• Title/Summary/Keyword: Cancer surgery

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Recent Advances in Sentinel Node Navigation Surgery for Early Gastric Cancer

  • Eisuke Booka;Hiroya Takeuchi
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.159-170
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    • 2023
  • Maintaining the postoperative quality of life (QOL) while ensuring curability without overtreatment is important in the treatment of early gastric cancer. Postoperative QOL is anticipated to be maintained through minimally invasive function-preserving gastrectomy in early gastric cancer. The concept of the sentinel lymph node (SN) basin is essential to maintain the curability of early gastric cancer using minimally invasive function-preserving gastrectomy. However, additional resection after surgery is difficult to perform in gastric cancer. Thus, the SN basin theory is important. Recently, a multicenter randomized phase III trial in South Korea (SENORITA trial) proved that laparoscopic sentinel node navigation surgery (LSNNS) for stomach preservation results in better postoperative QOL compared with standard gastrectomy in patients with early gastric cancer. LSNNS contributes to patients' QOL based on the concept that curability is not impaired. A multicenter nonrandomized phase III trial is ongoing in Japan, and oncologic safety is expected to be demonstrated. LSNNS has been established as a treatment option for selected patients with early gastric cancer, and its application will become widespread in the future.

Video-Assisted Thoracic Surgery Mediastinal Lymph Node Dissection in Lung Cancer Surgery

  • Kim, Kwhanmien
    • Journal of Chest Surgery
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    • v.54 no.4
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    • pp.258-262
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    • 2021
  • Mediastinal lymph node dissection is an important part of lung cancer surgery that provides accurate nodal staging and may improve survival outcomes. The minimally invasive approach, such as video-assisted thoracic surgery (VATS) lobectomy for patients with non-small cell lung cancer, has become a standard operation worldwide. VATS mediastinal lymph node dissection should be thorough and accurate to ensure the completeness of lung cancer surgery. Herein, the author describes techniques for VATS mediastinal lymph node dissection.

Five-year Survival Associated with Stage I Gastric Cancer after Resection of Early Recurrence at Nodal Station No. 14v: a Case Report

  • Abe, Iku;Kinoshita, Takahiro;Kaito, Akio;Sunagawa, Hideki;Watanabe, Masahiro;Sugita, Shizuki;Tonouchi, Akiko;Sato, Reo
    • Journal of Gastric Cancer
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    • v.17 no.2
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    • pp.186-191
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    • 2017
  • The role of nodal station No. 14v (along the superior mesenteric vein) in lymphadenectomy for distal gastric cancer remains elusive. A 73-year-old woman underwent endoscopic submucosal dissection for gastric cancer, and was referred to our division for additional surgery because of pathologically non-curative resection. A laparoscopic distal gastrectomy with D1+ dissection was performed, with a final diagnosis of pT1bN1M0, Stage IB (2 nodal metastases to No. 6). Four months post-surgery, abdominal computed tomography revealed a 14-mm solitary nodule along the superior mesenteric vein. The lesion was excised and pathologically identified as a lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for the metastasis. Presently the patient survives without recurrence, 5.5 years after the second operation. Our findings suggest that there is lymphatic flow from the No. 6 to the No. 14v nodal station. Some patients with a No. 6 metastasis may benefit from a No. 14v lymphadenectomy, even in early-staged disease.

Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer

  • Kunitomo, Aina;Misawa, Kazunari;Ito, Yuichi;Ito, Seiji;Higaki, Eiji;Natsume, Seiji;Kinoshita, Takashi;Abe, Tetsuya;Komori, Koji;Shimizu, Yasuhiro
    • Journal of Gastric Cancer
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    • v.21 no.4
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    • pp.392-402
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    • 2021
  • Purpose: Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC. Materials and Methods: The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node. Results: Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92. Conclusions: The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.

Down-regulation of miRNA-452 is Associated with Adriamycin-resistance in Breast Cancer Cells

  • Hu, Qing;Gong, Jian-Ping;Li, Jian;Zhong, Shan-Liang;Chen, Wei-Xian;Zhang, Jun-Ying;Ma, Teng-Fei;Ji, Hao;Lv, Meng-Meng;Zhao, Jian-Hua;Tang, Jin-Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5137-5142
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    • 2014
  • Adriamycin (ADR) is an important chemotherapeutic agent frequently used in treatment of breast cancer. However, resistance to ADR results in treatment failure in many patients. Recent studies have indicated that microRNAs (miRNAs) may play an important role in such drug-resistance. In the present study, microRNA-452 (miR-452) was found to be significantly down-regulated in adriamycin-resistant MCF-7 cells (MCF-7/ADR) compared with the parental MCF-7 cells by miRNA microarray and real-time quantitative PCR (RT-qPCR). MiR-452 mimics and inhibitors partially changed the adriamycin-resistance of breast cancer cells, as also confirmed by apoptosis assay. In exploring the potential mechanisms of miR-452 in the adriamycin-resistance of breast cancer cells, bioinformatics analysis, RT-qPCR and Western blotting showed that dysregulation of miR-452 played an important role in the acquired adriamycin-resistance of breast cancer, maybe at least in part via targeting insulin-like growth factor-1 receptor (IGF-1R).

