Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 110
Filter
1.
Rev. cuba. cir ; 60(2): e1049, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280215

ABSTRACT

Introducción: El cáncer de colon mantiene un importante impacto social y una alta morbilidad a pesar de programas de detección precoz existentes. Ocupa el cuarto lugar entre los tumores malignos y un número importante de pacientes son operados de urgencia por las complicaciones de esta enfermedad, muchas veces desconocida hasta el momento de la cirugía. Objetivo: Caracterizar la cirugía de urgencia realizada a los pacientes con diagnóstico de cáncer de colon complicado. Método: Se realizó un estudio observacional, descriptivo, de corte transversal entre enero de 2014 y diciembre de 2016, en el Servicio de Cirugía General. La muestra fue de 96 pacientes portadores de esta entidad en el Hospital Universitario "General Calixto García". Resultados: Se analizó la incidencia según sexo, relación sexo/localización, relación localización/complicación, estadificación y mortalidad. Prevalecieron los tumores de colon en el sexo femenino y por ende fueron más frecuente las pacientes con complicaciones quirúrgicas por esta entidad en nuestro centro. Predominó la localización derecha globalmente, con predominio femenino. La oclusión intestinal fue la complicación más frecuente. Sobresalió el estadio II según TNM con un 37,5 por ciento y una mortalidad postoperatoria del 31 por ciento. Conclusiones: Nuestros datos coinciden con la tendencia nacional sobre la mayor incidencia del cáncer de colon en pacientes femeninas, son estas las que mayor tasa de morbilidad y mortalidad reportan. Seguir perfeccionando el programa de prevención y detección temprana de la entidad y su tratamiento oportuno causará la reducción de los índices que hoy se exhiben(AU)


Introduction: Colon cancer still has an important social impact and high morbidity despite existing early detection programs. It ranks fourth among malignant tumors, while a significant number of patients undergo emergency surgery for complications of this disease, many times unknown until the time of surgery. Objective: To characterize the emergency surgery performed to patients with a diagnosis of complicated colon cancer. Method: An observational, descriptive, cross-sectional study was carried out, between January 2014 and December 2016, in the general surgery service. The sample consisted of 96 patients with this entity and from General Calixto García University Hospital. Results: The incidence was analyzed according to sex, sex/location relationship, location/complication relationship, staging and mortality. Colon tumors prevailed in the female sex and, therefore, patients with surgical complications from this entity were more frequent in our center. There right location predominated globally, with a predominance in the female sex. Intestinal obstruction was the most frequent complication. Stage two, according to the TNM classification, stood out, accounting for 37.5 percent, together with a postoperative mortality of 31 percent. Conclusions: Our data coincide with the national trend on the highest incidence of colon cancer in female patients, who account for the highest morbidity and mortality rates. Continuing to improve the entity's prevention and early detection program, as well as its timely treatment, will bring about a reduction in the rates nowadays reported(AU)


Subject(s)
Humans , Male , Female , Colonic Neoplasms/diagnosis , Emergencies , Intestinal Obstruction/complications , Neoplasm Staging/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Colonic Neoplasms/epidemiology , Observational Studies as Topic
2.
Dermatol. argent ; 26(1): 23-25, 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1146359

ABSTRACT

Antecedentes: En la octava edición del manual de estadificación del cáncer del American Joint Committee on Cancer (AJCC), se introdujeron cambios importantes en las categorías T, N y M. Al entrar en vigencia la octava guía de la AJCC, se modificó no solo el T, sino también la indicación de biopsia del ganglio centinela (BGC). Entre los cambios más significativos en la estadificación se encuentran: la exclusión del índice mitótico (IM) de la categoría T en los melanomas finos (de hasta 1 mm de espesor) y el cambio del punto de corte para el espesor tumoral para discriminar un T1a (< 0,8 mm sin ulceración) de un T1b (≥ 0,8 mm). Objetivo: Comparar la estadificación inicial de los melanomas finos según el criterio utilizado en la séptima edición, con la que tendrían de acuerdo con la perspectiva actual del AJCC, con especial atención en el índice mitótico. Diseño y métodos: Estudio observacional, de corte transversal, realizado mediante la recolección de datos de las historias clínicas desde el 1 de enero de 2000 hasta el 31 de diciembre de 2017. Resultados: De 131 melanomas finos incluidos, 28 tendrían cambios en su estadificación. Al considerar el nuevo punto de corte para el espesor tumoral, 22 melanomas T1a pasarían a T1b. Asimismo, se detectaron 20 melanomas con un IM ≥ 1 mitosis/mm2, de los cuales solo 6 tuvieron indicación de BGC por este criterio exclusivamente y serían clasificados como T1a en la actualidad. De estos, en 2 no se realizó la BGC por autodeterminación de los pacientes y en los 4 restantes el resultado fue negativo. Conclusiones: Veintiocho de nuestros pacientes tendrían hoy diferencias en la indicación de BGC: 22 serían considerados con mayor riesgo de metástasis ganglionares y serían candidatos a su pesquisa. Los otros 6 pacientes ya no tendrían indicación de ese estudio por la baja posibilidad de encontrar metástasis ocultas, lo cual coincide con el resultado negativo de la BGC en los 4 pacientes que se sometieron al procedimiento. (AU)


