scholarly journals Surgical Resection with Neoadjuvant Chemotherapy for Locoregionally Recurrent Appendiceal Cancer Invading the External Iliac Vessels

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Jun Takahashi ◽  
Shingo Tsujinaka ◽  
Nao Kakizawa ◽  
Noriya Takayama ◽  
Erika Machida ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Resection ◽  
Ileocecal Resection ◽  
Pelvic Cavity ◽  
Recurrent Colorectal Cancer ◽  
Appendiceal Cancer ◽  
En Bloc ◽  
One Year ◽  
The Right

Recent advancements in multimodal therapy can provide oncologic benefits for patients with recurrent colorectal cancer. This report presents a case of locoregionally recurrent appendiceal cancer treated with neoadjuvant chemotherapy followed by surgical resection with vascular reconstruction. A 68-year-old Japanese woman was diagnosed with appendiceal cancer and underwent ileocecal resection. The pathological evaluation revealed KRAS-mutant adenocarcinoma with the final stage of T4bN1M0. She received oral fluorouracil-based adjuvant chemotherapy. One year later, she was found to have peritoneal dissemination in the pelvic cavity and vaginal metastasis. She received an oxaliplatin-based chemotherapy followed by surgical resection. One year after the second surgery, she developed a locoregional recurrence involving the right external iliac vessels and small intestine. She received an irinotecan-based regimen with bevacizumab as neoadjuvant chemotherapy, followed by surgical resection. At first, a femoro-femoral bypass was made to secure the blood supply to the right lower extremities. Subsequently, an en bloc resection including the recurrent tumor and the external iliac vessels was completed. Surgical resection for recurrent colorectal cancer is often technically challenging because of the tumor location and invasion to adjacent organs. In this case, a surgical approach with persistent chemotherapy achieved oncologic resection of locoregionally recurrent appendiceal cancer.

scholarly journals Clinical Features, Treatment, and Outcome in 102 Adult and Pediatric Patients with Localized High-Grade Synovial Sarcoma

Sarcoma ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
H. Al-Hussaini ◽  
D. Hogg ◽  
M. E. Blackstein ◽  
B. O'Sullivan ◽  
C. N. Catton ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Synovial Sarcoma ◽  
Surgical Resection ◽  
Pediatric Patients ◽  
Response Rate ◽  
High Grade ◽  
En Bloc ◽  
Positive Surgical Margins ◽  
Response To Neoadjuvant Chemotherapy

Background. There remains controversy on the routine use of chemotherapy in localized SS.Methods. The records of 87 adult (AP) and 15 pediatric (PP) patients with localized SS diagnosed between 1986 and 2007 at 2 centres in Toronto were reviewed.Results. Median age for AP and PP was 37.6 (range 15–76) and 14 (range 0.4–18) years, respectively. 65 (64%) patients had large tumours (>5 cm). All patients underwent en bloc surgical resection resulting in 94 (92.2%) negative and 8 (7.8%) microscopically positive surgical margins. 72 (82.8%) AP and 8 (53%) PP received radiotherapy. Chemotherapy was administered to 12 (13.8%) AP and 13 (87%) PP. 10 AP and 5 PP were evaluable for response to neoadjuvant chemotherapy, with response rate of10%and40%, respectively. 5-year EFS and OS was69.3±4.8%and80.3±4.3%, respectively, and was similar for AP and PP, In patients with tumors >5 cm, in whom chemotherapy might be considered most appropriate, relapse occurred in 9/19 (47%) with chemotherapy, compared to 17/46 (37%) In those without.Conclusions. Patients with localized SS have a good chance of cure with surgery and RT. Evidence for a well-defined role of chemotherapy to improve survival In localized SS remains elusive.

