Difference In Tumor Recurrence Rate Research Articles

Effect of preoperative colonoscopy combined with preservation of the right vein of the gastric omentum during radical resection of intestinal cancer on the efficacy and prognostic indicators of the procedure.

The aim of this study was to investigate the clinical value of preoperative colonoscopy combined with right gastroepiploic vein preservation (RGV) in radical resection of colorectal cancer for right colon cancer. A total of 120 patients with right colon cancer in our hospital from February 2019 to October 2021 were selected and randomly divided into study group (RGV preserved during operation) and control group (RGV not preserved during operation), with 60 cases in each group. Perioperative parameters, intestinal fatty acid binding protein (I-FABP), Pittsburgh Sleep Quality Index (PSQI), total protein (TP), D-lactate (D-LA), quality of life scale (SF-36) scores, incidence of complications, and tumor recurrence rate were compared between the two groups. Duration of hospitalization was shorter in the study group than in the control group (P<0.05). Six months after surgery, I-FABP, D-LA levels and PSQI scores were lower, and TP levels and SF-36 scores were higher in the study group than in the control group (P<0.05). The incidence of complications in the study group (11.67% vs. 33.33%) was lower than that in the control group (P<0.05). There was no significant difference in tumor recurrence rate 6 months after operation between the two groups (P>0.05). Preoperative colonoscopy combined with RGV preservation in radical resection of colorectal cancer for right colon cancer can avoid surgical trauma caused by unnecessary transection, reduce gastrointestinal function damage, promote physical rehabilitation and shorten hospital stay, and reduce the risk of complications such as gastroparesis.

Comparison of Clinical Outcome between Minimally Invasive and Open Hepatectomy at High Difficulty Score for Hepatocellular Carcinoma

Introduction: Minimally invasive (MIS) hepatectomy at high difficulty score for hepatocellular carcinoma (HCC) is controversial. Method: From 2004 to 2019, there were 338 patients (MIS group n = 35, open group n = 303) undergone hepatectomy at high difficulty score (score 7 – 10) for HCC. Propensity score (PS) matching was performed between two groups. Short-term and long-term outcomes were compared. Univariate and multivariate analyses was performed to identify prognostic factors affecting overall and disease-free survival. Results: After PS matching, there were 35 patients in MIS group and 70 patients in open group. Compared with open group, MIS group had less blood loss (150 mL vs. 360 mL), longer operative time (375 min vs. 250 min) and shorter hospital stay (6 days vs. 7 days). The R0 resection rate, hospital mortality, severe complication rate and hospital stay were similar between two groups. With a median follow-up of 24 months, there was no difference in tumor recurrence rate (MIS group: 25.7%; open group: 47.1%). There was no significant difference in 5-year overall survival rate between MIS and open groups (85.9% vs. 71.6%) (P = 0.083). The 5-year disease-free survival rate was also comparable between two groups (66.2% vs. 45.2%) (P = 0.199). Serum albumin, cirrhosis, intraoperative blood loss and postoperative complication, but not surgical approach (MIS vs. open), were associated with poor disease-free survival. Conclusions: MIS hepatectomy at high difficulty score for HCC can achieve similar clinical outcomes in selected patients as those with open approach.

PRISMA-Extracapsular Dissection Versus Superficial Parotidectomy in Treatment of Benign Parotid Tumors: Evidence From 3194 Patients.

Benign parotid tumor is one of the most common neoplasms in head and neck region. Its therapeutic methods have been debatable topics over the past 100 years. Recently, some surgeons suggest that extracapsular dissection (ECD) instead of superficial parotidectomy (SP) for treatment of benign parotid tumor. This study aimed to compare ECD with SP in the treatment of benign parotid tumors by a meta-analysis.We searched Cochrane Library, PubMed, Embase, Ovid, and Web of Science databases on February 14, 2015 for studies that assessed clinical outcomes of SP and ECD as surgical techniques for the management of benign parotid tumors. Outcome data were evaluated by pooled risk ratio (RR) and corresponding 95% confidence interval (CI).After serious scrutiny, a total of 14 cohort studies with 3194 patients were included in this meta-analysis. The pooled RR revealed that there were no significant difference in tumor recurrence rate between ECD and SP (fixed-effect model: RR = 0.71, 95% CI = 0.40–1.27, P = 0.249; random-effect model: RR = 0.67, 95% CI = 0.38–1.23, P = 0.197). However, there were significantly lower incidences of transient facial nerve dysfunction (FND), permanent FND, and Frey's syndrome in patients of ECD group compared with SP group.ECD might be a good choice in treatment of the benign parotid tumor that were mobile, small, located in superficial lobe and without adhesion to facial nerve; ECD should be performed by the experienced surgeons with ability of dissection facial nerve, who should perform SP if tumor is found adhere to facial nerve during an operation; and a multicenter randomized control trial study is necessary to decide the optimal treatment of benign parotid tumor.

