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[PMID]:29489700
[Au] Autor:Chen Q; Liu Q; Suo Y; Xie Q
[Ad] Endereço:Department of Hand Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.
[Ti] Título:A new surgical treatment for abdominal wall defects: A vascularized ribs-pleural transfer technique that can be used with or without a thoracic umbilical flap a case report.
[So] Source:Medicine (Baltimore);97(9):e9993, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Abdominal wall defects are common after tumor resection. PATIENT CONCERNS: We report an 83-year-old male patient with recurrent tumors in his abdomen, and who had an incision wound that could not be directly closed. Mesh was not suitable because the wound was infected. DIAGNOSES: Abdominal wall defect result from the resection of recurrent tumor. INTERVENTIONS: We carried out a vascularized ribs-pleural transfer operation. OUTCOMES: After the surgery, the patient gained a functional recovery. No evidence of recurrence was noted 1 year after operation, and the patient showed no symptoms of abdominal compression syndrome. LESSONS: We discuss the clinical diagnosis, treatment, and follow up and argue that the vascularized ribs-pleural transfer technique is a good method to deal with abdominal wall defects.
[Mh] Termos MeSH primário: Parede Abdominal/cirurgia
Pleura/transplante
Complicações Pós-Operatórias/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Costelas/transplante
[Mh] Termos MeSH secundário: Neoplasias Abdominais/cirurgia
Idoso de 80 Anos ou mais
Seres Humanos
Masculino
Recidiva Local de Neoplasia/cirurgia
Retalhos Cirúrgicos
Umbigo/transplante
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009993


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[PMID]:28453537
[Au] Autor:Kersemans V; Beech JS; Gilchrist S; Kinchesh P; Allen PD; Thompson J; Gomes AL; D'Costa Z; Bird L; Tullis IDC; Newman RG; Corroyer-Dulmont A; Falzone N; Azad A; Vallis KA; Sansom OJ; Muschel RJ; Vojnovic B; Hill MA; Fokas E; Smart SC
[Ad] Endereço:Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom.
[Ti] Título:An efficient and robust MRI-guided radiotherapy planning approach for targeting abdominal organs and tumours in the mouse.
[So] Source:PLoS One;12(4):e0176693, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Preclinical CT-guided radiotherapy platforms are increasingly used but the CT images are characterized by poor soft tissue contrast. The aim of this study was to develop a robust and accurate method of MRI-guided radiotherapy (MR-IGRT) delivery to abdominal targets in the mouse. METHODS: A multimodality cradle was developed for providing subject immobilisation and its performance was evaluated. Whilst CT was still used for dose calculations, target identification was based on MRI. Each step of the radiotherapy planning procedure was validated initially in vitro using BANG gel dosimeters. Subsequently, MR-IGRT of normal adrenal glands with a size-matched collimated beam was performed. Additionally, the SK-N-SH neuroblastoma xenograft model and the transgenic KPC model of pancreatic ductal adenocarcinoma were used to demonstrate the applicability of our methods for the accurate delivery of radiation to CT-invisible abdominal tumours. RESULTS: The BANG gel phantoms demonstrated a targeting efficiency error of 0.56 ± 0.18 mm. The in vivo stability tests of body motion during MR-IGRT and the associated cradle transfer showed that the residual body movements are within this MR-IGRT targeting error. Accurate MR-IGRT of the normal adrenal glands with a size-matched collimated beam was confirmed by γH2AX staining. Regression in tumour volume was observed almost immediately post MR-IGRT in the neuroblastoma model, further demonstrating accuracy of x-ray delivery. Finally, MR-IGRT in the KPC model facilitated precise contouring and comparison of different treatment plans and radiotherapy dose distributions not only to the intra-abdominal tumour but also to the organs at risk. CONCLUSION: This is, to our knowledge, the first study to demonstrate preclinical MR-IGRT in intra-abdominal organs. The proposed MR-IGRT method presents a state-of-the-art solution to enabling robust, accurate and efficient targeting of extracranial organs in the mouse and can operate with a sufficiently high throughput to allow fractionated treatments to be given.