Retrospective review of FOLFIRINOX in local advanced pancreatic cancer: Single institution experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15714-e15714
Author(s):  
Ashish Manne ◽  
Sushanth Reddy ◽  
Martin Heslin ◽  
Rojymon Jacob ◽  
Selwyn M. Vickers ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Resection ◽  
Retrospective Review ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Metastatic Setting ◽  
Significant Difference ◽  
One Year

e15714 Background: Although combination of fluorouracil, irinotecan, Leucovorin and oxaliplatin [FOLFIRINOX] significantly increases survival in metastatic pancreatic cancer (MPC) compared to gemcitabine based on ACCORD trial, the efficacy and toxicities may be different in non-metastatic setting. We reviewed our institution’s experience with FOLFIRINOX in locally advanced pancreatic cancer (LAPC). Methods: We performed a retrospective review of clinical outcomes in patients diagnosed with LAPC and receiving between June 2010 and July 2015, with at least one year of follow up from diagnosis, at University of Alabama at Birmingham. Results: Total of 41 patients with ECOG performance scale of 0 or 1, who underwent neoadjuvant chemotherapy with FOLFIRINOX were assessed for clinical and pathological characteristics. Median age was 61 years (range 38-81) with 23 (56.1%) males, 28 (68.3%) Caucasians and 16 (39.0%) underwent surgery (whipple operation) post-neoadjuvant. Median OS (time of diagnosis to last follow up/death) is 83.5 months for whole cohort, survival rates are 94.9% at 1 year, 58.4% at 2 year, and 33.3% at 5 year.Median OS for those who underwent surgical resection following the chemotherapy is 38.6 months; 100% at one year, 85.1% at 2 year, 55.3% at 5 year; while median OS for those who did not undergo surgery is 21.8 months; 91.7% at one year, 41.5% at 2 year, 20.7% at 5 years. Among those who underwent surgery, the median recurrence free survival (time from surgery to relapse/progression) is 19.9 months with liver being common recurrence site (81%). There was no post-operative mortality in 30 days. Grade 3-4 toxicity occurred in 46% ( vomiting (12%), fatigue (28%) and neutropenia (54%), febrile neutropenia (9%)). There is a significant difference between surgery and non-surgery groups (p = 0.012) for improved OS by log-rank test. Conclusions: Neoadjuvant FOLFIRINOX treatment associated with high response rates leading to surgical resection in our cohort. Patients who underwent neoadjuvant chemotherapy followed by resection for LAPC have statistically significant improved OS compared to those who did not.

scholarly journals Vesico-appendiceal fistula in a mucinous adenocarcinoma of the appendix

2008 ◽  
Vol 21 (1) ◽  
pp. 44-46 ◽  
Author(s):  
Ivan R B Orso ◽  
Rodrigo Ambar Pinto ◽  
Marcus FKP Ramos ◽  
Desidério Roberto Kiss ◽  
Roberto Iglesias Lopes ◽  
...  
Keyword(s):  
Mucinous Adenocarcinoma ◽  
Bladder Wall ◽  
Posterior Wall ◽  
Right Hemicolectomy ◽  
Pelvic Cavity ◽  
En Bloc ◽  
Optimal Care ◽  
Peritoneal Washing ◽  
One Year ◽  
Tract Infections

BACKGOUND: A rare case of vesicoappendiceal fistula secondary to mucinous adenocarcinoma of the appendix is presented. CASE REPORT: A 62-year-old man with a one year history of recurrent urinary tract infections. After two months he developed pneumaturia and fecaluria. An abdominal and pelvic computed tomography demonstrated a trans-mural mass in the posterior wall of the bladder with a vesicoenteric fistula leading to the terminal ileum. Laparotomy revealed a tumor arising from the appendix contiguous with the bladder posterior wall. The bladder was opened and a large fistula and tumor on the posterior bladder wall near the trigone was identified. Frozen pathological analysis showed a mucinous adenocarcinoma. En-bloc right hemicolectomy and partial cystectomy, preserving bladder trigone was performed. After manipulating the tumor, grossly leakage of mucinous materials occurred into the pelvic cavity. A peritoneal washing with a mytomicin solution at 42º C was then performed, to prevent peritoneal seeding. The patient had a prolonged postoperative ileus and was discharged at the 15th day. Five months after the procedure the patient was recieving chemotherapy with 5-fluoracil and leucovorin and there was no signs of recurrent disease. CONCLUSION: The presentation with vesico-appendiceal fistula is extremely rare with only a few cases reported in the literature. Knowledge of different types of neoplasm and appropriate treatment allows the surgeon to provide patients optimal care referring to specialized centers whenever appropriate.

