Objective: To explore the current therapies on castration-resistant prostate cancer (CRPC), such as drug therapy and radiotherapy. Recent Advances: Currently, CRPC is an incurable disease. CRPC treatment options available can only relieve symptoms and prolong the survival time. Because of the in-depth study of resistance mechanisms, various new drugs have been reported, including androgen synthetic inhibitor, abiraterone. Novel targeted therapy and immunotherapy have been thoroughly investigated. The recent advances in well-studied radiotherapy and chemotherapy against CRCP have also been reviewed. In this review, we have summarized new generation hormone drugs (e.g., abiraterone, enzalutamid), chemotherapeutic drugs (docetaxel), targeted therapy drugs, immunotherapy drugs (Sipulecel-T), and radioactive drugs (Radium 223). The overall treatment goals include to prolong OS, to improve quality of life, to relieve symptoms, and to prevent complications in CRCP patients. Conclusions: The use of drug therapy in combination with other drugs might improve the efficacy of CRPC treatment and might help overcome drug resistance.
{"title":"Current Status of Castration-Resistant Prostate Cancer Drug Therapy","authors":"Yifeng Mao, Mingqiu Hu, Gaowei Yang, Erke Gao, Wenbang Chen","doi":"10.29337/ijsonco.126","DOIUrl":"https://doi.org/10.29337/ijsonco.126","url":null,"abstract":"Objective: To explore the current therapies on castration-resistant prostate cancer (CRPC), such as drug therapy and radiotherapy. Recent Advances: Currently, CRPC is an incurable disease. CRPC treatment options available can only relieve symptoms and prolong the survival time. Because of the in-depth study of resistance mechanisms, various new drugs have been reported, including androgen synthetic inhibitor, abiraterone. Novel targeted therapy and immunotherapy have been thoroughly investigated. The recent advances in well-studied radiotherapy and chemotherapy against CRCP have also been reviewed. In this review, we have summarized new generation hormone drugs (e.g., abiraterone, enzalutamid), chemotherapeutic drugs (docetaxel), targeted therapy drugs, immunotherapy drugs (Sipulecel-T), and radioactive drugs (Radium 223). The overall treatment goals include to prolong OS, to improve quality of life, to relieve symptoms, and to prevent complications in CRCP patients. Conclusions: The use of drug therapy in combination with other drugs might improve the efficacy of CRPC treatment and might help overcome drug resistance.","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89392908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We analyzed local regional recurrence patterns of thoracic esophageal carcinoma after three-field lymph node dissection (3-FLD) with and without postoperative radiotherapy, and assessed the postoperative radiation value for local control. Methods: The study reviewed 239 local recurrences of esophageal squamous cell carcinoma after 3-FLD from 2010 to 2018 in our hospital, retrospectively, and compared local regional recurrence patterns between surgery followed by radiotherapy (S+RT) and surgery alone (SA). Results: In 239 thoracic esophageal carcinomas that underwent curative surgery, the lymph node recurrence was the most common type of local recurrence for patients in both groups. The sequence of lymph node recurrence rate in both groups from highest to lowest was mediastinal, cervical, and abdominal. The recurrence rate of superior mediastinal lymph node in patients without radiotherapy was significantly higher than that in patients with radiotherapy (67.72% vs. 47.54%, x2 = 7.615, P = 0.006). The recurrence rate of abdominal lymph node in the upper TEC was significantly lower than that in the middle and lower TEC (x2 = 9.452, P = 0.009). The abdominal lymph node recurrence rate in patients with preoperative abdominal LNM was very significantly higher than that in patients without preoperative abdominal LNM (43.63% vs. 6.66%, P Conclusions: The dangerous lymph node recurrence regions included superior, middle mediastinum, and neck. Postoperative radiotherapy shows great value for patients in reducing superior mediastinal lymph node recurrence rate. The lower segment of thoracic esophageal carcinoma and preoperative abdominal lymph node metastasis, especially para-aortic lymph node metastasis, may be risk factors for abdominal lymph node recurrence.
