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[PMID]:29480823
[Au] Autor:Qiu HB; Zhou ZG; Feng XY; Liu XC; Guo J; Ma MZ; Chen YB; Sun XW; Zhou ZW
[Ad] Endereço:Department of Gastric and Pancreatic Surgery.
[Ti] Título:Advanced gastrointestinal stromal tumor patients benefit from palliative surgery after tyrosine kinase inhibitors therapy.
[So] Source:Medicine (Baltimore);97(2):e9097, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The role of palliative surgery is controversial in advanced gastrointestinal stromal tumors (GIST) after tyrosine kinase inhibitors (TKIs) therapy.We evaluated safety and clinical outcomes in a single institution series of advanced GIST patients from January 2002 to December 2008.One hundred and fifty-six patients had been recruited, including 87 patients underwent surgical resection and 69 patients kept on TKIs treatment. Four patients had major surgical complications. Median follow-up was 38.3 months, the overall survival (OS) and progression-free survival (PFS) of the patients in surgical group were longer than the nonsurgical group, PFS: 46.1 versus 33.8 months (P < .01), OS: 54.8 versus 40.4 months. In the subgroup analysis for the patients received surgery, the median PFS for patients with progression disease, stable disease, and partial response was 33.3, 51.5, and 83.0 months, respectively (P < .01). Median OS was 68.0 months in those with only liver or peritoneal metastases, and 45.3 months in those with both metastases. Median PFS of patients underwent R0/R1 resection was 73.6 months compared with 35.8 months in R2 resection patients (P < .01).Patients with advanced GISTs have prolonged OS after debulking procedures. Surgery for patients who have responsive disease after TKIs treatment should be considered.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Tumores do Estroma Gastrointestinal/tratamento farmacológico
Tumores do Estroma Gastrointestinal/cirurgia
Cuidados Paliativos
Inibidores de Proteínas Quinases/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Intervalo Livre de Doença
Feminino
Seguimentos
Tumores do Estroma Gastrointestinal/mortalidade
Tumores do Estroma Gastrointestinal/patologia
Seres Humanos
Mesilato de Imatinib/uso terapêutico
Neoplasias Hepáticas/mortalidade
Neoplasias Hepáticas/secundário
Masculino
Meia-Idade
Neoplasias Peritoneais/mortalidade
Neoplasias Peritoneais/secundário
Proteínas Tirosina Quinases/antagonistas & inibidores
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Protein Kinase Inhibitors); 8A1O1M485B (Imatinib Mesylate); EC 2.7.10.1 (Protein-Tyrosine Kinases)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009097


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[PMID]:29465550
[Au] Autor:Kim SH; Choi YH; Kim JW; Oh S; Lee S; Kim BG; Lee KL
[Ad] Endereço:Department of Internal Medicine.
[Ti] Título:Clinical significance of computed tomography-detected ascites in gastric cancer patients with peritoneal metastases.
[So] Source:Medicine (Baltimore);97(8):e9343, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients with peritoneal metastases (PM) are generally considered incurable; therefore, the presence of PM is a critical factor in deciding between palliative surgery and curative resection as a therapeutic strategy. Previous studies have not determined the predictive value of ascites detected on computed tomography (CT) for the presence of PM. We aimed to analyze the factors that are associated with PM in patients with CT-detected ascites.A total of 2207 consecutive patients who were diagnosed with gastric cancer between 2004 and 2013 were identified. Eleven patients with liver cirrhosis or chronic renal insufficiency with ascites and 57 patients who received previous treatment were excluded. Ninety-eight patients who had definite evidence of distant metastasis or PM on CT and 64 patients who did not undergo surgery were excluded. A total of 91 patients were enrolled in the study to analyze the association between CT-detected ascites and surgically confirmed PM.Seventy-six patients underwent curative resection and 15 patients underwent palliative surgery. Twelve patients exhibited peritoneal seeding and 37 patients showed regional lymph node metastasis. Regional lymph node metastasis, advanced gastric cancer, undifferentiated pathology, and the amount of ascites were significantly associated with PM. Multivariable logistic regression analysis identified the amount of ascites to be an independent risk factor for the presence of PM.Regional lymph node metastasis, advanced gastric cancer, undifferentiated pathology, and the amount of ascites were associated with PM. The amount of ascites was found to be an independent risk factor for PM.
