• Title/Summary/Keyword: Surgical oncology

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Predicting recurrence in oral cavity cancers: a review of 116 patients with buccal mucosa carcinoma in northwestern India

  • Pinakin Patel;Pranav Mohan Singhal;Kamal Kishor Lakhera;Aishwarya Chatterjee;Agil Babu;Suresh Singh;Shubhra Sharma;Bhoopendra Singh Gora;Naina Kumar Agarwal
    • Archives of Craniofacial Surgery
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    • v.24 no.5
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    • pp.211-217
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    • 2023
  • Background: Oral cavity cancers, the second most common type in India, are responsible for 10% of the overall cancer burden. With a recurrence rate of 30% to 40% and a 5-year survival rate of 50%, these malignancies account for substantial morbidity and mortality. Despite advances in treatment modalities, survival rates following treatment completion have not improved significantly. The present study aimed to establish specific epidemiological and pathological factors responsible for recurrence after treatment completion in buccal mucosa cancers. Methods: A retrospective analysis of the data of 116 patients treated for biopsy-proven cancers of the buccal mucosa was undertaken 1 year after treatment completion. Factors such as age, sex, education, lymphovascular invasion, extranodal extension (ENE), perineural invasion, depth of invasion, and pathological margin status were compared between patients who presented with recurrence and those who did not. Statistical significance was set at p< 0.05. Results: Of the 116 patients, 40 (34.5%) developed a recurrent disease within 1 year. The mean age of the study population was 43.3 years, and males constituted 91.4% of the included patients. Ipsilateral buccal mucosa was the commonest site of disease recurrence. Neck node metastasis, ENE, and margins of resection < 5 mm were significantly related to the recurrence of disease. However, surprisingly, lymphovascular invasion, perineural invasion, and depth of invasion > 10 mm did not show statistically significant associations. Conclusion: Neck node metastasis, ENE, and margins of resection < 5 mm were the histopathological factors associated with recurrence in cancers of the buccal mucosa.

Gastric Adenocarcinoma with Thymic Metastasis after Curative Resection: A Case Report

  • Matsunaga, Tomoyuki;Saito, Hiroaki;Miyatani, Kozo;Takaya, Seigo;Fukumoto, Yoji;Osaki, Tomohiro;Ikeguchi, Masahide
    • Journal of Gastric Cancer
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    • v.14 no.3
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    • pp.207-210
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    • 2014
  • The peritoneum is the most frequent site of recurrence for gastric cancer after gastrectomy, followed by the liver and lymph nodes. In contrast, metastasis to the thymus is rare. Annual surveillance with computed tomography was performed on a 67-year-old man who previously underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer at Tottori University. Five years after the initial operation, an anterior mediastinal tumor was detected by computed tomography. The patient underwent video-assisted thoracic surgery to remove the tumor. Histopathology revealed adenocarcinoma cells similar to those of the gastric cancer resected 5 years previously. Thymic metastasis was considered likely based on the location of the tumor. The recognition that gastric cancer can metastasize to unusual anatomic locations, such as the thymus, can facilitate an accurate, prompt diagnosis and appropriate treatment.

Prognostic Significance of Preoperative Serum Alpha-fetoprotein in Hepatocellular Carcinoma and Correlation with Clinicopathological Factors: a Single-center Experience from China

