Academic literature on the topic 'Cancerous deposit'
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Journal articles on the topic "Cancerous deposit"
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Rusin, Matthew, Nardine Ghobrial, Endre Takacs, Jeffrey S. Willey, and Delphine Dean. "Changes in ionizing radiation dose rate affect cell cycle progression in adipose derived stem cells." PLOS ONE 16, no. 4 (April 27, 2021): e0250160. http://dx.doi.org/10.1371/journal.pone.0250160.
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Biomedical use of radiation is utilized in effective diagnostic and treatment tools, yet can introduce risks to healthy tissues. High energy photons used for diagnostic purposes have high penetration depth and can discriminate multiple tissues based on attenuation properties of different materials. Likewise, the ability to deposit energy at various targets within tumors make the use of photons effective treatment for cancer. Radiation focused on a tumor will deposit energy when it interacts with a biological structure (e.g. DNA), which will result in cell kill should repair capacity of the tissue be overwhelmed. Likewise, damage to normal, non-cancerous tissues is a consequence of radiation that can lead to acute or late, chronic toxicity profiles. Adipose derived stem cells (ADSCs) are mesenchymal stem cells that have been proven to have similar characteristics to bone marrow derived stem cells, except that they are much easier to obtain. Within the body, ADSCs act as immunomodulators and assist with the maintenance and repair of tissues. They have been shown to have excellent differentiation capability, making them an extremely viable option for stem cell therapies and regenerative medicine applications. Due to the tissue ADSCs are derived from, they are highly likely to be affected by radiation therapy, especially when treating tumors localized to structures with relatively high ADSC content (eg., breast cancer). For this reason, the purpose behind this research is to better understand how ADSCs are affected by doses of radiation comparable to a single fraction of radiation therapy. We also measured the response of ADSCs to exposure at different dose rates to determine if there is a significant difference in the response of ADSCs to radiation therapy relevant doses of ionizing radiation. Our findings indicate that ADSCs exposed to Cesium (Cs 137)-gamma rays at a moderate dose of 2Gy and either a low dose rate (1.40Gy/min) or a high dose rate (7.31Gy/min) slow proliferation rate, and with cell cycle arrest in some populations. These responses ADSCs were not as marked as previously measured in other stem cell types. In addition, our results indicate that differences in dose rate in the Gy/min range typically utilized in small animal or cell irradiation platforms have a minimal effect on the function of ADSCs. The potential ADSCs have in the space of regenerative medicine makes them an ideal candidate for study with ionizing radiation, as they are one of the main cell types to promote tissue healing.
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Chavali, Laxmi B., Adana A. M. Llanos, Jing-Ping Yun, Stephanie M. Hill, Xiang-Lin Tan, and Lanjing Zhang. "Radiotherapy for Patients With Resected Tumor Deposit–Positive Colorectal Cancer: A Surveillance, Epidemiology, and End Results–Based Population Study." Archives of Pathology & Laboratory Medicine 142, no. 6 (October 19, 2017): 721–29. http://dx.doi.org/10.5858/arpa.2017-0099-oa.
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Context.— According to the American Joint Committee on Cancer's Cancer Staging Manual, 7th edition, TNM classification, tumor deposit (TD)–positive colorectal cancers (CRCs) are classified as N1c. The effects of radiotherapy and the effects of the updated American Joint Committee on Cancer 7th edition TNM N1c classification for patients with TD-positive CRC are unclear. Objective.— To investigate outcomes of radiotherapy in patients with resected TD-positive CRC. Design.— Resected TD-positive CRCs diagnosed from 2010 to 2014 were identified in the Surveillance, Epidemiology, and End Results 18 database. Factors associated with overall survival (OS) and cancer-specific survival (CSS) were investigated using Kaplan-Meier and Cox proportional hazards models. Results.— We included 2712 qualified CRC patients, who either underwent adjuvant radiotherapy (n = 187; 6.9%) or received no radiotherapy (n = 2525; 93.1%). Univariate Cox proportional models showed improved CSS among all CRC patients who underwent adjuvant radiotherapy (CSS hazard ratio, 0.73; 95% CI, 0.57–0.95) and among rectal cancer patients when separated by location (hazard ratio, 0.57; 95% CI, 0.40–0.83), although these associations were attenuated in multivariable-adjusted models. There was improved OS among rectal cancer patients (hazard ratio, 0.77; 95% CI, 0.59–0.99). In subgroup analyses, radiotherapy was not associated with OS or CSS in either metastatic or nonmetastatic CRC patients. Instead, N1c category (versus N0) was associated with a worse OS (hazard ratio, 1.43; 95% CI, 1.31–1.57) but was not associated with CSS. Conclusions.— Radiotherapy did not independently improve OS among TD-positive CRC patients. In this study, classifying TD positivity as N1c was associated with worse OS than classifying TD positivity as N0. The findings seem to challenge the benefits of radiotherapy and the new N1c classification of TD for TD-positive CRC patients.
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Win, Aung Zaw, and Carina Mari Aparici. "Omental Nodular Deposits of Recurrent Chromophobe Renal Cell Carcinoma Seen on FDG-PET/CT." Journal of Clinical Imaging Science 4 (September 23, 2014): 51. http://dx.doi.org/10.4103/2156-7514.141560.