[Mh] Termos MeSH primário: Neoplasias Abdominais/diagnóstico por imagem
Neoplasias Abdominais/radioterapia
Imagem por Ressonância Magnética/métodos
Planejamento da Radioterapia Assistida por Computador/métodos
Radioterapia Guiada por Imagem/métodos
[Mh] Termos MeSH secundário: Abdome/diagnóstico por imagem
Abdome/efeitos da radiação
Glândulas Suprarrenais/diagnóstico por imagem
Glândulas Suprarrenais/efeitos da radiação
Animais
Linhagem Celular Tumoral
Seres Humanos
Imagem por Ressonância Magnética/instrumentação
Camundongos Endogâmicos BALB C
Camundongos Endogâmicos CBA
Camundongos Endogâmicos NOD
Camundongos Nus
Camundongos Transgênicos
Movimento (Física)
Imagem Multimodal/instrumentação
Transplante de Neoplasias
Imagens de Fantasmas
Radiometria/instrumentação
Dosagem Radioterapêutica
Planejamento da Radioterapia Assistida por Computador/instrumentação
Radioterapia Guiada por Imagem/instrumentação
Tomografia Computadorizada por Raios X/instrumentação
Tomografia Computadorizada por Raios X/métodos
Carga Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180125
[Lr] Data última revisão:
180125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176693


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[PMID]:29310403
[Au] Autor:Yorita K; Tanaka Y; Hirano K; Kuwahara M; Nakatani K; Fukunaga M; Agaimy A
[Ad] Endereço:Department of Diagnostic Pathology.
[Ti] Título:Multilocular cystic leiomyoma of the anterolateral abdominal wall: A case report and literature review.
[So] Source:Medicine (Baltimore);96(48):e8971, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Leiomyomas arising from the anterolateral abdominal wall are uncommon, and their pathogenesis remains unknown. We present the 15th case of such a tumor, having this unique tumor morphology, followed by a detailed discussion on disease pathogenesis. PATIENT CONCERNS: A 48-year-old, asymptomatic perimenopausal, multiparous Japanese woman presented with a left-sided pelvic mass. She had no history of previous surgeries or uterine leiomyomas. Although a transabdominal ultrasonogram raised suspicions of an ovarian tumor, a transvaginal ultrasonogram confirmed normal ovaries. Radiological images showed a multilocular cystic mass with enhanced solid lesions connected to the uterus. Retrospective radiological evaluation showed that the mass was largely connected to the peritoneum of the anterolateral abdominal wall. INTERVENTIONS: Intraoperatively, the mass appeared as a dome-like protrusion from the left lower quadrant of the abdominal wall, without connection to the uterus, ovaries, or the left round ligament. No other peritoneal masses were seen. The mass was easily enucleated from the abdominal wall. Pathology confirmed that the mass was a leiomyoma with hydropic and myxoid degeneration. No striated muscle tissues were noted between the tumor and resection margin, but a thin smooth muscle layer, positive for hormone receptors, was present at the periphery, suggesting the origin of the tumor. LESSONS: Benign leiomyomas of the anterolateral abdominal wall likely originate from Müllerian-like smooth muscle remnants in this region. They should be considered in the differential diagnosis of solid and cystic masses and be distinguished from uterine and ovarian masses on imaging to avoid unnecessary organ resection.
[Mh] Termos MeSH primário: Neoplasias Abdominais/diagnóstico por imagem
Neoplasias Abdominais/cirurgia
Leiomioma/diagnóstico por imagem
Leiomioma/cirurgia
[Mh] Termos MeSH secundário: Neoplasias Abdominais/patologia
Parede Abdominal
Diagnóstico Diferencial
Feminino
Seres Humanos
Leiomioma/patologia
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008971


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[PMID]:29176541
[Au] Autor:Junejo S; Ali Y; Singh Lubana S; Tuli SS
[Ad] Endereço:Icahn School of Medicine at Mount Sinai-Queens Hospital Center, Jamaica, NY, USA.
