Comparison of Central Venous Port Procedures Between Puncture vs. Cut-down and Residents vs. Senior Surgeons

xlomafota13 shared this article with you from Inoreader Comparison of Central Venous Port Procedures Between Puncture <em>vs</em>. Cut-down and Residents <em>vs</em>. Senior Surgeons Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1197-1204. doi: 10.21873/invivo.12369. ABSTRACT BACKGROUND/AIM: To compare operative results between venous puncture (P) with real-time ultrasonography vs. cut-down (CD) with preoperative ultrasonography for totally implantable central vein access device (TICVAD) implantation performed by residents (R) vs. senior surgeons (S). PATIENTS AND METHODS: Adult oncologic patients (n=268) undergoing TICVAD implantations were retrospectively compared between 172 Ps and 96 CDs. Then, we compared Ps performed by R (P-R, n=131) and S (P-S, n=41) and CDs performed by R (CD-R, n=59) and S (CD-S, n=37). RESULTS: Median operation times were 40 min in the P group and 53.5 min in the CD group, and times were significantly shorter for P-S and CD-S. Completion rates were comparable for each method and each surgeon. Intraoperative complication rates were 3.8% (P-R), 2.4% (P-S), and 0% (CD-R and CD-S). CONCLUSIO N: P with real-time ultrasonography did not avoid complications compared to CD with preoperative ultrasonography. The latter performed safely even by residents. PMID:33622921 | DOI:10.21873/invivo.12369 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pelvic Insufficiency Fractures in Cervical Cancer After Radiation Therapy: A Meta-Analysis and Review

xlomafota13 shared this article with you from Inoreader Pelvic Insufficiency Fractures in Cervical Cancer After Radiation Therapy: A Meta-Analysis and Review Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1109-1115. doi: 10.21873/invivo.12356. ABSTRACT AIM: The aim of the study was to estimate the prevalence of pelvic insufficiency fractures (PIFs) after radiation therapy (RT) in patients with cervical cancer. PATIENTS AND METHODS: A total of 3,633 patients from 15 cohort studies were included. Proportion meta-analysis was performed to estimate prevalence and subgroup analysis was performed according to imaging modalities for diagnosis of PIF. For continuous variables (age and length of follow-up), meta-regression analysis was performed. RESULTS: Pooled prevalence estimate of PIF was 14% (95% CI=10-19). Incidence of PIF was higher in studies that used MRI as a diagnostic tool (17%, 95% CI=12-22) than non-MRI (8%, 95% CI=2-14). In meta-regression, we found a significant association of prevalence of PIF with age (p=0.021) but not with length of follow-up (p=0.118). CONCLUSION: PIF after RT in patients with cervical cancer is not rare. Physicians need to pay attention to PIFs, especially in patients with high-risk factors for osteoporotic fracture. PMID:33622908 | DOI:10.21873/invivo.12356 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Grade 1 Endometrioid Carcinoma With an Area of Serous Carcinoma Less than 5% Is More Aggressive than Stage IA Pure-type Grade 1 Endometrioid Carcinoma

xlomafota13 shared this article with you from Inoreader Grade 1 Endometrioid Carcinoma With an Area of Serous Carcinoma Less than 5% Is More Aggressive than Stage IA Pure-type Grade 1 Endometrioid Carcinoma Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1205-1209. doi: 10.21873/invivo.12370. ABSTRACT BACKGROUND/AIM: In 2020, the percentages were removed from the World Health Organization's criteria for mixed carcinoma. The aim was to examine the clinical significance of an area of serous carcinoma (SC) <5%. PATIENTS AND METHODS: Our study included 236 patients with the 2009 International Federation of Obstetrics and Gynecology (FIGO) stage IA grade 1 endometrioid carcinoma (EG1) from multiple hospitals. EG1 patients with an area of SC <5% and those with pure-type EG1 were retrospectively compared. RESULTS: In the multivariate analysis for recurrence, an area of SC <5% was an independent risk factor [hazard ratio (HR)=101.51, p<0.01]. In the multivariate analysis for progression-free survival, an area of SC <5% was identified as a negative prognostic factor (HR=62.43, p<0.01). CONCLUSION: EG1 with an area of SC <5% may be more aggressive than pure-type EG1 at FIGO stage IA. PMID:33622922 | DOI:10.21873/invivo.12370 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Differentiated Thyroid Carcinoma Having Distant Metastasis: A Comparison With Thyroglobulin-doubling Rate and Tumor Volume-doubling Rate

