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International Journal of Surgery... Dec 2023
Meta-Analysis
A commentary on '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 based on 23 randomized studies'.
Topics: Humans; Pelvic Neoplasms; Diarrhea; Abdomen; Chemoradiotherapy; Probiotics
PubMed: 37678298
DOI: 10.1097/JS9.0000000000000674 -
BMJ Case Reports Mar 2022Pelvic exenteration surgery is used as a standard procedure in recurrent pelvic cancers. Total pelvic exenteration (TPE) includes resection of the uterus, prostate,...
Pelvic exenteration surgery is used as a standard procedure in recurrent pelvic cancers. Total pelvic exenteration (TPE) includes resection of the uterus, prostate, ureters, bladder and rectosigmoid colon from pelvic space. Empty pelvis syndrome is a complication of the TPE procedure. Following TPE, complications such as haematoma, abscess leading to permanent pus discharge and chronic infections can occur. Herein, we present the case of a man in his 50s who was referred for pelvic pain, foul-smelling discharge and non-functioning colostomy, and operated for distal rectal cancer 1.5 years ago and underwent low anterior resection. In this case, we performed TPE for the recurrent tumour. To prevent TPE complications, we used a breast implant for filling the pelvic cavity. The early and late postoperative course was uneventful.
Topics: Breast Implants; Female; Humans; Male; Neoplasm Recurrence, Local; Pelvic Exenteration; Pelvic Neoplasms; Pelvis
PubMed: 35351741
DOI: 10.1136/bcr-2021-245630 -
The Journal of Veterinary Medical... Jan 2017A 12-year-old, spayed female Schnauzer presented with constipation. A mass was observed in the pelvic cavity, and metastasis was not identified. Mass resection was...
A 12-year-old, spayed female Schnauzer presented with constipation. A mass was observed in the pelvic cavity, and metastasis was not identified. Mass resection was performed through celiotomy with pubic osteotomy, and hemangiosarcoma was diagnosed. At 10 weeks post-operatively, the patient died of multiple metastasis. Primary intrapelvic hemangiosarcoma is rare in dogs.
Topics: Animals; Dog Diseases; Dogs; Fatal Outcome; Female; Hemangiosarcoma; Pelvic Neoplasms
PubMed: 27746404
DOI: 10.1292/jvms.16-0186 -
Medicine Feb 2018Pleomorphic liposarcoma (PLS), is a rare subtype of liposarcoma, and is considered to be of the highest malignancy grade. (Review)
Review
RATIONALE
Pleomorphic liposarcoma (PLS), is a rare subtype of liposarcoma, and is considered to be of the highest malignancy grade.
PATIENT CONCERNS
We aimed to analyze the clinical features, diagnosis, treatment, and recurrence of the 6 cases of PLS.
DIAGNOSES
Six cases with confirmed pathological PLS presented at out hospital from January 2003 to January 2017. The postoperative pathology of 5 cases confirmed PLS, and the other was confirmed as PLS with well-differentiated liposarcoma.
INTERVENTIONS
All 6 patients underwent complete tumor resection at the time of the first definite diagnosis, and one of them had underwent 3 cycles of chemotherapy treatment.
OUTCOMES
There were 4 cases with local recurrence and surgery was repeated after the first radical excision. One case was not recurrent after 27 months post-operation, and the other was lost. The shortest recurrence time of all of these cases was 4 months, and the longest was 29 months after the first radical surgery.
LESSONS
PLS is a rare and high-grade malignancy with high recurrence, poor prognosis, and its treatment is still highly controversial. More studies are required to determine the appropriate treatment and therapeutic strategies to improve the survival rate of patients with PLS, as the disease is associated with frequent relapse.
Topics: Aged; Aged, 80 and over; Female; Humans; Liposarcoma; Male; Middle Aged; Neoplasm Recurrence, Local; Pelvic Neoplasms; Retroperitoneal Neoplasms; Skin Neoplasms; Treatment Outcome
PubMed: 29465602
DOI: 10.1097/MD.0000000000009986 -
Radiation Oncology (London, England) Nov 2018Patients with recurrent retroperitoneal and pelvic region tumors often require multimodal therapies. Intraoperative radiation therapy (IORT) can deliver high-dose... (Clinical Trial)
Clinical Trial
BACKGROUND
Patients with recurrent retroperitoneal and pelvic region tumors often require multimodal therapies. Intraoperative radiation therapy (IORT) can deliver high-dose radiation to tumor beds, even if first-line external beam radiation therapy (EBRT) was administered. We evaluated local control (LC) and survival in patients receiving IORT for recurrent tumors.