[Ti] Título:Diffuse Peritoneal and Bowel Wall Infiltration by Light Chain-AL Amyloidosis with Omental Calcification Mimicking Abdominal Carcinomatosis - An Elderly Female with Incidental Finding of Light Chain Monoclonal Gammopathy of Undetermined Significance (LC-MGUS).
[So] Source:Am J Case Rep;18:1247-1250, 2017 Nov 25.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Amyloidosis is the extracellular tissue deposition of plasma proteins, which after conformational changes, forms antiparallel beta pleated sheets of fibrils. Amyloid light-chain (AL) is a type of amyloidosis that is due to deposition of proteins derived from immunoglobulin (Ig) light chains. Gastrointestinal tract (GIT) involvement most often found in amyloid A (AA) amyloidosis type. There have been no reports of obstructive GIT AL amyloid patients having monoclonal gammopathy of undetermined significance (MGUS). Our case is the first case to show two coinciding conditions; one is the association of GIT AL amyloidosis with the incidental finding of a rare type of MGUS (LC-MGUS) and the other is the radiologic presentation of GIT amyloidosis with omental calcification mimicking the GIT malignancy. CASE REPORT A 68-year-old female presented with symptoms of partial bowel obstruction, including intermittent diffuse abdominal pain and constipation. After computed tomography (CT) abdomen and pelvis, an exploratory laparotomy was needed because of suspicion of abdominal carcinomatosis due to diffuse omental calcification. The tissue sent for biopsy surprisingly showed AL amyloidosis. The patient did not report any systemic symptoms. Further workup was advised to inquire about the plasma cell dyscrasia which eventually turned into a very rare version of MGUS knows as light chain MGUS (LC-MGUS). Following adequate resection of the involved structures, the patient was then placed on chemotherapy and successfully went into remission. CONCLUSIONS This case report illustrates that in an era of evidence based medicine, it is important to show through case reports the association of GIT AL amyloidosis with LC-MGUS, as the literature on this topic is lacking. It also points to the importance of timely intervention that can greatly enhance, not only the only the chances of remission but also prevention of further complications such as malignant transformation.
[Mh] Termos MeSH primário: Amiloidose/diagnóstico
Calcinose/diagnóstico
Gamopatia Monoclonal de Significância Indeterminada/diagnóstico
Omento/patologia
Doenças Peritoneais/diagnóstico
[Mh] Termos MeSH secundário: Neoplasias Abdominais/diagnóstico
Idoso
Diagnóstico Diferencial
Feminino
Seres Humanos
Achados Incidentais
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28743162
[Au] Autor:Cahn DB; Handorf EA; Ghiraldi EM; Ristau BT; Geynisman DM; Churilla TM; Horwitz EM; Sobczak ML; Chen DYT; Viterbo R; Greenberg RE; Kutikov A; Uzzo RG; Smaldone MC
[Ad] Endereço:Department of Urology, Einstein Healthcare Network, Philadelphia, Pennsylvania.
[Ti] Título:Contemporary use trends and survival outcomes in patients undergoing radical cystectomy or bladder-preservation therapy for muscle-invasive bladder cancer.
[So] Source:Cancer;123(22):4337-4345, 2017 Nov 15.
