Cancer medicine journal最新文献

Uterine sarcomas are a rare group of malignancies that account for less than 10% of all uterine malignancies. They are histologically diverse and fall into two broad groups: mesenchymal and epithelial tumors. The treatment in both these groups is marked by high failure rates and quick progression of disease. Patients with stage I to II with resectable disease benefit from operative cytoreduction. Those with advanced stages, benefit from chemotherapy with or without external beam radiation therapy. Our research in this paper looks at the number of LMS cases at our institution, Wyckoff Heights Medical Center in Brooklyn, NY for a period of 20 years from 1996 until 2015 and assesses our cohort's age at diagnosis and their survival in accordance to grade and stage of diagnosis. Our findings suggest that disease stage is a strong prognostic factor with good survival rates in stage I and II, with higher incidence in African-American women. All LMS patients with distant metastasis died within five years.

Introduction: Outcomes for hepatectomy for breast cancer metastasis and sarcomatous disease processes are not well defined in literature. We sought to use a national database to identify outcomes in these patients compared to subset of patients more well studied in literature - primary Hepatocellular cancer patients and patients with colorectal metastasis.

Methods: We identified patients undergoing major hepatectomy (≥ 3 segments) for primary hepatocellular cancer (HCC), sarcoma metastasis, breast cancer metastasis, and colorectal metastasis using NSQIP database. The Primary outcome measure was 30-day mortality. Secondary outcome measures were 30-day readmission and complication rates.

Results: A total of 5580 patients underwent major hepatectomy during the study period. Patients who underwent hepatectomy for breast cancer metastasis had higher incidence of in-hospital complications (37%) compared to sarcoma (29%), colon (26%), and HCC patients (24%) and 30-days readmission rate (37% vs. 29% - sarcoma vs. 26% - colon vs. 25% HCC). There was no difference in 30-days mortality among the groups.

Conclusion: Patients undergoing major hepatectomies for breast cancer metastasis and sarcoma are more likely to have adverse outcomes than compared to their counterparts. This difference highlights the lack of experience in managing breast cancer and sarcoma with metastatic disease to the liver. This also highlights the difference in tumor biology among all the lesions we studied. An extensive discussion should take place when dealing with breast and sarcoma lesions in the liver because of these outcomes.

Background: Gastrointestinal stromal tumors (GISTs) represent approximately 0.2% of all gastrointestinal tumors. GISTs can occur anywhere along the length of the gastrointestinal tract. Most common clinical manifestations of GISTs include GI bleeding, abdominal discomfort, distention and pain. Small lesions can be found incidentally during imaging studies, endoscopy, surgery and post-mortem. The progression of disease from incidentally found indolent to symptomatic disease is unknown.

Case series: Here we describe a series of cases of incidentally found GIST and their management. The first patient was a 38-years old morbid obese female with an incidentally found GIST in the stomach following an elective laparoscopic vertical sleeve gastrectomy. The second patient was a 69-year-old male who underwent elective sleeve gastrectomy for his obesity and associated refractory acid reflux. On pathologic examination of the gastrectomy specimen, GIST was diagnosed in the gastric fundus.

Discussion: Coexistence of GIST with other malignancies is higher than previously reported and should draw attention of clinicians towards these incidental findings. Prognosis in these patients is usually determined by other malignancy and not significantly influenced by GIST. Therefore, treatment algorithms should be focused on prognostically relevant malignancy.