I supplementi di Tumori : official journal of Societa italiana di cancerologia ... [et al.]最新文献

The study is conducted on a series of 57 patients treated with D2 gastrectomy with curative intent for gastric cancer between January 2000 and December 2004, at Policlinico Multimedica (Milan). Postoperative mortality was 2%. Recurrence rate was 10%. The overall survival of the series is 36% at 4 years follow-up. Negative prognostic factors were: high grade tumor, locally advanced primary disease, presence of lymph node metastases, advanced stage of disease and recurrent disease at follow-up. The data of the study are comparable to those in the literature.

The authors are interested in determining causes of gallbladder cancer (GBC). By this intention, they theorize a correlation between genetic modifications (which are responsible of malignant transformation of biliary epithelium) and some intestinal infections. From 1999 to 2004 they observed 15 GBC and all 15 gallbladder have been analyzed histologically and from microbiological aspect; by these means from 1999 till 2004 they have studied also 30 persons with colelithiasis. The authors noticed that bile of both groups contained, in three cases in the first and in 8 cases in the second, a germ named Escherichia Coli which normally lives in intestine, while in 10 operated gallbladders of the first group and 12 of the second there was a positive for k-ras. They are studying to confirm their theories.

Background: Adenocarcinoma of lower esophagus and GEJ shows worldwide an increasing incidence. The optimal approach to resection is still controversial. One of the major disadvantages of radical esophagectomy with extensive lymphadenectomy with open technique is its high rate of morbidity and mortality. Recent advances in minimally invasive surgical technology have allowed surgeons to apply laparoscopy and thoracoscopy to perform esophagectomy.

Patient and methods: In the video we report the case of a 79 years old man with Siewert I adenocarcinoma of GEJ, who was submitted to a 3-stage minimally invasive esophagectomy by laparoscopy, right thoracoscopy and cervicotomy. Preoperative endoscopic ultrasound and CT scan showed a marked thickening of the wall of the distal esophagus, with extension proximal to the mediastinal pleura and the anterior surface of the aorta, but still showing features of resectability. Four ports were used for the abdominal approach. A complete mobilization of the stomach preserving the right gastroepiploic arcade was achieved. The patient was then turned to the left lateral decubitus position proned to 30 degrees. Three ports were needed for right thoracoscopy. Mobilization of the thoracic esophagus was carried out from the diaphragm to the thoracic inlet. After extraction of the specimen through a small abdominal incision, the stomach was pulled up to the neck and esophagogastric anastomosis with the Orringer technique was constructed through a left cervicotomy. Pathology showed pT3 pN1 G3 adenocarcinoma.

Conclusions: The minimally invasive approach to adenocarcinoma of the lower esophagus, in center with expertise in minimally invasive surgical technique, is feasible and safe.

The primitive tumors of the liver are relatively rare in the Western countries (around the 0.7% of all the neoplasms) while they present more elevated incidence in Africa and in the South Asian East. While the hepatocellular carcinoma rises up in the 50-70% of the cases in livers cirrosis, this correlation is not valid for the form of carcinoma to departure from the learned intra and extra biliar. The etiology of the intrahepatic colangiocarcinoma (CC) stays unknown. They have stayed observe, on the other hand, of the conditions sometimes correlated to the development of the CC (Carolí morbs, ulcerative colitis, asbestosis). The CC usually rises up from the epithelial cells of surface that delimit the biliary ducts, although different studies suggest that these tumors can also originate from the learned smaller biliary ducts, from the hepatic cysts of the policistic illness and from the complexes of von Meyenburg. The low incidence of the CC, the clinical atypical debut, the not facility of a precise diagnosis have aroused our interest so that the present job wants to be a modest scientific contribution to this type of pathology.

Although hemangiopericytoma (HPT) may arise in any anatomic site, it rarely develops in the greater omentum. To our knowledge, only twelve cases have been reported to date in the English language literature. In this report, we describe the case of a patient with sudden severe lower abdominal pain caused by primary HPT in the greater omentum treated with laparoscopic approach and a review of the reported cases is made.

Maximum tumor diameter (MTD) is considered by many authors as an important prognostic factor in gastric cancer and, in some series, is reported to be strongly correlated with depth of infiltration. Aim of this study was to evaluate the prognostic value of tumor diameter in a monoistitutional series of 153 gastric cancer patients. The Spearman correlation coefficient was also calculated between MTD and other known prognostic factors. For statistical analysis, patients were grouped as follows: MTD 1, < or = 40 mm, and MTD2, > 40 mm. In our series, MTD resulted significantly linked to survival at univariate analysis (p = 0.0001), but multivariate analysis did not evidence MTD as an independent prognostic indicator. The Spearman correlation test documented that MTD2 is strongly correlated with tumor depth (pT), nodal status (pN) and p-stage (p < 0.01) and is a good predictor of locally advanced stage. This retrospective study showed that patients with larger tumor are at an increased risk for tumor advancement and, therefore, MTD could represent a useful parameter for choosing the most appropriate therapeutic strategy.

Pelvic exenteration has been described as a formidable procedure in cases of advanced or recurrent pelvic cancers for a variety of primary tumors, including colorectal, gynaecologic and urologic. We report our 14-year experience in a community hospital with 37 cases who underwent pelvic exenteration for recurrent (n = 15) or locally advanced (n = 22) colorectal cancers. At a median follow-up of 36 months, the median survival was 24 and 36 months, respectively, and the 5-year actuarial survival was 18% and 44%.

The aim of this work is the investigation of the level of expression of the vascular endothelial growth factor (VEGF) and metalloproteases (such as Cox-2) in the colon rectal cancer. The final goal is the correlation with liver metastases. Molecular biology approaches will be adopted: in particular: RT-PCR, quantitative real time PCR with fluorescent probes, immunolocalizations and Western blotting This is a proposal of research. The work is under development and results and conclusions cannot be at the moment anticipated. However, in recent publication we found human polyomavirus DNA sequences in colorectal tumors.