背景:我们分析胸段食管癌三野淋巴结清扫(3-FLD)术后加放疗和不加放疗的局部复发类型,并评估术后放疗对局部控制的价值。方法:回顾性分析我院2010 ~ 2018年3-FLD术后239例食管鳞状细胞癌局部复发病例,比较手术加放疗(S+RT)与单纯手术(SA)的局部复发模式。结果:239例行根治性手术的胸段食管癌中,淋巴结复发是两组患者最常见的局部复发类型。两组淋巴结复发率从高到低依次为纵隔、颈部、腹部。未放疗患者上纵隔淋巴结复发率明显高于放疗患者(67.72% vs. 47.54%, x2 = 7.615, P = 0.006)。上TEC腹部淋巴结复发率明显低于中、下TEC (x2 = 9.452, P = 0.009)。术前腹腔淋巴结转移患者的腹腔淋巴结复发率明显高于术前无腹腔淋巴结转移患者(43.63% vs. 6.66%), P结论:淋巴结复发危险区域包括上纵隔、中纵隔和颈部。术后放疗对降低患者上纵隔淋巴结复发率有重要价值。胸段食管癌下段及术前腹部淋巴结转移,尤其是腹主动脉旁淋巴结转移可能是腹部淋巴结复发的危险因素。
{"title":"Comparison of Local Recurrence Patterns of Postoperative Radiotherapy with Surgery Alone for Esophageal Carcinoma Patients","authors":"Zhi Xu, B. Su","doi":"10.29337/ijsonco.65","DOIUrl":"https://doi.org/10.29337/ijsonco.65","url":null,"abstract":"Background: We analyzed local regional recurrence patterns of thoracic esophageal carcinoma after three-field lymph node dissection (3-FLD) with and without postoperative radiotherapy, and assessed the postoperative radiation value for local control. Methods: The study reviewed 239 local recurrences of esophageal squamous cell carcinoma after 3-FLD from 2010 to 2018 in our hospital, retrospectively, and compared local regional recurrence patterns between surgery followed by radiotherapy (S+RT) and surgery alone (SA). Results: In 239 thoracic esophageal carcinomas that underwent curative surgery, the lymph node recurrence was the most common type of local recurrence for patients in both groups. The sequence of lymph node recurrence rate in both groups from highest to lowest was mediastinal, cervical, and abdominal. The recurrence rate of superior mediastinal lymph node in patients without radiotherapy was significantly higher than that in patients with radiotherapy (67.72% vs. 47.54%, x2 = 7.615, P = 0.006). The recurrence rate of abdominal lymph node in the upper TEC was significantly lower than that in the middle and lower TEC (x2 = 9.452, P = 0.009). The abdominal lymph node recurrence rate in patients with preoperative abdominal LNM was very significantly higher than that in patients without preoperative abdominal LNM (43.63% vs. 6.66%, P Conclusions: The dangerous lymph node recurrence regions included superior, middle mediastinum, and neck. Postoperative radiotherapy shows great value for patients in reducing superior mediastinal lymph node recurrence rate. The lower segment of thoracic esophageal carcinoma and preoperative abdominal lymph node metastasis, especially para-aortic lymph node metastasis, may be risk factors for abdominal lymph node recurrence.","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"30 8 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82747379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laparoscopic approach for management of renal cell carcinoma (RCC) has been increasingly use by many surgeons which can provide a better surgical option for T1-T3aN0M0 renal tumors. Surgical resection in the form of radical nephrectomy and caval thrombectomy represents the only option to obtain local control of the disease and is associated with durable oncologic control. Herein we present a case of 82 year old male presenting with haematuria and right flank pain with palpable mass in right lumbar region. CT scan revealed presence of right upper pole renal mass limited within Gerota’s fascia with thrombus in right renal vein extending to IVC. Patient underwent laparoscopic right radical nephrectomy with cavatomy for thrombus extension. Procedure was uneventful and patient recovered well.
{"title":"Laparoscopic Right Radical Nephrectomy for Renal Cell Carcinoma with Cavatomy for Thrombus Extension in Renal Vein & IVC","authors":"A. Punpale, G. Swami, Sayali S. Samudre","doi":"10.29337/IJSONCO.123","DOIUrl":"https://doi.org/10.29337/IJSONCO.123","url":null,"abstract":"Laparoscopic approach for management of renal cell carcinoma (RCC) has been increasingly use by many surgeons which can provide a better surgical option for T1-T3aN0M0 renal tumors. Surgical resection in the form of radical nephrectomy and caval thrombectomy represents the only option to obtain local control of the disease and is associated with durable oncologic control. Herein we present a case of 82 year old male presenting with haematuria and right flank pain with palpable mass in right lumbar region. CT scan revealed presence of right upper pole renal mass limited within Gerota’s fascia with thrombus in right renal vein extending to IVC. Patient underwent laparoscopic right radical nephrectomy with cavatomy for thrombus extension. Procedure was uneventful and patient recovered well.","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"150 1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83142949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Musculoskeletal tumors are rare group of disorders. To reach a diagnosis requires detailed medical history, physical examination, radiological investigations and histopathological correlation. Intra operative consultation plays an important role in the management of soft tissue tumors. However, there is a considerable lack of literature evaluating the diagnostic accuracy of frozen sections in musculoskeletal tumors. This study is aimed because no local data is available on the accuracy of frozen section in musculoskeletal tumors and frozen section allows intraoperative diagnosis. Objective: To evaluate the diagnostic accuracy of intra-operative frozen sections for musculoskeletal tumors i.e, bone and soft tissue benign and malignant. Study Design: Descriptive cross sectional study. Setting: Section of Orthopaedic, Department of Surgery, The Aga Khan University Hospital. Duration of Study: From 12 th October 2018 to 5 th August to 2019. Materials and Methods: A cross sectional descriptive study was designed to evaluate the Diagnostic accuracy of frozen section in musculoskeletal tumors at a tertiary care hospital, Karachi. All the patients meeting the inclusion criteria were enrolled in the study and sensitivity, specificity, PPV, NPV and diagnostic accuracy were calculated for frozen section keeping permanent section as gold standard. Results: Of the total 88 patient 48 (54.54%) were male and 40 (45.45%) were female. Mean age was 30.75 years (5–80 years). 63(71.59%) patients have bone tumors while 25(28.40%) have soft tissue tumors. 50(56.81%) patients have tumour involving lower extremity, 23(26.13%) have upper extremity tumors and 15 (17.04%) have tumour involving pelvis. Overall sensitivity of frozen section for benign and malignant tumour of bone and soft tissue was 96.66%, specificity was 100%, positive predictive value 100%, and negative predictive value 93.33% and accuracy was 97.72%. Conclusion: Frozen section serves as an invaluable and accurate tool in the intraoperative evaluation of musculoskeletal tumors. A diagnosis of musculoskeletal tumor by the frozen section method is highly reliable.
