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Laparoscopic versus open gastric wedge resection for primary gastrointestinal tumors: clinical outcomes and health care costs analysis. Surg Laparosc Endosc Percutan Tech 2016; 25:143-6. [PMID: 25054569 DOI: 10.1097/sle.0000000000000080] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The study aimed to compare laparoscopic wedge resection (LWR) versus open-wedge resections (OWR) for primary gastrointestinal stromal tumors (GISTs) of the stomach. Twenty-five patients who underwent LWR were matched by tumor size and location with 25 patients who underwent OWR. GISTs close to the pylorus or the esophagogastric junction, incidental, and metastatic GISTs were excluded. Demographic, clinical, and histologic variables did not differ between groups. Estimated blood loss, time to flatus, and duration of hospitalization were significantly lower in the LWR group. Overall, 6 patients developed minor postoperative complications that were medically treated. Mortality was nil. No group difference was observed for the incidence of diseases during the follow-up (average, 46.8 mo). The OWR procedure had significantly higher costs (+34%) than the LWR. Both techniques appear safe and oncologically feasible. However, laparoscopy is associated with faster recovery and shorter hospital stay, which reflect advantages in terms of contracted costs for the health care system.
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Jiang D, Li X, Wang H, Shi Y, Xu C, Lu S, Huang J, Xu Y, Zeng H, Su J, Hou Y, Tan L. The prognostic value of EGFR overexpression and amplification in Esophageal squamous cell Carcinoma. BMC Cancer 2015; 15:377. [PMID: 25953424 PMCID: PMC4437683 DOI: 10.1186/s12885-015-1393-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/29/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In view of the prominent role in cancer cell biology and alteration in substantial numbers of ESCC, defining EGFR molecular characteristics relevant to patient prognosis is of great importance. Therefore, we analyzed the protein expression and gene copy variation of the epithelial growth factor receptor (EGFR) in Chinese esophageal squamous cell carcinoma (ESCC) and explored the possible associations with various features of the tumors and survival of the patients. METHODS Sections were made from tissue microarray composed of 96 ESCC, and examined for EGFR expression by means of immunohistochemistry (IHC) and for EGFR gene amplification by means of fluorescence in situ hybridization (FISH). The results of IHC were evaluated with six different reported scoring systems. Correlation with clinical features and survival was evaluated using chi-square test and Kaplan-Meier analysis. RESULTS EGFR overexpression according to scoring system 1 significantly correlated with advanced lymph node involvement (P = 0.046), patient disease specific free survival (DFS) (P = 0.006) and overall survival (OS) (P = 0.007). No such association was observed using other 5 scoring systems (P > 0.05 ). EGFR amplification was associated with lymph node metastasis (P = 0.028), but not correlated with DFS and OS until 20 months. CONCLUSIONS EGFR IHC overexpression evaluated by scoring system 1 might be suitable to be used in predicting patients survival in ESCC. EGFR gene amplification showed delayed prognostic information after 20 months.
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Affiliation(s)
- Dongxian Jiang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Xiaojing Li
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Haixing Wang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Yuan Shi
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Chen Xu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Shaohua Lu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Jie Huang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Yifan Xu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Haiying Zeng
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Jieakesu Su
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Lijie Tan
- Department of Thorax Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
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Duodenal bulb tumour of unknown origin. GASTROENTEROLOGY REVIEW 2014; 9:365-70. [PMID: 25653733 PMCID: PMC4300353 DOI: 10.5114/pg.2014.47900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 07/28/2012] [Accepted: 02/08/2013] [Indexed: 12/14/2022]
Abstract
Gastrointestinal stromal tumours (GIST) are rare mesenchymal neoplasms of the gastrointestinal tract. Their development typically depends on mutations in the Kit or PDGFRA gene. We have diagnosed and treated a duodenal bulb GIST in a 63-year-old woman. The confirmation of the diagnosis was made on the basis of a histological test after radical resection of the tumour. Making the right diagnosis is crucial for patients, since complex surgical and pharmacological approaches are effective even in the advanced stages of the disease. Nevertheless, radical surgical treatment is still the primary choice for patients with GIST.
