scholarly journals Second-Look Surgery for Colorectal Cancer: Revised Selection Factors and New Treatment Options for Greater Success

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Paul H. Sugarbaker
Keyword(s):  
Colorectal Cancer ◽  
Treatment Options ◽  
Cancer Recurrence ◽  
Exploratory Laparotomy ◽  
Second Look ◽  
New Treatment ◽  
Local Regional Recurrence ◽  
Selection Factors ◽  
Term Survivor

Proper indications for second-look surgery in patients with colorectal cancer have always been a controversial subject. The surgical literature suggests benefit in a reoperation, where a limited extent of cancer is discovered and then resected with negative margins. However, patients are often subjected to a negative exploratory laparotomy or an intervention that is unable to achieve an R-0 resection; in these circumstances, little or no benefit occurs. Unfortunately, an unsuccessful repeat intervention may place the patient in a worse condition, especially if morbidity occurs. This paper seeks to identify the clinical parameters of a primary colorectal cancer and a followup plan that are associated with cancer recurrence that can be definitively addressed by the second look surgery. New surgical technologies, including cytoreductive surgery with peritonectomy and perioperative intraperitoneal chemotherapy with hyperthermia, are suggested for use in this group of patients. This new management strategy used in patients with local-regional recurrence may result in a high proportion of patients converted from a second-look positive patient to a long-term survivor.

scholarly journals Different Mechanism Involvement in the Formation of Colorectal Cancer; Mega Review

2021 ◽  
Vol 8 (9) ◽  
pp. 558-573
Author(s):  
Muhammad Ali ◽  
Yang Wang ◽  
Qi Zhang
Keyword(s):  
Colorectal Cancer ◽  
Dietary Habits ◽  
Treatment Options ◽  
Developed Countries ◽  
Term Survival ◽  
Keywords Colorectal Cancer ◽  
Cancer Tumor ◽  
Low Incidence ◽  
New Treatment ◽  
New Treatments

Colorectal cancer was infrequently diagnosed several decades ago. Nowadays, it is the world's fourth most deadly cancer with almost 900,000 deaths annually. Colorectal cancer had a low incidence several decades ago. However, it has become predominant cancer and now accounts for approximately 10% of cancer-related mortality in western countries. The ‘rise’ of colorectal cancer in developed countries can be attributed to the increasingly aging population, unfavorable modern dietary habits and an increase in risk factors such as smoking, low physical exercise and obesity. New treatments for primary and metastatic colorectal cancer have emerged, providing additional options for patients; these treatments include laparoscopic surgery for primary disease, more aggressive resection of metastatic disease (such as liver and pulmonary metastases), radiotherapy for rectal cancer and neoadjuvant and palliative chemotherapies. However, these new treatment options have had a limited impact on cure rates and long-term survival. Keywords: Colorectal cancer, Tumor marker, Hereditary colorectal cancer, Mediterranean diet.

scholarly journals Patient-Reported Communication With Their Health Care Team About New Treatment Options for Chronic Lymphocytic Leukemia

2021 ◽  
Vol 8 ◽  
pp. 237437352110349
Author(s):  
Elissa C Kranzler ◽  
Julie S Olson ◽  
Helen M Nichols ◽  
Eva YN Yuen ◽  
Shauna McManus ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Treatment Options ◽  
Cancer Recurrence ◽  
Improve Patient Care ◽  
Lymphocytic Leukemia ◽  
Standards Of Care ◽  
Novel Therapies ◽  
Cancer Support ◽  
Patient Reported ◽  
New Treatment

Chronic lymphocytic leukemia (CLL) often requires consideration of multiple treatment options. Shared decision-making (SDM) is important, given the availability of increasingly novel therapies; however, patient–provider treatment conversations vary. We examined relationships between patient–provider discussions of new CLL treatment options and sociodemographic, clinical, and patient–provider communication variables among 187 CLL patients enrolled in Cancer Support Community’s Cancer Experience Registry. Factors significantly associated with self-reports of whether patients’ providers discussed new CLL treatment options with them were examined using χ2 tests, t tests, and hierarchical logistic regression. Fifty-eight percent of patients reported discussing new treatment options with their doctor. Patients with higher education were 3 times more likely to discuss new treatment options relative to those with lower education (OR = 3.06, P < .05). Patients who experienced a cancer recurrence were 7 times more likely to discuss new treatment options compared to those who had not (OR = 7.01, P < .05). Findings offer insights into the correlates of patient–provider discussions of new CLL treatment options. As novel therapies are incorporated into standards of care, opportunities exist for providers to improve patient care through enhanced SDM.