METHODS
We retrospectively analyzed 41 patients with isolated pelvic or retroperitoneal recurrences of colorectal, gynecological, or retroperitoneal primary tumors. Following salvage surgery, all patients underwent tumor bed IORT via electron beam or high dose rate brachytherapy. Isolated IORT (median dose: 15 Gy) was administered to patients who had received first-line EBRT; other patients received IORT (median dose 12 Gy) plus EBRT. Local (LF), regional (RF), and distant failures (DF) were evaluated, and the Kaplan-Meier method and log-rank test were used to evaluate and compare overall survival (OS) from the date of IORT.
RESULTS
Forty-one patients underwent 44 treatments, including 27 (61.3%) isolated IORT and 17 (38.7%) IORT and EBRT combination regimens. The median follow-up was 8.1 years (range: 4.4-11.7 years), and the 2, 5, and 8 year overall LC rates were 87.9, 64.0, and 49.8%, respectively. Regarding resection status, the respective 2, 5, and 8 year LC rates were 90, 76, and 76% for R0 resection and 75, 25, and 0% for R1 resection (p < 0.001). The 2, 5, and 8 year OS rates were 68, 43, and 26%, respectively. OS was better among patients with LC (p < 0.001). Twenty-four patients (58.5%) experienced a DF, and the 5 year OS rates for the patients with and without DF were 36 and 52%, respectively (p = 0.04). In a multivariate analysis, LF (p = 0,012) and recurrent retroperitoneal sarcoma (p = 0,014) were identified as significant predictors of worse OS. Thirteen patients (31%) developed clinically treatable complications related to IORT.
CONCLUSIONS
Many patients achieve long-term OS and LC without significant morbidity after salvage surgery and IORT, especially in case of clear margins.
Topics: Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Humans; Intraoperative Care; Male; Middle Aged; Neoplasm Recurrence, Local; Pelvic Neoplasms; Prognosis; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated; Retroperitoneal Neoplasms; Retrospective Studies; Survival Rate; Young Adult
PubMed: 30454036
DOI: 10.1186/s13014-018-1168-x -
Annals of the Royal College of Surgeons... Nov 2004Aggressive angiomyxoma (AAM) was first reported in 1983 as a distinct, slow growing, benign but locally infiltrative, soft tissue tumour. It usually arises in the pelvic... (Review)
Review
Aggressive angiomyxoma (AAM) was first reported in 1983 as a distinct, slow growing, benign but locally infiltrative, soft tissue tumour. It usually arises in the pelvic and perineal organs, mostly in women. A 47-year-old woman was found to have a large encapsulated retroperitoneal aggressive angiomyxoma. The mass was completely excised via abdomino-perineal approach, and no recurrence noted on MRI at 19 months' follow-up. The encapsulation of this tumour together with other reported rare presentations, suggest an isolated mesenchymal cell origin. A review of the literature is provided.
Topics: Female; Humans; Magnetic Resonance Imaging; Middle Aged; Myxoma; Pelvic Neoplasms; Retroperitoneal Neoplasms
PubMed: 16749950
DOI: 10.1308/14787080465 -
Cancer Imaging : the Official... Oct 2011The commonest urogenital tumours in childhood are Wilms tumour of the kidney and rhabdomyosarcoma in the pelvis. We review these tumours along with other primary renal... (Review)
Review
The commonest urogenital tumours in childhood are Wilms tumour of the kidney and rhabdomyosarcoma in the pelvis. We review these tumours along with other primary renal tumours and less common ovarian and testicular tumours in childhood. Current clinical concepts, relevant staging investigations and imaging features are described.
Topics: Female; Humans; Kidney Neoplasms; Magnetic Resonance Imaging; Male; Multimodal Imaging; Neoplasm Staging; Pelvic Neoplasms; Positron-Emission Tomography; Prognosis; Rhabdomyosarcoma; Tomography, X-Ray Computed; Wilms Tumor
PubMed: 22187115
DOI: 10.1102/1470-7330.2011.9009 -
Asian Journal of Surgery May 2024
Topics: Humans; Myxoma; Pelvic Neoplasms
PubMed: 38326110
DOI: 10.1016/j.asjsur.2024.01.135 -
Canadian Journal of Surgery. Journal... Apr 2004To compare the prognosis of patients undergoing a hemipelvectomy (HP) in the treatment of pelvic sarcomas and carcinomas and to review the morbidity and mortality...
OBJECTIVE
To compare the prognosis of patients undergoing a hemipelvectomy (HP) in the treatment of pelvic sarcomas and carcinomas and to review the morbidity and mortality associated with HP.