[Is] ISSN:1097-0142
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The current study was performed to examine temporal trends and compare overall survival (OS) in patients undergoing radical cystectomy (RC) or bladder-preservation therapy (BPT) for muscle-invasive urothelial carcinoma of the bladder. METHODS: The authors reviewed the National Cancer Data Base to identify patients with AJCC stage II to III urothelial carcinoma of the bladder from 2004 through 2013. Patients receiving BPT were stratified as having received any external-beam radiotherapy (any XRT), definitive XRT (50-80 grays), and definitive XRT with chemotherapy (CRT). Treatment trends and OS outcomes for the BPT and RC cohorts were evaluated using Cochran-Armitage tests, unadjusted Kaplan-Meier curves, adjusted Cox multivariate regression, and propensity score matching, using increasingly stringent selection criteria. RESULTS: A total of 32,300 patients met the inclusion criteria and were treated with RC (22,680 patients) or BPT (9620 patients). Of the patients treated with BPT, 26.4% (2540 patients) and 15.5% (1489 patients), respectively, were treated with definitive XRT and CRT. Improved OS was observed for RC in all groups. After adjustments with more rigorous statistical models controlling for confounders and with more restrictive BPT cohorts, the magnitude of the OS benefit became attenuated on multivariate (any XRT: hazard ratio [HR], 2.115 [95% confidence interval [95% CI], 2.045-2.188]; definitive XRT: HR, 1.870 [95% CI, 1.773-1.972]; and CRT: HR, 1.578 [95% CI, 1.474-1.691]) and propensity score (any XRT: HR, 2.008 [95% CI, 1.871-2.154]; definitive XRT: HR, 1.606 [95% CI, 1.453-1.776]; and CRT: HR, 1.406 [95% CI, 1.235-1.601]) analyses. CONCLUSIONS: In the National Cancer Data Base, receipt of BPT was associated with decreased OS compared with RC in patients with stage II to III urothelial carcinoma. Increasingly stringent definitions of BPT and more rigorous statistical methods adjusting for selection biases attenuated observed survival differences. Cancer 2017;123:4337-45. © 2017 American Cancer Society.
[Mh] Termos MeSH primário: Carcinoma de Células de Transição/mortalidade
Carcinoma de Células de Transição/cirurgia
Cistectomia
Neoplasias Musculares/mortalidade
Neoplasias Musculares/cirurgia
Tratamentos com Preservação do Órgão
Neoplasias da Bexiga Urinária/mortalidade
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Músculos Abdominais/patologia
Neoplasias Abdominais/mortalidade
Neoplasias Abdominais/secundário
Neoplasias Abdominais/cirurgia
Adulto
Idoso
Carcinoma de Células de Transição/patologia
Quimiorradioterapia
Cistectomia/métodos
Cistectomia/mortalidade
Cistectomia/estatística & dados numéricos
Cistectomia/tendências
Bases de Dados Factuais
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Musculares/secundário
Invasividade Neoplásica
Estadiamento de Neoplasias
Tratamentos com Preservação do Órgão/mortalidade
Tratamentos com Preservação do Órgão/estatística & dados numéricos
Tratamentos com Preservação do Órgão/tendências
Análise de Sobrevida
Resultado do Tratamento
Neoplasias da Bexiga Urinária/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1002/cncr.30900


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[PMID]:29069019
[Au] Autor:Muradbegovic M; St-Amour P; Martin D; Petermann D; Benabidallah S; Di Mare L
[Ad] Endereço:aDepartment of General and Visceral Surgery, EHC Hospital, Morges b Department of Visceral Surgery, University Hospital CHUV, Lausanne cUnilabs, Department of Pathology, Lausanne, Switzerland.
[Ti] Título:End-colostomy diverticulitis with parastomal phlegmon: A case report.
[So] Source:Medicine (Baltimore);96(43):e8358, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Acute colonic diverticulitis is a well-known surgical emergency, which occurs in about 10 percent of patients known for diverticulosis. PATIENT CONCERNS: The case of a 77-year-old woman is reported, with past history of abdominoperineal resection with end-colostomy for low rectal adenocarcinoma, and who developed an acute colonic diverticulitis in a subcutaneous portion of colostomy with parastomal phlegmon. DIAGNOSES: Initial computed tomography imaging demonstrated a significant submucosal parietal edema with local fat tissues infiltration in regard of 3 diverticula. INTERVENTIONS: A two-step treatment was decided: first a nonoperative treatment was initiated with 2 weeks antibiotics administration, followed by, 6 weeks after, a segmental resection of the terminal portion of the colon with redo of a new colostomy by direct open approach. OUTCOMES: Patient was discharged on the second postoperative day without complications. Follow-up at 2 weeks revealed centimetric dehiscence of the stoma, which was managed conservatively until sixth postoperative week by stomatherapists. LESSONS SUBSECTIONS: Treatment of acute diverticulitis with parastomal phlegmon in a patient with end-colostomy could primary be nonoperative. Delayed surgical treatment with segmental colonic resection was proposed to avoid recurrence and potential associated complications.
