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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 -
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 -
Diagnostic and Interventional Radiology... 2016Burkitt lymphoma is an aggressive and rapidly growing tumor that is curable and highly sensitive to chemotherapy. It can affect almost every tissue in the body,... (Review)
Review
Burkitt lymphoma is an aggressive and rapidly growing tumor that is curable and highly sensitive to chemotherapy. It can affect almost every tissue in the body, producing various clinical presentations and imaging appearances, according to the predilection of the different subtypes for certain sites. Awareness of its diagnostically specific imaging appearances plays an important role in rapid detection and treatment. In this pictorial review, we aimed to identify the most common imaging features of Burkitt lymphoma in pediatric patients.
Topics: Abdominal Neoplasms; Burkitt Lymphoma; Child; Female; Head and Neck Neoplasms; Humans; Male
PubMed: 26611257
DOI: 10.5152/dir.2015.15211 -
PloS One 2017To determine the rate of abdominal lymph node metastasis after radical surgery for esophageal cancer and define the radiotherapy target area.
AIM
To determine the rate of abdominal lymph node metastasis after radical surgery for esophageal cancer and define the radiotherapy target area.
METHODS
Of the 1593 patients who underwent R0 radical esophagectomy for thoracic esophageal squamous cell carcinoma (TE-SCC), 148 developed abdominal lymph node (LN) metastases within three years of surgery. During that time interval, patients were examined by various imaging methods (enhanced computer tomography, magnetic resonance imaging, and positron emission tomography-CT) at set time points. The emerging recurrence pattern, preferred sites for abdominal metastasis, and correlation with added clinical factors were carefully recorded, to permit for delineation of a target area for radiotherapy.
RESULTS
We found postoperative metastatic abdominal LNs in 9.3% of the patients treated for esophageal cancer. Lesions in the upper, middle, and lower esophageal segments metastasized to abdominal LNs at 2.3%, 7.8%, and 26.6% (P < 0.0001), respectively. Of all cases, 4.8% had fewer than two affected LNs, while 20.1% had more than three metastatic LNs (P< 0.0001). The metastasis rates of negative and positive celiac LNs were 4.6% and 22.7%, respectively. Abdominal LN metastasis rates for the following LNs: 16a2 and 16a1 of para-aortic, celiac artery, posterior surface of the pancreatic head and common hepatic artery were 64.9%, 41.2%, 37.8%, 32.4%, and 20.9%, respectively. The overall rate of metastasis to these groups of LNs was 91.9%.
CONCLUSION
This study determined that stations 16a1 and 16a2 of the para-aortic, truncus coeliacus, posterior surface of the pancreatic head, and arteria hepatica communis lymph nodes were the preferred sites for abdominal LN metastasis, thus defining target areas for postoperative radiotherapy.
Topics: Abdominal Neoplasms; Adult; Aged; Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Esophagectomy; Female; Hepatic Artery; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Positron-Emission Tomography
PubMed: 29016614
DOI: 10.1371/journal.pone.0185424 -
Cancer Jul 2003Less than 5% of neuroblastomas are diagnosed in adolescent patients. Previous studies of patients who were treated with less intensive chemotherapy regimens relative to...
BACKGROUND
Less than 5% of neuroblastomas are diagnosed in adolescent patients. Previous studies of patients who were treated with less intensive chemotherapy regimens relative to currently available regimens suggested that adolescents survived longer than younger children, and this finding was related to a lack of myc-N amplification. Those reports prompted the authors to study a cohort of adolescent patients who had been included in more recent trials.
METHODS
The authors investigated the presentation, treatment, and outcome in 28 adolescent patients who were enrolled in studies of the French Society of Pediatric Oncology during the period from 1987 to 1999 and who were older than age 10 years at the time they were diagnosed with neuroblastoma. The results were used to compare this subpopulation with a control group of children.
RESULTS
None of the six patients with Stage I-II disease either developed recurrent disease or died. At 5 years, disease progression was high (progression-free survival [PFS], 28%) for the 9 adolescents with Stage III disease, but so was survival (overall survival [OS], 86%). The 13 adolescent patients with metastatic neuroblastoma had very poor outcomes (PFS, 18%; OS, 27%). Despite intensive therapy, advanced neuroblastoma appeared to carry a poorer prognosis in adolescent patients compared with children, although patients with Stage III disease had a more indolent course. No difference was found between adolescent patients and children regarding the clinical presentation, treatment schedule, or doses and tolerance of chemotherapy. The incidence of elevated urinary catecholamine metabolite secretion was lower in adolescents compared with children.
CONCLUSIONS
Adolescent patients with advanced neuroblastoma had less favorable outcomes compared with children, even if survival in adolescents with Stage III disease seemed longer.