Background: In the 8th edition of the cancer staging manual of the American Joint Committee on Cancer (AJCC), important changes were made in the T, N and M categories. When the 8th guideline of the AJCC came into effect, not only was the T stage modified, but also the indication for sentinel lymph node biopsy (SLNB). The most significant changes in staging included: the exclusion of the mitotic index (MI) as a determinant of the T category and the change of the threshold of tumor thickness to discriminate a T1a (< 0.8 mm without ulceration) from a T1b (≥ 0.8 mm). Objective: To compare the initial staging of thin melanomas according to the criteria used in the 7th edition, with the one that would have been used according to the current AJCC recommendations, with special focus on MI. Design and methods: Observational, cross-sectional study, carried out through the collection of data from medical records from January 1, 2000 to December 31, 2017. Results: There were 131 thin melanomas included, 28 of which would have had changes in their staging. When considering the modified threshold for tumor thickness, 22 T1a melanomas would be classified as T1b. Among 20 thin melanomas with a MI ≥ 1, only 6 had an indication for SLNB solely due to the MI criterion and would be now classified as T1a. Two of these did not undergo SLNB because they rejected the procedure, and in the remaining 4, there were no SLN metastasis. Conclusions: Nowadays, 28 of our patients would have differences in the indication for SLNB: 22 would be considered to be at greater risk of lymph node metastasis and would be candidates for screening. The other 6 patients would no longer have an indication for this procedure due to the low probability of clinically occult metastases, which seems to concur with the negative result of SLNB in the 4 patients who underwent the procedure. (AU)


Subject(s)
Humans , Skin Neoplasms/pathology , Practice Guidelines as Topic , Sentinel Lymph Node Biopsy , Melanoma/pathology , Mitotic Index , Neoplasm Staging/methods , Skin Neoplasms/diagnosis , Cross-Sectional Studies , Risk Factors , Lymphatic Metastasis , Melanoma/diagnosis
3.
ABCD arq. bras. cir. dig ; 33(3): e1535, 2020. tab
Article in English | LILACS, BIGG | ID: biblio-1141903

ABSTRACT

The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. Conclusion: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.


O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico (ABCG) foi recentemente publicado. Nesta ocasião, inúmeros especialistas que atuam no tratamento desta doença expressaram sua opinião diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 1) quanto ao diagnóstico, estadiamento, tratamento endoscópico e seguimento dos pacientes com câncer gástrico. Métodos: Para formulação destas Diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO com os seguintes descritores: câncer gástrico, estadiamento, tratamento endoscópico e seguimento. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 24 declarações, duas (8,3%) foram classificadas com nível de evidência A, 11 (45,8%) B e 11 (45,8%) C. Quanto ao grau de recomendação, seis (25%) declarações obtiveram grau de recomendação 1, nove (37,5%) grau 2a, seis (25%) 2b e três (12,5%) 3. Conclusão: As diretrizes aqui presentes têm a finalidade de auxiliar os profissionais que atuam no combate ao câncer gástrico com informações relevantes e atuais, permitindo que sejam aplicadas na prática médica diária.


