Management Of Primary Cancer Research Articles

Outcome after curative resection for colorectal cancer liver metastasis in Sri Lanka

Introduction: Colorectal cancer is the third most common cancer globally and in Sri Lanka. The liver is the commonest site of metastasis, developing in 25%-30%. Surgical resection and ablation are the only curative options available.Objective: To determine the clinical characteristics and treatment outcome in patients with colorectal cancer liver metastases.Method: Details of 73 patients with colorectal cancer liver metastases referred between 2010 and 2022 were reviewed. Demographic data, presentation, management of primary cancer and liver metastases, surgical outcome, recurrence free survival and overall survival were analyzed retrospectively.Results: The median age was 60 years (31-82) with a female predominance (n=39; 53.4%). Primary located in the left colon in 90.4% (n=66), presenting synchronously in 61.6% (n=45). Right hemi-liver (n=60; 82.2%) is more commonly involved with the caudate lobe alone involved in 1.4% (n=1). Segment VI is the commonest liver segment involved (n=39; 53.4%). Liver resection was performed in 45 patients (61.6%). 25 (55.6%) were major resections, and 6 (13.3%) were staged resections. The surgery group had a median recurrence-free survival of 24 (range=9.19-38.8) months and overall survival of 31 (range=14.51-47.50) months. 28 Patients who were offered palliative treatment had a poor overall survival of 16 (range=12.23-19.77) months (p <0.05).Conclusion: Surgical resection was possible in 61.6% of patients giving superior survival outcomes.

201 Descriptive Case Series of Oncologic Brachial Plexopathy at a Comprehensive Cancer Center

INTRODUCTION: Primary compression or metastatic spread into the peripheral nervous system is an unfortunate sequela of solid-organ cancers and leads to serious pain and neurologic symptoms. Neoplastic brachial plexopathy is poorly understood and treatments vary based on systemic disease burden and symptoms. METHODS: After IRB approval, a systematic search of the medical record was conducted for patients with brachial plexopathy based on CPT from 2016 to 2020. Patients with direct neural infiltration and/or external compression by primary or metastatic tumor were included. Radiation-induced brachial plexopathy cases were excluded. Data were collected regarding demographics, primary cancer, symptoms, exam, pain management treatments, primary cancer management, and outcomes. RESULTS: A total of 15 patients were identified with either infiltrative or compressive brachial plexopathies. The most common primary cancer was breast. Other types included squamous cell carcinoma of the head and neck, renal cell carcinoma, cholangiocarcinoma, and prostate carcinoma. Patients presented with a diverse array of motor and sensory symptoms including proximal and distal upper extremity weakness, hand spasms, numbness and decreased sensation, paresthesia, and upper extremity swelling. The majority of included patients complained of pain of varying nature. Gabapentin, opioids, and pregabalin were the most common prescribed medications. Overall prognosis in patients with brachial plexus infiltration was poor and less than 1 year. There was little consensus on standardized treatment regimens and management for included patients with plexopathies. CONCLUSIONS: Neoplastic brachial plexopathy is a relatively uncommon, and perhaps underrecognized, pattern of metastatic disease or direct spread in solid organ malignancy and is often associated with severe symptoms and disability. This study highlights need for a multidisciplinary approach including medical oncology, neurosurgery, radiation medicine, pain management, and physical/occupational therapy.

Cysticercosis Infested Pectoralis Major Myocutaneous Flap Reconstruction: An Ethical Dilemma.

Disseminated cysticercosis is a rare manifestation of cysticercosis, a relatively common tropical disease in Asia, Africa and South America. Here the embryo of pork tapeworm Taenia Solium gets disseminated to multiple organs and tissues via hepatoportal system. we report here a 45year gentleman with stage IV oral malignancy who was incidentally found to have disseminated cysticercosis on pre-operative work up. Along with the management of primary cancer and new found asymptomatic disseminated cysticercosis, the ethical challenge was to choose an appropriate reconstructive option for the composite oral cavity resection defect, since all the skeletal muscles in body where studded with cysticercosis larvae. We couldn't find any such report in literature to resolve our dilemma. After surgical board discussion, we zeroed down to pedicled pectoralis major myocutaneous flap, the most versatile and workhorse flap for head and neck reconstruction. Eventually the patient underwent surgery and adjuvant radiotherapy without any delay. He was simultaneously treated with oral albendazole under steroid cover and remained complication free at 2years.

Implementing Guideline-Based, Experience-Based, and Case-Based Approaches to Enrich Decision Support for the Management of Breast Cancer Patients in the DESIREE Project.

DESIREE is a European-funded project to improve the management of primary breast cancer. We have developed three decision support systems (DSSs), a guideline-based, an experience-based, and a case-based DSSs, resp. GL-DSS, EXP-DSS, and CB-DSS, that operate simultaneously to offer an enriched multi-modal decision support to clinicians. A breast cancer knowledge model has been built to describe within a common ontology the data model and the termino-ontological knowledge used for representing breast cancer patient cases. It allows for rule-based and subsumption-based reasoning in the GL-DSS to provide best patient-centered reconciled care plans. It also allows for using semantic similarity in the retrieval algorithm implemented in the CB-DSS. Rainbow boxes are used to display patient cases similar to a given query patient. This innovative visualization technique translates the question of deciding the most appropriate treatment into a question of deciding the colour dominance among boxes.