[Mh] Termos MeSH primário: Celulite (Flegmão)/etiologia
Colostomia/efeitos adversos
Doença Diverticular do Colo/etiologia
Complicações Pós-Operatórias/etiologia
Estomas Cirúrgicos/efeitos adversos
[Mh] Termos MeSH secundário: Neoplasias Abdominais/cirurgia
Idoso
Neoplasias do Ânus/cirurgia
Feminino
Seres Humanos
Períneo/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008358


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[PMID]:29019905
[Au] Autor:Yuan KM; Fu SY; Li J; Shangguan WN; Lian QQ
[Ad] Endereço:Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
[Ti] Título:Bezold-Jarisch reflex occurred in a pediatric patient with giant intra-abdominal teratoma during induction of anesthesia: A case report.
[So] Source:Medicine (Baltimore);96(41):e8304, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Bezold-Jarisch reflex (BJR) occurs when the cardioinhibitory receptors in the walls of ventricles are activated by various stimuli, with typical features of bradycardia, vasorelaxation, and hypotension. This reflex usually happens in parturient intrathecal anesthesia, as a result of decreased venous return by compression of inferior vena cava, but it is only rarely reported during general anesthesia. PATIENT CONCERNS: Severe bradycardia and hypotension, indicating BJR, occurred during the induction of general anesthesia in a 3-month-old female child with giant intra-abdominal teratoma. DIAGNOSES: A giant intra-abdominal teratoma was detected by computed tomography scanning. The decreased left ventricular ejection faction along with increased troponin I and N-terminal pro-B-type natriuretic peptide indicated a preoperative mild cardiac dysfunction. BJR was diagnosed on the basis of the severe bradycardia and hypotension observed during the induction of general anesthesia, INTERVENTIONS:: Atropine failed to increase heart rate. Cardiopulmonary resuscitation was initiated immediately and epinephrine was injected intravenously because of sudden circulatory collapse. Soon after the return of spontaneous circulation, a central venous line was placed and invasive blood pressure was monitored. Vital signs and homeostasis were kept stable during teratoma resection. OUTCOMES: The child was extubated after emergence from anesthesia in the operating room. Eleven days later, she had recovered without complications and was discharged. LESSONS: General anesthesia should be induced with great care in patients with giant intra-abdominal masses, and the patient should be kept in the left-lateral table tilt position before induction.
[Mh] Termos MeSH primário: Neoplasias Abdominais
Bradicardia
Dissecação/métodos
Hipotensão
Teratoma
Vasodilatação/fisiologia
[Mh] Termos MeSH secundário: Neoplasias Abdominais/patologia
Neoplasias Abdominais/fisiopatologia
Neoplasias Abdominais/cirurgia
Bradicardia/diagnóstico
Bradicardia/etiologia
Reanimação Cardiopulmonar/métodos
Feminino
Seres Humanos
Hipotensão/diagnóstico
Hipotensão/etiologia
Lactente
Peptídeo Natriurético Encefálico/análise
Fragmentos de Peptídeos/análise
Reflexo Anormal
Volume Sistólico
Teratoma/patologia
Teratoma/fisiopatologia
Teratoma/cirurgia
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
Troponina I/análise
Carga Tumoral
Disfunção Ventricular Esquerda/diagnóstico
Disfunção Ventricular Esquerda/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Peptide Fragments); 0 (Troponin I); 0 (pro-brain natriuretic peptide (1-76)); 114471-18-0 (Natriuretic Peptide, Brain)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008304


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[PMID]:29016614
[Au] Autor:Chen J; Cai W; Lin Y; Chen Y; Zheng Q; Pan J; Chen C
[Ad] Endereço:Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China.