Subject(s)
Humans , Stomach Neoplasms/diagnosis , Endoscopy/methods , Neoplasm Staging/methods , Follow-Up Studies , Consensus Development Conference
4.
Int. braz. j. urol ; 45(2): 229-236, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002210

ABSTRACT

ABSTRACT Purpose: The 8th edition of the TNM has been updated and improved in order to ensure a high degree of clinical relevance. A major change in prostate includes pathologically organ - confined disease to be considered pT2 and no longer subclassified by extent of involvement or laterality. The aim of this study was to validate this major change. Materials and Methods: Prostates were step - sectioned from 196 patients submitted to radical prostatectomy with organ confined disease (pT2) and negative surgical margins. Tumor extent was evaluated by a semiquantitative point count method. The dominant nodule extent was recorded as the maximal number of positive points of the largest single focus of cancer from the quadrants. Laterality was considered as either total tumor extent (Group 1) or index tumor extent (Group 2). Time to biochemical recurrence was analyzed with the Kaplan - Meier product limit analysis and prediction of shorter time to biochemical recurrence with Cox proportional hazards model. Results: In Group 1, 43 / 196 (21.9%) tumors were unilateral and 153 / 196 (78.1%) bilateral and in Group 2, 156 / 196 (79.6%) tumors were unilateral and 40 / 196 (20.4%) bilateral. In both groups, comparing unilateral vs bilateral tumors, there was no significant clinicopathological difference, and no significant association with time as well as prediction of shorter time to biochemical recurrence following surgery. Conclusions: Pathologic sub - staging of organ confined disease does not convey prognostic information either considering laterality as total tumor extent or index tumor extent. Furthermore, no correlation exists between digital rectal examination and pathologic stage.


Subject(s)
Humans , Male , Prostatectomy/methods , Prostatic Neoplasms/pathology , Digital Rectal Examination , Neoplasm Staging/standards , Prognosis , Prostatic Neoplasms/surgery , Prostatic Neoplasms/chemistry , Retrospective Studies , Follow-Up Studies , Prostate-Specific Antigen , Neoplasm Grading , Neoplasm Recurrence, Local/pathology , Neoplasm Staging/methods , Neoplasms/classification
5.
Rev. méd. Panamá ; 39(2): 66-73, 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1102124

ABSTRACT

Introducción: A nivel mundial hay un incremento de la incidencia de melanoma, Panamá no escapa a esta realidad. Para todas las etapas hay riesgo de recurrencia inclusive luego de una cirugía adecuada y elevadas probabilidades de fallecer a causa de metástasis. Este trabajo busca conocer la experiencia del ION en el tratamiento de estos pacientes, la cual no ha sido publicada a la fecha. Objetivos: Descri­ bir las características de los pacientes con melanoma y determinar la Supervivencia Global (OS) y la Su­ pervivencia Libre de Recurrencia (RFS). Metodología: Estudio retrospectivo de los pacientes con melanoma referidos al ION en los años 2012 a 2017 y el análisis de OS y RFS por el método de Kaplan­ Meier. Resultados: Un total de 247 pacientes de melanoma fueron atendidos en el ION en el periodo del estudio; 51.8% eran masculinos con mediana de edad de 65 años. El sitio más común fue acral (31%). En total 46% de nuestros pacientes están en etapas III­IV. Un 65% del total fueron operados, de éstos 80% con resección amplia, 27% con evaluaciones de ganglio centinela y 25% linfadenectomías. Encon­tramos 39% ulcerados y la histología más frecuente fue nodular con 31.6%. Hubo 31.4% de recurren­cias, de los cuales 63.8% era a distancia. La mOS: 55.8 meses en no metastásicos vs 13.1 meses en metastásicos (p<0.0001). La mRFS para los operados fue 53.6 meses y los factores pronósticos fueron ulceración (p=0.007) y realización de linfadenectomía (p=0.000). Conclusión: El diagnóstico de melano­ ma en la población panameña se hace en etapas avanzadas, lo que influye en su pronóstico. Su tasa de supervivencia está muy por debajo de otros países tanto desarrollados como en vías de desarrollo. Estos resultados deben tomarse con cuidado, ya que los factores clásicos descritos en múltiples estu­ dios, no parecen influenciar a nuestra población (edad, sexo, sitio anatómico, subtipo, mitosis). Siendo una enfermedad tan letal hace falta realizar estudios prospectivos a nivel nacional, así como fortalecer la red de prevención y atención primaria.


