Surgically treated rectal cancer patients--outcomes at a tertiary care cancer hospital in Pakistan.

AIM: The aim of this study was to analyze our experience with rectal cancer patients who underwent surgical excision at our institution. METHODS: Data on 112 rectal cancer patients who underwent surgical resection with total mesorectal excision, from January 2005 to December 2008, were evaluated retrospectively. RESULTS: We achieved an initial complete remission rate of 74.1%. Overall, 92.8% of patients had a complete total mesorectal excision. The overall survival analysis for all patients showed a 1-year survival rate of 98%, a 3-year survival rate of 82%, and a 5-year survival rate of 70%. We report a 41.9% rate of postoperative complications. The 1-, 3-, and 5-year survival rates for females were 100%, 90%, and 72%, respectively and for males, they were 90%, 80%, and 68%, respectively. Differences in overall survival by sex were not statistically significant (p > 0.05). Those patients who were treated with only surgery had the best outcomes with survival being worse in those treated with surgery and adjuvant therapy. Neoadjuvant treatment followed by surgery led to better results. CONCLUSION: We conclude that we have been successful in achieving high rates of curative resection, complete remission, and overall survival. Neoadjuvant and adjuvant chemotherapy significantly impact rates of remission.

Endoscopic ultrasound - fine needle aspiration of 2-deoxy-2-[18F] fluoro-D-glucose avid lymph nodes seen on positron emission tomography- computed tomography -what looks like cancer may not always be so.

BACKGROUND: Patients suffering from malignancies often undergo serial positron emission tomography - computed tomography (PET-CT) scans, using 2-deoxy-2-[18F] fluoro-D-glucose (FDG) for diagnosis and follow up. This principle may also be applied to benign conditions as inflammatory cells take up increased amounts of FDG as well. The aim of our study was to retrospectively review the cytological diagnoses made at EUS-FNA of FDG-avid PET-CT lesions in patients with a history of cancer and to determine whether the cause of FDG-avidity was neoplastic or benign. METHODS: We used the endoscopy database to extract clinical information on all patients with malignancies who underwent EUS-FNA to obtain tissue from FDG-avid nodes seen on PET-CT at our institution from 2009 - 2012. All patients who were referred for EUS-FNA after their scans were included. Those who had contraindications to endoscopic procedures were excluded. RESULTS: The most common location of positive lymph nodes was the subcarinal region (46%). A definitive diagnosis was obtained in 87.8% cases, of which 51.2% had a diagnosis of malignancy confirmed on cytology, while 36.5% were benign. Out of these, 29% had granulomatous inflammation. In 12.2% of cases no definitive diagnosis was obtained. CONCLUSION: Our results show that great caution should be exercised when evaluating FDG-avid PET-CT nodes in patients with known malignant disease, as a significant proportion of these lesions may be benign, particularly in geographic locations with a high background prevalence of granulomatous inflammation.