Vascular malformations revisited

VASA ◽  
2015 ◽  
Vol 44 (1) ◽  
pp. 5-22 ◽  
Author(s):  
Robert K. Clemens ◽  
Thomas Pfammatter ◽  
Thomas O. Meier ◽  
Ahmad I. Alomari ◽  
Beatrice R. Amann-Vesti
Keyword(s):  
Gold Standard ◽  
Multidisciplinary Approach ◽  
Vascular Malformations ◽  
Treatment Options ◽  
Reduce Blood Loss ◽  
Significant Morbidity ◽  
Treatment Techniques ◽  
New Treatment ◽  
Common Understanding

Vascular malformations are congenital anomalies that can affect each part of the vasculature. Combined forms are common and they are often part of complex syndromes. Most malformations are diagnosed during infancy, but some get obvious only later in life. The field of vascular malformations is emerging with recently described new entities and treatments. Still, misdiagnosis is common in this field, leading to nosologic confusion and wrong treatment. Clinical evaluation and imaging are the gold standard for diagnostic confirmation. Sclerotherapy and embolization are the main treatment techniques but are also used preoperatively to reduce blood loss and shrink the lesion if surgery is planned. Despite new treatment options, especially if extensive in size or involving vulnerable structures, vascular malformations are still considered chronic diseases and cause significant morbidity. Common understanding and agreement on terminology and a multidisciplinary approach are the basis of successful treatment and long-term support for these patients. Continuing research in the field of vascular anomalies will improve knowledge and create further treatment options.

scholarly journals Health impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE

2009 ◽  
Vol 7 (2) ◽  
pp. 185-207 ◽  
Author(s):  
Mark J. Nieuwenhuijsen ◽  
Rachel Smith ◽  
Spyros Golfinopoulos ◽  
Nicky Best ◽  
James Bennett ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Assessment ◽  
Drinking Water ◽  
Congenital Anomalies ◽  
Semen Quality ◽  
Treatment Options ◽  
Human Consumption ◽  
Premature Births ◽  
By Products

There appears to be very good epidemiological evidence for a relationship between chlorination by-products, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers, including colorectal cancer appears to be inconclusive and inconsistent. There appears to be some evidence for a relationship between chlorination by-products, as measured by THMs, and small for gestational age (SGA)/intrauterine growth retardation (IUGR) and preterm delivery, but evidence for other outcomes such as low birth weight (LBW), stillbirth, congenital anomalies and semen quality appears to be inconclusive and inconsistent. The overall aim of the HIWATE study is to investigate potential human health risks (e.g. bladder and colorectal cancer, premature births, SGA, semen quality, stillbirth, congenital anomalies) associated with long-term exposure to low levels of disinfectants (such as chlorine) and DBPs occurring in water for human consumption and use in the food industry. The study will comprise risk–benefit analyses including quantitative assessments of risk associated with microbial contamination of drinking water versus chemical risk and will compare alternative treatment options. The outcome will be improved risk assessment and better information for risk management. The work is divided into different topics (exposure assessment, epidemiology, risk assessment and management) and studies.

scholarly journals Modern combined targeted and immunotherapy of metastatic skin melanoma

2020 ◽  
pp. 54-61
Author(s):  
S. A. Protsenko ◽  
E. N. Imyanitov ◽  
A. I. Semenova ◽  
D. Kh. Latipova ◽  
A. V. Novik ◽  
...  
Keyword(s):  
Treatment Options ◽  
Survival Rates ◽  
New Drugs ◽  
Phase Iii ◽  
Immune Checkpoints ◽  
Malignant Neoplasms ◽  
Skin Melanoma ◽  
Clinical Prognosis ◽  
New Treatment

Melanoma of the skin is one of the most aggressive malignant neoplasms. Metastatic skin melanoma has an extremely poor clinical prognosis with a high mortality rate, accounting for 80% of all deaths from skin malignancies. The approaches to the treatment of metastatic skin melanoma have been dynamically developing over the past decade. New drugs and their combinations are becoming more affordable. In connection with the advances in molecular genetics and the development of new targeted drugs, treatment outcomes have significantly improved: first of all, overall survival and the time to progression of the disease, which has set new challenges for continuing research in this area. The development of new treatment options for patients with inoperable and/or metastatic melanoma with a mutation in the BRAFV600 gene is still in high demand. Emerging data from clinical and preclinical studies suggest that synergies can be observed between inhibitors of immune checkpoints and inhibitors of BRAF and MEK. Despite the fact that inhibitors of the BRAF signaling pathway have a high frequency of objective responses, in most cases their duration is short. Inhibitors of immune checkpoints provide a longer lasting effect, but the response rate is relatively low. Combining the two types of therapy can improve survival rates over the long term. This review demonstrates the results of phase III randomized trials that have allowed to determine the current standards in the treatment of metastatic skin melanoma. We also demonstrated our own experience of using a triple combination of targeted therapy with BRAF/MEK inhibitors in combination with PD-1 inhibitors.

scholarly journals THE GHRELIN SYSTEM; BEYOND THE ROLE IN ENERGY HOMEOSTASIS

2017 ◽  
pp. 33
Author(s):  
Ljiljana Šaranac ◽  
Zoran Gucev
Keyword(s):  
Endocrine Cells ◽  
Energy Homeostasis ◽  
Treatment Options ◽  
Distinct Group ◽  
Peptide Ligand ◽  
Oxyntic Mucosa ◽  
Cardio Protection ◽  
New Treatment ◽  
Hunger Signal