[Mh] Termos MeSH primário: Ascite/diagnóstico por imagem
Neoplasias Peritoneais/diagnóstico por imagem
Neoplasias Gástricas/diagnóstico por imagem
Estômago/diagnóstico por imagem
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Ascite/etiologia
Feminino
Seres Humanos
Linfonodos/diagnóstico por imagem
Linfonodos/patologia
Metástase Linfática
Masculino
Meia-Idade
Neoplasias Peritoneais/secundário
Peritônio/diagnóstico por imagem
Peritônio/patologia
Estudos Retrospectivos
Estômago/patologia
Neoplasias Gástricas/complicações
Neoplasias Gástricas/patologia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009343


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[PMID]:28448662
[Au] Autor:Al-Batran SE; Homann N; Pauligk C; Illerhaus G; Martens UM; Stoehlmacher J; Schmalenberg H; Luley KB; Prasnikar N; Egger M; Probst S; Messmann H; Moehler M; Fischbach W; Hartmann JT; Mayer F; Höffkes HG; Koenigsmann M; Arnold D; Kraus TW; Grimm K; Berkhoff S; Post S; Jäger E; Bechstein W; Ronellenfitsch U; Mönig S; Hofheinz RD
[Ad] Endereço:Institute of Clinical Cancer Research, Krankenhaus Nordwest, Universitären University Cancer Center, Frankfurt, Germany.
[Ti] Título:Effect of Neoadjuvant Chemotherapy Followed by Surgical Resection on Survival in Patients With Limited Metastatic Gastric or Gastroesophageal Junction Cancer: The AIO-FLOT3 Trial.
[So] Source:JAMA Oncol;3(9):1237-1244, 2017 Sep 01.
[Is] ISSN:2374-2445
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Surgical resection has a potential benefit for patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction. Objective: To evaluate outcome in patients with limited metastatic disease who receive chemotherapy first and proceed to surgical resection. Design, Setting, and Participants: The AIO-FLOT3 (Arbeitsgemeinschaft Internistische Onkologie-fluorouracil, leucovorin, oxaliplatin, and docetaxel) trial is a prospective, phase 2 trial of 252 patients with resectable or metastatic gastric or gastroesophageal junction adenocarcinoma. Patients were enrolled from 52 cancer care centers in Germany between February 1, 2009, and January 31, 2010, and stratified to 1 of 3 groups: resectable (arm A), limited metastatic (arm B), or extensive metastatic (arm C). Data cutoff was January 2012, and the analysis was performed in March 2013. Interventions: Patients in arm A received 4 preoperative cycles of fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) followed by surgery and 4 postoperative cycles. Patients in arm B received at least 4 cycles of neoadjuvant FLOT and proceeded to surgical resection if restaging (using computed tomography and magnetic resonance imaging) showed a chance of margin-free (R0) resection of the primary tumor and at least a macroscopic complete resection of the metastatic lesions. Patients in arm C were offered FLOT chemotherapy and surgery only if required for palliation. Patients received a median (range) of 8 (1-15) cycles of FLOT. Main Outcomes and Measures: The primary end point was overall survival. Results: In total, 238 of 252 patients (94.4%) were eligible to participate. The median (range) age of participants was 66 (36-79) years in arm A (n = 51), 63 (28-79) years in arm B (n = 60), and 65 (23-83) years in arm C (n = 127). Patients in arm B (n = 60) had only retroperitoneal lymph node involvement (27 patients [45%]), liver involvement (11 [18.3%]), lung involvement (10 [16.7%]), localized peritoneal involvement (4 [6.7%]), or other (8 [13.3%]) incurable sites. Median overall survival was 22.9 months (95% CI, 16.5 to upper level not achieved) for arm B, compared with 10.7 months (95% CI, 9.1-12.8) for arm C (hazard ratio, 0.37; 95% CI, 0.25-0.55) (P < .001). The response rate for arm B was 60% (complete, 10%; partial, 50%), which is higher than the 43.3% for arm C. In arm B, 36 of 60 patients (60%) proceeded to surgery. The median overall survival was 31.3 months (95% CI, 18.9-upper level not achieved) for patients who proceeded to surgery and 15.9 months (95% CI, 7.1-22.9) for the other patients. Conclusions and Relevance: Patients with limited metastatic disease who received neoadjuvant chemotherapy and proceeded to surgery showed a favorable survival. The AIO-FLOT3 trial provides a rationale for further randomized clinical trials. Trial Registration: clinicaltrials.gov identifier: NCT00849615.