Has the “paradigm shift” in the management of advanced ovarian, tubal and primary peritoneal cancer altered the locations of recurrence?

Has the “paradigm shift” in the management of advanced ovarian, tubal and primary peritoneal cancer altered the locations of recurrence?

A review of updated guidelines for radiotherapy for primary liver cancer

The treatment guidelines based on evidence-based medical evidence provide appropriate treatment strategies for clinical oncologists. Currently, many treatment guidelines for primary liver cancer have been published and updated by many organizations from different countries, including Barcelona Clinic Liver Cancer (BCLC), European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), American Association for the Study of Liver Diseases (AASLD), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), Korean Liver Cancer Study Group and National Cancer Center (KLCSG-NCC), and Chinese Society for Therapeutic Radiology and Oncology (CSTRO), Chinese Medical Association. Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment strategy. In this article, we review the current treatment guidelines and discuss the current status and future prospects of radiotherapy in the management of primary liver cancer. Key words: Liver neoplasms/radiotherapy; Consensus

Comparing the impact of melatonin and captopril on early effects of radiation on the heart tissue by studying glutathione, malondialdehyde, and lactate dehydrogenase enzyme activity in rats

Prevention of secondary malignancy while the patient is receiving radiotherapy for the management of primary cancer has been an enormous challenge for biological and medical safety. The aim of the study is to compare protective effects of melatonin and captopril on early effects of radiation on the heart tissue of rats. Forty-eight adult male Wistar rats weighing 180-220 g were used. The rats were divided into six groups and the rats were exposed to 8 Gy whole body dose from cobalt-60 sources. Thirty minutes prior to irradiation, six animals received melatonin (100 mg/kg body weight), and six animals received captopril (50 mg/kg body weight). All groups were sacrificed 10 days post-irradiation, and hearts were collected. Malondialdehyde (MDA), lactate dehydrogenase (LDH), and glutathione (GSH) were measured to evaluate cellular oxidative stress-induced injury. The biochemical data are presented as mean ± standard error of the mean, and the difference between the groups was analyzed using a two-way variance analysis. Treatment with captopril resulted in a significant increase in LDH and MDA, although the level of GSH was decreased ( P P

Expert consensus on standardization of the management of primary liver cancer

一、前言 原发性肝癌(PLC)是临床上最常见的恶性肿瘤之一,全球发病率逐年增长,已超过62.6万/年,居于恶性肿瘤的第5位;死亡接近60万/年,位居肿瘤相关死亡的第3位.PLC在我国高发,目前,我国患者数约占全球的55%;在肿瘤相关死亡中仅次于肺癌,位居第二.因此,肝癌严重威胁我国人民健康和生命。

Management of primary cancer of the floor of the mouth experience of the curie institute in Paris

Management of primary cancer of the floor of the mouth experience of the curie institute in Paris

Management of primary cancer of the mobile tongue experience of the foundation curie, in Paris

Management of primary cancer of the mobile tongue experience of the foundation curie, in Paris

Observations followingCorynebacterium parvum administration to patients with advanced malignancy.A phase I study

There has been increasing interest regarding the use of Corynebacterium parvum (CP) with other modalities in the management of primary cancer. Due to the paucity of specific information available relative to CP toxicity, a Phase I study was carried out in patients with advanced disease. The purpose of the investigation was not to evaluate the effect of CP on tumor growth. from 273 injections of CP in 40 patients it was observed that following intravenous (i.v.) infusion of CP: a) a febrile response and chills of considerable severity occured in almost all patients and did not appreciably diminish in intensity following repetitive administrations; b) nausea, vomiting, headache, and confusion were not infrequent; c) a "flu-like" syndrome lasting 24 to 48 hours occurred following almost all courses of CP; d) blood pressure elevations occurred on occasion and were related to the severity of other-side-effects; hyper- or hypo- tension was not a problem; e) ther were no anaphalactic reactions. Pretreatment with a single administration of 100 mg of hydrocortisone prior to CP infusion markedly and in some instances dramatically diminished the toxicity and made acceptable the use of i.v. CP on an outpatient basis. The use of i.v. CP in patients with cerebral metasteses may be hazardous. Subcutaneously administered CP resulted in a significant number of undesirable local reactions. Evaluation of delayed cutaneous hypersensitivity response, immunoglobulins, complement, and E- and EAC-rosette-forming cells during CP administration failed to demonstrate significant change from injection values. Results were similar whether hydrocortisone pretreatment was or was not employed. From the standpoint of toxicity it now seems appropriate to use i.v. CP, particularly following pretreatment with hydrocortisone, in a controlled clinical trial to evaluate its therapeutic effectiveness in the management of primary cancer.

Management of primary cancer of the breast. New considerations.

Management of primary cancer of the breast. New considerations.