ABSTRACT
BACKGROUND: We assessed the effectiveness of perioperative MAGIC-style chemotherapy in our series focused on the tumor regression grade and survival rate. METHODS: We conducted a retrospective study of 53 patients following a perioperative regimen of epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/X). Forty-four (83 %) neoplasias were located in the stomach and 9 (17 %) were located at the esophagogastric junction. Perioperative chemotherapy completion, resection, TNM staging, the tumor regression grade (Becker's classification) and survival were analyzed. RESULTS: Forty-five patients (85 %) completed the 3 preoperative cycles. R0 resection was achieved in 42 (79 %) patients. Thirty-five (66 %) patients completed the 3 postoperative cycles. Nine carcinomas (17 %) were considered major responders after preoperative chemotherapy. With multivariate analysis, only completion of perioperative chemotherapy (HR: 0.25; 95%CI: 0.08 - 0.79; p = 0.019) was identified as an independent prognostic factor for disease-specific survival. However, the protective effect of perioperative therapy was lost in patients with ypT3-4 and more than 4 positive lymph nodes (HR: 1.16; 95%CI: 1.02 - 1.32; p = 0.029). The tumor regression grade (major vs minor responders) was at the limit of significance only with univariate analysis. The 5-year overall and disease-specific survival rates were 18 % and 22 % respectively. CONCLUSIONS: The percentage of major responder tumors after preoperative chemotherapy was low. Completion of perioperative ECF/X chemotherapy may benefit patients with gastric carcinomas that do not invade the subserosa with few positive lymph nodes.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Esophageal Neoplasms/drug therapy , Esophagectomy , Esophagogastric Junction , Gastrectomy , Stomach Neoplasms/drug therapy , Adult , Aged , Antineoplastic Agents/administration & dosage , Capecitabine , Chemotherapy, Adjuvant , Cisplatin/administration & dosage , Deoxycytidine/administration & dosage , Deoxycytidine/analogs & derivatives , Drug Administration Schedule , Epirubicin/administration & dosage , Esophageal Neoplasms/mortality , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Esophagogastric Junction/pathology , Esophagogastric Junction/surgery , Female , Fluorouracil/administration & dosage , Fluorouracil/analogs & derivatives , Follow-Up Studies , Humans , Male , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Retrospective Studies , Stomach Neoplasms/mortality , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Survival Analysis , Treatment OutcomeABSTRACT
Peritoneal adenomatoid tumours are rare benign neoplasms originating from mesothelial cells. We present a case of peritoneal adenomatoid tumour penetrating into the bowel wall and causing massive intra- and extraluminal bleeding.
Subject(s)
Adenomatoid Tumor/complications , Colonic Diseases/etiology , Gastrointestinal Hemorrhage/etiology , Hemangioma, Capillary/pathology , Hemoperitoneum/etiology , Peritoneal Neoplasms/complications , Adenomatoid Tumor/pathology , Cecal Diseases/etiology , Cecal Diseases/pathology , Diagnosis, Differential , Female , Humans , Ileal Diseases/etiology , Ileal Diseases/pathology , Intestinal Perforation/etiology , Middle Aged , Peritoneal Neoplasms/pathologyABSTRACT
Lung cancer is the most prevalent malignancy in western countries and most of the patients present at advanced stages, but single splenic metastasis is exceptional instead. We report on a case of a seventy- three-year old male presenting with non-hemoptoic productive cough, constitutional syndrome and pain in the left lower quadrant. Physical examination and complementary radiological and histological procedures revealed the presence of an adenocarcinoma of the left lung with probable splenic metastasis. The patient underwent splenectomy, which confirmed the diagnose of splenic metastasis of lung adenocarcinoma and, secondly, lung resection was performed. Topics about lung cancer metastasis are discussed.
Subject(s)
Adenocarcinoma/secondary , Lung Neoplasms/pathology , Splenic Neoplasms/secondary , Adenocarcinoma/diagnosis , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Male , Splenectomy , Splenic Neoplasms/diagnostic imaging , Splenic Neoplasms/pathology , Splenic Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
No disponible
Lung cancer is the most prevalent malignancy inwestern countries and most of the patients presentat advanced stages, but single splenic metastasis isexceptional instead. We report on a case of a seventy-three-year old male presenting with non-hemoptoicproductive cough, constitutional syndrome andpain in the left lower quadrant. Physical examinationand complementary radiological and hystologycalprocedures revealed the presence of an adenocarcinomaof the left lung with probable splenicmetastasis. The patient underwent splenectomy,which confirmed the diagnose of splenic metastasisof lung adenocarcinoma and, secondly, lung resectionwas performed. Topics about lung cancermetastasis are discussed
