1,721,026 research outputs found
Role of radioimmunoguided surgery using iodine-125-labeled B72.3 monoclonal antibody in gastric cancer surgery.
No full textUniform and accurate staging of gastric cancer is essential to predict prognosis and assess the effectiveness of treatment strategies. An appropriate amount of surgical resection of the primary tumor and lymph node dissection appears to be fundamental for such staging. In seven out of 10 patients who were candidates for curative surgery, we assessed the usefulness of radioimmunoguided surgery (RIGS) using B72.2 monoclonal antibody (MoAb) labeled to Iodine-125 (I125) for the intraoperative staging of the tumor and the first (N1) and second echelon (N2) lymph nodes. We obtained a correct RIGS identification of primary lesions in four out of seven patients (57.1%), while lymph node staging assessment showed positive results in two out of four patients with lymph node metastases. RIGS correctly identified 26/ 40 (65%) metastatic nodes of these last two patients. RIGS intraoperative staging of gastric cancer--which may be essential for the assessment of the extension of the primary resection and to modulate lymph node dissection--was unsatisfactory. We believe that other technical approaches and more specific MoAbs should be evaluated for RIGS purposes in gastric cancer surgery
Insertion of central venous catheters (CVCs): any changes in the past 10 years?
No full textWe read with great interest the article ‘Central venous access in
oncology: ESMO Clinical Practice Guidelines’ by Sousa et al. [1]
and congratulate the Authors for the excellent work done. A key
point—clearly recognized by the authors in their Introduction—
is that some of contained recommendations are based on guidelines
and randomized trials (RCTs) which may lack specificity for
cancer patients. Nevertheless, evidence provided in non-oncology
settings should be carefully analyzed. We would like to point out
this aspect, and give a contribution to a possible re-evaluation of
some conclusions, in th
Immunosuppressive effect of surgery evaluated by the multitest cell-mediated immunity system.
No full textTreatment of esophageal anastomotic leakages after cancer resection. The role of total parenteral nutrition.Riboli EB, Bertoglio S, Arnulfo G, Terrizzi A.
No full textA series of 16 cases of esophageal anastomotic leakages after cancer resection observed from 1978 to 1982 is analyzed in a retrospective manner. Eight patients related to the period 1978 to 1980 (series A) were treated with emergency surgery while the remaining eight patients observed from 1980 to 1982 (series B) were treated conservatively with total parenteral nutrition (TPN) and complete fasting. Seven patients from series A eventually died postoperatively and one patient had a good recovery after emergency reintervention. In the series B six patients left the hospital with complete healing of the anastomotic leaks after 27.2 +/- 13.5 days of TPN and complete fasting, while failure of the treatment was observed in two patients who died from septic mediastinitis and acute respiratory failure. Different incidence of positive clinical results in Series A and B was statistically significant (p less than 0.01). The role of TPN and complete fasting will be discussed as the primary approach for the management of this severe complication, taking in consideration the suture line drainage and the control of infection
Preliminary analysis of a randomized clinical trial of adjuvant postoperative RT vs. postoperative RT plus 5-FU and levamisole in patients with TNM stage II-III resectable rectal cancer.
No full textOBJECTIVES:
Two-hundred eighteen patients with TNM stage II-III resectable rectal cancer, enrolled into a randomized clinical trial, were assessed for efficacy and toxicity of adjuvant postoperative radiation therapy (RT) vs. those of combined RT and chemotherapy (CT), with 5-fluorouracil (5-FU) plus levamisole. End points were overall survival, disease-free survival, the rate of loco-regional recurrence, and treatment-related toxicity.
METHODS:
Patients in arm I underwent RT (50 Gy) in daily fractions of 2 Gy, 5 days/week for 5 weeks. Patients in arm II began with 5-FU (450 mg/m(2)/day intravenous bolus, days 1-5) plus levamisole (150 mg/day orally, days 1-3); postoperative RT was delivered during week 2 at the same dosage and schedule as in arm I. The other five cycles of CT (5-FU every 28 days and levamisole every 15 days for the length of 5-FU administration) continued after the end of RT if clinical and hemato-biochemical parameters were normal.
RESULTS:
RT was completed or modified in 170 (90%) of 189 evaluable patients undergoing RT (both treatment groups). Only 44 (59%) of 75 evaluable patients of arm II completed or had an adjustment of the CT schedule; the remaining 31 patients (41%) had to stop or never started the CT regimen. Patients undergoing combined RT and CT had more severe toxicity (enteritis, P = 0.03). There was one CT-related death (gastrointestinal bleeding) in this subset. No significant difference was observed in outcome of patients in the two study groups, nor for pattern of recurrence (heterogeneity chi(2) = 4.82; d.f. = 2; P = 0.08).
CONCLUSIONS:
These preliminary findings suggest a similar efficacy, coupled with less morbidity, of postoperative RT alone compared with a combined regimen of postoperative RT and CT in patients undergoing radical surgery for stage II-III rectal cancer
[Total parenteral nutrition in the treatment of Crohn's disease and ulcerative colitis in acute or hyper-acute phase].
No full text
Peripherally inserted central catheters (PICCs) in cancer patients under chemotherapy: A prospective study on the incidence of complications and overall failures
No full textAbstract
BACKGROUND AND OBJECTIVES:The increasing use of peripherally inserted central venous catheters (PICCs) for chemotherapy has led to the observation of an elevated risk of complications and failures. This study investigates PICC failures in cancer patients.
METHODS:A prospective study was conducted at a single cancer institution on 291 PICC placement for chemotherapy. The primary study outcome was PICC failure.
RESULTS:Median follow-up was 119 days. PICC complications occurred in 72 patients (24.7%) and failures with removal in 44 (15.1%). Reasons for failures were upper extremity deep venous thrombosis (UEDVT) 12 (4.1%), central line associate bloodstream infection (CLABSI) 5 (1.7%) with an infection rate of 0.95 per 1,000 catheter days, exit site infection 9 (3.1%) with a rate of 1.46 per 1,000 catheter days, catheter dislodgment 11 (3.8%), and occlusion 7 (2.4%). Statistically significant risk factors were previous DVT (HR 2.95, 95%CI 1.33-6.53), reason for PICC implant (HR 3.65, 95%CI 1.12-10.34) and 5-fluorouracil, oxaliplatin and bevacizumab based chemotherapy (HR 3.11, 95%CI 1.17-8.26).
CONCLUSIONS:PICC is a safe venous device for chemotherapy delivery. Nevertheless, a 15% rate of failure has to be taken in account when planning PICC insertion for chemotherapy purposes
[Current status of the classification and clinical staging of primary and secondary tumors of the liver].
No full textOver the past few decades there has been outstanding expansion in the surgical exeresis of primary and metastatic liver tumours and particularly hepatic metastases of colorectal carcinomas. With the advance in surgical technique it becomes increasingly necessary to codify the system for the classification and clinical staging of these conditions for the purposes of correct programming of treatment and assessment of the clinical results obtained. The most commonly used systems of classification and clinical staging are analysed, in particular the classifications proposed by the American Joint Committee on Cancer and D. Manfredi for primary liver tumours and those proposed by Gennari et al and Sugerbaker et al for hepatic metastases of colorectal carcinomas. The selection criteria adopted in each system are analysed as the basis for a more thorough discussion of the problem that is felt to be fundamental for the standardisation of classification and clinical staging systems in the future. Such standardisation is essential for the assessment of the value and limitations of liver surgery in cancer
- …