xlomafota13 shared this article with you from Inoreader Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Differentiated Thyroid Carcinoma Having Distant Metastasis: A Comparison With Thyroglobulin-doubling Rate and Tumor Volume-doubling Rate Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1125-1132. doi: 10.21873/invivo.12358. ABSTRACT BACKGROUND/AIM: To date, thyroglobulin-doubling rate (Tg-DR) and tumor volume-doubling rate (TV-DR) of metastatic lesions have been identified as dynamic prognostic factors for differentiated thyroid carcinoma (DTC). In this study, we investigated the prognostic impact for another dynamic factor, the neutrophil-to-lymphocyte ratio (NLR), for DTC with distant metastasis. PATIENTS AND METHODS: We enrolled 321 patients in total, and NLR at the first detection of distant metastasis (initial NLR) was collected for 312. RESULTS: Patients with initial NLR >3 had a significantly poorer cause-specific survival than those with initial NLR ≤3. On multivariate analysis, initial NLR >3 was recognized as an independent prognostic factor together with Tg-DR >1/year, TV-DR >1/year, radioactive iodine-refractory distant metastasis, and distant metastas is to organs other than the lung. CONCLUSION: Careful observation and active therapies, including multitarget kinase inhibitors, are recommended for patients with NLR >3 at the first detection of distant metastasis or during follow-up. PMID:33622910 | DOI:10.21873/invivo.12358 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Paclitaxel-based Chemotherapy After Progression on Nivolumab for Head and Neck Cancer

xlomafota13 shared this article with you from Inoreader Efficacy of Paclitaxel-based Chemotherapy After Progression on Nivolumab for Head and Neck Cancer Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1211-1215. doi: 10.21873/invivo.12371. ABSTRACT BACKGROUND/AIM: In the CheckMate-141 trial regarding head and neck cancer (HNC), nivolumab conferred a survival benefit to patients. However, the best treatment sequence of chemotherapy and anti-PD-1/PD-L1 therapy in these cancers is unclear. PATIENTS AND METHODS: This was an observational study using data collected prospectively from 97 HNC patients treated with nivolumab at our institutions. Twenty-two HNC patients who received paclitaxel-based chemotherapy before (pre-PTX, n=12) and after (post-PTX, n=10) nivolumab were evaluated. RESULTS: The median follow-up time was 15.9 months (range=6.9-35.9 months). There was a significant difference in the overall response rate (ORR) between pre-PTX (17%) and post-PTX (70%) (p=0.027). Similarly, time to progression (TTP) was significantly longer after nivolumab than before nivolumab (post-PTX, 7.4 months; pre-PTX, 4.9 months, p=0.020). CONCLUSION: Paclitaxel-based chemotherapy had a better ORR and TTP after nivolumab than before nivolumab for HNC. The sequential administration of anti-PD-1 therapy followed by paclitaxel-based chemotherapy could be a better strategy for HNC. PMID:33622923 | DOI:10.21873/invivo.12371 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

KRAS Mutation in an Implant-associated Peripheral Giant Cell Granuloma of the Jaw: Implications of Genetic Analysis of the Lesion for Treatment Concept and Surveillance

xlomafota13 shared this article with you from Inoreader <em>KRAS</em> Mutation in an Implant-associated Peripheral Giant Cell Granuloma of the Jaw: Implications of Genetic Analysis of the Lesion for Treatment Concept and Surveillance Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):947-953. doi: 10.21873/invivo.12335. ABSTRACT The aim of this case report was to detail diagnosis and therapy in a case of implant-associated peripheral giant cell granuloma (IA-PGCG) of the jaw. Case Report: The 41-year-old female attended the outpatient clinic for treatment of recurrent mandibular IA-PGCG. The lesion was excised and the defect was closed with a connective tissue graft of the palate. Healing of oral defects was uneventful, and no local recurrence has occurred during a follow-up of 7 months. Genetic examination of the lesion identified a somatic mutation in KRAS. Conclusion: The lesions are assessed as reactive-inflammatory changes in the mucous membrane of the oral cavity. The cause of the lesion is unknown. KRAS mutations are commonly found in various cancer tissues, but also in germline and mosaic RASopathies. Recently, KRAS mutations have been identified in several IA-PGCG. The clinical course of a frequently locally recurring lesion gives rise to the assumption that lesions of this type show characteristics known in benign neoplasms. PMID:33622887 | DOI:10.21873/invivo.12335 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incidental Gallbladder Cancer on Cholecystectomy: Strategy for Re-resection of Presumed Benign Diseases from a Retrospective Multicenter Study by the Yokohama Clinical Oncology Group