Hexaminolevulinate-induced Fluorescence versus White Light During Transurethral Resection of Noninvasive Bladder Tumor: Does It Reduce Recurrences?

To evaluate the effect of hexaminolevulinate (HAL)-induced fluorescence during resection of noninvasive bladder cancer on tumor recurrence compared with resection under white light. Between 2008 and 2010, 102 consecutive patients with suspected bladder cancer were randomized to undergo transurethral resection with either conventional white light or combination of white light and HAL-induced fluorescence. Difference in tumor recurrence rate and recurrence-free survival between the 2 groups was evaluated. Subgroup analysis on recurrence-free survival was performed for different tumor parameters. Cystoscopy at 3 months revealed tumor recurrence in 6 of 45 (13.3%) patients of the white light group compared with only 1 of 41 patients of the HAL group (2.4%) (P < .001). The recurrence-free rates in white light patients at 12 and 18 months were 56.3% and 50.6%, respectively, compared with 91% and 82.5% in HAL patients (P = .0006). In subgroup analyses, recurrence-free survival was similar between the 2 groups when solitary tumors were treated (P = .3525). However, the HAL group had a favorable recurrence-free survival compared with the white light group when multifocal tumors (P < .001), primary tumors (P = .0237), recurrent tumors (P = .0189), nonaggressive (papillary urothelial neoplasm of low malignant potential and low grade) tumors (P = .0204), or aggressive (high grade and carcinoma in situ) tumors (P = .0134) were treated. HAL significantly aids resection of non-muscle-invasive bladder cancer with the result of reduction in tumor recurrence rates.

Association of Morbidity with Extent of Resection and Cavernous Sinus Invasion in Sphenoid Wing Meningiomas

Sphenoid wing meningiomas (SWMs) typically are histologically benign, insidious lesions, but the propensity of these tumors for local invasion makes disease control very challenging. In this review, we assess whether the degree of resection and extent of cavernous sinus invasion affects morbidity, mortality, and recurrence in patients with SWM. A comprehensive search of the English-language literature was performed. Patients were stratified according to extent of resection and extent of cavernous sinus invasion, and tumor recurrence rate, morbidity, and mortality were analyzed. A total of 23 studies and 131 patients were included. Overall recurrence and surgical mortality rate were 11% and 2%, respectively (average follow-up = 65 months). Cranial nerve III palsy was significantly associated with incompletely versus completely resected SWMs (7 to 0%) as well as meningiomas with cavernous sinus invasion versus no sinus invasion (14 vs. 0%). No significant difference in tumor recurrence rate was noted between these groups. In conclusion, complete excision of SWMs is always recommended whenever possible, but surgeons should acknowledge that there is nonetheless a chance of recurrence and should weigh this against the risk of causing cranial nerve injuries.

Unilateral salpingo-oophorectomy as fertility-sparing surgery for borderline ovarian tumors

Background To investigate recurrence rates and fertility outcomes of patients with borderline ovarian tumors (BOTs) treated with fertility-sparing surgery. Methods This was a retrospective study. All women with BOTs from 2000 to 2006 were evaluated. Clinical outcomes were compared among groups that underwent radical, unilateral salpingo-oophorectomy, or ovarian cystectomy. The effects of clinical characteristics on recurrence were analyzed by independent t test, chi-square test, and Cox proportional hazard model. Results After a mean follow-up period of 56.5 months, all 61 patients were alive. Seven (11.5%) had developed disease recurrence, and all were in the fertility-sparing group. Of these, five were in the cystectomy-only group and two in the unilateral salpingo-oophorectomy group. There was significant difference in tumor recurrence rates between the two groups (hazard ratio: 0.26, 95% confidence interval: 0.11–0.61). Nine pregnancies were achieved in six women, resulting in five deliveries Conclusion Fertility-sparing surgery is an acceptable and safe option for women with BOTs who wish to preserve fertility. Unilateral salpingo-oophorectomy must be considered as the first choice.