[Ti] Título:Patterns and rates of abdominal lymphatic metastasis following esophageal carcinoma.
[So] Source:PLoS One;12(10):e0185424, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo: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.
[Mh] Termos MeSH primário: Neoplasias Abdominais/patologia
Carcinoma de Células Escamosas/patologia
Neoplasias Esofágicas/patologia
Metástase Linfática/patologia
Recidiva Local de Neoplasia/patologia
[Mh] Termos MeSH secundário: Neoplasias Abdominais/epidemiologia
Neoplasias Abdominais/secundário
Neoplasias Abdominais/cirurgia
Adulto
Idoso
Carcinoma de Células Escamosas/diagnóstico por imagem
Carcinoma de Células Escamosas/epidemiologia
Carcinoma de Células Escamosas/cirurgia
Neoplasias Esofágicas/diagnóstico por imagem
Neoplasias Esofágicas/epidemiologia
Neoplasias Esofágicas/cirurgia
Esofagectomia
Feminino
Artéria Hepática/patologia
Seres Humanos
Linfonodos/diagnóstico por imagem
Linfonodos/patologia
Metástase Linfática/diagnóstico por imagem
Masculino
Meia-Idade
Recidiva Local de Neoplasia/epidemiologia
Tomografia por Emissão de Pósitrons
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185424


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[PMID]:28904708
[Au] Autor:Bourra K; El Mazouz S
[Ad] Endereço:Service de Chirurgie Plastique, Hôpital Al Farabi Oujda, Maroc.
[Ti] Título:[Latissimus dorsi flap in reconstruction following treatment of giant tumor of the abdominal wall: about a rare case].
[Ti] Título:Lambeau grand dorsal dans la reconstruction d'une tumeur géante de la paroi abdominale: à propos d'un cas rare..
[So] Source:Pan Afr Med J;27:181, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:We report the case of a 16-year old patient presenting with giant, multinodular, mesenchymal tumor of the abdominal wall occupying the left abdominal region and measuring 25 cm on the vertical axis, 20 cm on the transverse axis, mobile when compared with the deep structures and gradually increasing in volume over childhood and neglected. After small biopsy, which showed desmoid tumor, the patient underwent complete surgical resection of the tumor with immediate reconstruction by free muscolo skin flap of the latissimus dorsi attached to the large blood vessels of the inguinal fold (left iliac artery and left external iliac vein), connected by termino lateral anastomosis. Flap survival was correctly performed and reconstruction was successful.
[Mh] Termos MeSH primário: Neoplasias Abdominais/cirurgia
Parede Abdominal/cirurgia
Fibromatose Agressiva/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Mh] Termos MeSH secundário: Neoplasias Abdominais/patologia
Parede Abdominal/patologia
Adolescente
Biópsia
Fibromatose Agressiva/patologia
Retalhos de Tecido Biológico
Seres Humanos
Masculino
Músculos Superficiais do Dorso
Retalhos Cirúrgicos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.181.11028


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[PMID]:28817753
[Au] Autor:Powles T; O'Donnell PH; Massard C; Arkenau HT; Friedlander TW; Hoimes CJ; Lee JL; Ong M; Sridhar SS; Vogelzang NJ; Fishman MN; Zhang J; Srinivas S; Parikh J; Antal J; Jin X; Gupta AK; Ben Y; Hahn NM
[Ad] Endereço:Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London, England.
[Ti] Título:Efficacy and Safety of Durvalumab in Locally Advanced or Metastatic Urothelial Carcinoma: Updated Results From a Phase 1/2 Open-label Study.
[So] Source:JAMA Oncol;3(9):e172411, 2017 Sep 14.
