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Journal of Pediatric Surgery Mar 2018The impact of abdominal topography and surgical technique on resectability and local relapse pattern of relapsed abdominal high-risk neuroblastoma (R-HR-NB) is not...
BACKGROUND/PURPOSE
The impact of abdominal topography and surgical technique on resectability and local relapse pattern of relapsed abdominal high-risk neuroblastoma (R-HR-NB) is not clearly defined.
METHODS
A sample of thirty-nine patients with R-HR-NB enrolled in the German neuroblastoma trials between 2001 and 2010 was analyzed retrospectively using surgical and imaging reports. We evaluated resectability and local relapse pattern within 6 standardized abdominal regions, impact of extent of the first resective surgery on overall survival (OS), and of number of operations and a higher cumulative surgical assessment score (C-SAS) on OS after the first event.
RESULTS
In the left upper abdomen, rates for tumor persistence and relapse were 45.9% and 13.5% and in the left lower abdomen 27.7% and 8.3%, respectively. OS in months did not differ between complete and incomplete first resections (median (interquartile range): 35 (45.6) vs. 40 (65.4), P=.649). Better OS after the first event was associated with repeated as compared to single surgery (47.7 (64.7) vs. 4.3 (12.5), P=.000), and with higher as compared to lower C-SAS (47.7 (64.3) vs. 7.6 (14.7), P=.002).
CONCLUSIONS
OS after relapse/progression was not dependent on the extent of first resection. The number of operations was associated with better outcome after event.
TYPE OF STUDY
Treatment study.
LEVEL OF EVIDENCE
LEVEL III Retrospective comparative study.
Topics: Abdominal Neoplasms; Child, Preschool; Female; Humans; Infant; Male; Neoplasm Recurrence, Local; Neoplasm Staging; Neuroblastoma; Reoperation; Retrospective Studies; Survival Analysis
PubMed: 29021103
DOI: 10.1016/j.jpedsurg.2017.09.002 -
European Journal of Clinical Nutrition Nov 2016A systematic review and meta-analysis were designed to evaluate the efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with... (Meta-Analysis)
Meta-Analysis Review
The efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer: a systematic review and meta-analysis.
A systematic review and meta-analysis were designed to evaluate the efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer. We searched the Cochrane Library, PubMed, EMBASE and Web of Science up to November 2015. We also hand searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials. Odds ratio (OR) was used to compare efficacy, and the pooled OR was estimated using a random effects model; heterogeneity was assessed with Cochran's Q and the Higgins' I-test. Two reviewers assessed trial quality and extracted data independently. Analysis and bias for each included study were performed using Review Manager 5.2. Nine randomized and placebo-controlled studies (N=1265 participants) were included for assessing efficacy, of which seven were about radiotherapy and two about chemotherapy. Probiotic groups were compared with control groups with respect to the the incidence of diarrhea, OR=0.47 (95% confidence interval 0.28-0.76; P=0.002). Eleven studies, including 1612 people (873 consuming probiotics and 739 not consuming probiotics), were used for the analysis of safety of probiotics. Of the 11 studies, seven studies had no adverse events (AEs) caused by probiotics, whereas four studies reported varying degrees of AEs in their treatment. Probiotics may have a beneficial effect in prevention of chemoradiotherapy-induced diarrhea generally, especially for Grade⩾2 diarrhea. Probiotics may rarely cause AEs.
Topics: Abdominal Neoplasms; Diarrhea; Humans; Inflammatory Bowel Diseases; Pelvic Neoplasms; Probiotics; Radiation Injuries; Randomized Controlled Trials as Topic; Safety
PubMed: 27329608
DOI: 10.1038/ejcn.2016.102 -
BMJ Case Reports Apr 2016
Topics: Abdominal Neoplasms; Aged, 80 and over; Diagnosis, Differential; Female; Humans; Keratosis, Seborrheic
PubMed: 27060075
DOI: 10.1136/bcr-2016-215316 -
Medical Ultrasonography Aug 2019Budd Chiari syndrome defines an obstruction of the hepatic venous outflow. Primary causes include pro-coagulant states resulting in venous thrombosis, while secondary... (Review)
Review
Budd Chiari syndrome defines an obstruction of the hepatic venous outflow. Primary causes include pro-coagulant states resulting in venous thrombosis, while secondary Budd Chiari syndrome appears in conditions associated with extrinsic compression of the hepatic veins or tumor invasion. Clinical presentation is greatly varied, from incidentally discovered asymptomatic thrombosis to fulminant liver failure due to hepatic congestion. Abdominal ultrasonography is the key diagnostic tool of Budd Chiari syndrome. This pictorial essay aims to show the ultrasonographic aspect of Budd-Chiari syndrome associated with other medical conditions (abdominal malignancy, hematologic disorders and abdominal surgery).
