scholarly journals A Single Centre Analysis of Clinical Characteristics and Treatment of Endocrine Pancreatic Tumours

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
M. T. Adil ◽  
R. Nagaraja ◽  
V. Varma ◽  
N. Mehta ◽  
V. Kumaran ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Cohort Analysis ◽  
Pancreatic Head ◽  
Uncinate Process ◽  
Lower Grade ◽  
High Grade ◽  
Single Centre ◽  
Term Survival ◽  
Surgical Interventions ◽  
Pancreatic Tumours

Background. Endocrine Pancreatic Tumours (PENs) are rare and can be nonfunctioning or functioning. They carry a good prognosis overall though high grade lesions show a relatively shorter survival. The aim of the current study is to describe a single centre analysis of the clinical characteristics and surgical treatment of PENs.Patients and Methods. This is a cohort analysis of 40 patients of PENs who underwent surgery at Sir Ganga Ram Hospital, New Delhi, India, from 1995 to 2013. Patient particulars, clinical features, surgical interventions, postoperative outcome, and followup were done and reviewed. The study group was divided based on grade (G1, G2, and G3) and functionality (nonfunctioning versus functioning) for comparison.Results. PENs comprised 6.3% of all pancreatic neoplasms (40 of 634). Twenty-eight patients (70%) had nonfunctioning tumours. Eighteen PENs (45%) were carcinomas (G3), all of which were nonfunctioning. 14 (78%) of these were located in the pancreatic head and uncinate process (P=0.09). The high grade (G3) lesions were significantly larger in size than the lower grade (G1 + G2) tumours (7.0 ± 3.5 cms versus 3.1 ± 1.6 cms,P=0.007). Pancreatoduodenectomy was performed in 18 (45%), distal pancreatectomy in 10 (25%), and local resection in 8 (20%) and nonresective procedures were performed in 4 patients (10%). Fourteen patients (35%) had postoperative complications. All G3 grade tumours which were resected had positive lymph nodes (100%) and 10 had angioinvasion (71%). Eight neoplasms (20%) were cystic, all being grade G3 carcinomas, while the rest were solid. The overall disease related mortality attributable to PEN was 14.3% (4 of 28) and for malignant PENs was 33.3% (4 of 12) after a mean follow-up period of 49.6 months (range: 2–137 months).Conclusion. Majority of PENs are nonfunctioning. They are more likely malignant if they are nonfunctioning and large in size, show cystic appearance, and are situated in the pancreatic head. Early surgery leads to good long term survival with acceptable postoperative morbidity.

Clinical characteristics of nonosteogenic, non-Ewing’s sarcoma of the bone: Experience at the Toronto Sarcoma Program.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11029-11029
Author(s):  
Zachary William Neil Veitch ◽  
Peter Charles Ferguson ◽  
Anthony Griffin ◽  
Kanan Alshammari ◽  
Esmail Mutahar Al-Ezzi ◽  
...  
Keyword(s):  
Tumor Size ◽  
Clinical Characteristics ◽  
Malignant Tumors ◽  
Osteogenic Sarcoma ◽  
Tumor Location ◽  
R0 Resection ◽  
Data Series ◽  
High Grade ◽  
Term Survival

11029 Background: Non-osteogenic sarcoma of the bone is a rare entity comprising a heterogenous group of malignant tumors. Clinical characteristics and outcome data are sparse in the literature. We evaluated the characteristics and long-term outcomes of patients (pts) with this disease. Methods: Pts with non-osteogenic sarcoma of the bone treated at the Toronto Sarcoma Program from 1987-2017 were identified from our institutional sarcoma database. Patient characteristics (ie: age, gender, tumor size, histology, grade, necrosis, tumor location), treatment modality (ie: surgical management, chemotherapy, radiotherapy), and survival information were collected. Survival was estimated by Kaplan-Meier (log-rank). Multi-variate analysis (MVA) was used to evaluate characteristics for sarcoma specific survival. Results: Of 130 pts identified, 106 had non-metastatic disease with a median age of 46 (range 18-89). Male-to-female predominance was 1.5:1. Common histologies were undifferentiated pleomorphic sarcoma (UPS; 42%), leiomyosarcoma (21%), and fibrosarcoma (11%). Tumors were generally high grade (59%) and > 5 cm in size (73%). The majority of pts received chemotherapy (68%), with Cisplatin/Doxorubicin based regimens (95%). R0 resection was achieved in 85% of cases. Survival for the entire cohort, showed a median (m)DFS of 8.13 years (95%CI:2.52-18.02), and a mOS of 11.72 (95%CI:7.00-not reached [NR]). Median sarcoma specific survival was NR, however 15- and 25-year survivals were 60.4% and 52.6% respectively. MVA demonstrated axial tumor location (HR = 13.03; p = 0.005), no chemotherapy (HR = 4.50; p = 0.017) and tumor grade (G2: HR = 36.21; p = 0.012; G3: HR = 20.30; p = 0.015) as risk factors for sarcoma specific death. Tumor size > 10cm (p = 0.085) and necrosis > 90% (p = 0.082) trended towards significance. Conclusions: Non-osteogenic sarcoma of the bone is a rare tumor entity, with a predominant UPS histology. Patient outcomes are reasonable, with measurable long-term survival. Axial tumor location, absence of chemotherapy, and high-grade disease predict for worse survival outcome. Further evaluation with larger data series is warranted to more fully understand this disease.