[Is] ISSN:2374-2445
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The data reported herein were accepted for assessment by the US Food and Drug Administration for Biologics License Application under priority review to establish the clinical benefit of durvalumab as second-line therapy for locally advanced or metastatic urothelial carcinoma (UC), resulting in its recent US approval. Objective: To report a planned update of the safety and efficacy of durvalumab in patients with locally advanced/metastatic UC. Design, Setting, and Participants: This is an ongoing phase 1/2 open-label study of 191 adult patients with histologically or cytologically confirmed locally advanced/metastatic UC whose disease had progressed on, were ineligible for, or refused prior chemotherapy from 60 sites in 9 countries as reported herein. Intervention: Patients were administered durvalumab intravenous infusion, 10 mg/kg every 2 weeks, for up to 12 months or until progression, starting another anticancer therapy, or unacceptable toxic effects. Main Outcomes and Measures: Primary end points were safety and confirmed objective response rate (ORR) per blinded independent central review (Response Evaluation Criteria In Solid Tumors [RECIST], version 1.1). Results: A total of 191 patients with UC had received treatment. As of October 24, 2016 (90-day update), the median follow-up was 5.78 months (range, 0.4-25.9 months). The median age of patients was 67.0 years and most were male (136 [71.2%]) and white (123 [71.1%]). All patients had stage 4 disease, and 190 (99.5%) had prior anticancer therapy (182 [95.3%] postplatinum). The ORR was 17.8% (34 of 191; 95% CI, 12.7%-24.0%), including 7 complete responses. Responses were early (median time to response, 1.41 months), durable (median duration of response not reached), and observed regardless of programmed cell death ligand-1 (PD-L1) expression (ORR, 27.6% [n = 27; 95% CI, 19.0%-37.5%] and 5.1% [n = 4; 95% CI, 1.4%-12.5%] in patients with high and low or negative expression of PD-L1, respectively). Median progression-free survival and overall survival were 1.5 months (95% CI, 1.4-1.9 months) and 18.2 months (95% CI, 8.1 months to not estimable), respectively; the 1-year overall survival rate was 55% (95% CI, 44%-65%), as estimated by Kaplan-Meier method. Grade 3/4 treatment-related adverse events (AEs) occurred in 13 patients (6.8%); grade 3/4 immune-mediated AEs occurred in 4 patients (2.1%); and treatment-related AEs led to discontinuation of 3 patients (1.6%), 2 of whom had immune-mediated AEs that led to death (autoimmune hepatitis and pneumonitis). Conclusions and Relevance: Durvalumab, 10 mg/kg every 2 weeks, demonstrates favorable clinical activity and an encouraging and manageable safety profile in patients with locally advanced/metastatic UC. Trial Registration: clinicaltrials.gov Identifier: NCT01693562.
[Mh] Termos MeSH primário: Neoplasias Abdominais/tratamento farmacológico
Anticorpos Monoclonais/efeitos adversos
Antineoplásicos/efeitos adversos
Carcinoma de Células de Transição/tratamento farmacológico
Neoplasias Hepáticas/tratamento farmacológico
[Mh] Termos MeSH secundário: Neoplasias Abdominais/química
Neoplasias Abdominais/secundário
Adulto
Idoso
Idoso de 80 Anos ou mais
Anticorpos Monoclonais/uso terapêutico
Antineoplásicos/uso terapêutico
Antígeno B7-H1/análise
Carcinoma de Células de Transição/química
Carcinoma de Células de Transição/secundário
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Neoplasias Hepáticas/química
Neoplasias Hepáticas/secundário
Masculino
Meia-Idade
Estadiamento de Neoplasias
Critérios de Avaliação de Resposta em Tumores Sólidos
Retratamento
Taxa de Sobrevida
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE I; CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents); 0 (B7-H1 Antigen); 0 (CD274 protein, human); 0 (durvalumab)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1001/jamaoncol.2017.2411



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