Introduction: Worldwide there is an increase in the incidence of melanoma, Panama does not escape this reality. For all stages there is a risk of recurrence even after adequate surgery and high chances of death due to metastasis. This work seeks to know the experience of ION in the treatment of these pa­ tients, which has not been published to date. Objectives: To describe the characteristics of patients with melanoma and determine the Global Survival (OS) and the Free Survival of Recurrence (RFS). Metho­ dology: Retrospective study of patients with melanoma referred to the ION in the years 2012 to 2017 and the analysis of OS and RFS by the Kaplan­Meier method. Results: A total of 247 melanoma patients we­ re treated at the ION during the study period; 51.8% were male with a median age of 65 years. The most common site was acral (31%). In total 46% of our patients are in stages III­IV. 65% of the total were ope­ rated, of these 80% with wide resection, 27% with sentinel lymph node evaluations and 25% lymphade­ nectomy. We found 39% ulcerated and the most frequent histology was nodular with 31.6%. There were 31.4% of recurrences, of which 63.8% were distant. The mOS: 55.8 months in non­metastatic vs 13.1 months in metastatic (p <0.0001). The mRFS for the operated patients was 53.6 months and the prog­ nostic factors were ulceration (p = 0.007) and lymphadenectomy (p = 0.000). Conclusion: The diagnosis of melanoma in the Panamanian population is made in advanced stages, which influences its prognosis. Its survival rate is well below other developed and developing countries. These results should be taken with care, since the classical factors described in multiple studies do not seem to influence our population (age, sex, anatomical site, subtype, mitosis). Being such a lethal disease, it is necessary to carry out prospective studies at the national level, as well as to strengthen the prevention and primary care network


Subject(s)
Humans , Male , Female , Middle Aged , Melanoma/diagnosis , Melanoma/mortality , Melanoma/epidemiology , Lower Extremity/physiopathology , Kaplan-Meier Estimate , Immunotherapy/statistics & numerical data , Lymph Node Excision , Neoplasm Staging/methods
6.
Rev. méd. Chile ; 145(5): 579-584, mayo 2017. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-902515

ABSTRACT

Background: The role of staging studies in patients with prostate cancer (PCa) is a topic of discussion. Aim: To evaluate the usefulness of imaging studies in patients with prostate cancer. Material and Methods: We reviewed the pathology service records to identify patients with prostate cancer diagnosed between 2003 and 2013. We reviewed the electronic medical records of those patients identified as having a prostate cancer. Patients were grouped according D’amico’s classification of cancer dissemination risk. We analized the frequency of imaging studies requested and their efficacy to detect metastases in each risk group. Results: We identified 241 patients with a mean age of 67 years. Fifty two percent of patients were classified as low-risk, 32% as intermediate-risk and 16% as high risk. At least one imaging study was requested to 64% of patients (49, 78 and 87% of patients with low, intermediate and high risk respectively). Among the 155 patients in whom an imaging study was requested, no metastases were found in the low risk group. On the other hand, dissemination was found in 7% of the intermediate-risk group and 62% of the high-risk group. Conclusions: Half of patients with prostate cancer were classified as low risk. In half of this group of low risk patients, staging studies were requested and the probability of detecting metastases was low or nil. The odds of detecting metastases increased in higher risk groups.


Subject(s)
Humans , Male , Middle Aged , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Retrospective Studies , Risk Assessment , Neoplasm Staging/methods
8.
Rev. saúde pública (Online) ; 49: 57, 2015. tab, graf
Article in English | LILACS | ID: biblio-962159

ABSTRACT

OBJECTIVE To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer.METHODS The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies' accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used.RESULTS The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively.CONCLUSIONS The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.


OBJETIVO Estimar o impacto orçamentário da incorporação da tomografia por emissão de pósitrons (PET) no estadiamento mediastinal e à distância do câncer pulmonar de células não pequenas.MÉTODOS As estimativas foram calculadas pelo método epidemiológico para os anos de 2014 a 2018. Utilizaram-se dados nacionais de incidência; de distribuição de doença e acurácia das tecnologias procedentes da literatura, e de custos, de estudo de microcustos e das bases de dados do Sistema Único de Saúde. Analisaram-se duas estratégias de uso da PET: oferta a todos os pacientes recém-diagnosticados, e restrita àqueles que apresentassem resultados negativos de tomografia computadorizada (TC) prévia. Foram realizadas análises de sensibilidade univariadas e por cenários extremos para avaliar influência de fontes de incertezas nos parâmetros utilizados.RESULTADOS A incorporação da PET-TC ao Sistema Único de Saúde implicaria na necessidade de recursos adicionais de R$158,1 (US$98,2) milhões para oferta restrita a R$202,7 (US$125,9) milhões para oferta abrangente em cinco anos, com diferença entre as duas estratégias de oferta de R$44,6 (US$27,7) milhões no período. Em termos absolutos, o impacto orçamentário total da incorporação no Sistema Único de Saúde, em cinco anos, seria de R$555 (US$345) e R$600 (US$372,8) milhões, respectivamente. Custos do procedimento PET-TC foram o parâmetro de maior influência nos resultados. No cenário por extremos mais otimista, os impactos orçamentários incrementais reduzir-se-iam para R$86,9 (US$54) e R$103,8 (US$64,5) milhões, considerando PET-TC para TC negativa e PET-TC para todos, respectivamente.CONCLUSÕES A incorporação da PET no estadiamento clínico do câncer pulmonar de células não-pequenas parece ser financeiramente factível frente à magnitude do orçamento do Ministério da Saúde. A potencial redução no número de cirurgias desnecessárias pode produzir maior eficiência na alocação dos recursos disponíveis.


