ABSTRACT
Objective To assess the feasibility and indications of local resection as an alternative to pancreaticoduedenectomy for the treatment of early stage ampullary cancer. Methods In this study,36 patients with an AJCC.stage pTl ampullary carcinoma were operated on between 1989 and 2009.Among those local resection was performed in 11 cases and pancreaticoduodenectomy in 25 cases.The main outcome measures were pre-and intra-operative diagnosis and staing,postoperative morbidity and mortality,recurrence.free and overall survival.Results Amp-llary cancerat early stageWas difficult to be diagnosed and staged before and during operation.It was at a much lower risk to perform local resection than pancreaticoduodenectomy.Postoperative complications were significantly lower in local resefion group than in pancreaticoduodenectomy group(P=0.031);whereas the postoperative hospital stay(P=0.254),perioperative mortality(P=1.000).disease-free survival(P=0:301)and long-term survival(P=0.289) were not statistically different between.the two groups. Conclusions Since accurate diagnosis and staginging of early ampullary cancer was diit3cult to establish perioperatively.local resection should be indicated forpoor risk pafients or those who refuse pancreaticoduedenectomy.
ABSTRACT
Objective To analyze the clinical features of primary splenic lymphoma. Method Clinicopatholngie features of 29 patients with primary splenic lymphoma treated in Cancer Hospital, Chinese Academy of Medical Sciences from November 2000 to August 2008 were analyzed retrospectively. Results In this study 27 cases were confirmed to be non-Hodgkin's lymphoma (NHL), and 2 cases were of Hodgkin's lymphoma (HL). According to Ahmann's staging, 6 cases belonged to stage Ⅰ, 4 was stage Ⅱ, and 19 was stage Ⅲ. Twenty-six patients received spleneetomy, 2 cases did splenectomy plus pancreatic body and tail resection, and 1 case did spleneetomy plus partial gastrectomy. Postoperatively, 19 cases received chemotherapy, and 5 of the 19 patients received rituximab (Mabthera) treatment. One patient received radiotherapy for regional lymph node invasion. The median time of follow-up was 24 months (range, 2 -93 months). The l-year, 3-year and 5-year overall survival rates were 96%, 83% and 73%, respectively. The 1-year, 3-year and 5-year disease-free survival rates were 96%, 51% and 51%, respectively. Conclusions Primary splenic lymphoma is the most common malignant tumor of the spleen. Splenectomy combined with excision of invaded tissues or organs is important therapy for patients with primary splenic lymphoma. Comprehensive treatments including chemotherapy, radiotherapy and biotherapy are recommended after operation.
ABSTRACT
Objective To investigate the effects of different surgical modalities on primary anorectal malignant melanoma. Methods Clinical data of 60 primary anorectal malignant melanoma cases who were admitted between 1965 and 2007 were collected, summarized and analyzed. Multivariate analysis was performed using the COX proportional hazards regression method. Results Tumors located in the rectum in 50 cases, in the anal canal in 10 cases. The overall survival rates were not significantly different between the 23 cases who received tumor resection only and those 30 cases receiving postoperative adjuvant therapy (X2=0. 078, P>0.05). Among these 53 surgical cases of anorectal malignant melanoma, 37underwent abdominoperineal resection, 16 underwent wide local excisions, There was no significant difference of the survival rates between the two groups (X2=1.464,P>0.05). Risk factors analysis revealed that the depth of tumor invasion is a risk factor (P<0.05), the modality of treatment is a protective factor (P<0.05). Conclusions Surgical operation is the principal effective management for anorectal malignant melanoma, Wide local excision is the principal therapeutic choice for localized well-circumferential anorectal malignant melanomas.