Home About us Contact
|
Home About us Contact | ||
|
|
||
Serosal Invasion (serosal + invasion)
Selected AbstractsAnalysis of risk factors for recurrence and effective adjuvant therapy in patients with endometrial cancerJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2002Tomoko Goto Objective: The aim of this study was to explore risk factors for recurrence and effective adjuvant therapy in endometrial cancer. Methods: Between 1985 and 1999, 170 patients with uterine endometrial cancer received initial therapy at the National Defense Medical College Hospital. We retrospectively analyzed risk factors including; histopathological features, operative procedures, adjuvant therapies and surgical staging. Results: Although the prognosis in stage I and II patients was fairly good, recurrences were observed in patients with stage Ib or worse. Vagina walls were the frequent site of recurrence. About a half of relapses which occurred within seven months after surgery were observed during adjuvant chemotherapy. Multivariate analysis revealed that myometrial invasion (P = 0.0231) was the only risk factor for recurrence. Although the prognosis in stage III and IV patients was generally poor, serosal invasion in stage III disease seemed to be an im-portant risk factor. With regard to adjuvant therapy in stage I,III patients who could receive optimal cytoreductive surgery; the risk of recurrence was significantly (P = 0.0127) lower in patients receiving radiation therapy than in those receiving chemotherapy including platinum agents. Conclusion: The data suggested that in stage I,III patients with optimal cytoreductive surgery, myometrial invasion is an independent risk factor for recurrence and radiation therapy is more effective than chemotherapy as adjuvant therapy. [source] Prognostic indicators in node-negative advanced gastric cancer patientsJOURNAL OF SURGICAL ONCOLOGY, Issue 7 2010Hiroaki Saito MD Abstract Background and Objectives Despite carrying better overall prognoses, some node-negative gastric cancer patients die from recurrent malignancies. Identifying factors associated with disease-specific survival in adequately staged node-negative gastric cancer is important, as these patients are presumably free of microscopic regional metastases and may derive significant benefit from existing or future adjuvant strategies. Methods To investigate significant prognostic indicators in node-negative advanced gastric cancer patients, we reviewed 777 advanced gastric cancer patients who had undergone curative gastrectomies. Results The 5-year survival rate of node-negative advanced gastric cancer patients is 84.9%, which is significantly better than that of patients with lymph node metastasis. Multivariate analysis indicated that tumor size, histology, and depth of invasion are independent prognostic factors. The 5-year survival rate of patients with larger tumors (,7,cm), poorly differentiated adenocarcinoma, and serosal invasion was 49.1%, which was significantly worse that of patients with fewer or none of these factors. Conclusions Tumor size, histology, and the presence of serosal invasion are strong indicators of poor prognosis in node-negative advanced gastric cancer patients. J. Surg. Oncol. 2010; 101:622,625. © 2010 Wiley-Liss, Inc. [source] The effect of spleen-preserving lymphadenectomy on surgical outcomes of locally advanced proximal gastric cancerJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2009Sung Jin Oh MD Abstract Background The aim of this study was to investigate the effects of D2 lymphadenectomy with spleen preservation on surgical outcomes in locally advanced proximal gastric cancer. Methods Between January 2000 and December 2004, a total of 366 patients who underwent curative total gastrectomy were studied retrospectively from a prospectively designed database. Results The spleen-preservation group experienced shorter operation times, a lower incidence of perioperative transfusion, and shorter postoperative hospital stays. Perioperative transfusion and splenectomy were independent risk factors for morbidity. There was no significant difference between the two groups in recurrence or cumulative survival rate when adjusted according to cancer stage. Multivariate analysis showed that tumor size, serosal invasion, and nodal metastasis were independent prognostic factors, while splenectomy was not. The cumulative survival rate in pN0-status patients was significantly higher in the spleen-preservation group, while there was no significant difference in the survival of pN1- or pN2-status patients between the two groups. Conclusions Splenectomy for lymph node dissection in proximal gastric cancer patients obviously showed poor short-surgical outcomes, but it did not affect long-term outcomes in terms of recurrence and overall survival rate. Therefore, spleen-preserving lymphadenectomy is a feasible method for radical surgery in locally advanced proximal gastric cancer. J. Surg. Oncol. 