Characteristics of colorectal cancer in patients younger than 40 years compared to older patients.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 371-371
Author(s):  
Mohamed E. Salem ◽  
Monica Arun ◽  
Greg Dyson ◽  
Chadi Saad ◽  
Cassra Arbabi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Rates ◽  
Age Groups ◽  
Cancer Center ◽  
Tumor Characteristics ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Poorly Differentiated ◽  
One Year ◽  
The Right

371 Background: The incidence of colorectal cancer (CRC) in younger patients (pts) is increasing. There is limited data on tumor characteristics and treatment outcome in this population. Methods: Patients with CRC treated at the Karmanos Cancer Center from 2005 to 2011 were studied. Younger (≤40 years) and older (>40 years) groups from a predominantly inner city population were compared for patient and tumor characteristics, treatment patterns, and survivals. T-tests and Fisher’s exact tests were used to determine statistical differences between age groups while the Kaplan-Meier method was used to estimate survival. Results: 42 pts were ≤ 40 (range, 17-40 years) and 96 pts were > 40 (range, 42-88 years). Mean ages for the groups were 33 and 60 years, respectively. There was no statistically significant difference in the distribution of race, gender, stage or KRAS mutation status between the two groups; however, older pts had a higher mean body mass index compared to younger pts (28 versus 23, p<0.001). Older pts were more likely to have a right colon primary (OR = 7.5, p = 0.04), while younger pts had higher likelihood of having sigmoid primary (OR = 3.4, p = 0.002) and worse grade (poorly differentiated) tumors (OR = 8.3, p <0.001). There were no significant differences between metastatic status or sites of metastases between the two groups. Significantly more young pts underwent surgery than older pts (92% versus 62%, p = 0.005). FOLFOX plus bevacizumab was the most commonly used first line treatment for both groups. The median survival estimates were 16.9 (8.1-23.9) and 17.1 months (13.3-31.0) for the younger and older pts, respectively. Importantly, the one-year survival rates were similar for both groups: 41% for both (p = 1). On the multivariate analysis, whether pts had a primary in the right or sigmoid colon was the only independent predictor of survival. Conclusions: Younger pts with colon cancer were diagnosed at a similar stage of the disease as older pts, but more likely to have poorly differentiated tumors. Younger pts were more likely to receive surgical interventions; however, both groups had equivalent one-year survivals. These results support the need for further prospective investigation in a larger population.

scholarly journals Surgical resection for small bowel obstruction due to right ovarian metastasis after ileocecal resection for cecal cancer: A case report

2022 ◽  
Author(s):  
Naohiko Otsuka ◽  
Kimiyuki Shirayama
Keyword(s):  
Colorectal Cancer ◽  
Case Report ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Surgical Resection ◽  
Ovarian Metastasis ◽  
Ileocecal Resection ◽  
Surgical Case ◽  
Cecal Cancer

Although oophorectomy for ovarian metastasis from colorectal cancer is encouraged to improve the prognosis, that is also performed to relieve the symptom such as abdominal distention. We report a surgical case of intestinal obstruction due to ovarian metastasis after ileocecal resection for cecal cancer diagnosed at 77 years old.

scholarly journals Cardiac angiosarcoma in the right ventricle treated by surgical resection

