-
1
المؤلفون: Eui Han Chung, Jin Woo Kim, Byeong Soo Kwon
المصدر: Archives of Craniofacial Surgery
مصطلحات موضوعية: medicine.medical_specialty, medicine.medical_treatment, Sebaceous Gland Neoplasm, Case Report, Metastasis, 03 medical and health sciences, 0302 clinical medicine, medicine, 030223 otorhinolaryngology, Lymph node, Sebaceous gland neoplasms, business.industry, Radical Lymph Node Dissection, Wide local excision, 030206 dentistry, medicine.disease, Primary tumor, Radiation therapy, medicine.anatomical_structure, Otorhinolaryngology, Adenocarcinoma, sebaceous, Surgery, Radiology, business, Sebaceous carcinoma
الوصف: Sebaceous carcinoma (SC) is a rare tumor, accounting for approximately 0.7% of skin cancers. SC can be classified as ocular SC (OSC) or extraocular SC (EOSC) depending on its location. Because EOSC accompanied by metastases is rare, there is a paucity of data about EOSC accompanied by metastasis. This study presents a case of an aggressive EOSC of the scalp with lymph node metastases. The patient underwent wide local excision of the primary tumor with a 1 cm safety margin and bilateral radical lymph node dissection. However, recurrence was observed 1 month after surgery. Radiation therapy and resection were performed for the recurrent tumor. However, distant metastases to both lungs eventually occurred. Here, we describe a rare recurrent case of EOSC of the scalp with distant organ metastasis with a review of the literature.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::23c19494de13d04c2908ae9352fa264c
http://europepmc.org/articles/PMC7968984 -
2
المؤلفون: Kingo Hirasawa, Jun Watanabe, Toshihiro Misumi, Itaru Endo, Yoshiaki Inayama, Chikara Kunisaki, Keigo Chida
المصدر: Annals of Gastroenterological Surgery, Vol 4, Iss 5, Pp 562-570 (2020)
Annals of Gastroenterological Surgeryمصطلحات موضوعية: medicine.medical_specialty, Univariate analysis, Receiver operating characteristic, RD1-811, Lymphovascular invasion, Colorectal cancer, business.industry, Radical Lymph Node Dissection, Gastroenterology, risk assessment, Original Articles, RC799-869, Neuroendocrine tumors, Diseases of the digestive system. Gastroenterology, Malignancy, medicine.disease, Tumor budding, medicine, Original Article, Surgery, Radiology, lymphatic metastasis, business, neuroendocrine tumor
الوصف: Aim Although rectal neuroendocrine tumors (NETs) are considered to be rare low‐grade malignancies when lymph node metastasis (LNM) is present, their degree of malignancy is comparable to that of colorectal cancer (CRC). However, it remains unclear as to which patients require radical lymph node dissection. The aim of this study was to elucidate the risk factors for LNM and develop a risk‐scoring system for LNM to help determine appropriate therapeutic approaches. Methods In this study, we examined 103 patients with rectal NETs who underwent local resection (n = 55) or radical resection with LN dissection (n = 48). We evaluated each pathological feature, including the depth of submucosal invasion (SM depth) and tumor budding grade. Results According to our univariate analyses and previous reports, the significant five risk factors for LNM were weighted with point values: 2 points for tumor size ≥ 15 mm and muscularis invasion, and 1 point each for SM depth ≥ 2000 µm, positive lymphovascular invasion, budding grade 3, and vertical margin. The area under the receiver operating curve for the scoring system was 0.899 (95% CI: 0.843‐0.955). When a score of 2 was used as the cut‐off value, the sensitivity and specificity for the prediction of LNM were 100% and 72.1%, respectively. Conclusions The risk‐scoring system for LNM of rectal NETs showed high diagnostic performance. Using this risk‐scoring system, it is possible to predict the risk of LNM and thereby potentially avoid unnecessary surgery. Further prospective external validation studies should be performed. The study was registered in the Japanese Clinical Trials Registry as UMIN000036658.
