Analysis of liver-directed therapies in U.S. cancer patients.

BACKGROUND: The liver is a common site of primary and metastatic cancer. Liver-directed therapies are commonly used to treat cancer involving the liver. We report on the patterns, predictors, and outcomes of liver-directed therapies in hospitalized cancer patients in the United States. METHODS: Data were obtained from all U.S. states that contributed to the Nationwide Inpatient Sample maintained by the Agency for Healthcare Research and Quality between 2006 and 2010. Univariate and multivariate testing was used to identify factors significantly associated with patient outcome. RESULTS: For the 5-year period of interest, 12,540 patient discharges were identified. Mean age in the sample was 60 years. Primary liver lesions (n = 8840) made up 26.9% of the sample; the remaining cases were metastases. Most procedures were performed in large (79%) urban (98%) hospitals and in patients with insurance (97.9%). The most common intervention was partial hepatectomy (42.7%), followed by open (9.9%), percutaneous (7.2%), and laparoscopic (5.04%) ablation of liver lesions; embolization (9.8%); and liver transplantation (2.64%). The incidence of in-hospital mortality was very low (2.4%), and the complication rate was 12.2%. Complications such as acute liver necrosis, ascites, hepatic coma, hepatorenal syndrome, liver abscess, and high number of comorbid illnesses (>8) accounted for 60% of the in-hospital mortality. CONCLUSIONS: The low rate of morbidity and mortality associated with liver-directed therapies in hospitalized cancer patients supports the continuing utility of such procedures in the management of primary and metastatic liver cancer. The patterns of health disparities observed with respect to the use of liver-directed therapies are concerning.

Mucinous cystadenoma of the appendix: a case report.

INTRODUCTION: Tumours of the appendix are emerging as diseases of increasing concern due to a rising incidence1. We present a case of mucinous cystadenoma of the appendix in an elderly patient. To our knowledge, this is the first report of mucinous cystadenoma of the appendix from Nigeria.

Adenomatous polyposis coli in an elderly female nigerian.

Colorectal cancer is reported to occur in lower rates in Africans and some of the reasons adduced include a rarity of polyposis coli syndromes. Only two cases of polyposis coli have been documented in Nigeria in the last 15 years. The present case is an elderly lady who had radiologic and colonoscopic evidence of multiple colonic polyps. She had a colonic resection and the histology was reported as multiple polyposis coli, follicular hyperplasia and submucosal fibrosis in the appendix, and reactive hyperplasia in the mesenteric lymph nodes. There was no evidence of malignancy. This is the first case report of polyposis coli in a living elderly patient in Nigeria.