[Mh] Termos MeSH primário: Adenocarcinoma/tratamento farmacológico
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Junção Esofagogástrica
Neoplasias Hepáticas/tratamento farmacológico
Neoplasias Pulmonares/tratamento farmacológico
Neoplasias Peritoneais/tratamento farmacológico
Neoplasias Gástricas/tratamento farmacológico
[Mh] Termos MeSH secundário: Adenocarcinoma/secundário
Adenocarcinoma/cirurgia
Adulto
Idoso
Idoso de 80 Anos ou mais
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Quimioterapia Adjuvante
Fluoruracila/administração & dosagem
Gastrectomia
Seres Humanos
Leucovorina/administração & dosagem
Neoplasias Hepáticas/secundário
Neoplasias Hepáticas/cirurgia
Neoplasias Pulmonares/secundário
Neoplasias Pulmonares/cirurgia
Metástase Linfática
Metastasectomia
Meia-Idade
Terapia Neoadjuvante
Estadiamento de Neoplasias
Compostos Organoplatínicos/administração & dosagem
Neoplasias Peritoneais/secundário
Neoplasias Peritoneais/cirurgia
Estudos Prospectivos
Neoplasias Gástricas/patologia
Neoplasias Gástricas/cirurgia
Taxa de Sobrevida
Taxoides/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Organoplatinum Compounds); 0 (Taxoids); 04ZR38536J (oxaliplatin); 15H5577CQD (docetaxel); Q573I9DVLP (Leucovorin); U3P01618RT (Fluorouracil)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jamaoncol.2017.0515


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[PMID]:28468593
[Au] Autor:Ikemoto H; Lingasamy P; Anton Willmore AM; Hunt H; Kurm K; Tammik O; Scodeller P; Simón-Gracia L; Kotamraju VR; Lowy AM; Sugahara KN; Teesalu T
[Ad] Endereço:1 Laboratory of Cancer Biology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia.
[Ti] Título:Hyaluronan-binding peptide for targeting peritoneal carcinomatosis.
[So] Source:Tumour Biol;39(5):1010428317701628, 2017 May.
[Is] ISSN:1423-0380
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Peritoneal carcinomatosis results from dissemination of solid tumors in the peritoneal cavity, and is a common site of metastasis in patients with carcinomas of gastrointestinal or gynecological origin. Peritoneal carcinomatosis treatment is challenging as poorly vascularized, disseminated peritoneal micro-tumors are shielded from systemic anticancer drugs and drive tumor regrowth. Here, we describe the identification and validation of a tumor homing peptide CKRDLSRRC (IP3), which upon intraperitoneal administration delivers payloads to peritoneal metastases. IP3 peptide was identified by in vivo phage display on a mouse model of peritoneal carcinomatosis of gastric origin (MKN-45P), using high-throughput sequencing of the peptide-encoding region of phage genome as a readout. The IP3 peptide contains a hyaluronan-binding motif, and fluorescein-labeled IP3 peptide bound to immobilized hyaluronan in vitro. After intraperitoneal administration in mice bearing peritoneal metastases of gastric and colon origin, IP3 peptide homed robustly to macrophage-rich regions in peritoneal tumors, including poorly vascularized micro-tumors. Finally, we show that IP3 functionalization conferred silver nanoparticles the ability to home to peritoneal tumors of gastric and colonic origin, suggesting that it could facilitate targeted delivery of nanoscale payloads to peritoneal tumors. Collectively, our study suggests that the IP3 peptide has potential applications for targeting drugs, nanoparticles, and imaging agents to peritoneal tumors.
[Mh] Termos MeSH primário: Carcinoma/tratamento farmacológico
Receptores de Hialuronatos/administração & dosagem
Peptídeos/administração & dosagem
Neoplasias Peritoneais/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Bacteriófagos/genética
Carcinoma/genética
Carcinoma/patologia
Linhagem Celular Tumoral
Modelos Animais de Doenças
Sistemas de Liberação de Medicamentos
Seres Humanos
Receptores de Hialuronatos/genética
Camundongos
Nanopartículas/administração & dosagem
Nanopartículas/química
Metástase Neoplásica
Peptídeos/genética
Cavidade Peritoneal/patologia
Neoplasias Peritoneais/genética
Neoplasias Peritoneais/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hyaluronan Receptors); 0 (Peptides)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1177/1010428317701628


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[PMID]:29187933
[Au] Autor:El M'rabet FZ; Azegrar M
[Ad] Endereço:Department of Medical Oncology, University Hospital Hassan II, Fes, Morocco.
[Ti] Título:Intraperitoneal recurrence of renal haemangiopericytoma.