Topics: Abdominal Neoplasms; Adolescent; Case-Control Studies; Child; Disease-Free Survival; Female; Humans; Male; Neoplasm Recurrence, Local; Neoplasm Staging; Neuroblastoma; Prognosis; Retrospective Studies; Treatment Outcome
PubMed: 12872356
DOI: 10.1002/cncr.11521 -
Cancer Jan 2011Primary extradural meningiomas (PEMs) represent about 2% of all meningiomas and are often encountered by non-neurosurgeons. These lesions typically present as enlarging,... (Review)
Review
Primary extradural meningiomas (PEMs) represent about 2% of all meningiomas and are often encountered by non-neurosurgeons. These lesions typically present as enlarging, painless, benign masses that can be surgically cured. Imaging is critical for defining involvement of adjacent structures; however, diagnosis depends on classic histologic patterns. Treatment for benign PEMs (WHO I) consists of resection with wide margins, whereas adjuvant therapy after resection of atypical (WHO II) or malignant (WHO III) PEMs should be considered. By using the collective experience from our comprehensive cancer center, including neuro-oncologists, neuroradiologists, and neurosurgeons, in addition to a complete literature review, the authors have established treatment guidelines not previously reported. This manuscript describes key features of these challenging tumors to aid in diagnosis, presents the largest published review of all reported PEMs (n = 163), and provides salient treatment guidelines to surgeons unfamiliar with these challenging tumors.
Topics: Abdominal Neoplasms; Algorithms; Bone Neoplasms; Head and Neck Neoplasms; Humans; Meningeal Neoplasms; Meningioma; Practice Guidelines as Topic
PubMed: 20824719
DOI: 10.1002/cncr.25384 -
Journal of Clinical Pathology Nov 2005Although the standard treatment for desmoid tumours is complete surgical resection with wide margins, the optimal adjuvant treatment for recurrent or inoperable disease...
BACKGROUND/AIMS
Although the standard treatment for desmoid tumours is complete surgical resection with wide margins, the optimal adjuvant treatment for recurrent or inoperable disease is unclear, often being based on sporadic immunohistochemical reports with a low number of cases. Therefore, a large immunohistochemical study was performed, to provide a theoretical basis for adjuvant treatment regimens.
METHODS
One hundred and sixteen tissue samples from 80 patients (49 female, 31 male; mean age, 34 years; range, 0-83) with desmoid tumours (46 extra-abdominal, 21 abdominal, 13 intra-abdominal) were tested for oestrogen receptors alpha and beta, progesterone and androgen receptors, and somatostatin, in addition to HER2, cathepsin D, Ki-67, and c-KIT by immunohistochemistry.
RESULTS
All samples were negative for oestrogen receptor alpha, HER2, and the progesterone receptor. Positive staining for the androgen receptor was found in six extra-abdominal cases. Staining for oestrogen receptor beta was positive in four extra-abdominal, two abdominal, and one intra-abdominal case. Staining for somatostatin was positive in six extra-abdominal, two abdominal, and one intra-abdominal case, and staining for cathepsin D was positive in all cases. Positive staining for Ki-67 was found in 14 extra-abdominal, three abdominal, and three intra-abdominal cases. C-KIT was detectable in one abdominal case only.
CONCLUSIONS
The data from this immunohistochemical study show that the published effects of antioestrogens and imatinib mesylate in the treatment of aggressive fibromatoses may not be attributable to oestrogen receptor alpha or c-KIT expression.
Topics: Abdominal Neoplasms; Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Cathepsin D; Chemotherapy, Adjuvant; Child; Child, Preschool; Female; Fibromatosis, Aggressive; Humans; Infant; Infant, Newborn; Ki-67 Antigen; Male; Middle Aged; Neoplasm Proteins; Proto-Oncogene Proteins c-kit; Receptors, Androgen; Receptors, Estrogen; Receptors, Progesterone; Soft Tissue Neoplasms; Somatostatin
PubMed: 16254103
DOI: 10.1136/jcp.2005.026278 -
Annals of Surgery Mar 1997The authors determined the accuracy of laparoscopy in detecting metastatic disease in patients with gastric adenocarcinoma. (Clinical Trial)
Clinical Trial Review
OBJECTIVE
The authors determined the accuracy of laparoscopy in detecting metastatic disease in patients with gastric adenocarcinoma.
SUMMARY BACKGROUND DATA
The majority of patients with gastric adenocarcinoma in the United States present with advanced disease. They are at high risk for intraabdominal metastatic spread.
METHODS
One hundred eleven patients with gastric adenocarcinoma underwent laparoscopy at Memorial-Sloan Kettering Cancer Center from December 1991 to December 1995. All were judged to be free of intra-abdominal metastatic disease on preoperative computed tomographic scan imaging.
