ABSTRACT
The most fatal complication in trastuzumab therapy for breast cancer is cardiac disfunction. It can be classified two patterns, early onset type and late onset type. This complication often becomes severe, but it is reversible if appropriate steps are taken. In treating patients with trastuzumab, their cardiac function must be checked by echocardiogram every three months.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antineoplastic Agents/adverse effects , Breast Neoplasms/drug therapy , Heart Failure/chemically induced , Heart/physiopathology , Receptor, ErbB-2/analysis , Aged , Antibodies, Monoclonal, Humanized , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/chemistry , Breast Neoplasms/surgery , Chemotherapy, Adjuvant , Cyclophosphamide/administration & dosage , Drug Administration Schedule , Echocardiography , Epirubicin/administration & dosage , Female , Fluorouracil/administration & dosage , Heart/drug effects , Heart Failure/diagnostic imaging , Humans , Middle Aged , TrastuzumabABSTRACT
PURPOSE: We created a new clinical staging system for end-stage gastrointestinal (GI) carcinoma to clarify the therapeutic goals for these patients. METHODS: Data were obtained from a retrospective review of medical charts. Based on daily clinical observation of 144 patients with end-stage GI carcinoma, we classified the terminal stages as A, B, C, and D. RESULTS: The mean durations of terminal stages A, B, C, and D were 19, 16.6, 6.6, and 1.8 days, respectively, in patients with end-stage gastric cancer and 28.5, 9.1, 5.4, and 1.9 days, respectively, in patients with colorectal cancer. Moreover, 88.0% of patients with gastric carcinoma and 82.6% of patients with colorectal carcinoma passed through terminal stages A, B, C, and D sequentially. The patients in terminal stage B experienced temporary relief of symptoms, but those in terminal stage C did not (P < 0.05). CONCLUSIONS: These terminal stages can easily be judged by clinical observation and may be an effective new tool with which to manage patients with end-stage GI carcinoma and their families.
Subject(s)
Colorectal Neoplasms/diagnosis , Neoplasm Staging , Stomach Neoplasms/diagnosis , Terminally Ill , Adult , Aged , Aged, 80 and over , Colorectal Neoplasms/pathology , Disease Progression , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Stomach Neoplasms/pathologyABSTRACT
Local resection of the stomach is suitable for the treatment of submucosal tumors (SMT). However, it cannot be easily performed laparoscopically on tumors located near the esophagogastric junction. We have developed a new technique, which is called transgastric tumor-everting resection. To identify the location of the SMT laparoscopically without an oral endoscope, an Indiana ink mark was made prior to the operation. The SMT was everted from the gastrotomy and held by the Mini Loop Retractor II. The gastric mucosa could be observed from gastrotomy, allowing us to confirm that the staple line would not cause deformity of the esophagogastric junction. The lesion was then resected, and the gastrotomy was closed simultaneously using the Endo-GIA Universal. This technique is easy, safe, and useful for the laparoscopic resection of gastric SMTs located on the greater curvature or anterior wall of the fornix, near the esophagogastric junction.