Topics: Abdominal Neoplasms; Budd-Chiari Syndrome; Hematologic Diseases; Humans; Postoperative Complications; Ultrasonography
PubMed: 31476215
DOI: 10.11152/mu-1921 -
Rozhledy V Chirurgii : Mesicnik... 2021A complex review of surgery treatment of unusually giant intra-abdominal and retroperitoneal tumors regardless of their origin and histological findings. The therapy of...
A complex review of surgery treatment of unusually giant intra-abdominal and retroperitoneal tumors regardless of their origin and histological findings. The therapy of such neoplasms requires a multidisciplinary approach which is necessary to make a reasonable and responsible decision concerning not only the indication of surgery, but also its extent. The authors describe 5 case reports, highlighting specific aspects and pitfalls of the diagnosis and treatment of these rare cases.
Topics: Abdominal Neoplasms; Humans; Retroperitoneal Neoplasms
PubMed: 33691417
DOI: 10.33699/PIS.2021.100.1.10-16 -
Der Anaesthesist Feb 2020Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are therapeutic options for the treatment of intra-abdominal neoplasms. Following the... (Review)
Review
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are therapeutic options for the treatment of intra-abdominal neoplasms. Following the resection of all visible tumor areas by CRS, microscopic tumor areas are treated with HIPEC. This procedure increases the quality of life and survival. The CRS with HIPEC is a complex surgical procedure in which the mainly younger and often otherwise healthy patients undergo several pathophysiological changes during the operation. The main concern of the anesthesiologist is the massive volume loss, volume shift and metabolic alterations. Patients with a high comorbidity should undergo preoperative optimization to reduce the perioperative morbidity and mortality especially by protracted interventions.
Topics: Abdominal Neoplasms; Combined Modality Therapy; Cytoreduction Surgical Procedures; Humans; Hyperthermic Intraperitoneal Chemotherapy; Perioperative Care
PubMed: 31820018
DOI: 10.1007/s00101-019-00706-4 -
Cancer Epidemiology Jun 2021More than 11,500 abdominal cancers are yearly diagnosed in Denmark. Nevertheless, little is known about which investigations the patients undergo before a diagnosis of...
BACKGROUND
More than 11,500 abdominal cancers are yearly diagnosed in Denmark. Nevertheless, little is known about which investigations the patients undergo before a diagnosis of abdominal cancer. We aimed to investigate the frequency and timing of selected diagnostic investigations during the year preceding an abdominal cancer diagnosis.
METHODS
We conducted a nationwide registry-based cohort study of patients aged ≥ 18 years who were diagnosed with a first-time abdominal cancer in 2014-2018. We included the following cancer types: oesophageal, gastric, colon, rectal, liver, gall bladder/biliary tract, pancreatic, endometrial, ovarian, kidney, and bladder cancer. Investigations of interest were transvaginal ultrasound, abdominal ultrasound, colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography, cystoscopy, hysteroscopy, abdominal computed tomography and abdominal magnetic resonance imaging. Generalised linear models were used to calculate incidence rate ratios to enable comparison of monthly rates of investigations.
RESULTS
All types of investigations were performed, with varying frequency, across the 11 abdominal cancer types in the year preceding the diagnosis. Increased use of investigations revealed that the timing of the onset differed for the different abdominal cancers, with increases seen 2-6 months before the diagnosis. Abdominal ultrasound, colonoscopy and computed tomography were the investigations with the earliest increase.
CONCLUSION
In the year before a diagnosis of an abdominal cancer, some patients appear to undergo investigations typically used to detect another cancer type. This indicates that a window of opportunity exists to diagnose some abdominal cancers at an earlier time point. Future studies should explore an alternative clinical pathway to promote earlier diagnosis of abdominal cancers.
Topics: Abdominal Neoplasms; Adolescent; Adult; Aged; Cohort Studies; Denmark; Diagnostic Techniques and Procedures; Female; Humans; Male; Middle Aged; Registries; Young Adult
PubMed: 33689927
DOI: 10.1016/j.canep.2021.101926 -
Endokrynologia Polska 2019Extraperitoneal, abdominal paragangliomas most commonly originate from the sympathetic nervous system. Typical features include catecholamine overproduction and the... (Comparative Study)
Comparative Study
INTRODUCTION
Extraperitoneal, abdominal paragangliomas most commonly originate from the sympathetic nervous system. Typical features include catecholamine overproduction and the potential for malignancy. Lesions are usually located paravertebrally, but when growing in a more expansive manner they may also appear between the inferior vena cava and aorta. In the authors' opinion this site excludes laparoscopic tumourectomy.
MATERIAL AND METHODS
Twenty-eight patients were selected for surgical management of abdominal paragangliomas in the past eight years at our endocrine surgical centre. This group consisted of 21 (75%) women and seven (25%) men, aged 14 to 84 years (mean 47.9). In 13 (46.4%) cases paroxysmal hypertension was observed. Type 2 diabetes was noted in another 10 (35.7%) patients, and Takotsubo acute coronary syndrome in two (7.1%). Patients were preoperatively qualified for either open surgery or laparoscopic tumourectomy based on visualisation and location of the tumours in imaging studies.