The risk‐scoring system for LNM of rectal NETs could predict the risk of LNM and thereby potentially avoid unnecessary surgery. -
3
المؤلفون: Juliana Guarize, Giulia Sedda, Antonio Mazzella, Francesco Petrella, Filippo de Marinis, Monica Casiraghi, Lorenzo Spaggiari, Patrick Maisonneuve
المصدر: Journal of Clinical Medicine
Volume 10
Issue 16
Journal of Clinical Medicine, Vol 10, Iss 3465, p 3465 (2021)مصطلحات موضوعية: medicine.medical_specialty, Population, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, 0302 clinical medicine, robotic surgery, Medicine, Robotic surgery, Stage (cooking), Prospective cohort study, education, Lung cancer, INDUCTION TREATMENT, education.field_of_study, business.industry, Radical Lymph Node Dissection, induction therapy, Case-control study, General Medicine, medicine.disease, Surgery, lung cancer, 030220 oncology & carcinogenesis, business
الوصف: Despite there already being many studies on robotic surgery as a minimally invasive approach for non-small-cell lung cancer (NSCLC) patients, the use of this technique for stage III disease is still poorly described. These are the preliminary results of our prospective study on the safety and effectiveness of robotic approaches in patients with locally advanced NSCLC in terms of postoperative complications and oncological outcomes. Since 2016, we prospectively investigated 19 consecutive patients with NSCLC stage IIIA-pN2 (diagnosed by EBUS-TBNA) who underwent lobectomy and radical lymph node dissection with robotic approaches after induction treatment. Furthermore, we matched a case-control study with 46 patients treated with open surgery during the same period of time, with similar age, comorbidities, clinical stage and tumor size. The individual matched population was composed of 16 robot-assisted thoracic surgeries and 16 patients who underwent open surgery. The median time range of resection was inferior in the open group compared to robotic lobectomy (243 vs. 161 min
p <
0.001). Lymph node resection and positivity were not significantly different (p = 0.96 and p = 0.57, respectively). Moreover, no difference was observed for PFS (p = 0.16) or OS (p = 0.41). In conclusion, we demonstrated that the early outcomes and oncological results of N2-patients after robotic lobectomy were similar to those who had open surgery. Considering the advantages of minimally invasive surgery, robot-assisted lobectomy appears to be a safe approach to patients with locally advanced diseases.وصف الملف: application/pdf
-
4
المؤلفون: Hsueh-Yu Li, Hsiu-Feng Chung, Yi-An Lu, Hui-Chen Chiang, Alice M. K. Wong, Yu-Cheng Pei, Tuan-Jen Fang
المصدر: Diagnostics
Volume 11
Issue 5
Diagnostics, Vol 11, Iss 914, p 914 (2021)مصطلحات موضوعية: medicine.medical_specialty, Medicine (General), medicine.medical_treatment, Clinical Biochemistry, Anastomosis, survival, Article, 03 medical and health sciences, 0302 clinical medicine, R5-920, Recurrent laryngeal nerve, Medicine, unilateral vocal fold paralysis, esophageal cancer, Stage (cooking), 030223 otorhinolaryngology, injection laryngoplasty, business.industry, Radical Lymph Node Dissection, Cancer, Esophageal cancer, medicine.disease, Surgery, Esophagectomy, 030220 oncology & carcinogenesis, Concomitant, esophagectomy, business
الوصف: (1) Background: severe weight loss was reported to be related to unilateral vocal fold paralysis (UVFP) after esophagectomy and could thus impair survival. Concomitant radical lymph node dissection along the recurrent laryngeal nerve during esophageal cancer surgery is controversial, as it might induce UVFP. Early intervention for esophagectomy-related UVFP by administering intracordal injections of temporal agents has recently become popular. This study investigated the survival outcomes of esophagectomy for esophageal squamous cell carcinoma (ESCC) after the introduction of early injection laryngoplasty (EIL). (2) Methods: a retrospective review of patients with ESCC after curative-intent esophagectomy was conducted in a tertiary referral medical center. The necessity of EIL with hyaluronic acid was comprehensively discussed for all symptomatic UVFP patients. The survival outcomes and related risk factors of ESCC were evaluated. (3) Results: among the cohort of 358 consecutive patients who underwent esophagectomy for ESCC, 42 (11.7%) showed postsurgical UVFP. Twenty-nine of them received office-based EIL. After EIL, the glottal gap area, maximum phonation time and voice outcome survey showed significant improvement at one, three and six months measurements. The number of lymph nodes in the resected specimen was higher in those with UVFP than in those without UVFP (30.1 ± 15.7 vs. 24.6 ± 12.7, p = 0.011). The Kaplan–Meier overall survival was significantly better in patients who had UVFP (p = 0.014), received neck anastomosis (p = 0.004), underwent endoscopic resection (p <
0.001) and had early-stage cancer (p <
0.001). Multivariate Cox logistic regression analysis showed two independent predictors of OS, showing that the primary stage and anastomosis type are the two independent predictors of OS. (4) Conclusion: EIL is effective in improving UVFP-related symptoms, thus providing compensatory and palliative measures to ensure the patient’s postsurgical quality of life. The emerging use of EIL might encourage cancer surgeons to radically dissect lymph nodes along the recurrent laryngeal nerve, thus changing the survival trend.وصف الملف: application/pdf
