RESUMO
Background: Complete resection (CR) serves as the standard of surgical treatment for retroperitoneal liposarcoma (RPLS). Unfortunately, even at referral centers, recurrence rates are high, and CR may not address multifocal diseases, which are a common phenomenon in RPLS. We sought to retrospectively compare the clinical outcomes of RPLS patients treated with total (ipsilateral) retroperitoneal lipectomy (TRL) and CR. Because TRL remove potentially multifocal tumors in the fat, patients may have a better prognosis than CR. Methods: Patients with primary/first-recurrent RPLS who had been treated at 5 referral centers were recruited from December 2014 to June 2018. Multivariable Cox regression analyses were conducted to determine the effects of demographic, operative, and clinicopathological variables on the following primary endpoints: local recurrence (LR), local recurrence-free survival (LRFS), and overall survival (OS). Results: A total of 134 patients were enrolled in this retrospective study, 53 of whom underwent TRL, and 81 of whom underwent CR. The 2 groups were comparable in terms of age, gender, presentation (primary vs. first-recurrent RPLS), number of tumors (unifocal vs. multifocal) at presentation, and Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade. The TRL group had higher levels of preoperative hemoglobin (Hb) (13 vs. 12.5 g/dL; P=0.008) and a lower amount of intraoperative blood loss (400 vs. 500 mL; P=0.034), but there were no significant differences in the length of hospital stay (23 vs. 22 d; P=0.47) or complications (32 vs. 30; P=0.82) between the 2 groups. In a subset of patients with multifocal tumors at initial presentation, OS was more prolonged in those treated with TRL than those treated with CR (P=0.0272). Based on the multivariable analysis, primary liposarcoma and a low FNCLCC grade were associated with decreased LR and improved OS. Conclusions: TRL is a safe procedure that positively affects the OS of patients with multifocal RPLS. This novel strategy deserves further investigation in prospective studies.
RESUMO
Gastric cancer is a malignant tumor with a high degree of malignancy. Multiple liver metastases from gastric cancer (LMGCs) are common. However, the treatment of LMGCs is very difficult. It is rare to achieve complete remission (CR) and long-term survival after treatment. We present the case of a patient with gastric adenocarcinoma and multiple liver metastases who showed CR for more than 33 months after perioperative EOX (epirubicin, oxaliplatin, and capecitabine) combination chemotherapy with radical distal gastrectomy and resection of liver metastases. The patient is still in follow-up without tumor recurrence. These findings suggest that LMGC does not necessarily mean a poor prognosis; preoperative chemotherapy combined with surgery may be a good treatment option for LMGC in selected patients. Further studies are needed to support this treatment approach.
RESUMO
BACKGROUND & OBJECTIVE: We have previously developed and reported the general module of the system of quality of life instruments for cancer patients (QLICP-GM). This study was to develop and evaluate the quality of life instrument for patients with stomach cancer (QLICP-ST). METHODS: The QLICP-ST was developed using the structured group methods applicable to Chinese populations. The system of QLICP-ST was evaluated by analyzing data from 86 stomach cancer patients using statistical description, Pearson's correlation, exploratory factor analysis, and paired student's t test. RESULTS: The test-retest reliability of the overall scale was 0.98 and that of each domain was greater than 0.90. The internal consistency coefficient alpha of the overall scale was 0.91 and that of each domain was higher than 0.65. Correlation analysis and the exploratory factor analysis revealed good construct validity of the QLICP-ST. Differences of the quality of life scores before and after the treatment in physical domain, psychological domain, common symptom and side effect domain, specific domain and the overall scale were significant. Moreover, the standardized response mean(SRM) of these domains were greater than 0.30. CONCLUSION: The system of QLICP-ST can be used in clinical evaluation of the quality of life for stomach cancer patients with sound validity, reliability and responsiveness.