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Gur S, Sikka SC, Abdel-Mageed AB, Abd Elmageed ZY, Rezk B, Pankey E, Kadowitz PJ, Hellstrom WJ. Imatinib Mesylate (Gleevec) Induces Human Corpus Cavernosum Relaxation by Inhibiting Receptor Tyrosine Kinases (RTKs): Identification of New RTK Targets. Urology 2013; 82:745.e11-6. [DOI: 10.1016/j.urology.2013.04.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/10/2013] [Accepted: 04/19/2013] [Indexed: 12/23/2022]
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A 32-month follow-up study of nanovesicle concentrations in blood from 12 patients with gastrointestinal stromal tumour treated with imatinib. Biochem Soc Trans 2013; 41:303-8. [DOI: 10.1042/bst20120247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Clinical studies have indicated that the NV (nanovesicle) concentration in blood samples is a potential indicator of clinical status and can be used to follow the development of the disease. For 32 months, we monitored the effect of imatinib treatment on NV concentrations in blood samples from 12 patients with GIST (gastrointestinal stromal tumour). The NV concentration before the treatment increased with respect to control by a factor of 3.5 on average (range 2.6–9.2). The first week after initiation of the treatment, the NV concentration increased considerably, by a factor of 13 on average (range 5.9–21.2), whereas on average, after 1 month, it decreased to the level of the control and remained at that level for at least 1.5 years. Recent assessment (after 2.5 years) showed a somewhat increased NV concentration, by a factor of 2 on average (range 0.7–3.9). Low NV concentrations in blood samples during the treatment reflect a favourable effect of imatinib in these patients and no remission of the disease was hitherto observed.
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Wu Q, Hou X, Xia J, Qian X, Miele L, Sarkar FH, Wang Z. Emerging roles of PDGF-D in EMT progression during tumorigenesis. Cancer Treat Rev 2012; 39:640-6. [PMID: 23261166 DOI: 10.1016/j.ctrv.2012.11.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 11/22/2012] [Accepted: 11/24/2012] [Indexed: 12/12/2022]
Abstract
Platelet-derived growth factor-D (PDGF-D) signaling pathway has been reported to be involved in regulating various cellular processes, such as cell growth, apoptotic cell death, migration, invasion, angiogenesis and metastasis. Recently, multiple studies have shown that PDGF-D plays a critical role in governing epithelial-to-mesenchymal transition (EMT), although the underlying mechanism of PDGF-D-mediated acquisition of EMT is largely unclear. Therefore, this mini review will discuss recent advances in our understanding of the role of PDGF-D in the acquisition of EMT during tumorigenesis. Furthermore, we will summarize the function of chemical inhibitors and natural compounds that are known to inactivate PDGF-D signaling pathway, which leads to the reversal of EMT. In summary, inactivation of PDGF-D could be a novel strategy for achieving better treatment outcome of patients inflicted with cancers.
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Affiliation(s)
- Qiong Wu
- Department of Medical Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui, PR China.
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Weissferdt A, Wistuba II, Moran CA. Molecular aspects of thymic carcinoma. Lung Cancer 2012; 78:127-32. [PMID: 22921473 DOI: 10.1016/j.lungcan.2012.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 07/26/2012] [Accepted: 08/05/2012] [Indexed: 02/03/2023]
Abstract
Thymic carcinomas are tumors of the anterior mediastinum derived from the epithelial cells of the thymic gland. Due to their low incidence they are often investigated in combination with thymomas under the rubric of "thymic epithelial neoplasms" and studies exclusively addressing thymic carcinomas are sparse. Thymic carcinomas are characterized by their histologic variability, often resembling tumors seen in other organ systems. This morphologic variation coupled with their rarity has prevented large scale research of these tumors and little is known about the etiology, biologic behavior or best treatment for thymic carcinoma. In recent years, attempts have been made to investigate the molecular characteristics of these tumors in the hope that molecular profiling can be used to predict the prognosis or lead to the development of new treatment strategies. Herein we provide an overview of the recent advances of the molecular analysis of thymic carcinoma with particular emphasis on the potential use for molecularly targeted therapies.