  • An, Song-Lin;Xiao, Ting;Wang, Li-Ming;Rong, Wei-Qi;Wu, Fan;Feng, Li;Liu, Fa-Qiang;Tian, Fei;Wu, Jian-Xiong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4421-4427
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    • 2015
  • Objectives: To investigate the prognosis significance of preoperative serum alpha-fetoprotein (AFP) and the correlation with clinicopathological factors of hepatocellular carcinoma (HCC) patients who underwent hepatectomy. Materials and Methods: Clinicopathological data of retrospective analysis were collected for 251 HCC patients undergoing hepatectomy in this study. According to preoperative AFP level, patients were categorized into AFP-negative (0-20ng/mL) and AFP-positive (>20 ng/mL) groups for Kaplan-Meier analysis and Cox proportional hazard regression modeling. Results: The results demonstrated that increased AFP was associated with longer prothrombin time (PTs), liver capsule invasion, low grade differentiation, and late Barcelona Clinic Liver Center (BCLC) stage. Moreover, the female patients had a greater prevalence of increased preoperative AFP than male patients [284.8 (3.975-3167.5) vs (3.653-140.65); Z-2.895, p=0.004]. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 78.1, 57.5, and 40.6 % in the AFP-negative group and 61.8, 37.7, and 31.4 %, respectively, in the AFP-positive group (log-rank test 8.312, p=0.004). The 1-, 3-, and 5-year overall survival (OS) rates were 94.4, 83.8, and 62.3% in the AFP-negative group and 87.2, 60.0, and 36.7%, respectively, in the AFP-positive group. The difference was statistically significant (log-rank test, 16.884, p=0.000). Cox proportional-hazards model identified preoperative AFP to be an independent prognostic predictor of overall survival. Conclusions: Preoperative serum AFP is an independent predictor of prognosis among HCC patients following surgical resection. Female patients have a higher preoperative AFP than their male counterparts.

Impact of Omega-3 Fatty Acid Supplements on Gastrointestinal Cancer Patients after Surgery: Beneficial or Useless?

  • Zhang, Haibin;Zhang, Jing;Wang, Haiyong;Su, Xingyun;Teng, Lisong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6841-6843
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    • 2015
  • Omega-3 polyunsaturated fatty acids (${\omega}$-3 PUFAs) are essential nutrients for human beings and their potential roles against cancer development and progression have become of wide concern recently. Some studies have suggested that perioperative supplementation with omega-3 fatty acids may have beneficial effects in gastrointestinal cancer patients undergoing surgery, while other researchers reported contrary results. This paper reviews recent research to establish therapeutic effects as well as possible underlying mechanisms of ${\omega}$-3 PUFA actions, and to help explain possible reasons for inconsistent results from different institutions.

CHEMOPREVENTION OF MAMMARY CARCINOGENESIS BY SYNTHETIC ANALOG OF VITAMIN D5.

  • Mehta, Rajendra G.;Hussain, Erum;Moriarty, Robert M.;Mehta, Rajeshwari R.;Das Gupta, Tapas K.
    • Proceedings of the Korean Society of Toxicology Conference
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    • 2001.10a
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    • pp.52-53
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    • 2001
  • In order for vitamin D to be active, it needs to get metabolized to 1, 25 (OH)$_2$D3. This active metabolite of vitamin D induces epithelial cell differentiation and is antiproliferative. However, at the efficacious concentration, the natural ligand for VDR is hypercalcemic and toxic to cells. Therefore, numerous analogs have been synthesized with the hope of generating a compound that retains vitamin D activity and is non-toxic.(omitted)

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CHEMOPREVENTION OF MAMMARY CARCINOGENESIS BY SYNTHETIC ANALOG OF VITAMIN D5.

  • Mehta, Rajendra G.;Hussain, Erum;Moriarty, Robert M.;Mehta, Rajeshwari R.;DasGupta, Tapas K.
    • Proceedings of the Korean Society of Toxicology Conference
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    • 2001.10b
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    • pp.9-10
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    • 2001
  • In order for vitamin D to be active, it needs to get metabolized to 1, 25 (OH)$_2$D3. This active metabolite of vitamin D induces epithelial cell differentiation and is antiproliferative. However, at the efficacious concentration, the natural ligand for VDR is hypercalcemic and toxic to cells. Therefore, numerous analogs have been synthesized with the hope of generating a compound that retains vitamin D activity and is non-toxic.(omitted)

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Impact of Time Interval Between Chemoradiation and Surgery on Pathological Complete Response and Survival in Rectal Cancer