[So] Source:Pan Afr Med J;27:264, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Mh] Termos MeSH primário: Hemangiopericitoma/diagnóstico
Neoplasias Renais/patologia
Neoplasias Peritoneais/diagnóstico
[Mh] Termos MeSH secundário: Hemangiopericitoma/patologia
Seres Humanos
Meia-Idade
Recidiva Local de Neoplasia
Neoplasias Peritoneais/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.264.10106


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[PMID]:29374723
[Au] Autor:Robella M; Vaira M; Borsano A; Mossetti C; DE Simone M
[Ad] Endereço:Unit of Surgical Oncology, Candiolo Cancer Institute, IRCCS - FPO, Candiolo, Italy manuela.robella@ircc.it.
[Ti] Título:Low-dose Pressurized Intrathoracic Aerosol Chemotherapy (PITAC) as an Alternative Therapy for Pleuropulmonary Involvement in Pseudomyxoma Peritonei.
[So] Source:Anticancer Res;38(2):929-932, 2018 02.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIM: Pseudomyxoma peritonei (PMP) is a rare disease characterized by mucinous ascites and widespread peritoneal implants. It usually originates from the rupture of an adenoma/adenocarcinoma of the appendix. Although this tumor is only superficially invasive and does not metastasize, it could be a fatal disease. Extra-abdominal spread of PMP is an unusual occurrence with few reports in medical literature. CASE REPORT: A 50-year-old man was diagnosed with PMP according to the findings of thorax and abdomen CT scan and cytologic and histological examinations. The radiological exam showed irregular thickening on the surface of left diaphragmatic and parietal pleura. RESULTS: First, cytoreductive surgery associated with hyperthermic intraperitoneal chemotherapy (HIPEC) for the abdominal disease was performed. Histopathological examination confirmed the diagnosis of low grade PMP. The radiological evaluation performed 5 months later showed a dimensional increase in pleural nodules. The treatment consisted of an extensive intrathoracic cytoreductive surgery in combination with pressurized intra-thoracic aerosol chemotherapy (PITAC). Postoperative course was uneventful. CONCLUSION: PMP with pleural extension is a rare phenomenon and carries an unfavourable prognosis. Due to the rarity of this presentation, its correct treatment is still unclear. We present a therapeutic approach to be applied in selected patients.
[Mh] Termos MeSH primário: Terapias Complementares
Procedimentos Cirúrgicos de Citorredução
Hipertermia Induzida
Neoplasias Pulmonares/terapia
Neoplasias Peritoneais/terapia
Neoplasias Pleurais/terapia
Pseudomixoma Peritoneal/terapia
[Mh] Termos MeSH secundário: Terapia Combinada
Seres Humanos
Neoplasias Pulmonares/patologia
Masculino
Meia-Idade
Neoplasias Peritoneais/patologia
Neoplasias Pleurais/patologia
Prognóstico
Pseudomixoma Peritoneal/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE


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[PMID]:29268777
[Au] Autor:Longo R; Melgar E; Campitiello M; Plastino F; Eid N; Quirin I; Hennequin L; Grignon Y; Gunther M; Quétin P
[Ad] Endereço:Division of Medical Oncology, Centre Hospitalier Régional (CHR) Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France. raflongo@libero.it.
[Ti] Título:Breast metastasis from squamous cell carcinoma of the oropharynx: a case report.
[So] Source:J Med Case Rep;11(1):355, 2017 Dec 22.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Breast metastases from extramammary tumors are extremely rare, the most common primary tumors being contralateral breast carcinoma, followed by lung, gynecological, gastrointestinal, melanoma, and hematological cancers. Only a few cases deriving from head and neck squamous cell carcinoma have been reported in the literature to date. CASE PRESENTATION: We report a case of a 47-year-old Caucasian woman who presented to our hospital with a solitary breast lesion in the right upper external quadrant associated with multiple bone and visceral metastases. Two years before, she had undergone radical resection of a squamous cell carcinoma of the oropharynx (stage pT2, pN1), which was followed by adjuvant radiotherapy. Breast ultrasound showed a hypoechogenic tumor lesion of 4 cm in the right upper external quadrant that was associated with multiple axillary and infra-/supraclavicular adenopathies. A positron emission tomographic scan documented multiple visceral and bone metastases with a single hypermetabolic lesion of the right breast. The results of histology and immunohistochemistry were consistent with a metastasis from a squamous cell carcinoma. The patient died of acute respiratory insufficiency 1 month after her breast metastasis diagnosis and before starting any systemic antitumoral treatment. CONCLUSIONS: Although breast metastases are extremely rare, they should be considered in any patient with a history of cancer and confirmed by histology and immunohistochemistry because they are very difficult to distinguish from other primary breast tumors based only on clinical and radiological features. There are no standardized treatment guidelines for breast metastasis management. Surgery and radiotherapy can play a role in symptom palliation, but they do not have any relevant impact on survival, the prognosis being poor, with an estimated overall survival less than 1 year from diagnosis.