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Affiliation(s)
- Annikka Weissferdt
- Department of Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
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Hawa N, Robinson J, Obias V. Cystically degenerated leiomyoma of the rectosigmoid managed laparoscopically at 13 weeks of gestation. J Minim Invasive Gynecol 2012; 19:383-5. [PMID: 22546424 DOI: 10.1016/j.jmig.2011.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 12/14/2011] [Accepted: 12/21/2011] [Indexed: 01/26/2023]
Abstract
The safety of laparoscopic management of adnexal masses in pregnancy has been documented. Herein we report laparoscopic removal during pregnancy of a cystically degenerated leiomyoma of the sigmoid colon, which had been mistaken for an adnexal mass. When smooth muscle gastrointestinal tumors are observed, it is important that they be characterized with appropriate markers so that postoperative treatment can be individualized to the patient.
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Affiliation(s)
- Nadim Hawa
- Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC 20037, USA.
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Zaydfudim V, Okuno SH, Que FG, Nagorney DM, Donohue JH. Role of operative therapy in treatment of metastatic gastrointestinal stromal tumors. J Surg Res 2012; 177:248-54. [PMID: 22831567 DOI: 10.1016/j.jss.2012.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 05/24/2012] [Accepted: 07/03/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND Operative resection of metastatic gastrointestinal stromal tumors (GIST) is controversial. Current treatment strategies rely on the response to tyrosine kinase inhibitors (TKIs), with resultant individualization of operative intervention. We investigated the role of operative therapy in patients with metastatic GIST. METHODS This retrospective cohort study included all consecutive patients treated for metastatic and/or recurrent GIST from January 2002 to June 2011. The patients were stratified by the use of operative therapy and disease response to TKI therapy. Kaplan-Meier survival analyses with log-rank comparisons tested the effects of operative therapy and the response to TKIs on survival. RESULTS Of the 438 patients treated for GIST during the study period, 87 (median age 61 y, interquartile range 50-71; 55% male) had metastatic GIST (84% metastatic, 3% recurrent, and 13% metastatic and recurrent). Of these patients, 54 (62%) underwent operative exploration. Subtotal resection for palliative debulking (R2 resection) were performed in 19 patients; 32 patients underwent R0 resection. Operative intervention was associated with improved overall survival (OS) compared with systemic therapy alone (1 y OS, 98% versus 80% and 5-y OS, 65% versus 11%, respectively; P < 0.001). A TKI was used before resection in 32 patients. The disease response was partial in 13 patients, stable in 10, and progressive in 9. The 1- and 5-y OS and progression-free survival were strongly associated with the preoperative response to TKI and an R0 resection (all P ≤ 0.002). CONCLUSIONS Among patients with metastatic GIST, preoperative response to TKI therapy and margin-negative resection were strongly associated with improved progression-free and OS.
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Affiliation(s)
- Victor Zaydfudim
- Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Intervention in gastrointestinal stromal tumour with a high risk of malignancy and associated with thalassaemia minor. Anticancer Drugs 2012; 23 Suppl:S13-4. [PMID: 22614104 DOI: 10.1097/cad.0b013e3283559fef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study reports on a 65-year-old female patient with controlled comorbidity, who was diagnosed with gastrointestinal stromal tumours following regular monitoring of renal cysts. After the surgical treatment, coadjuvant treatment with imatinib was initiated. After a few months, the patient complained of angor and asthenia and the diagnosis of anaemic syndrome was made on the basis of blood test results. We studied the causes of the anaemia (maturation factors and other causes of secondary anaemia) and it led to the diagnosis of vitamin B12 deficiency. Treatment with vitamin B12 supplementation was initiated. With the correction of the vitamin levels with supplementation, the symptoms improved. Thalassaemia led to the misdiagnosis of vitamin B12 deficiency because of the lower mean corpuscular volume levels.
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Adekola K, Agulnik M. Advances in Adjuvant Therapy of Gastrointestinal Stromal Tumors. Curr Oncol Rep 2012; 14:327-32. [DOI: 10.1007/s11912-012-0241-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Sanford M, Scott LJ. Imatinib: as adjuvant therapy for gastrointestinal stromal tumor†: profile report. BioDrugs 2011; 25:191-2. [PMID: 21627342 DOI: 10.2165/11207040-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Mark Sanford
- Adis, a Wolters Kluwer Business, Auckland, New Zealand.
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Sandberg AA, Meloni-Ehrig AM. Cytogenetics and genetics of human cancer: methods and accomplishments. ACTA ACUST UNITED AC 2010; 203:102-26. [DOI: 10.1016/j.cancergencyto.2010.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 09/22/2010] [Accepted: 10/07/2010] [Indexed: 12/31/2022]
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