Subject(s)
Humans , Male , Female , Positron-Emission Tomography/economics , Lung Neoplasms/diagnostic imaging , Neoplasm Staging/economics , Reproducibility of Results , Sensitivity and Specificity , Carcinoma, Non-Small-Cell Lung/economics , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Lung Neoplasms/economics , Lung Neoplasms/pathology , Middle Aged , Neoplasm Staging/methods
9.
Article in English | WPRIM | ID: wpr-182510

ABSTRACT

Imaging studies including magnetic resonance imaging (MRI) play a crucial role in the diagnosis and staging of hepatocellular carcinoma (HCC). Several recent studies reveal a large number of MRI features related to the prognosis of HCC. In this review, we discuss various MRI features of HCC and their implications for the diagnosis and prognosis as imaging biomarkers. As a whole, the favorable MRI findings of HCC are small size, encapsulation, intralesional fat, high apparent diffusion coefficient (ADC) value, and smooth margins or hyperintensity on the hepatobiliary phase of gadoxetic acid-enhanced MRI. Unfavorable findings include large size, multifocality, low ADC value, non-smooth margins or hypointensity on hepatobiliary phase images. MRI findings are potential imaging biomarkers in patients with HCC.


Subject(s)
Aged , Biological Products , Biomarkers, Tumor , Carcinoma, Hepatocellular/diagnosis , Contrast Media , Gadolinium DTPA , Humans , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neoplasm Staging/methods , Prognosis
10.
Article in English | WPRIM | ID: wpr-22488

ABSTRACT

Contrast-enhanced computed tomography colonography (CE-CTC) is a useful guide for the laparoscopic surgeon to avoid incorrectly removing the colonic segment and the failure to diagnose of synchronous colonic and extra-colonic lesions. Lymph node dissection and vessel ligation under a laparoscopic approach can be time-consuming and can damage vessels and organs. Moreover, mesenteric vessels have extreme variations in terms of their courses and numbers. We describe the benefit of using an abdominal vascular map created by CE-CTC in laparoscopic colorectal surgery candidates. We describe patients with different diseases (colorectal cancer, diverticular disease, and inflammatory bowel disease) who underwent CE-CTC just prior to laparoscopic surgery.


Subject(s)
Adult , Aged , Colectomy/methods , Colon/blood supply , Colonography, Computed Tomographic/methods , Colorectal Neoplasms/pathology , Contrast Media , Female , Humans , Laparoscopy/methods , Lymph Node Excision/methods , Male , Middle Aged , Neoplasm Staging/methods
11.
Gut and Liver ; : 437-448, 2015.
Article in English | WPRIM | ID: wpr-34671

ABSTRACT

Hepatocellular carcinoma (HCC) is the second most common cause of cancer death worldwide. This cancer commonly arises against a background of chronic liver disease. As a result, a patient with HCC requires multidisciplinary care. Treatment options vary widely based on tumor burden and metastases. The most widely utilized staging system is the Barcelona Clinic Liver Cancer staging system, which recommends treatments based on tumor size and the underlying liver disease and functional status of the patient. Treatment options range from surgical resection or transplantation to locoregional therapies with modalities such as radiofrequency ablation and transarterial chemoembolization to systemic chemotherapies. Future care involves the development of combination therapies that afford the best tumor response, further clarification of the patients best suited for therapies and the development of new oral chemotherapeutic agents.


Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/pathology , Catheter Ablation/trends , Chemoembolization, Therapeutic/trends , Combined Modality Therapy/trends , Forecasting , Humans , Liver Neoplasms/pathology , Liver Transplantation , Neoplasm Staging/methods
14.
Indian J Cancer ; 2014 Jul-Sep; 51(3): 193-199
Article in English | IMSEAR | ID: sea-154342

ABSTRACT

Objectives: The usage of Ultrasonography (US) in the diagnosis and management of patients with thyroid nodules and thyroid cancer is increasing. This method is also advocated for the pre-operative and post-operative diagnosis of cervical lymph node (LN) metastases. This article is trying to figure out the correlation between ultrasound features and pathological classification of thyroid carcinoma (TC). Materials and Methods: A total of 407 cases of patients with TC were selected from records between 2000 and 2006, which were used to analyze and compare the ultrasound features in different pathologic classification of TC. We grouped the US typing of TC according to the ultrasound features. Then, we implemented pre-surgery evaluation of TC by ultrasound assessment. Results: We classified these patients into six groups by ultrasound: (1) classical, (2) non-typical, (3) microminiaturize, (4) diffuse sclerosing, (5) medullary, and (6) undifferentiated. Ultrasonographic types of papillary TC: (1) classical, (2) microminiaturize, (3) diffuse, (4) cystic, (5) peripheral, (6) multi-nodules, (7) invasive, and (8) complicated Hashimoto. Grouping of the ultrasonic type of cervical LN metastasis: (1) cystic, (2) micro calcification, (3) macro-lymph, (4) microminiaturize, and (5) invasive. The ultrasound assessment of clinical staging had a higher sensitivity rate and specificity, and the accuracy rate of T stage was 93.9%. Conclusion: Ultrasound is a useful tool in the evaluation, characterization, quantification, and location of TC and cervical LN metastasis.


Subject(s)
Humans , Precision Medicine , Neoplasm Staging/methods , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Thyroid Neoplasms/diagnostic imaging , Ultrasonography/methods
16.
Indian J Cancer ; 2014 Apr-Jun; 51(2): 170-175
Article in English | IMSEAR | ID: sea-154329

ABSTRACT

BACKGROUND: Technical advancement in imaging has helped to stage and plan treatment modality for carcinoma rectum with still some objectives controversial. AIMS: The aim of our study was to evaluate the accuracy of multidetector row computed tomography (MDCT) with multiplanar reformations in the pre‑operative staging of rectal carcinoma and correlation with intraoperative and histopathologic staging of retrieved specimen with respect to the depth of tumor invasion (T‑staging), lymph node metastasis (N‑staging) and mesorectal fascia (MRF) involvement. MATERIALS AND METHODS: The study was a prospective one and consisted of 52 patients with biopsy proved rectal carcinoma. MDCT studies were performed on a 64‑slice computed tomography system. Images were reconstructed in axial, coronal and sagittal planes. MDCT findings were compared with intraoperative and pathologic (reference standard) findings. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were assessed. RESULTS: The diagnostic accuracy of MDCT for T1/T2, T3 and T4 lesions was 77%, 86.5% and 100%, respectively. For perirectal lymph node metastasis (N+), the diagnostic accuracy of MDCT was 84.1%. The diagnostic accuracy of MDCT for MRF involvement was 91%. CONCLUSION: MDCT is a reliable radiological tool for local staging of rectal cancer with excellent accuracy rates for T and N‑staging of rectal cancer.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma/pathology , Carcinoma/diagnostic imaging , Female , Humans , Image Interpretation, Computer-Assisted , Male , Middle Aged , Neoplasm Staging/methods , Prospective Studies , Rectal Neoplasms/pathology , Rectal Neoplasms/diagnostic imaging , Sensitivity and Specificity , Tomography, X-Ray Computed/methods , Young Adult
17.
Rev. chil. radiol ; 20(4): 135-140, 2014. ilus
Article in Spanish | LILACS | ID: lil-734820

ABSTRACT

The preoperative study in search of multifocality, multicentricity and bilaterality is essential for the proper therapeutic management of breast cancer. The reference standard to accomplish this is breast Magnetic Resonance Imaging (MRI). Based on the literature, we adapted the thorax CT protocol for the study of the breast. The aim of this paper is to demonstrate the feasibility of CT with emphasis on the breast, as an alternative to preoperative MRI in places where it is not available. Pre-operative CT was performed in all patients with newly diagnosed breast cancer between August 2013 and September 2014...