-
5
المؤلفون: Koki Nakanishi, Mitsuro Kanda, Yasuhiro Kodera
المصدر: World Journal of Gastroenterology
مصطلحات موضوعية: medicine.medical_specialty, Blood transfusion, medicine.medical_treatment, Blood Loss, Surgical, Adverse effect, Perioperative Care, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Gastrectomy, Stomach Neoplasms, Tumor Microenvironment, Medicine, Humans, Transplantation, Homologous, Blood Transfusion, Mortality, business.industry, Radical Lymph Node Dissection, Transfusion, Gastroenterology, Cancer, Blood loss, Transfusion Reaction, Immunosuppression, Minireviews, General Medicine, Perioperative, medicine.disease, Prognosis, Surgery, 030220 oncology & carcinogenesis, Lymph Node Excision, 030211 gastroenterology & hepatology, Tumor Escape, Neoplasm Recurrence, Local, business, Complication, Gastric cancer
الوصف: Gastrectomy with radical lymph node dissection is the most promising treatment avenue for patients with gastric cancer. However, this procedure sometimes induces excessive intraoperative blood loss and requires perioperative allogeneic blood transfusion. There are lasting discussions and controversies about whether intraoperative blood loss or perioperative blood transfusion has adverse effects on the prognosis in patients with gastric cancer. We reviewed laboratory and clinical evidence of these associations in patients with gastric cancer. A large amount of clinical evidence supports the correlation between excessive intraoperative blood loss and adverse effects on the prognosis. The laboratory evidence revealed three possible causes of such adverse effects: anti-tumor immunosuppression, unfavorable postoperative conditions, and peritoneal recurrence by spillage of cancer cells into the pelvis. Several systematic reviews and meta-analyses have suggested the adverse effects of perioperative blood transfusions on prognostic parameters such as all-cause mortality, recurrence, and postoperative complications. There are two possible causes of adverse effects of blood transfusions on the prognosis: Anti-tumor immunosuppression and patient-related confounding factors (e.g., preoperative anemia). These factors are associated with a worse prognosis and higher requirement for perioperative blood transfusions. Surgeons should make efforts to minimize intraoperative blood loss and transfusions during gastric cancer surgery to improve patients' prognosis.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e84738123e8e295414e7f98fa02f47f9
http://europepmc.org/articles/PMC6580348 -
6
المؤلفون: Faruk Tas, Kayhan Erturk
المصدر: International Journal of Clinical Oncology. 24:721-726
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Skin Neoplasms, Adolescent, Gastroenterology, Young Adult, Internal medicine, medicine, Humans, Stage (cooking), Melanoma, Lymph node, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, business.industry, Radical Lymph Node Dissection, Hematology, General Medicine, Middle Aged, medicine.disease, Survival Rate, Dissection, medicine.anatomical_structure, Oncology, Lymphatic Metastasis, Cutaneous melanoma, Lymph Node Excision, Female, Surgery, Histopathology, Lymph Nodes, Lymph, Neoplasm Recurrence, Local, business
الوصف: Even though both the involvement of regional lymph nodes and the number of metastatic lymph nodes are regarded as major determinants of survival in cutaneous melanoma, the extent of node dissection has been analyzed as an independent prognostic indicator in only a few studies. This study aims to determine how the lymph node ratio (NR) (ratio of positive nodes to total nodes removed) might predict the disease relapse and survival in node-positive melanoma. A total of 317 patients with stage III primary melanoma were included in the study and reviewed retrospectively. All patients had nodal staging (N) by radical lymph node dissection. Patients were divided into three groups based on NR1 ≤ 10%, NR2 10–25%, and NR3 > 25%. The median age was 50 years (range 16–86) and men were predominant (59.3%). The majority of the patients had thicker Breslow depth (> 2 mm) (83.3%), higher mitotic rate (> 2/mm2) (64.1%) and ulcerated lesions (69.4%). The median number of positive nodes was 1 (range 1–32). The largest group was N1 (52.4%), which was followed by N2 (29.6%) and N3 (18%). The ratios of patients were 37.5%, 35.3%, and 27.1% in NR1, NR2, and NR3, respectively. The median number of excised lymph nodes was 13 (range 1–73). For all patients the estimated 5-and 10-year relapse-free survival (RFS) rates were 41% and 39%, respectively; and the estimated 5-and 10-year overall survival (OS) rates were 51% and 42%, respectively. Nodular histopathology, ulcerated lesions, higher mitotic rates, and higher node substages were the independent variables that were inversely correlated with survival for all patients; and NR was one of the significant prognostic factors and strongest predictors of relapse and survival (p = 0.03 and p = 0.01, respectively). Our results suggest that, apart from the conventional nodal status, NR is an independent prognostic factor-regarding both RFS and OS in stage III cutaneous melanoma.