[Mh] Termos MeSH primário: Neoplasias da Mama/secundário
Carcinoma de Células Escamosas/secundário
Neoplasias Orofaríngeas/patologia
[Mh] Termos MeSH secundário: Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/secundário
Neoplasias da Mama/diagnóstico por imagem
Carcinoma de Células Escamosas/diagnóstico por imagem
Feminino
Seres Humanos
Neoplasias Pulmonares/diagnóstico por imagem
Neoplasias Pulmonares/secundário
Linfonodos/diagnóstico por imagem
Metástase Linfática
Meia-Idade
Neoplasias Peritoneais/diagnóstico por imagem
Neoplasias Peritoneais/secundário
Tomografia por Emissão de Pósitrons
Neoplasias Esplênicas/diagnóstico por imagem
Neoplasias Esplênicas/secundário
Tomografia Computadorizada por Raios X
Imagem Corporal Total
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1500-3


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[PMID]:29248013
[Au] Autor:Ghalleb M; Bouzaiene H; Slim S; Hadiji A; Hechiche M; Ben Hassouna J; Rahal K
[Ad] Endereço:Surgical Oncology Department, Salah Azaiez Institute of Cancer, Tunis, Tunisia.
[Ti] Título:Fertility-sparing surgery in advanced stage malignant ovarian germ cell tumor: a case report.
[So] Source:J Med Case Rep;11(1):350, 2017 Dec 17.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Malignant ovarian germ cell tumor is a rare type of disease, which generally has a good prognosis due to the high chemosensitivity of this type of tumor. Fertility preservation is an important issue because malignant ovarian germ cell tumor commonly affects young women. Although conservation is the standard for early stage, it becomes more debatable as the disease progresses to more advanced stages. AIM: Report the case of a patient with an International Federation of Gynecology and Obstetrics Stage IIIc malignant ovarian germ cell tumor, who had conservative surgery and chemotherapy with a good fertility outcome. CASE PRESENTATION: A 23-year-old North African woman with a left malignant ovarian germ cell tumor stage IIIc was treated by left adnexectomy and omentectomy followed by chemotherapy. A 15-year follow-up showed no signs of relapse, and she completed three full-term natural pregnancies. CONCLUSIONS: Malignant ovarian germ cell tumor is a rare ovarian tumor with a good prognosis. It is usually associated with a good fertility outcome in early stages. However, due to the rarity of the disease in advanced stages, the fertility outcome for this group of patients is not clear. This lack of data surrounding advanced stages points to the need for a meta-analysis of all published cases.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Preservação da Fertilidade/métodos
Neoplasias Embrionárias de Células Germinativas/cirurgia
Neoplasias Ovarianas/cirurgia
Ovariectomia/métodos
Neoplasias Peritoneais/cirurgia
[Mh] Termos MeSH secundário: Bleomicina/uso terapêutico
Quimioterapia Adjuvante
Cisplatino/uso terapêutico
Etoposídeo/uso terapêutico
Feminino
Seres Humanos
Estadiamento de Neoplasias
Neoplasias Embrionárias de Células Germinativas/patologia
Omento/cirurgia
Neoplasias Ovarianas/patologia
Neoplasias Peritoneais/secundário
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 6PLQ3CP4P3 (Etoposide); Q20Q21Q62J (Cisplatin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171218
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1516-8


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[PMID]:29277807
[Au] Autor:Naffouje SA; Salti GI
[Ad] Endereço:Department of General Surgery, University of Illinois at Chicago Hospital and Health Sciences System, Chicago, IL, U.S.A. snaffouj@uic.edu.
[Ti] Título:Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Elderly Patients: Complete Cytoreduction Is Feasible and Crucial for Improved Survival Despite High Carcinomatosis Index.