2009;99:275,280. © 2009 Wiley-Liss, Inc. [source] Plasma concentration of tissue inhibitor of matrix metalloproteinase 1 in patients with colorectal carcinoma,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2001N. Yukawa Background: The expression of tissue inhibitor of matrix metalloproteinase (TIMP) 1 in tumour tissue from patients with colorectal carcinoma has been reported to be related to disease progression. However, the clinical significance of plasma TIMP-1 has not been fully elucidated. Methods: The plasma level of TIMP-1 protein was determined by enzyme-linked immunosorbent assay in samples from 54 patients who underwent resection of the primary tumour. Results: Plasma TIMP-1 levels were associated significantly with depth of invasion and metastasis to lymph nodes and liver. Circulating TIMP-1 levels were significantly higher in patients with serosal invasion, liver metastases and Dukes' stage C tumours. Using a cut-off value of 160 ng/ml, serosal invasion and Dukes' C stage could be predicted with an accuracy of 68·5 per cent. With a cut-off value of 170 ng/ml, metastasis to the lymph node and liver could be predicted with an accuracy of 66·7 and 70·4 per cent respectively. These values were greater than those for carcinoembryonic antigen and CA19-9. Conclusion: These data suggest that the plasma concentration of TIMP-1 correlates with both invasion and metastasis in patients with colorectal carcinoma. © 2001 British Journal of Surgery Society Ltd [source] Recurrence following curative resection for gastric carcinomaBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2000C. H. Yoo Background: The diagnosis and treatment of recurrent gastric cancer remains difficult. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the prognosis for these patients. Methods: Of 2328 patients who underwent curative resection for gastric cancer from 1987 to 1995, 508 whose recurrence was confirmed by clinical examination or reoperation were studied retrospectively. The risk factors that determined the recurrence patterns and timing were investigated by univariate and multivariate analysis. Results: The mean time to recurrence was 21·8 months and peritoneal recurrence was the most frequent (45·9 per cent). Logistic regression analysis showed that serosal invasion and lymph node metastasis were risk factors for all recurrence patterns and early recurrence (at 24 months or less). In addition, independent risk factors involved in each recurrence pattern included younger age, infiltrative or diffuse type, undifferentiated tumour and total gastrectomy for peritoneal recurrence; older age and larger tumour size for disseminated, haematogenous recurrence; and older age, larger tumour size, infiltrative or diffuse type, proximally located tumour and subtotal gastrectomy for locoregional recurrence. Other risk factors for early recurrence were infiltrative or diffuse type and total gastrec-tomy. Reoperation for cure was possible in only 19 patients and the mean survival time after conservative treatment or palliative operation was less than 12 months. Conclusion: The risk factors for each recurrence pattern and timing of gastric cancer can be predicted by the clinicopathological features of the primary tumour. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted. © 2000 British Journal of Surgery Society Ltd [source] Genome-wide array-based comparative genomic hybridization analysis of pancreatic adenocarcinoma: Identification of genetic indicators that predict patient outcomeCANCER SCIENCE, Issue 3 2007Panayiotis Loukopoulos We analyzed the subchromosomal numerical aberrations of 44 surgically resected pancreatic adenocarcinomas by array-based comparative genomic hybridization. The aberration profile ranged widely between cases, suggesting the presence of multiple or complementary mechanisms of evolution in pancreatic cancer, and was associated with lymph node metastasis and venous or serosal invasion. A large number of small loci, previously uncharacterized in pancreatic cancer, showed non-random loss or gain. Frequent losses at 1p36, 4p16, 7q36, 9q34, 11p15, 11q13, 14q32-33, 16p13, 17p11-13, 17q11-25, 18q21-tel, 19p13, 21q22 and 22q11-12, and gains at 1q25, 2p16, 2q21-37, 3q25, 5p14, 5q11-13, 7q21, 7p22, 8p22, 8q21-23, 10q21, 12p13, 13q22, 15q13-22 and 18q11 were identified. Sixteen loci were amplified recurrently. We identified novel chromosomal alterations that were significantly associated with a range of malignant phenotypes. Gain of LUNX, HCK, E2F1 and DNMT3b at 20q11, loss of p73 at 1p36 and gain of PPM1D at 17q23 independently predicted patient outcome. Expression profiling of amplified genes identified Smurf1 and TRRAP at 7q22.1, BCAS1 at 20q13.2-3, and VCL at 10q22.1 as potential novel oncogenes. Our results contribute to a complete description of genomic structural aberrations and the identification of potential therapeutic targets and genetic indicators that predict patient outcome in pancreatic adenocarcinoma. (Cancer Sci 2007; 98: 392,400) [source] | ||||||||||