Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Chemotherapy, Adjuvant/methods , Colorectal Neoplasms/therapy , Digestive System Surgical Procedures/methods , Hyperthermic Intraperitoneal Chemotherapy/methods , Peritoneal Neoplasms/prevention & control , Acute Kidney Injury/epidemiology , Anastomotic Leak/epidemiology , Cisplatin/administration & dosage , Colorectal Neoplasms/pathology , Humans , Mitomycin/administration & dosage , Oxaliplatin/administration & dosage , Pancreatitis/epidemiology , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/secondary , Postoperative Complications/epidemiologyABSTRACT
Breast cancer-related lymphedema (LE) represents an important morbidity that jeopardizes breast cancer patients' quality of life. Different attempts to prevent LE brought about improvements in the incidence of the pathology but LE still represents a frequent occurrence in breast cancer survivors. Over 4 years ago, Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) was proposed and long-term results are reported in this study. From July 2008 to December 2012, 74 patients underwent axillary nodal dissection for breast cancer treatment together with LYMPHA procedure. Volumetry was performed preoperatively in all patients and after 1, 3, 6, 12 months, and once a year. Lymphoscintigraphy was performed in 45 patients preoperatively and in 30 also postoperatively after at least over 1 year. Seventy one patients had no sign of LE, and volumetry was coincident to preoperative condition. In three patients, LE occurred after 8-12 months postoperatively. Lymphoscintigraphy showed the patency of lymphatic-venous anastomoses at 1-4 years after operation. LYMPHA technique represents a successful surgical procedure for primary prevention of arm LE in breast cancer patients.
Subject(s)
Axillary Vein/surgery , Breast Neoplasms/surgery , Lymph Node Excision , Lymphatic Vessels/surgery , Lymphedema/prevention & control , Microsurgery , Postoperative Complications/prevention & control , Adult , Aged , Anastomosis, Surgical , Axilla , Female , Follow-Up Studies , Humans , Lymphedema/diagnosis , Lymphedema/etiology , Mastectomy , Middle Aged , Postoperative Complications/diagnosis , Primary PreventionABSTRACT
A case of ileal carcinoid metastatic to the liver is reported. The diagnosis was made and treatment given ten years after the detection of a left hypervascular liver mass, which was first confounded with a hemangioma. The onset of right heart failure led to surgical replacement of the tricuspid and pulmonary valves. After cardiac surgery the patient underwent an ileal resection and left hepatectomy for a cystic left liver metastasis. Isolated right heart failure and cystic degeneration of a liver metastasis are uncommon features of metastatic carcinoid tumors; only a few cases have been described in the literature. Cardiac surgery is recommended before liver surgery to reduce venous pressure and consequent bleeding during hepatectomy. Surgical treatment of liver metastases may relieve endocrine symptoms and result in an overall five-year survival rate of 47%.
Subject(s)
Carcinoid Heart Disease/etiology , Carcinoid Tumor/diagnosis , Carcinoid Tumor/secondary , Ileal Neoplasms/pathology , Liver Neoplasms/diagnosis , Liver Neoplasms/secondary , Aged , Carcinoid Heart Disease/surgery , Carcinoid Tumor/complications , Carcinoid Tumor/surgery , Cysts/surgery , Heart Valve Prosthesis Implantation , Hepatectomy , Humans , Ileal Neoplasms/complications , Liver Neoplasms/complications , Liver Neoplasms/surgery , Magnetic Resonance Imaging , Male , Pulmonary Valve/surgery , Tomography, X-Ray Computed , Treatment Outcome , Tricuspid Valve/surgeryABSTRACT
Gastric cancer is a major clinical challenge, with poor overall prognosis and limited life expectancy for patients with advanced disease. Even with surgery and other modalities, palliation is often difficult. Improvement of response rates has evolved with the development of standard regimens and those incorporating newer chemotherapy agents, such as oral fluoropyrimidines, the taxanes, camptothecins, novel platinums (eg, oxaliplatin [Eloxatin]), and antifolates (eg, pemetrexed [Alimta]). Ongoing trials with these regimens aim toward improving survival, as well as improving the safety profile. It is hoped that in conjunction with molecular research in the pathogenesis of gastric cancer and development of targeted therapies in this disease, these trial data might lead to the evolution of treatment strategies that could prove effective.
