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Pan W, Xiang S, Zhang J, Gao Y, Liu S. Chemotherapy-induced pneumatosis intestinalis followed by hepatic portal venous gas. A case report. J Int Med Res 2024; 52:3000605241239276. [PMID: 38513142 PMCID: PMC10958815 DOI: 10.1177/03000605241239276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Pneumatosis intestinalis (PI) is a rare disease, and there are many theories about its pathogenesis. Hepatic portal venous gas (HPVG), is thought to occur secondary to intramural intestinal gas emboli migrating through the portal venous system via the mesenteric veins. PI accompanied by HPVG is usually a sign of bowel ischaemia and is associated with a high mortality rate. We report here, a patient with liver metastases from colorectal cancer who developed PI followed by HPVG after treatment with 5-Fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6). Timely attention and management of gastrointestinal symptoms following chemotherapy are essential in the treatment of this type of patient.
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Affiliation(s)
- WenJun Pan
- Department of General Surgery Medical Center, Affiliated Hospital of Qingdao University, China
| | - Shuai Xiang
- Department of General Surgery Medical Center, Affiliated Hospital of Qingdao University, China
| | - Junhao Zhang
- Department of General Surgery Medical Center, Affiliated Hospital of Qingdao University, China
| | - Yuan Gao
- Department of General Surgery Medical Center, Affiliated Hospital of Qingdao University, China
| | - Shanglong Liu
- Department of General Surgery Medical Center, Affiliated Hospital of Qingdao University, China
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Li R, Wang Q, Zhang B, Yuan Y, Xie W, Huang X, Zhou C, Zhang S, Niu S, Chang H, Chen D, Miao H, Zeng ZF, Xiao W, Gao Y. Neoadjuvant chemotherapy and radiotherapy followed by resection/ablation in stage IV rectal cancer patients with potentially resectable metastases. BMC Cancer 2021; 21:1333. [PMID: 34906114 PMCID: PMC8672531 DOI: 10.1186/s12885-021-09089-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background The optimal treatment of stage IV rectal cancer remains controversial. The purpose of this study was to assess the treatment outcomes and toxicity of neoadjuvant chemotherapy and radiotherapy followed by local treatment of all tumor sites and subsequent adjuvant chemotherapy in stage IV rectal cancer patients with potentially resectable metastases. Methods Adult patients diagnosed with locally advanced rectal adenocarcinoma with potentially resectable metastases, who received neoadjuvant chemotherapy and radiotherapy from July 2013 and September 2019 at Sun Yat-sen University cancer center, were included. Completion of the whole treatment schedule, pathological response, treatment-related toxicity and survival were evaluated. Results A total of 228 patients were analyzed with a median follow-up of 33 (range 3.3 to 93.4) months. Eventually, 112 (49.1%) patients finished the whole treatment schedule, of which complete response of all tumor sites and pathological downstaging of the rectal tumor were observed in three (2.7%) and 90 (80.4%) patients. The three-year overall survival (OS) and progression-free survival (PFS) of all patients were 56.6% (50.2 to 63.9%) and 38.6% (95% CI 32.5 to 45.8%), respectively. For patients who finished the treatment schedule, 3-year OS (74.4% vs 39.2%, P < 0.001) and 3-year PFS (45.5% vs 30.5%, P = 0.004) were significantly improved compared those who did not finish the treatment. Grade 3–4 chem-radiotherapy treatment toxicities were observed in 51 (22.4%) of all patients and surgical complications occurred in 22 (9.6%) of 142 patients who underwent surgery, respectively. Conclusions Neoadjuvant chemotherapy and radiotherapy followed by resection/ablation and subsequent adjuvant chemotherapy offered chances of long-term survival with tolerable toxicities for selected patients with potentially resectable stage IV rectal cancer, and could be considered as an option in clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-09089-5.
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Affiliation(s)
- Rongzhen Li
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Qiaoxuan Wang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Bin Zhang
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China
| | - Yan Yuan
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Weihao Xie
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Xiaoxue Huang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Chengjing Zhou
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Shu Zhang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Shaoqing Niu
- Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510060, People's Republic of China
| | - Hui Chang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Dongni Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Huikai Miao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Zhi Fan Zeng
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China
| | - Weiwei Xiao
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China. .,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.
| | - Yuanhong Gao
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China. .,State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.
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Garajova I, Balsano R, Tommasi C, Dalla Valle R, Pedrazzi G, Ravaioli M, Spallanzani A, Leonardi F, Santini C, Caputo F, Riefolo M, Giuffrida M, Gelsomino F. Synchronous and metachronous colorectal liver metastases: impact of primary tumor location on patterns of recurrence and survival after hepatic resection. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 92:e2021061. [PMID: 33682832 PMCID: PMC7975968 DOI: 10.23750/abm.v92i1.11050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 11/23/2022]
Abstract
Background: Considerable differences in terms of prognosis exist between the right-sided (RCC) and the left-sided colon cancer (LCC). Aim of the work: In this study, we evaluated prognostic implications of primary tumor location (PTL) among patients who underwent curative-intent hepatectomy for synchronous (SM) and metachronous (MM) colorectal liver metastases (CRLM). Methods: The study population included all consecutive patients affected by CRLM scheduled for first liver resection at three Italian oncological centers. Results: A total of 204 patients who underwent CRLM resection were included, 50% with RCC. Synchronous lesions were prevalent (n=133, 65%). Median OS was respectively 40.3 months for SM-RCC, 53.5 months for SM-LCC, 64.5 months for MM-RCC and 81.6 months for MM-LCC. Patients with MM-LCC showed an OS better than patients with SM-RCC (p=0.008) and SM-LCC (p=0.002). PTL had no influence on RFS. RCC group had less recurrences (75% vs 86.5%), though further surgery with curative-intent was possible more in LCC group (29.3% vs 32.5%). Cox proportional hazards model analysis showed that age and the presence of SM vs MM was associated with a significantly higher hazard ratio (HR) for death (HR=1.024; 95%CI=1.005-1.043; p=0.011 and HR=2.010; 95%CI=1.328-3.043; p=0.001, respectively). Conclusions: We confirmed that patients with CRLM and right-sided primary colon cancer experience worse survival after hepatic resection. The timing of metastasis has been revealed as important prognostic factor.
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Affiliation(s)
| | - Rita Balsano
- Medical Oncology Unit, University Hospital of Parma.
| | | | | | | | - Matteo Ravaioli
- 3Department of General Surgery and Transplantation, Sant'Orsola-Malpighi Hospital, University of Bologna.
| | | | | | - Chiara Santini
- Department of Oncology and Hematology, University Hospital of Modena.
| | - Francesco Caputo
- Department of Oncology and Hematology, University Hospital of Modena.
| | - Mattia Riefolo
- 5Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Sant'Orsola-Malpighi Hospital, University of Bologna.
| | | | - Fabio Gelsomino
- Department of Oncology and Hematology, University Hospital of Modena.
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