Gastric Cancer Surgery in Elderly Patients

To investigate the value of individual risk-adapted therapy in geriatric patients, we performed a consecutive analysis of 363 patients undergoing potentially curative surgery for gastric cancer. All patients underwent extensive preoperative workup to assess surgical risk. The following criteria were evaluated in 3 age groups (<60 years, 60-75 years, and >75 years): comorbidity, tumor characteristics, type of resection, postoperative morbidity and mortality, recurrence rate, overall survival, and disease-free survival. There was an increased rate of comorbidity in the higher age groups (51% vs 76% vs 83%; P<0.05). Cardiovascular and pulmonary diseases were most common. There was a decrease in the rate of both total gastrectomy (74%, 54%, 46%; P<0.05) and D2 lymphadenectomy (78%, 53%, 31%; P<0.05). The 30-day mortality in the 3 age groups was 0%, 1%, and 8%, respectively (P<0.05). There was only a slight difference in tumor recurrence rate (35%, 37%, and 27%; P=0.437), with no significant difference in 5-year cancer-related survival (61%, 53%, 61%; P=0.199). Patient selection and risk-adapted surgery in elderly patients can result in acceptable therapeutic results comparable to younger patients. Limited surgery in elderly gastric cancer patients with high comorbidity does not necessarily compromise oncological outcome.

Autologous bone marrow versus non-mobilized peripheral blood stem cell transplantation for lymphoid malignancies: A prospective, comparative trial

Autologous transplantation using bone marrow stem cells (BMSC) or peripheral blood stem cells (PBSC) is widely used for non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD). We report a randomized, comparative trial comparing BMSC vs. non-mobilized PBSC for responsive NHL or HD. Patients randomized to BMSC (n = 13) vs. PBSC (n = 15) had more rapid neutrophil recovery (median 23 vs. 30 days), RBC independence (25 vs. 62 days), platelet independence (24 vs. 54 days), and shorter hospital stay. However, neither relapse, overall survival, nor relapse-free survival were different receiving BMSC vs. PBSC (all P > .7). Concurrently, 54 others (34 BMSC, 20 PBSC) were assigned non-randomly because of resistant disease or marrow unsuitable for harvest and similar patterns of engraftment favoring BMSC over PBSC were observed. In the entire group, BMSC transplantation (n = 47) led to quicker neutrophil recovery (P = .02), RBC (P = .06), and platelet independence (P =.04) and earlier hospital discharge (P = .02) vs. PBSC (n = 35). No difference in relapse, overall, or relapse-free survival were observed using BMSC vs. PBSC. These data suggest that non-mobilized PBSC are a satisfactory alternative to BMSC in patients with unsuitable marrow; however, transplantation with non-mobilized PBSC was associated with slower hematologic recovery, and longer hospital stay. No difference in tumor recurrence rates was observed between the PBSC or BMSC recipients. Unprimed PBSC transplantation offered no clinical advantage to BMSC.

Tumor Cell Implantation Following Neodymium-YAG Bladder Injury: A Comparison to Electrocautery Injury

Recent clinical experience using the neodymium-YAG laser for the ablation of superficial bladder carcinoma seems to indicate a decreased local and second-site recurrence rate when compared to standard electrosurgical methods. Altered tumor cell implantation has been suggested as a mechanism explaining this phenomenon. The purpose of this study was to compare the effects of laser ablation and standard electrosurgical resection on tumor implantation.Each of three requisite steps in tumor cell implantation was assayed in an animal model system. The number of viable tumor cells liberated during ablation of a standardized lesion was 620% greater in the electrosurgically resected group compared to the laser irradiated group. No difference was observed in the qualitative or quantitative patterns of cellular adherence to a fulguration bladder injury compared to a laser bladder injury. The number of cells adhering to an injury site was shown to increase as a function of the cell concentration to which it was exposed. There was no difference between groups in occurrence of tumor at the injury site following exposure to an equal number of tumor cells.This study has demonstrated marked differences between electroresection and laser ablation in terms of the number of viable cells released during the course of tumor removal. This data, together with the absence of injury site differences, suggests it may play a role in the clinically observed differences in tumor recurrence rates.