INFLUENCE OF CLINICAL CHARACTERISTICS AND VOLUME OF CYTOREDUCTION IN PATIENTS WITH PRIMARY GLIOBLASTOMA ON OVERALL SURVIVAL

2017 ◽  
Vol 63 (6) ◽  
pp. 907-914
Author(s):  
Marina Matsko ◽  
Dmitriy Matsko ◽  
Nikita Volkov ◽  
Aleksey Ulitin ◽  
Aglaya Ievleva
Keyword(s):  
Survival Rate ◽  
Clinical Characteristics ◽  
Tumor Location ◽  
Ki 67 ◽  
Term Survival ◽  
Surgical Interventions ◽  
Primary Glioblastoma ◽  
Small Patient

Patients with glioblastoma (GB) rarely survive more than 3 years. This study aimed to analyze clinical characteristics of long-term GB survivors. 69 patients with primary GB who were treated at the A.L. Polenov Neurosurgical Institute since 2009 and had sufficient follow-up were analyzed; survival of 11 of these patients exceeded 3 years, while the remaining 58 failed to achieve this threshold. An immunohistochemical study was performed using Ki-67 and GFAP antibodies. Patients were divided into two groups: the first included 11 patients with a survival rate of more than 3 years, the second (comparison group) with a survival rate of less than 3 years included 58 patients. Long-term survival correlated with the younger patients age (p = 0.002) and tumor response to temozolomide (p = 0.004). Other clinical features, including gender (p = 0.484), Karnovsky status (p = 0.322); tumor location (p = 0.078), volume of the lesion and the number of affected lobes (p = 0.132), the number of surgical interventions (p = 0.278) and the volume of cytoreduction (p = 0.105) were not prognostic in this small patient cohort.

scholarly journals PATH-11. PROSPECTIVE (EPI-)GENETIC CLASSIFICATION OF > 1,000 PEDIATRIC CNS TUMORS—THE MNP 2.0 STUDY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii426-iii426
Author(s):  
Dominik Sturm ◽  
Felix Sahm ◽  
Felipe Andreiuolo ◽  
David Capper ◽  
Marco Gessi ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Gene Panel ◽  
Cns Tumors ◽  
Lower Grade ◽  
High Grade ◽  
Sequencing Data ◽  
Cns Tumor ◽  
Gene Panel Sequencing ◽  
Tumor Entities ◽  
Panel Sequencing

Abstract The large variety of CNS tumor entities affecting children and adolescents, some of which are exceedingly rare, results in very diverging patient outcomes and renders accurate diagnosis challenging. To assess the diagnostic utility of routine DNA methylation-based CNS tumor classification and gene panel sequencing, the Molecular Neuropathology 2.0 study prospectively integrated these (epi-)genetic analyses with reference neuropathological diagnostics as an international trial for newly-diagnosed pediatric patients. In a four-year period, 1,215 patients with sufficient tissue were enrolled from 65 centers, receiving a reference neuropathological diagnosis according to the WHO classification in >97%. Using 10 FFPE sections as input, DNA methylation analysis was successfully performed in 95% of cases, of which 78% with sufficient tumor cell content were assigned to a distinct epigenetic tumor class. The remaining 22% did not match any of 82 represented classes, indicating novel rare tumor entities. Targeted gene panel sequencing of >130 genes performed for 96% of patients with matched blood samples detected diagnostically, prognostically, or therapeutically relevant somatic alterations in 48%. Germline DNA sequencing data indicated potential predisposition syndromes in ~10% of patients. Discrepant results by neuropathological and epigenetic classification (29%) were enriched in histological high-grade gliomas and implicated clinical relevance in 5% of all cases. Clinical follow-up suggests improved survival for some patients with high-grade glioma histology and lower-grade molecular profiles. Routine (epi-)genetic profiling at the time of primary diagnosis adds a valuable layer of information to neuropathological diagnostics and will improve clinical management of CNS tumors.

scholarly journals What comprises the plate-like structure between the pancreatic head and the celiac trunk and superior mesenteric artery? A proposal for the term “P–A ligament” based on anatomical findings

2021 ◽  
Author(s):  
Satoru Muro ◽  
Wachirawit Sirirat ◽  
Daisuke Ban ◽  
Yuichi Nagakawa ◽  
Keiichi Akita
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Pancreatic Head ◽  
Celiac Trunk ◽  
Dorsal Side ◽  
Uncinate Process ◽  
Anatomical Basis ◽  
The Right ◽  
Upper Abdomen ◽  
Macroscopic Examination