-
7
المصدر: General Thoracic and Cardiovascular Surgery. 67:442-449
مصطلحات موضوعية: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Turkey, Comorbidity, 030204 cardiovascular system & hematology, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Carcinoma, Non-Small-Cell Lung, Internal medicine, medicine, Humans, Lung cancer, Lymph node, Survival rate, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Radical Lymph Node Dissection, Mortality rate, General Medicine, medicine.disease, Cardiac surgery, Survival Rate, Dissection, medicine.anatomical_structure, 030228 respiratory system, Lymph Node Excision, Female, Surgery, Cardiology and Cardiovascular Medicine, Complication, business
الوصف: Lung cancer is a typical disease of elderly patients. While there are many publications in the literature on factors affecting survival, there is still no consensus on the survival impact of lymph node dissection. Our objective in this study was to evaluate prognostic factors influencing rates of complications, mortality, and survival in geriatric patients who underwent surgery for non-small cell lung cancer. Data obtained from the medical records of patients aged 70 years or older with early-stage non-small cell lung cancer who underwent surgery between January 01, 2008 and December 31, 2015 were evaluated retrospectively. Of the 72 patients included, 57 (79.2%) were male and 15 (20.8%) were female. Complications were observed in 42 patients (58.3%). Nineteen patients (26.4%) developed major complications. Percent predicted forced expiratory volume in 1 s (ppFEV1) and age was found to be risk factors for complications. Thirty days days mortality rate was 8.3%. Mortality was not significantly associated with low CCI, physical status, and ppFEV1 values. The 5-year survival rate was 40.5%. ppFEV1 were risk factors affecting survival, whereas radical lymph node dissection was not associated with survival. The main prognostic factors affecting long-term postoperative survival in the present study was a low postoperative ppFEV1 value. Radical lymph node dissection did not increase the risk of postoperative complications and it did not affect long-term survival in patients aged 70 years or older. A key finding was that comorbidities were not associated with postoperative complications or long-term survival.
-
8
المصدر: Surgery Today. 49:158-169
مصطلحات موضوعية: Male, medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, Clinical Decision-Making, Gene Expression, 03 medical and health sciences, 0302 clinical medicine, Transcription Factor TFIIIB, Surgical oncology, Biomarkers, Tumor, Humans, Medicine, Esophagus, Survival analysis, Aged, Neoplasm Staging, Proportional Hazards Models, business.industry, Proportional hazards model, Radical Lymph Node Dissection, General Medicine, Middle Aged, Surgery, Esophagectomy, Dissection, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Lymph Node Excision, Female, 030211 gastroenterology & hepatology, Lymph, Neoplasm Recurrence, Local, business
الوصف: Radical lymph-node dissection surgery in patients with cN0 middle thoracic esophageal squamous cell carcinoma (ESCC) remains controversial. We sought a novel biomarker that could be used for decision-making in relation to radical lymph-node dissection. One hundred and nineteen patients with cN0 middle thoracic ESCC undergoing three-field lymph-node dissection (3FLND) or two-field lymph-node dissection (Ivor Lewis) esophagectomy were reviewed. A survival analysis, and Chi-square and parametric tests were performed. A Cox regression analysis revealed that the expression of BRF2 was an independent prognostic factor for overall survival (P = 0.014) and progression-free survival (P = 0.014). The survival of patients who underwent 3FLND was better than that of patients who underwent Ivor Lewis esophagectomy in the BRF2 overexpression group (P = 0.002), but not in the BRF2 nonoverexpression group (P = 0.386). The risk of lymph-node recurrence and the number of recurrent lymph nodes in patients with the overexpression of BRF2 were increased in the Ivor Lewis group in comparison to the 3FLND group (P = 0.01 and P
-
9
المؤلفون: Daisuke Fujimoto, Hirotoshi Kobayashi, Keizo Taniguchi
المصدر: Updates in surgery. 73(2)