xlomafota13 shared this article with you from Inoreader Incidental Gallbladder Cancer on Cholecystectomy: Strategy for Re-resection of Presumed Benign Diseases from a Retrospective Multicenter Study by the Yokohama Clinical Oncology Group Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1217-1225. doi: 10.21873/invivo.12372. ABSTRACT BACKGROUND/AIM: Current expert consensus recommends re-resection for incidental gallbladder cancer (IGBC) of pT1b-3. This study examined whether this consensus was reasonably applicable to patients with IGBC in one Japanese region. PATIENTS AND METHODS: This was a multicenter, retrospective analysis of cholecystectomies for presumed benign diseases between January 2000 and December 2009. RESULTS: IGBC was diagnosed in 70 (1.0%) out of 6,775 patients undergoing cholecystectomy. Five-year disease-specific cumulative survival was 100% in 19 patients with pT1a, 80.0% in five with pT1b, 49.5% in 33 with pT2, and 23.1% in 13 with pT3. Re-resection was not performed for the 24 patients with pT1a/1b disease, whereas 24 out of 46 patients with pT2/3 underwent re-resection. Regardless of re-resection, independent factors associated with a poor prognosis on mu ltivariate analysis were grade 2 or poorer disease and bile spillage at prior cholecystectomy. In the 24 patients with pT2/3 re-resection, 11 patients without either of these two factors had significantly better 5-year disease-specific cumulative survival than the 13 patients with one or two independent factors associated with a poor prognosis (72.7% vs. 30.8%, p=0.009). CONCLUSION: This Japanese regional study suggests that indication of re-resection for IGBC should not be determined by pT-factor alone and that much more attention should be paid to pathological and intraoperative findings at prior cholecystectomy. PMID:33622924 | DOI:10.21873/invivo.12372 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cytotoxic T-lymphocyte Antigen-4 (CTLA-4) Gene Polymorphism (rs3087243) Is Related to Risk and Survival in Patients With Colorectal Cancer

xlomafota13 shared this article with you from Inoreader Cytotoxic T-lymphocyte Antigen-4 (<em>CTLA-4</em>) Gene Polymorphism (rs3087243) Is Related to Risk and Survival in Patients With Colorectal Cancer Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):969-975. doi: 10.21873/invivo.12339. ABSTRACT BACKGROUND/AIM: Cytotoxic T-lymphocyte antigen-4 (CTLA-4), transiently expressed on T cells, plays a pivotal role in the negative feedback regulation of T-cell activation and proliferation. The aim of the present study was to examine the influence of CTLA-4 gene polymorphism rs3087243 on CRC susceptibility and long-term survival in Swedish patients with CRC. PATIENTS AND METHODS: Genotypes of 491 patients and 433 healthy controls were determined, using TaqMan single nucleotide polymorphism (SNP) assays based on polymerase chain reaction. RESULTS: Patients carrying allele A were found to be at a higher risk of CRC and this allele was found to be more common in patients with disseminated disease compared to localized disease in the right colon. Kaplan-Meier analysis of cancer-specific survival showed that carriers of allele A had the highest risk of CRC -related death. CONCLUSION: The SNP rs3087243 of the CTLA-4 gene was associated with CRC risk and, therefore, it could be a prognostic marker for Swedish patients with CRC. PMID:33622891 | DOI:10.21873/invivo.12339 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk Factors for Postoperative Liver Enzyme Elevation After Laparoscopic Gastrectomy for Gastric Cancer