El estudio preoperatorio en búsqueda de multifocalidad, multicentricidad y bilateralidad es fundamental para el adecuado manejo terapéutico del cáncer (CA) mamario. El estándar de referencia para realizarlo es la resonancia magnética (RM) mamaria. Basados en la literatura, adaptamos el protocolo de TC de tórax para el estudio de la mama. El objetivo de este trabajo es demostrar la factibilidad de la TC con énfasis en mama como método alternativo a la RM pre-operatoria, en lugares donde ésta no está disponible. Se realizaron TC pre-operatorias en todas las pacientes con diagnóstico reciente de CA mamario entre agosto de 2013 y septiembre de 2014...


Subject(s)
Humans , Adult , Female , Middle Aged , Aged, 80 and over , Neoplasm Staging/methods , Breast Neoplasms/pathology , Preoperative Care , Tomography, X-Ray Computed/methods , Retrospective Studies
18.
Article in English | WPRIM | ID: wpr-200226

ABSTRACT

The gastrointestinal tract is the most common primary extranodal site for diffuse large B-cell lymphoma (DLBCL). However, there is no consensus on the most appropriate staging system for intestinal DLBCL. We evaluated the utility of the modified Ann Arbor system, the Lugano system, and the Paris staging system (a modification of the Tumor, Node, Metastases [TNM] staging for epithelial tumors) in 66 cases of resected intestinal DLBCL. The cases were treated with surgery, plus either cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy alone (n=26) or with the addition of rituximab immunotherapy (n=40). Median follow-up time was 40.4 months (range, 2.1-171.6 months). Fifty-six patients (84.8%) achieved complete remission. The overall 5-yr survival rate was 86.4% (57/66). Of the stage categories defined for each staging system, only the T stage of the Paris classification showed prognostic significance for overall survival by univariate analysis. However, none of the stage parameters was significantly correlated with patient survival on multivariate analysis. In conclusion, the results suggest that the T stage of the Paris classification system may be a prognostic indicator in intestinal DLBCL. The results also imply that in surgically resected intestinal DLBCL, the addition of rituximab to the CHOP regimen does not confer significant survival advantage.


Subject(s)
Adolescent , Adult , Aged , Antibodies, Monoclonal, Murine-Derived/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Female , Humans , Immunologic Factors/therapeutic use , Intestinal Neoplasms/classification , Lymphoma, Large B-Cell, Diffuse/classification , Male , Middle Aged , Neoplasm Staging/methods , Prednisone/therapeutic use , Retrospective Studies , Survival , Survival Rate , Treatment Outcome , Vincristine/therapeutic use , Young Adult
19.
Article in English | WPRIM | ID: wpr-114859

ABSTRACT

OBJECTIVE: To evaluate the accuracy of magnetic resonance imaging (MRI) with lumen distention for rectal cancer staging and circumferential resection margin (CRM) involvement prediction. MATERIALS AND METHODS: Seventy-three patients with primary rectal cancer underwent high-resolution MRI with a phased-array coil performed using 60-80 mL room air rectal distention, 1-3 weeks before surgery. MRI results were compared to postoperative histopathological findings. The overall MRI T staging accuracy was calculated. CRM involvement prediction and the N staging, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were assessed for each T stage. The agreement between MRI and histological results was assessed using weighted-kappa statistics. RESULTS: The overall MRI accuracy for T staging was 93.6% (k = 0.85). The accuracy, sensitivity, specificity, PPV and NPV for each T stage were as follows: 91.8%, 86.2%, 95.5%, 92.6% and 91.3% for the group < or = T2; 90.4%, 94.6%, 86.1%, 87.5% and 94% for T3; 98,6%, 85.7%, 100%, 100% and 98.5% for T4, respectively. The predictive CRM accuracy was 94.5% (k = 0.86); the sensitivity, specificity, PPV and NPV were 89.5%, 96.3%, 89.5%, and 96.3% respectively. The N staging accuracy was 68.49% (k = 0.4). CONCLUSION: MRI performed with rectal lumen distention has proved to be an effective technique both for rectal cancer staging and involved CRM predicting.


Subject(s)
Adult , Aged , Air , Dilatation/methods , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neoplasm Staging/methods , Prospective Studies , Rectal Neoplasms/pathology , Rectum/pathology , Sensitivity and Specificity
SELECTION OF CITATIONS
SEARCH DETAIL