{"title":"Diagnostic Accuracy of Frozen Section in Musculoskeletal Tumors","authors":"S. Fahad, M. Umer","doi":"10.29337/IJSONCO.25","DOIUrl":"https://doi.org/10.29337/IJSONCO.25","url":null,"abstract":"Introduction: Musculoskeletal tumors are rare group of disorders. To reach a diagnosis requires detailed medical history, physical examination, radiological investigations and histopathological correlation. Intra operative consultation plays an important role in the management of soft tissue tumors. However, there is a considerable lack of literature evaluating the diagnostic accuracy of frozen sections in musculoskeletal tumors. This study is aimed because no local data is available on the accuracy of frozen section in musculoskeletal tumors and frozen section allows intraoperative diagnosis. Objective: To evaluate the diagnostic accuracy of intra-operative frozen sections for musculoskeletal tumors i.e, bone and soft tissue benign and malignant. Study Design: Descriptive cross sectional study. Setting: Section of Orthopaedic, Department of Surgery, The Aga Khan University Hospital. Duration of Study: From 12 th October 2018 to 5 th August to 2019. Materials and Methods: A cross sectional descriptive study was designed to evaluate the Diagnostic accuracy of frozen section in musculoskeletal tumors at a tertiary care hospital, Karachi. All the patients meeting the inclusion criteria were enrolled in the study and sensitivity, specificity, PPV, NPV and diagnostic accuracy were calculated for frozen section keeping permanent section as gold standard. Results: Of the total 88 patient 48 (54.54%) were male and 40 (45.45%) were female. Mean age was 30.75 years (5–80 years). 63(71.59%) patients have bone tumors while 25(28.40%) have soft tissue tumors. 50(56.81%) patients have tumour involving lower extremity, 23(26.13%) have upper extremity tumors and 15 (17.04%) have tumour involving pelvis. Overall sensitivity of frozen section for benign and malignant tumour of bone and soft tissue was 96.66%, specificity was 100%, positive predictive value 100%, and negative predictive value 93.33% and accuracy was 97.72%. Conclusion: Frozen section serves as an invaluable and accurate tool in the intraoperative evaluation of musculoskeletal tumors. A diagnosis of musculoskeletal tumor by the frozen section method is highly reliable.","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"23 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90511530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. P. Matylevich, K. Schmeler, S. Polyakov, S. Mavrichev, I. Kosenko, S. Krasny
INTRODUCTION: The prognosis of patients with persistent or recurrent cervical cancer (CC) is poor, and patient selection for exenterative surgery is challenging. The aim of this study was to determine the outcomes of patients undergoing pelvic exenteration (PE) for persistent or recurrent CC after treatment with radiotherapy in Belarus. METHODS: A retrospective study was performed of 22 patients with persistent and recurrent CC who underwent supralevator PE from 2006 to 2012 at NN Alexandrov National Cancer Centre. Anterior PE was performed in 16 (72.7%) patients, posterior PE in 2 (9.1%) and total PE in 4 (18.2%) patients. RESULTS: The mean surgical procedure time was 289.1 minutes. Urinary diversion was performed in 20 patients: 5 (25.0%) underwent ureterostomy and 15 (75.0%) underwent neobladder formation. Fecal diversion with end colostomy (Hartman’s procedure) was performed in 5 patients and in one patient a rectosigmoid resection with anastomosis was performed. The median follow-up time was 87 months (range, 4.4–146.0 months). To date, 16 (72.7%) patients have died of cervical cancer and there were no deaths due to other causes. The median survival was 17 months with a 5-year survival rate of 31.8% (SE 9.9%). Cox regression analysis showed that surgical margin status and pelvic lymph node involvement were independent risk factors for survival. CONCLUSIONS: PE was found to be a safe and feasible option for patients with persistent or recurrent cervical cancer who do not have other potentially curative treatment options. Careful patient selection is needed to determine which patients will benefit from this treatment. HIGHLIGHTS: Treatment options are limited for patients with persistent or recurrent cervical cancer Pelvic exenteration is a safe and feasible option for women in Belarus Positive surgical margins and positive lymph node status are risk factors affecting survival