2021 ◽  
Vol 14 (3) ◽  
pp. e238736
Author(s):  
Koya Uemura ◽  
Hiroyuki Sano ◽  
Hideyuki Takaoka ◽  
Yutaka Okita
Keyword(s):  
Surgical Resection ◽  
Standard Treatment ◽  
Malignant Neoplasm ◽  
Japanese Woman ◽  
Right Ventricular Free Wall ◽  
Cardiac Angiosarcoma ◽  
Old Japanese ◽  
One Year ◽  
The Right ◽  
Irregular Mass

Cardiac angiosarcoma is a rare malignant neoplasm, the gold standard treatment is surgical resection. Our patient, an 81-year old Japanese woman, was admitted to hospital after chest pain over a month-long period. Transthoracic echocardiography (TTE) showed a heterogeneous and irregular mass-like lesion measuring approximately 45 mm and arising from the right ventricular free wall. Transesophageal echocardiography showed the lesion had a mobile portion. Considering the possibility of malignancy and a high risk of embolism and obstruction, we performed surgical resection of the tumour. Histological and immunohistochemical findings led to diagnosis of cardiac angiosarcoma. One year after surgery, TTE and CT showed no evidence of recurrence of angiosarcoma.

scholarly journals P161 Intra-abdominal abscess in Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S219-S219
Author(s):  
A SAIR ◽  
N Lagdali ◽  
I Ben El Barhdadi ◽  
C Berhili ◽  
M Borahma ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Surgical Resection ◽  
Therapeutic Option ◽  
Iliac Fossa ◽  
Clinical Signs ◽  
Ileocecal Resection ◽  
Abdominal Abscess ◽  
Therapeutic Success ◽  
The Right

Abstract Background Crohn’s disease (CD) is associated with the emergence of complications, including intra-abdominal abscess. Management is multidisciplinary based on close medical-surgical collaboration. The aim of the study was to evaluate the clinical characteristics, the efficacy of different therapeutic options of intra-abdominal abscess in CD patients and to identify predictive factors of a favorable response. Methods Medical records of 56 CD patients who had intra-abdominal abscess were retrospectively reviewed. Patients with postoperative abscess were excluded. Clinical, biological and therapeutic data were retrospectively assessed. Treatment progression was appreciated.IBM SPSS software 21.0 was used for statistical analysis of our data. Results In total, 897 patients were identified as having CD in the study period, 56 of them developed intra-abdominal abscess. Means that the prevalence of intra-abdominal abscess in CD patients was 6,2%. Mean age was 35,24 ± 11,6 years old with a sex ratio M/F 0,64. 47,3% had penetrating CD. 50.9% of our patients were known to be carriers of Crohn’s disease, 45% of whom were on 5-ASA, while the remaining patients 49.1% (n = 26), the abscess was inaugural and revealing of the CD.The clinical signs were dominated by pain in 80%, the abscess was localised mainly at the right iliac fossa in 77.7% of cases. Median size of collection was 3,8 ± 2 cm. There were 47,3% patients who had fistula associated to abscess. The initial reactive C protein ranged from 14 to 320 (median 58.3) mg/L. All patients had first-line treatment based on broad-spectrum bi-antibiotic therapy, alone in 25.5%, combined with surgical resection in 45.5%, surgical abscess drainage without resection in 23,6% or guided by imaging in 5.5%, the initial success was 71.7%. 28.3% of patients underwent surgery for initial treatment failure, which was dominated by ileocecal resection in 53.1%. Overall success was 92.3%, only one death was noted following postoperative release with peritonitis. Predictive factor of favorable response was: fistula associated with intra-abdominal abscess (p =0.03) and surgical resection seems to be the best therapeutic option (p &lt; 0,001). Conclusion Intra-abdominal abscess is a complication of Crohn’s disease (CD) mainly penetrating, in almost half of the cases, it can reveal CD. Our study showed that the presence of fistula appears to be significantly associated with therapeutic success and the best results are obtained in the case of surgical resection.

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