ABSTRACT
Cervical cancer,ovarian cancer and endometrial carcinoma are most common maligancies in gynecology.More and more women suffer from gynecologic malignancies at a younger age.For these young women with hoping to preserve fertility,the fertilitysparing surgery without increasing the rise of tumor has been paid much attention.How are the oncological outcomes of these patients after the fertility-sparing surgeries ? We try to discuss this in the article.
ABSTRACT
Given the demographic trends toward a considerably longer life expectancy, the percentage of elderly patients with prostate cancer will increase further in the upcoming decades. Therefore, the question arises, should patients ≥75 years old be offered radical prostatectomy and under which circumstances? For treatment decision-making, life expectancy is more important than biological age. As a result, a patient′s health and mental status has to be determined and radical treatment should only be offered to those who are fit. As perioperative morbidity and mortality in these patients is increased relative to younger patients, patient selection according to comorbidities is a key issue that needs to be addressed. It is known from the literature that elderly men show notably worse tumor characteristics, leading to worse oncologic outcomes after treatment. Moreover, elderly patients also demonstrate worse postoperative recovery of continence and erectile function. As the absolute rates of both oncological and functional outcomes are still very reasonable in patients ≥75 years, a radical prostatectomy can be offered to highly selected and healthy elderly patients. Nevertheless, patients clearly need to be informed about the worse outcomes and higher perioperative risks compared to younger patients.
ABSTRACT
Purpose: There is a controversy about the treatment of left-sided obstructive colorectal cancer. Recently, experience using an expandable metallic stent for relief of the obstruction has been increasing, but its oncological safety has not been confirmed. Therefore, we designed this study to evaluate the oncological safety of a metallic stent for the treatment of left-sided obstructive colorectal cancer. Methods: Forty-six patients with left-sided obstructive colorectal cancer who underwent a curative resection from 1994 to 2004, were retrospectively evaluated. Nineteen emergency operations (1994~2003) and 27 metallic stent insertions (2000~2004) were compared based on clinicopathologic features, postoperative complications, recurrence rates, and survival rates. Results: There were no significant differences in age, location, sex, and recurrence rate between the two groups. The complication rate in the emergency group was higher than it was in the stent group, but this difference was not statistically significant (26.3% vs. 14.8%; P=0.33). The overall and the disease-free survival rates were not significantly different. Conclusions: Because there was no significant differences in survival rate and recurrence rate between the two groups, metallic stent insertion can be used safely in the preoperative treatment of obstructive left-sided colorectal cancer.