{"title":"Pelvic Exenteration in Patients with Persistent and Recurrent Cervical Cancer: A Case Series from Belarus","authors":"O. P. Matylevich, K. Schmeler, S. Polyakov, S. Mavrichev, I. Kosenko, S. Krasny","doi":"10.29337/IJSONCO.24","DOIUrl":"https://doi.org/10.29337/IJSONCO.24","url":null,"abstract":"INTRODUCTION: The prognosis of patients with persistent or recurrent cervical cancer (CC) is poor, and patient selection for exenterative surgery is challenging. The aim of this study was to determine the outcomes of patients undergoing pelvic exenteration (PE) for persistent or recurrent CC after treatment with radiotherapy in Belarus. METHODS: A retrospective study was performed of 22 patients with persistent and recurrent CC who underwent supralevator PE from 2006 to 2012 at NN Alexandrov National Cancer Centre. Anterior PE was performed in 16 (72.7%) patients, posterior PE in 2 (9.1%) and total PE in 4 (18.2%) patients. RESULTS: The mean surgical procedure time was 289.1 minutes. Urinary diversion was performed in 20 patients: 5 (25.0%) underwent ureterostomy and 15 (75.0%) underwent neobladder formation. Fecal diversion with end colostomy (Hartman’s procedure) was performed in 5 patients and in one patient a rectosigmoid resection with anastomosis was performed. The median follow-up time was 87 months (range, 4.4–146.0 months). To date, 16 (72.7%) patients have died of cervical cancer and there were no deaths due to other causes. The median survival was 17 months with a 5-year survival rate of 31.8% (SE 9.9%). Cox regression analysis showed that surgical margin status and pelvic lymph node involvement were independent risk factors for survival. CONCLUSIONS: PE was found to be a safe and feasible option for patients with persistent or recurrent cervical cancer who do not have other potentially curative treatment options. Careful patient selection is needed to determine which patients will benefit from this treatment. HIGHLIGHTS: Treatment options are limited for patients with persistent or recurrent cervical cancer Pelvic exenteration is a safe and feasible option for women in Belarus Positive surgical margins and positive lymph node status are risk factors affecting survival","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"69 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85876912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-27DOI: 10.1097/IJ9.0000000000000101
Xuemei Tang, Wen Lu
Xanthogranulomatous in fl ammation is rare and occurs in several viscera in the body, such as the kidney, gallbladder, bone, and stomach. The pathogenesis of Xanthogranulomatous pancreatitis (XGP) is not well understood, and the disease is characterized by lipid-laden histiocytes deposited at various sites in the organs. XGP associated with multifocal necrosis is extremely rare. In this report, we described a case of XGP associated with multifocal necrosis and included a review of the literature. is in which lipid-laden are deposited at various in the organs. Xanthogranulomatous pancreatitis combined with We report a case of XGP with multifocal necrosis. To our knowledge, 2 cases in China have been published in Chinese journals. This is the fi rst reported case in China in the English-language literature.
{"title":"Xanthogranulomatous pancreatitis combined with multifocal necrosis: A\u0000 case report and literature review","authors":"Xuemei Tang, Wen Lu","doi":"10.1097/IJ9.0000000000000101","DOIUrl":"https://doi.org/10.1097/IJ9.0000000000000101","url":null,"abstract":"Xanthogranulomatous in fl ammation is rare and occurs in several viscera in the body, such as the kidney, gallbladder, bone, and stomach. The pathogenesis of Xanthogranulomatous pancreatitis (XGP) is not well understood, and the disease is characterized by lipid-laden histiocytes deposited at various sites in the organs. XGP associated with multifocal necrosis is extremely rare. In this report, we described a case of XGP associated with multifocal necrosis and included a review of the literature. is in which lipid-laden are deposited at various in the organs. Xanthogranulomatous pancreatitis combined with We report a case of XGP with multifocal necrosis. To our knowledge, 2 cases in China have been published in Chinese journals. This is the fi rst reported case in China in the English-language literature.","PeriodicalId":42930,"journal":{"name":"International Journal of Surgery-Oncology","volume":"4 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87197593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}