[So] Source:Anticancer Res;38(1):441-448, 2018 01.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We aimed to study the surgical outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in elderly patients, and investigate whether the pursuit of complete cytoreduction implies a survival benefit despite a high peritoneal carcinomatosis index (PCI). PATIENTS AND METHODS: All CRS and HIPEC procedures performed for patients with peritoneal surface malignancy (PSM) ≥65 years old between 2005-2017 were included. A control group comprising patients 60-64 years old who underwent CRS and HIPEC over the same period was also selected for comparison of characteristics and outcomes. RESULTS: A total of 54 elderly patients and 27 control patients were included. Increasing age did not result in any difference in demographics, perioperative characteristics, or surgical outcomes. Elderly patients who achieved completeness of cytoreduction (CC) 0/1 were compared to those with CC2/3, and were found to have a higher body mass index, lower peritoneal cancer index, higher rate of inpatient mortality, and a significantly longer median survival (43 vs. 15 months; p=0.020). Cox multivariate regression identified Charlson score ≥2, the occurrence of major morbidities, colorectal and sarcoma primary tumor, and CC2/3 as significant predictors of poor survival. CONCLUSION: CRS and HIPEC are feasible in elderly patients without a significant effect of increasing age on the surgical outcomes. CC0/1 carries higher postoperative mortality rate, but yields a longer overall survival. Baseline comorbidities, postoperative complications, certain histologies, and CC2/3 are predictors of poor prognosis in this population. PCI is a predictor of CC, but not of survival when CC0/1 is achieved.
[Mh] Termos MeSH primário: Carcinoma/patologia
Procedimentos Cirúrgicos de Citorredução/efeitos adversos
Procedimentos Cirúrgicos de Citorredução/métodos
Hipertermia Induzida/efeitos adversos
Hipertermia Induzida/métodos
Neoplasias Peritoneais/cirurgia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Índice de Massa Corporal
Feminino
Seres Humanos
Masculino
Meia-Idade
Prognóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171227
[St] Status:MEDLINE


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[PMID]:29277797
[Au] Autor:Falkenstein TA; Götze TO; Ouaissi M; Tempfer CB; Giger-Pabst U; Demtröder C
[Ad] Endereço:Basic Research Laboratories of the Department of Surgery, St. Mary's Hospital, Ruhr University Bochum, Herne, Germany.
[Ti] Título:First Clinical Data of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) as Salvage Therapy for Peritoneal Metastatic Biliary Tract Cancer.
[So] Source:Anticancer Res;38(1):373-378, 2018 01.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients suffering from peritoneal metastasis of biliary tract cancer were treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). PATIENTS AND METHODS: This was a study carried out at a single institution, tertiary referral center certified for therapy of peritoneal disease. Retrospective data analysis was performed of prospective data for PIPAC with intra-peritoneal low-dose doxorubicin (1.5 mg/m ) and cisplatin (7.5 mg/m ) delivered at intervals of 6 weeks. The outcome criteria were microscopic pathological response, survival, and adverse events [Common Terminology Criteria of Adverse Events (v4.0)]. RESULTS: A total of 13 patients (male/female=8/5) with a mean age of 58 (range=37-75) years underwent 17 PIPAC procedures without intraoperative complications. The mean number of PIPAC applications was 1.3 (range=0-3). Due to non-accessibility of the abdominal cavity in two patients (15.4%) and rapid clinical deterioration in six patients (46%), five patients underwent two or more PIPAC applications and were, therefore, eligible for histological analysis to assess carcinoma regression. Overall tumor regression of any degree was determined in 4/5 patients. An overall median survival of 85 days (95% confidence interval(CI)=59.2-110.4 days) after the first PIPAC application was observed. No complications greater than Common Terminology Criteria of Adverse Events (v4.0) level 2 occurred. CONCLUSION: PIPAC can induce objective regression of systemic chemotherapy-resistant peritoneal metastasis of biliary tract cancer. However, due to a rapid clinical deterioration of the patients, almost two-thirds of the patients cannot undergo repetitive PIPAC courses.
[Mh] Termos MeSH primário: Antibióticos Antineoplásicos/uso terapêutico
Neoplasias do Sistema Biliar/patologia
Infusões Parenterais/métodos
Neoplasias Peritoneais/tratamento farmacológico
Neoplasias Peritoneais/secundário
Terapia de Salvação/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias do Sistema Biliar/tratamento farmacológico
Cisplatino/uso terapêutico
Doxorrubicina/uso terapêutico
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Peritoneais/mortalidade
Peritônio/patologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibiotics, Antineoplastic); 80168379AG (Doxorubicin); Q20Q21Q62J (Cisplatin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171227
[St] Status:MEDLINE



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