BIOS-02. CLINICAL OUTCOMES OF OVER 600 PATIENTS WITH GLIOBLASTOMA TREATED AT A CANADIAN TERTIARY CENTER IN THE PAST 15 YEARS: A COMPARATIVE ANALYSIS WITH THE PIVOTAL STUPP TRIAL

Glioblastoma is the most common malignant primary central nervous system tumor in adults and is associated with a poor prognosis. The benefit of adding concomitant followed by adjuvant temozolomide to radiotherapy after maximal safe resection was demonstrated by Stupp and colleagues in 2005 and has since remained the standard of care. This regimen conferred a statistically significant benefit with a 2-year survival rate of 26.5% compared to 10.4% in patients treated with radiotherapy alone. Our primary goal was to retrospectively assess the clinical outcomes of patients with glioblastoma treated at our institution over the past 15 years by comparing the overall survival (OS) and progression-free survival (PFS) from our cohort to data from the pivotal trial. Our secondary objective was to create a comprehensive database with clinical and pathological information in order to identify predictive and prognostic factors. We reviewed the clinical records of patients treated for glioblastoma from January 2005 to November 2019 at our center. We extracted data on survival and calculated OS and PFS using the Kaplan-Meier method. 617 patient charts were reviewed, out of which 17 were excluded because of missing data. The remaining 600 patients were included. Baseline demographic information was similar to that of the Stupp cohort, with the exception of a larger proportion of patients aged 50 or above (76% versus 69%, respectively). The median OS at our center was 14.3 months, 95% confidence interval [12.8-15.2], which was comparable to that of the original trial (14.6 months [13.2-16.8]). PFS was better in our cohort at 6 months (74.2% [70.7-77.7] versus 53.9% [48.1-59.6]) and 12 months (36.3% [32.5-40.2] versus 26.9% [21.8-32.1]), and comparable thereafter. Our study confirms that the data from the Stupp trial are reproducible in a Canadian academic center setting. Our database will allow us to explore potentially new predictive factors.

Impact of calcification modeling to improve image fusion accuracy for endovascular aortic aneurysm repair

Since the 1990s, endovascular aortic aneurysm repair (EVAR) has become a common alternative to open surgery for the treatment of abdominal aortic aneurysms (AAAs). To aid the deployment of stent-grafts, fluoroscopic image guidance can be enhanced using preoperative simulation and intraoperative image fusion techniques. However, the impact of calcification (Ca) presence on the guidance accuracy of such techniques is yet to be considered. In the present work, we introduce a guidance tool that accounts for patient-specific Ca presence. Numerical simulations of EVAR were developed for 12 elective AAA patients, both with (With-Ca) and without (No-Ca) Ca consideration. To assess the accuracy of the simulations, the image results were overlaid on corresponding intraoperative images and the overlay error was measured at selected anatomical landmarks. With this approach we gained insight into the impact of Ca presence on image fusion accuracy. Inclusion of Ca improved mean image fusion accuracy by 8.68 ± 4.59%. In addition, a positive correlation between the relative Ca presence and the image fusion accuracy was found (R = .753, p < .005). Our results suggest that considering Ca presence in patient-specific EVAR simulations increases the reliability of EVAR image guidance techniques that utilize numerical simulation, especially for patients with severe aortic Ca presence.

Anemia as One of Presenting Symptoms in an Adult with Cyst and Torsion of the Omentum - A Case Report

BACKGROUND

Torsion is an uncommon disorder of the omentum and cysts are one of the rarest causes of omental torsion. To our knowledge, this is the first report of a case of an omental cyst presenting with both omental torsion and anemia.

CASE PRESENTATION

We herein present a case report of a 41 year old indian female patient who presented with anemia (hemoglobin concentration 6.5 g/dL) and intermittent abdominal pain caused by torsion of a hemorrhagic omental cyst. A computed tomography scan, showed an omental cyst with free fluid in the abdominal cavity. At abdominal exploration, 1.5 L of hemorrhagic fluid was confirmed in the abdominal cavity. The cyst and twisted omentum were removed en bloc. The patient had an uneventful postoperative course and was discharged on day 8. At her 2-month follow-up, she was no longer anemic (hemoglobin concentration 10.7 g/dL).

CONCLUSION

Cases of anemia associated with omental torsion have been reported in children; however, to the best of our knowledge, this is the first reported case of such a presentation in an adult. In such patients, surgical removal is the treatment of choice. Persons with recurrent abdominal pain and anemia must be assessed carefully and their differential diagnosis should include omental torsion. Appropriate diagnosis and treatment help avoid complications.

[Endoscopy and histology in the diagnosis of inflammatory intestinal diseases]

Colonoscopy is now a routine examination in the diagnosis and the follow-up of I.B.D. The most typical aspects of endoscopic and histological lesions are described. Colonoscopy and histological study of endoscopic biopsies permit a differential diagnosis of Crohn's disease and ulcerative colitis in 90% of the cases. Certain cases remain indeterminate even after colectomy.