Effects of Surgery Volume on In Hospital Mortality of Cancer Patients in General Hospitals (종합병원 암 종별 수술량이 병원 내 사망에 미치는 영향)

  • Youn, Kyung-Il
    • Health Policy and Management
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    • v.24 no.3
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    • pp.271-282
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    • 2014
  • Background: Although the mortality rate in cancers has been decreased recently, it is still one of the leading causes of death in most of the countries. This study analyzed the relationship between surgery volume and in hospital mortality of cancer patients. The purpose of this study is to investigate the relationship in Korean healthcare environment and to provide information for the policy development in reducing cancer mortality. Methods: The study sample was the 20,517 cancer patients who underwent surgery and discharged during a month period between 2008-2011. The data were collected in Patient Survey by Korean Institute of Social Affairs. Logistic regression was used to analyse a comprehensive analytic model that includes a binary dependent variable indicating death discharge and independent variables such as surgery volume, organizational characteristics of hospitals, socio-economical characteristics of the patients, and severity of disease indicators. Results: In chi-square test, as the surgery volume increases, the in-hospitals mortality showed a downward trends. In regression analysis, the relationship between surgery volume and mortality showed significant negative associations in all types of cancer except for pancreatic cancer. Conclusion: In the absence of other information patients undergoing cancer surgery can reduce their risk of operative death by selecting a high-volume hospital. Therefore, policies to enhance centralization of cancer surgery services should be considered.

Survey of Suitable Clothes for Breast Cancer Patients -Changes in Clothing Habits Before and After Surgery- (유방암 절제 수술을 받은 여성의 의복 설계를 위한 의생활 조사 -수술 전과 후의 의생활 변화에 대하여-)

  • Oh, Hee Kyoung
    • Journal of the Korean Society of Clothing and Textiles
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    • v.40 no.3
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    • pp.526-538
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    • 2016
  • Breast cancer surgery result in changes in clothing style due to changes in the size of the breast as well as body shape. This study provides basic data as a fashion therapy to improve the quality of life for breast cancer patients who have to change clothing habits after surgery. The regression results found that the most important factor are pain and the amount of breast loss for clothes style changes after breast cancer surgery. Breast cancer patients suffer pain relative to the proximity to the date of surgery and regardless of the breast cancer resection range. However, the changes in clothes style relates to the amount of pain and breast reduction range. The t-test results on the change of the clothing styles for before and after breast cancer surgery showed that women significantly prefer comfortable clothes with sleeves and consider a closure style on clothes to put on and take off instead of clothes that are tight-fitting, have thin fabric or deep neck lines. Painful breast cancer results in women who prefer closure style on clothes, front closure clothes and garments that hide body shape. However, the larger reduction range of breast cancer patients and those with painful breast cancer prefer garments that hide body shape and are looser size clothes with sleeves.

Expression of Intercellular Adhesion Molecule-1 and E-Selectin in Gastric Cancer and Their Clinical Significance

  • Jung, Woo-Chul;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Kim, Seung-Joo;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.12 no.3
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    • pp.140-148
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    • 2012
  • Purpose: Among cell adhesion molecules, serum levels of intercellular adhesion molecule-1 and E-selectin are known to be correlated with the metastatic potential of gastric cancer. In the present study, the authors investigated the expression of intercellular adhesion molecule-1 and E-selectin in gastric cancer tissues and cultured gastric cancer cells, and examined their clinical value in gastric cancer. Materials and Methods: The protein was extracted from gastric cancer tissues and cultured gastric cancer cells (MKN-28 and Kato-III) and the expression of intercellular adhesion molecule-1 and E-selectin was examined by western blotting. The clinical significance of intercellular adhesion molecule-1 and E-selectin was explored, using immunohistochemical staining of specimens from 157 gastric cancer patients. Results: In western blot analysis, the expressions of intercellular adhesion molecule-1 in gastric cancer tissues and cultured gastric cancer cells were increased, however, E-selectin in gastric cancer tissues and cells were not increased. Among 157 gastric cancer patients, 79 patients (50%) were intercellular adhesion molecule-1 positive and had larger tumor size, an increased depth of tumor invasion, lymph node metastasis and perineural invasion. The intercellular adhesion molecule-1 positive group showed a higher incidence of tumor recurrence (40.5%), and a poorer 3-year survival than the negative group (54.9 vs. 85.9%, respectively). Conclusions: Intercellular adhesion molecule-1 is overexpressed in gastric cancer tissues and cultured gastric cancer cells, whereas E-selectin is not overexpressed. Increased expression of intercellular adhesion molecule-1 in gastric cancer could be related to the aggressive nature of the tumor, and has a poor prognostic effect on gastric cancer.

Gastric Adenocarcinoma of Fundic Gland Type with Aggressive Transformation and Lymph Node Metastasis: a Case Report

  • Okumura, Yasuhiro;Takamatsu, Manabu;Ohashi, Manabu;Yamamoto, Yorimasa;Yamamoto, Noriko;Kawachi, Hiroshi;Ida, Satoshi;Kumagai, Koshi;Nunobe, Souya;Hiki, Naoki;Sano, Takeshi
    • Journal of Gastric Cancer
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    • v.18 no.4
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    • pp.409-416
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    • 2018
  • A 55-year-old man visited our hospital for a detailed examination of a gastric submucosal tumor that was first detected 10 years prior. The tumor continued to grow and had developed a depressed area in its center. A histopathological examination of biopsy specimens revealed gastric adenocarcinoma of the fundic gland type (GA-FG). It was diagnosed as T2 based on the invasion depth as determined by white-light endoscopy and endoscopic ultrasonography. A total gastrectomy with lymphadenectomy was performed and a GA-FG in the mucosa and submucosa was confirmed histopathologically. However, there was a gradual transition to an infiltrative tubular adenocarcinoma with poorly differentiated components in the muscular and subserosal layers. Metastasis was identified in a dissected lymph node (LN). This is the first report of a GA-FG progressing to an aggressive cancer with LN metastasis. These findings modify our understanding of the pathophysiology of GA-FG.