AbstractA plate-like structure is located posterior to the portal vein system, between the pancreatic head and roots and/or branches of two major arteries of the aorta: the celiac trunk and superior mesenteric artery. We aimed to clarify the distribution and components of this plate-like structure. Macroscopic examination of the upper abdomen and histological examination of the plate-like structure were performed on 26 cadavers. The plate-like structure is connected to major arteries (aorta, celiac trunk, superior mesenteric artery) and the pancreatic head; it contains abundant fibrous bundles comprising nerves, vessels, collagen fibers, and adipose tissue. Furthermore, it consists of three partly overlapping fibrous components: rich fibrous bundles (superior mesenteric artery plexus) fused to the uncinate process of the pancreas; fibrous bundles arising from the right celiac ganglion and celiac trunk that spread radially to the dorsal side of the pancreatic head and superior mesenteric artery plexus; and fibrous bundles, accompanied by the inferior pancreaticoduodenal artery, entering the pancreatic head. The plate-like structure is the pancreas–major arteries (aorta, celiac trunk, superior mesenteric artery) ligament (P–A ligament). The term “P–A ligament” may be clinically useful and can facilitate comprehensive understanding of the anatomy surrounding the pancreatic head and provide an anatomical basis for further pancreatic surgery studies.

scholarly journals Evaluating the effects of arthroscopic Bankart repair and open Latarjet shoulder stabilisation procedures on shoulder joint neuromechanics and function: a single-centre, parallel-arm trial protocol

2021 ◽  
Vol 7 (1) ◽  
pp. e000956
Author(s):  
Aaron Fox ◽  
Jason Bonacci ◽  
Stephen D Gill ◽  
Richard S Page
Keyword(s):  
Shoulder Instability ◽  
Shoulder Joint ◽  
Repeated Measures ◽  
Ethics Committees ◽  
Shoulder Function ◽  
Bankart Repair ◽  
Single Centre ◽  
Surgical Interventions ◽  
Shoulder Range Of Motion ◽  
Arthroscopic Bankart Repair

IntroductionShoulder instability injuries are common in sports involving collisions and overhead movements. Arthroscopic Bankart repair and the open Latarjet are two commonly used surgical stabilisation procedures. There is a lack of knowledge surrounding movement strategies, joint loading and muscle strength after each of these procedures. This study will compare: (1) shoulder joint neuromechanics during activities of daily living and an overhead sporting task; (2) shoulder range of motion; (3) shoulder strength; and (4) self-reported shoulder function and health status, between individuals who have undergone an arthroscopic Bankart repair versus open Latarjet.Methods and analysisThis is a prospective cohort, single-centre, non-randomised parallel arm study of surgical interventions for athletic shoulder instability injuries. Thirty participants will be recruited. Of these, 20 will have experienced one or more traumatic shoulder instability injuries requiring surgical stabilisation—and will undergo an arthroscopic Bankart repair or open Latarjet procedure. The remaining 10 participants will have no history of shoulder instability injury and act as controls. Participants will undergo baseline testing and be followed up at 3, 6 and 12 months. A two-way (group×time) analysis of variance with repeated measures on one factor (ie, time) will compare each outcome measure between groups across time points.Ethics and disseminationThis study was approved by the Barwon Health and Deakin University Human Research Ethics Committees. Outcomes will be disseminated through publications in peer-reviewed journals and presentations at relevant scientific conferences.Trial registration numberAustralian and New Zealand Clinical Trials Registry (ACTRN12620000016932).

scholarly journals Clinical Characteristics and Relevance of Oral Candida Biofilm in Tongue Smears

2021 ◽  
Vol 7 (2) ◽  
pp. 77
Author(s):  
Eunae Cho ◽  
YounJung Park ◽  
Ki-Yeol Kim ◽  
Dawool Han ◽  
Hyun Sil Kim ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Oral Candidiasis ◽  
Salivary Flow ◽  
Nutritional Deficiencies ◽  
Low Grade ◽  
High Grade ◽  
Novel Method ◽  
Oral Candida ◽  
Antifungal Use ◽  
Candida Biofilm

Dimorphic Candida exist as commensal yeast carriages or infiltrate hyphae in the oral cavity. Here, we investigated the clinical relevance of Candida hyphae in non-pseudomembranous oral candidiasis (OC) by smears of tongue biofilms. We conducted a retrospective study of 2829 patients who had had tongue smears regardless of OC suspicion. Clinical characteristics were evaluated using a novel method of assessing hyphae. Clinical factors (moderate/severe stimulated pain, pain aggravated by stimulation, tongue dorsum appearance and initial topical antifungal use) were highly significant in the high-grade hyphae group but were statistically similar in the low-grade hyphae and non-observed hyphae group, suggesting low-grade hyphae infection as a subclinical OC state. In addition to erythematous candidiasis (EC), a new subtype named “morphologically normal symptomatic candidiasis” (MNSC) with specific pain patterns and normal tongue morphology was identified. MNSC had a significantly higher proportion of moderate and severe stimulated pain cases than EC. Low unstimulated salivary flow rate (<0.1 mL/min) was found to be a common risk factor in MNSC and EC. In non-pseudomembranous OC, pain patterns were dependent on Candida hyphae degree regardless of tongue dorsum morphology. Morphologic differences seen in high-grade hyphae infection were not associated with systemic diseases or nutritional deficiencies.

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