xlomafota13 shared this article with you from Inoreader Risk Factors for Postoperative Liver Enzyme Elevation After Laparoscopic Gastrectomy for Gastric Cancer Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1227-1234. doi: 10.21873/invivo.12373. ABSTRACT BACKGROUND/AIM: Laparoscopic gastrectomy (LG) is more frequently associated with postoperative liver enzyme elevation (PLEE) than open gastrectomy in phase III clinical trials for Japanese gastric cancer patients. The aim of this study was to determine the risk factors for PLEE after LG for gastric cancer. PATIENTS AND METHODS: This study enrolled 153 consecutive patients with gastric cancer who underwent LG. The patient characteristics, the liver retraction method [silicone disc (SD) or Nathanson liver retractor (NLR)], and perioperative outcomes were compared between patients with and without PLEE. RESULTS: PLEE was observed in 26 patients (17%). The patients with PLEE exhibited longer operative times (p=0.005) and more frequent use of the NLR for liver retraction (p=0.022). In the multivariate analysis, liver retraction using the NLR (p=0.003) an d aberrant left hepatic artery (ALHA) ligation (p=0.042) were independent risk factors of PLEE. CONCLUSION: Liver retraction with the SD during LG was shown to be the safer method that is less likely to cause postoperative liver dysfunction. ALHA preservation may contribute to avoiding postoperative liver dysfunction. PMID:33622925 | DOI:10.21873/invivo.12373 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Controlling Nutritional Status CONUT Score in Patients With Advanced Bladder Cancer After Radical Cystectomy

xlomafota13 shared this article with you from Inoreader The Controlling Nutritional Status CONUT Score in Patients With Advanced Bladder Cancer After Radical Cystectomy Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):999-1006. doi: 10.21873/invivo.12343. ABSTRACT BACKGROUND/AIM: The impact of the controlling nutritional status (CONUT) score on oncological outcomes after radical cystectomy (RC) for advanced bladder cancer (BC) is unknown. PATIENTS AND METHODS: We retrospectively evaluated 115 patients who underwent RC for advanced BC at our department between November 2003 and February 2019. The CONUT score was calculated from serum albumin levels, total lymphocyte counts, and total cholesterol levels. Relapse-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) after RC were analyzed. RESULTS: For the CONUT score, the area under curve was 0.651 and the optimal cut-off value determined using the Youden index was 3. The high CONUT group had significantly shorter RFS, CSS, and OS than the low CONUT group. Multivariate analyses showed that the CONUT score was an independent prognostic fa ctor of RFS, CSS, and OS. CONCLUSION: The CONUT score could be an effective predictor for survival and tolerability following RC for advanced BC. PMID:33622895 | DOI:10.21873/invivo.12343 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transanal Endoscopic Microsurgery (TEMS) for Rectal Cancer: Patient Decision-making, Postoperative Experience and Quality of Life

xlomafota13 shared this article with you from Inoreader Transanal Endoscopic Microsurgery (TEMS) for Rectal Cancer: Patient Decision-making, Postoperative Experience and Quality of Life Via In vivo (Athens, Greece) In Vivo. 2021 Mar-Apr;35(2):1235-1245. doi: 10.21873/invivo.12374. ABSTRACT BACKGROUND/AIM: Transanal endoscopic microsurgery (TEMS) is a form of minimally invasive surgery for selected rectal cancers. The aim of this study was to explore the factors affecting patients' decision-making concerning the choice of surgical treatment as well as to measure the Quality of Life (QoL) post-TEMS. PATIENTS AND METHODS: Thirty-four patients with rectal cancer stage T1/T2-N0-M0 that underwent TEMS were studied. The questionnaires used included the Short Form SF12v2, Wexner Score (CCF-FIS) and the Sexual Function Questionnaire (SFQ). The patients' views on experience and treatment decision were obtained with a custom-designed questionnaire. Questionnaires were completed at a mean of 6.9 years following treatment. RESULTS: The factors that influenced the patients' decisions were: experience satisfaction (p=0.003), postoperative bowel func tion (p<0.001), lower incontinence score (p=0.020) and agreement of TEMS experience with preoperative information (p=0.049). Treatment experience satisfaction was associated with family support (p=0.034) and agreement with preoperative information (p=0.047), better bowel function (p=0.026) and mental QoL (MCS) (p=0.003). CONCLUSION: factors important to patients when reflecting on treatment experience are adequate and reliable information, a good QoL and the presence of family support. Clinicians should incorporate those parameters in their practice when assisting patients in making a surgical treatment choice and provide informed consent on TEMS for rectal cancer. PMID:33622926 | DOI:10.21873/invivo.12374 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.