The fascinating story of ghrelin started more than 30 years ago with the discovery of synthetic (non-natural) growth hormone (GH) releasing peptides. Scientists were searching for a novel peptide, ligand of orphan GH secretagogue receptor. The discovery of ghrelin is a typical example of reverse pharmacology. The new peptide quickly attracted a lot of attention by its pleiotropic nature, and provoked a burst of new enthusiasm among scientists and clinicians. Ghrelin is mainly produced in the stomach from a distinct group of endocrine cells located within the gastric oxyntic mucosa. It acts as hunger signal and long-term body weight regulator. But, ghrelin is much more than just a natural orexigenic factor and GH secretagogue. It exerts major peripheral endocrine and non-endocrine actions, and it has a role in learning and memory, glucose homeostasis, immunity, cardio protection, fertility and addiction. Exploring the actions of ghrelin and ghrelin agonists and receptor antagonists or reverse agonists could establish new treatment options for so far incurable diseases.

scholarly journals Severe alcoholic hepatitis: why do we know a lot, but can do so little?

2018 ◽  
Vol 96 (5) ◽  
pp. 401-410
Author(s):  
A. O. Buyeverov ◽  
V. E. Syutkin ◽  
P. O. Bogomolov
Keyword(s):  
Liver Failure ◽  
Alcoholic Hepatitis ◽  
Treatment Options ◽  
Infectious Complications ◽  
Intestinal Wall ◽  
Severe Alcoholic Hepatitis ◽  
New Treatment ◽  
Cytokine Cascade ◽  
Selective Influence

Severe alcoholic hepatitis (SAH) is characterized by high both immediate and long - term mortality, caused by these patients ’ a special form of liver failure development which is acute on the background of chronic one (acute-on-chronic liver failure). Steatosis, oxidative stress, increased permeability of the intestinal wall, the formation of toxic metabolites and the cytokine cascade are considered to be the main pathogenetic elements of the SAH. The course of SAH is accompanied by the so-called liver-associated immunodeficiency, which is associated with a high risk of fatal infectious complications, causing up to А of all deaths. This variant of immunodeficiency is characterized by hyperactivation of some elements of the immune system along with suppression of the activity of others. Despite advances in the study of pathogenesis, today the only therapeutic agent affecting the survival of patients with SAH are corticosteroids. A significant improvement in prognosis in the absence of response to corticosteroid therapy can only be achieved by performing an urgent liver transplant. Currently, several new treatment options for patients with SAH are being developed. We believe that selective influence on key immunopathological processes deserves special attention.

A new strategy for the early detection of colorectal cancer recurrence.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 416-416
Author(s):  
Afsaneh Motamed-Khorasani ◽  
Andrea Lee Small-Howard ◽  
Hooman Etemadi
Keyword(s):  
Colorectal Cancer ◽  
Survival Rate ◽  
Early Detection ◽  
Degradation Products ◽  
Treatment Options ◽  
Cancer Recurrence ◽  
Patient Treatment ◽  
Serum Samples ◽  
Combined Test ◽  
Low Sensitivity

416 Background: Several biological markers have been tested for colorectal cancer (CRC) including CEA; however, they are of limited use for recurrence diagnosis due to low sensitivity. Almost 50% of CRC cases experience recurrence and more than 50% of them have low values not detectable by CEA. Therefore, an effective marker for detection of recurrence will vastly increase the quality of life and survival rate. Onko-Sure is an FDA-cleared blood test that is used for the monitoring of treatment/recurrence of CRC. This ELISA assay measures the accumulation of Fibrin/Fibrinogen Degradation products in the serum using an antibody against the DR-70. The goal of this study was to determine whether the combined usage of DR-70 and CEA will improve the sensitivity for detecting recurrences. Methods: A total of 75 serum samples were retrospectively recruited through a serum bank in two arms including the confirmed healthy control (n=39) and biopsy-confirmed recurrent CRC (n=36) groups. For each patient, the serum sample was tested for DR-70 and CEA concentrations. Results: The results showed sensitivity of 75% and specificity of 58.97% for DR-70 and CEA combined. The cut points were calculated as 1.3ug/ml for DR-70, and 3 or 5ng/ml for CEA for non-smokers and smokers; respectively. For the combined analysis, if either CEA or DR-70 was positive, the test was considered positive and if both tests were negative, the result was considered negative. The sensitivity for the combined test was much better than that of each of the markers alone (35% higher than that of CEA). Conclusions: The combined usage of DR-70 and CEA in monitoring of CRC recurrence showed a significant clinical advantage in terms of sensitivity over each marker alone. Improvement in detection of recurrence has important implications to patient treatment options and prognosis. Should an IVD increase early detection of CRC recurrence when used adjunctively with other available diagnostic markers, the annual deaths due to CRC recurrence could be reduced due to the increase in early detection and the survival rate of those early detections.

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