  • Akbar, Ali;Bhatti, Abu Bakar Hafeez;Niazi, Samiullah Khan;Syed, Amir Ali;Khattak, Shahid;Raza, Syed Hassan;Kazmi, Ather Saeed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.89-93
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    • 2016
  • Background: Limited data are available regarding the impact of time duration between chemoradiation (CRT) and surgery on pathological complete response (PCR). A PCR translates into better overall and disease free survival. The objective of this study was to determine effect of time duration on outcome after preoperative CRT in rectal cancer. Materials and Methods: A retrospective review of patients undergoing operations for rectal adenocarcinoma between January 2005 and December 2010 was performed. Patients were divided in two groups: Group 1 underwent surgery in ${\leq}8weeks$ post neoadjuvant CRT and Group 2 after 8 weeks. Patient characteristics, surgical procedure, histopathological details and number of loco-regional and distant failures were compared. Expected 5 year overall survival and disease free survival was calculated using Kaplan Meier curves and significance was determined using the log rank test. Results: There were 66 patients in group 1 and 93 in group 2. No significant difference in PCR was observed between the two. However, estimated 5 year DFS was significantly higher in Group 1 (66.7%) as compared to Group 2 (53.8%) (P=0.04). Estimated overall 5 year overall survival was not significantly different at 68.2% versus 54.3% (P= 0.09). Conclusions: Delaying surgery more than 8 weeks after preoperative CRT does not impact for PCR in rectal cancer.

The Impact of Educational Status on the Postoperative Perception of Pain

  • Lanitis, Sophocles;Mimigianni, Christina;Raptis, Demetris;Sourtse, Gionous;Sgourakis, George;Karaliotas, Constantine
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.265-274
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    • 2015
  • Background: Postoperative (PO) pain interferes with the recovery and mobilization of the surgical patients. The impact of the educational status has not been studied adequately up to now. Methods: This prospective study involved 400 consecutive general surgery patients. Various factors known to be associated with the perception of pain including the educational status were recorded as was the preoperative and postoperative pain and the analgesia requirements for the $1^{st}$ PO week. Based on the educational status, we classified the patients in 3 groups and we compared these groups for the main outcomes: i.e. PO pain and PO analgesia. Results: There were 145 patients of lower education (junior school), 150 patients of high education (high school) and 101 of higher education (university). Patients of lower education were found to experience more pain than patients of higher education in all postoperative days (from the $2^{nd}$ to the $6^{th}$). No difference was identified in the type and quantity of the analgesia used. The subgroup analysis showed that patients with depression and young patients (< 40 years) had the maximum effect. Conclusions: The educational status may be a significant predictor of postoperative pain due to various reasons, including the poor understanding of the preoperative information, the level of anxiety and depression caused by that and the suboptimal request and use of analgesia. Younger patients (< 40), and patients with subclinical depression are mostly affected while there is no impact on patients over 60 years old.

Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center

  • Desiderio, Jacopo;Stewart, Camille L.;Sun, Virginia;Melstrom, Laleh;Warner, Susanne;Lee, Byrne;Schoellhammer, Hans F.;Trisal, Vijay;Paz, Benjamin;Fong, Yuman;Woo, Yanghee
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.230-241
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    • 2018
  • Purpose: Enhanced recovery after surgery (ERAS) protocols for gastric cancer patients have shown improved outcomes in Asia. However, data on gastric cancer ERAS (GCERAS) programs in the United States are sparse. The purpose of this study was to compare perioperative outcomes before and after implementation of an GC-ERAS protocol at a National Comprehensive Cancer Center in the United States. Materials and Methods: We reviewed medical records of patients surgically treated for gastric cancer with curative intent from January 2012 to October 2016 and compared the GC-ERAS group (November 1, 2015-October 1, 2016) with the historical control (HC) group (January 1, 2012-October 31, 2015). Propensity score matching was used to adjust for age, sex, number of comorbidities, body mass index, stage of disease, and distal versus total gastrectomy. Results: Of a total of 95 identified patients, matching analysis resulted in 20 and 40 patients in the GC-ERAS and HC groups, respectively. Lower rates of nasogastric tube (35% vs. 100%, P<0.001) and intraabdominal drain placement (25% vs. 85%, P<0.001), faster advancement of diet (P<0.001), and shorter length of hospital stay (5.5 vs. 7.8 days, P=0.01) were observed in the GC-ERAS group than in the HC group. The GC-ERAS group showed a trend toward increased use of minimally invasive surgery (P=0.06). There were similar complication and 30-day readmission rates between the two groups (P=0.57 and P=0.66, respectively). Conclusions: The implementation of a GC-ERAS protocol significantly improved perioperative outcomes in a western cancer center. This finding warrants further prospective investigation.