مصطلحات موضوعية: medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, Single Center, 03 medical and health sciences, 0302 clinical medicine, Monitoring, Intraoperative, medicine, Humans, Esophagus, Retrospective Studies, business.industry, Recurrent Laryngeal Nerve, Radical Lymph Node Dissection, Incidence, Thyroidectomy, Retrospective cohort study, Esophageal cancer, medicine.disease, Surgery, Esophagectomy, Dissection, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Recurrent Laryngeal Nerve Injuries, 030211 gastroenterology & hepatology, business, Vocal Cord Paralysis
الوصف: The incidence of recurrent laryngeal nerve palsy (RLNP) following minimally invasive esophagectomy has yet to be satisfactorily reduced. Use of intraoperative neuromonitoring (IONM), specifically of the RLN, during thyroidectomy has been reported to reduce the incidence of RLN injury. We now apply IONM during curative prone thoracoscopic esophagectomy, and we conducted a retrospective study to evaluate the feasibility and efficacy of intermittent monitoring of the RLN during the surgery. The study involved 32 consecutive patients who underwent esophagectomy with radical lymph node dissection for esophageal cancer. The patients were of two groups: an IONM group (n = 17) and a non-IONM group (n = 15). We chiefly strip around the esophagus preserving the membranous structure, which contains the tracheoesophageal artery, lymph nodes, and RLN. In the IONM group patients, we stimulated the RLN and measured the electromyography (EMG) amplitude after dissection, at the dissection starting point and dissection end point on both sides. For the purpose of the study, we compared outcomes between the two groups of patients. IONM was carried out successfully in all 17 patients in the IONM group. The incidence of RLNP was significantly reduced in this group. We found that both RLNs can be identified by mean of IONM easily, immediately, and safely and that the EMG amplitude attenuation rate is particularly useful for predicting RLNP.
-
10
المؤلفون: Felix Watzka, Hauke Lang, Julia I. Staubitz, A Läßig, Peter P. Grimminger, F Dette, Thomas J. Musholt, Felix Berlth, P C van der Sluis
المصدر: Langenbeck's Archives of Surgery
مصطلحات موضوعية: Larynx, medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, Laryngoscopy, Esophageal cancer, 610 Medizin, Intraoperative nerve monitoring, 03 medical and health sciences, 0302 clinical medicine, 610 Medical sciences, Monitoring, Intraoperative, medicine, Recurrent laryngeal nerve, Humans, Robot-assisted surgery, Prospective Studies, Paresis, medicine.diagnostic_test, business.industry, Recurrent Laryngeal Nerve, Paratracheal lymph nodes, Radical Lymph Node Dissection, Robotics, Surgery, Esophagectomy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Lymphadenectomy, Original Article, medicine.symptom, Vocal cord paresis, business
الوصف: Purpose The robot-assisted approach for Ivor Lewis esophagectomy offers an enlarged, three-dimensional overview of the intraoperative situs. The vagal nerve (VN) can easily be detected, preserved, and intentionally resected below the separation point of the recurrent laryngeal nerve (RLN). However, postoperative vocal cord paresis can result from vagal or RLN injury during radical lymph node dissection, presenting a challenge to the operating surgeon. Methods From May to August 2019, 10 cases of robot-assisted minimally invasive esophagectomy (RAMIE) with extended 2-field lymphadenectomy, performed at the University Medical Center Mainz, were included in a prospective cohort study. Bilateral intermittent intraoperative nerve monitoring (IONM) of the RLN and VN was performed, including pre- and postoperative laryngoscopy assessment. Results Reliable mean signals of the right VN (2.57 mV/4.50 ms) and the RLN (left 1.24 mV/3.71 ms, right 0.85 mV/3.56 ms) were obtained. IONM facilitated the identification of the exact height of separation of the right RLN from the VN. There were no cases of permanent postoperative vocal paresis. Median lymph node count from the paratracheal stations was 5 lymph nodes. Conclusion IONM was feasible during RAMIE. The intraoperative identification of the RLN location contributed to the accuracy of lymph node dissection of the paratracheal lymph node stations. RLN damage and subsequent postoperative vocal cord paresis can potentially be prevented by IONM.
إعادة تعيين المنقحات
عرض المنقحات (%%عد%%)
Find this article in full text from Springer Verlag.