DESIGN
Retrospective chart review.
SETTING
The Foothills Hospital, University of Calgary, Calgary, Alberta.
PATIENTS
Thirteen patients with clinically and radiographically isolated malignancies involving the bony pelvis and adjacent structures.
INTERVENTIONS
Patients were treated with either an external HP (9 patients) or internal HP (4) in 1983-2001.
OUTCOME MEASURES
Survival and recurrence rates for patients in 2 histopathologic groups (sarcoma v. carcinoma); morbidity and mortality associated with HP.
RESULTS
Hemipelvectomy was performed for 7 sarcomas (4 primary bone and 3 soft tissue) and 6 carcinomas (5 genital tract and 1 unknown primary). Seven of the 9 external HPs involved composite resection of other pelvic structures, including other pelvic viscera (3 patients), sacrum (3) and portions of lumbar vertebrae and nerves (1). There were no additional resections among the 4 internal HPs, but 3 patients had allograft reconstruction. Length of stay averaged 30 days (range 14-70 d). At least 1 complication occurred in 10 of 13 cases. The most common complication was flap necrosis occurring in 5 patients (38%). There was 1 perioperative death (8%). The survival of patients treated for sarcomas was better than for carcinomas, which were primarily of the genital tract. Only 1 of the patients with a pelvic sarcoma died of disease (86% disease-specific survival), with a median follow-up of 12 months (range 9-108 mo). Of the 7 sarcoma patients 5 were disease-free at last follow-up. One of 6 pelvic carcinoma patients died perioperatively, with another dying of unknown causes 4 months after surgery. Of the 4 remaining patients 3 died of disease, resulting in a median survival of 9 months (range 4-20 mo). Four of 6 patients with pelvic carcinomas developed recurrent disease, none local.
CONCLUSIONS
HP has considerable morbidity but is a viable and potentially curative treatment for patients with pelvic sarcomas. With pelvic carcinomas HP was not curative, but did provide short-term local disease control. Future improvements in imaging techniques and quality-of-life studies may help with patient selection. The role of HP in recurrent carcinoma remains to be determined.
Topics: Adolescent; Adult; Aged; Carcinoma; Hemipelvectomy; Hospital Mortality; Humans; Middle Aged; Pelvic Neoplasms; Postoperative Complications; Prognosis; Retrospective Studies; Sarcoma; Survival Rate; Time Factors
PubMed: 15132462
DOI: No ID Found -
Annals of Surgical Oncology Jul 2015We evaluated outcomes of intraoperative radiotherapy delivered with focal high-dose-rate (HDR) brachytherapy [intraoperative radiotherapy (IORT)] in the management of...
BACKGROUND
We evaluated outcomes of intraoperative radiotherapy delivered with focal high-dose-rate (HDR) brachytherapy [intraoperative radiotherapy (IORT)] in the management of locally recurrent (LR) and locally advanced (LA) primary T4 colorectal carcinoma (CRC). LR CRC or LA primary disease is a clinical challenge due to the difficulty in obtaining negative margins after radical surgery and the high risk of subsequent recurrence. Few data exist on long-term outcomes of patients treated with surgery and HDR-IORT for LR or LA primary CRC.
METHODS
Three hundred CRC patients underwent HDR-IORT to the pelvis with gross surgical resection during November 1992-December 2007. Median follow-up for surviving patients was 53 (range 5-216) months. Eighty-eight patients (29 %) were treated for LA primary and 212 (71 %) LR disease. HDR-IORT was delivered using an iridium-192 remote afterloader and a Harrison-Anderson-Mick applicator. Median IORT dose was 1,500 (range 1,000-2,000) cGy.
RESULTS
Five-year overall survival probability was 49 %. Positive margin status was associated with inferior overall survival and disease-free survival. Competing-risks analysis for time to local failure and distant metastases identified a 5-year cumulative incidence of local failure and distant metastases of 33 and 47 %, respectively. Five-year cumulative incidence of local failure was 22 % for the LA group and 38 % in the LR group. Five-year probability of disease-free survival was 48 and 31 % for LA and LR patients, respectively, and 5-year probability of overall survival was 56 and 45 % for LA and LR patients, respectively.
CONCLUSIONS
HDR-IORT combined with resection results in encouraging local control rates with acceptable toxicity for patients with locally aggressive CRC.
Topics: Adenocarcinoma; Brachytherapy; Carcinoma, Squamous Cell; Colorectal Neoplasms; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Pelvic Neoplasms; Prognosis; Radiotherapy Dosage; Survival Rate; Time Factors
PubMed: 25631062
DOI: 10.1245/s10434-014-4271-8