RESULTS
All patients were successfully operated. Eleven (39.3%) patients qualified for laparoscopy, while the remaining 17 (60.7%) were treated with an open surgical approach due to difficult access to the lesion. The mean operative time was 130 minutes for laparoscopy and 120 minutes for laparotomy (p = 0.2). There were no local or general complications after either type of procedure.
CONCLUSIONS
The use of laparoscopic access is practically excluded in the treatment of paragangliomas located between the inferior vena cava and aorta, especially at the level of the renal vessels and extending superiorly to the diaphragm.
Topics: Abdominal Neoplasms; Adolescent; Adult; Aged; Aged, 80 and over; Comorbidity; Diabetes Mellitus, Type 2; Female; Humans; Hypertension; Laparoscopy; Laparotomy; Male; Middle Aged; Paraganglioma; Vena Cava, Inferior; Young Adult
PubMed: 31529458
DOI: 10.5603/EP.a2019.0038 -
Oncology Research and Treatment 2022Resection of large anterior abdominal wall tumors causes large full-thickness abdominal wall defects, and the repair of these defects remains a challenging point.
BACKGROUND
Resection of large anterior abdominal wall tumors causes large full-thickness abdominal wall defects, and the repair of these defects remains a challenging point.
METHODS
Between July 2016 and February 2021, we retrospectively reviewed the internal database registry of the Oncology Center, Mansoura University (OCMU), Egypt, for patients with large abdominal wall defects after abdominal wall tumors resection and repair with omental flaps and synthetic polypropylene (PP) mesh. Thirty-two patients met the inclusion criteria. They were analyzed for demographics and operative data including defect size, mesh size, intra-abdominal tumor extension, and postoperative outcomes and complications.
RESULTS
Thirty-Two patients with abdominal wall neoplasm underwent local resection in our center and the defect was closed with an omental flap and PP mesh. The mean operative time was 143.75 ± 30.77 min. The mean size of the abdominal wall defect was 50.8 cm2 (range: 25-90 cm2). The meshes used in reconstruction had a mean size of 89.5 cm2 (range: 55-130 cm2). The median follow-up period of the patients was 13.5 months (range: 5-54 months). Postoperative complications included infection (n = 4 cases), seroma (n = 2 cases), hematoma (n = 1 case), and abnormal sensation (n = 5 cases). Tumor recurrence was reported in 2 cases, and no cases developed incisional hernia during the follow-up period.
CONCLUSION
Immediate use of omental flap with synthetic PP mesh for reconstruction of abdominal wall defects is a feasible technique and has avoided the complications associated with the use of synthetic mesh alone.
Topics: Abdominal Neoplasms; Abdominal Wall; Humans; Neoplasm Recurrence, Local; Polypropylenes; Postoperative Complications; Retrospective Studies; Surgical Flaps; Surgical Mesh
PubMed: 35537417
DOI: 10.1159/000524871 -
Breast (Edinburgh, Scotland) Oct 2015Aggressive breast cancer is a term commonly used in literature to describe breast cancer with a poor prognosis. Identifying and understanding the factors associated with... (Review)
Review
BACKGROUND
Aggressive breast cancer is a term commonly used in literature to describe breast cancer with a poor prognosis. Identifying and understanding the factors associated with aggressiveness could be helpful to the management of patients with breast cancer. Breast cancer is a heterogeneous disease, both clinically and biologically, which may be responsible for the wide range of survival durations for patients with metastatic disease.
AIM
The goal of this study was to identify the factors most often described in association with aggressive metastatic breast cancer (MBC).
METHODS
A systematic review was performed by querying PubMed from January 1, 2012 to June 1, 2014 for "metastatic breast cancer" ("aggressive" or "poor prognosis" or "high risk"). The level of evidence to support each potential prognostic factor of aggressive MBC was also reviewed.
RESULTS
The identified factors were grouped into 3 principle categories: clinical, biological, and patient related. Because patient-related factors may not be indicative of inherent cancer aggressiveness, this review focused only on clinical and biological factors. The factors with the highest levels of evidence to support associations with survival in metastatic breast cancer were visceral metastases, number of metastatic sites, disease-free interval, presence of CTCs, triple-negative disease, and tumour grade.
CONCLUSION
Identification of these factors and understanding their contribution to the aggressiveness of MBC and disease progression may lead to more personalized treatment in this patient population.
Topics: Abdominal Neoplasms; Brain Neoplasms; Disease-Free Survival; Female; Humans; Neoplasm Grading; Neoplastic Cells, Circulating; Triple Negative Breast Neoplasms; Tumor Burden
PubMed: 26144637
DOI: 10.1016/j.breast.2015.06.001