RESULTS
Laparoscopic exploration was successful in 110 of 111 patients and accurately staged 94% of the patients with respect to metastatic disease with a sensitivity of 84% and a specificity of 100%. The prevalence rate of metastatic disease was 37%. Twenty-four patients underwent laparoscopy only and were discharged in an average 1.4 days versus 6.5 days in patients undergoing exploratory laparotomy without resection (p < 0.05). No patients undergoing laparoscopy only have returned for palliative surgery.
CONCLUSIONS
Laparoscopy should be performed in nonobstructed, nonbleeding patients with advanced gastric cancer in the United States. More than one third of these patients have unsuspected metastatic disease at time of operation. Laparoscopy is highly accurate in detecting occult metastases and identifies a unique population of stage IV patients who may benefit from newer induction chemotherapeutic approaches while avoiding unnecessary laparotomy.
Topics: Abdominal Neoplasms; Adenocarcinoma; Humans; Laparoscopy; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; Stomach Neoplasms
PubMed: 9060581
DOI: 10.1097/00000658-199703000-00004 -
Physics in Medicine and Biology Jun 2023. In the current MR-Linac online adaptive workflow, air regions on the MR images need to be manually delineated for abdominal targets, and then overridden by air density...
. In the current MR-Linac online adaptive workflow, air regions on the MR images need to be manually delineated for abdominal targets, and then overridden by air density for dose calculation. Auto-delineation of these regions is desirable for speed purposes, but poses a challenge, since unlike computed tomography, they do not occupy all dark regions on the image. The purpose of this study is to develop an automated method to segment the air regions on MRI-guided adaptive radiation therapy (MRgART) of abdominal tumors.. A modified ResUNet3D deep learning (DL)-based auto air delineation model was trained using 102 patients' MR images. The MR images were acquired by a dedicated in-house sequence named 'Air-Scan', which is designed to generate air regions that are especially dark and accentuated. The air volumes generated by the newly developed DL model were compared with the manual air contours using geometric similarity (Dice Similarity Coefficient (DSC)), and dosimetric equivalence using Gamma index and dose-volume parameters.. The average DSC agreement between the DL generated and manual air contours is 99% ± 1%. The gamma index between the dose calculations with overriding the DL versus manual air volumes with density of 0.01 is 97% ± 2% for a local gamma calculation with a tolerance of 2% and 2 mm. The dosimetric parameters from planning target volume-PTV and organs at risk-OARs were all within 1% between when DL versus manual contours were overridden by air density. The model runs in less than five seconds on a PC with 28 Core processor and NVIDIA QuadroP2000 GPU.: a DL based automated segmentation method was developed to generate air volumes on specialized abdominal MR images and generate results that are practically equivalent to the manual contouring of air volumes.
Topics: Humans; Radiotherapy Planning, Computer-Assisted; Deep Learning; Abdominal Neoplasms; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Image Processing, Computer-Assisted
PubMed: 37253374
DOI: 10.1088/1361-6560/acda0b -
Risk of tumor implantation in percutaneous endoscopic gastrostomy in the upper aerodigestive tumors.Acta Bio-medica : Atenei Parmensis Dec 2018Percutaneous endoscopic gastrostomy (PEG) has become a mainstay in providing enteral access for patients with obstructive head, neck and esophageal tumors. Tumor cell... (Review)
Review
Percutaneous endoscopic gastrostomy (PEG) has become a mainstay in providing enteral access for patients with obstructive head, neck and esophageal tumors. Tumor cell implantation is a rare complication in patients with aerodigestive cancers, who have undergone PEG tube placement. The objective of this review is to determine the incidence and contributing risk factors leading to the implantation of metastases into the abdominal wall following PEG placement. A comprehensive review of the literature in PUBMED (2008-2018) was performed. The literature search revealed reports of more than 50 cases of abdominal wall metastases after PEG placement. As most of these studies were case reports, the exact rate of metastasis remains unknown. Generally pharyngoesophageal location of primary cancer (100%), squamous cell histology (98%), poorly differentiated tumor cells (92%), advanced pathological stage (97%), and large primary cancer size were identified as strong risk factors for the development of stomal metastasis. Abdominal wall metastases following PEG placement are a rare but serious complication in patients with head and neck malignancy.
Topics: Abdominal Neoplasms; Abdominal Wall; Antineoplastic Agents; Carcinoma; Chemoradiotherapy; Enteral Nutrition; Gastrostomy; Head and Neck Neoplasms; Humans; Incidence; Intubation, Gastrointestinal; Malnutrition; Neoplasm Seeding; Risk Factors
PubMed: 30561429
DOI: 10.23750/abm.v89i8-S.7894