literature occurred after palliative procedures, in which the tumor burden remains. In this report, we describe an unusual case of cutaneous recurrence at the site of a surgical drain after resection for curative intent and discuss the impact of surgery on tumor-growth characteristics.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"33 2-3","pages":"111-5"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/ijgc:33:2-3:111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24159342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mikulicz syndrome associated with a malignant large cell gastric lymphoma: a case report and review of the literature.","authors":"Anastasios A Mihas,&nbsp;Patricia B Lawson,&nbsp;Bernard J Dreiling,&nbsp;V S Gurram,&nbsp;Douglas M Heuman","doi":"10.1385/IJGC:33:2-3:123","DOIUrl":"https://doi.org/10.1385/IJGC:33:2-3:123","url":null,"abstract":"<p><p>There is much confusion in the literature regarding the differences between Mikulicz disease and Mikulicz syndrome. This may be because there seems to be a connection between the disease and disease processes associated with the syndrome. This article provides historical data discussing the emergence of Mikulicz disease, confusions regarding its definition, and finally offers an explanation to the interrelationships of these two entities. This case report hypothesizes that the non-Hodgkin's lymphoma (NHL), which in association with Sjögren's syndrome and Mikulicz disease in this patient comprised the Mikulicz syndrome, may have transformed into his malignant large-cell gastric lymphoma. It supports conclusions in the literature that Mikulicz disease, benign lymphoepithelial lesion, and Sjögren's syndrome may all be a part of the same disease process as graduated variants of one another, with malignant lymphoma being a recognized complication of these entities.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"33 2-3","pages":"123-7"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/IJGC:33:2-3:123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24159344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated abdominal wound metastasis from a gastrointestinal stromal tumor.","authors":"Steven C Cunningham,&nbsp;David Shibata,&nbsp;Carmine Volpe","doi":"10.1385/IJGC:33:2-3:129","DOIUrl":"https://doi.org/10.1385/IJGC:33:2-3:129","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal stromal tumors (GIST) frequently recur even after complete resection. The typical pattern of failure from GISTs is both local and distant with hepatic and peritoneal metastases being most common. Isolated abdominal-wall recurrence from GISTs has not been previously described.</p><p><strong>Aim of the study: </strong>To report an isolated abdominal-wound recurrence in the absence of widespread disease in a patient with GIST.</p><p><strong>Methods: </strong>Case report of a GIST and isolated abdominal-wound recurrence after laparoscopic-assisted en bloc resection.</p><p><strong>Results: </strong>Elderly male patient presented with an isolated abdominal wall incisional recurrence 18 mo after gastric resection and adjuvant imatinib mesylate therapy for a high-grade GIST.</p><p><strong>Conclusions: </strong>Complete resection of gastrointestinal stromal tumors followed by imatinib therapy may alter the extent of recurrence.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"33 2-3","pages":"129-32"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/IJGC:33:2-3:129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24159345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual presentation of hepatocellular carcinoma.","authors":"Seyfettin Köklü,&nbsp;Mehmet Arhan,&nbsp;Aydin Küksal,&nbsp;Aysel Ulker,&nbsp;Tülay Temuüin","doi":"10.1385/ijgc:34:2-3:063","DOIUrl":"https://doi.org/10.1385/ijgc:34:2-3:063","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) metastasis to the lymph nodes has been reported in about one-third of autopsies, mostly to the regional chains. Involvement of cervical lymph nodes is extremely rare. We encountered an unusual case of HCC in a patient with chronic liver disease presenting with right-sided anterior cervical lymph node metastasis skipping mediastinal and supraclavicular chains. One should be aware of that unusual site of presentation and metastasis of HCC so as not to miss the diagnosis.</p>","PeriodicalId":84927,"journal":{"name":"International journal of gastrointestinal cancer","volume":"34 2-3","pages":"63-5"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1385/ijgc:34:2-3:063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24678271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}