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We present the case of a 69-year-old male with chromophobe renal cell carcinoma (RCC). Chromophobe RCC accounts for only 4% of renal cancers and it is the least aggressive type. Omental nodular deposits due to RCC metastasis are very rare and it is reported only in more aggressive forms of RCC. This is the first report that shows FluoroDeoxyGlucose – Positron Emission Tomography/Computed Tomgraphy (FDG-PET/CT) images of omental nodular deposits from chromophobe RCC. FDG-PET/CT is becoming very useful in restaging RCC with distant metastases.
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Kozlovskaya, L. V., V. V. Rameev, I. N. Kogarko, N. B. Gordovskaya, N. V. Chebotareva, T. V. Androsova, S. V. Roshchupkina, et al. "Renal lesions associated with monoclonal gammopathies of undetermined significance: clinical forms, mechanisms of development, approaches to treatment." Clinical Medicine (Russian Journal) 94, no. 12 (February 19, 2017): 892–901. http://dx.doi.org/10.18821/0023-2149-2016-94-12-892-901.
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The term «monoclonal gammopathies of undetermined significance» (MGUS) was introduced by R. Kyle in 1978 to designate the condition characterized by the presence ofsmall amounts ofM-protein in the serum. In some patients, such condition remains benign for a long time but predetermines for the development of multiple myeloma and other B-lymphocytic tumours. Also, it can provoke non-cancerous diseases due to the toxic action of monoclonal proteins (immunoglobulins and free light chains) on various organs, especially kidneys. MGUS-associated renal lesions include glomerulopathies with organized deposits, such as AL-amyloidosis (amyloid light chain of immunoglobulin), cryoglobulinic and immunotactoid glomerulonephritis, and with unorganized deposits (light chain deposition and proliferative forms of idiopathic glomerulonephritis. The available experimental data throw light on the possible mechanisms of renal lesions. We summarized the literature data and original observations to describe methods for differential diagnostics of MGUS-associated renal lesions including the highly sensitive test for free light chine identification (Freelite method) and principles of pathogenetic treatment by the impact on the pathological B-cell clone.
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Malik, Akshat, and Sudhir Nair. "Reply to Letter to the Editor regarding “Soft tissue deposits in oral cancers”." Head & Neck 42, no. 11 (August 13, 2020): 3467–68. http://dx.doi.org/10.1002/hed.26412.
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Meesat, Ridthee, Hakim Belmouaddine, Jean-François Allard, Catherine Tanguay-Renaud, Rosalie Lemay, Tiberius Brastaviceanu, Luc Tremblay, et al. "Cancer radiotherapy based on femtosecond IR laser-beam filamentation yielding ultra-high dose rates and zero entrance dose." Proceedings of the National Academy of Sciences 109, no. 38 (August 27, 2012): E2508—E2513. http://dx.doi.org/10.1073/pnas.1116286109.
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Since the invention of cancer radiotherapy, its primary goal has been to maximize lethal radiation doses to the tumor volume while keeping the dose to surrounding healthy tissues at zero. Sadly, conventional radiation sources (γ or X rays, electrons) used for decades, including multiple or modulated beams, inevitably deposit the majority of their dose in front or behind the tumor, thus damaging healthy tissue and causing secondary cancers years after treatment. Even the most recent pioneering advances in costly proton or carbon ion therapies can not completely avoid dose buildup in front of the tumor volume. Here we show that this ultimate goal of radiotherapy is yet within our reach: Using intense ultra-short infrared laser pulses we can now deposit a very large energy dose at unprecedented microscopic dose rates (up to 1011 Gy/s) deep inside an adjustable, well-controlled macroscopic volume, without any dose deposit in front or behind the target volume. Our infrared laser pulses produce high density avalanches of low energy electrons via laser filamentation, a phenomenon that results in a spatial energy density and temporal dose rate that both exceed by orders of magnitude any values previously reported even for the most intense clinical radiotherapy systems. Moreover, we show that (i) the type of final damage and its mechanisms in aqueous media, at the molecular and biomolecular level, is comparable to that of conventional ionizing radiation, and (ii) at the tumor tissue level in an animal cancer model, the laser irradiation method shows clear therapeutic benefits.
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Udugama, Maheshi, Elaine Sanij, Hsiao P. J. Voon, Jinbae Son, Linda Hii, Jeremy D. Henson, F. Lyn Chan, et al. "Ribosomal DNA copy loss and repeat instability in ATRX-mutated cancers." Proceedings of the National Academy of Sciences 115, no. 18 (April 18, 2018): 4737–42. http://dx.doi.org/10.1073/pnas.1720391115.
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ATRX (alpha thalassemia/mental retardation X-linked) complexes with DAXX to deposit histone variant H3.3 into repetitive heterochromatin. Recent genome sequencing studies in cancers have revealed mutations in ATRX and their association with ALT (alternative lengthening of telomeres) activation. Here we report depletion of ATRX in mouse ES cells leads to selective loss in ribosomal RNA gene (rDNA) copy number. Supporting this, ATRX-mutated human ALT-positive tumors also show a substantially lower rDNA copy than ALT-negative tumors. Further investigation shows that the rDNA copy loss and repeat instability are caused by a disruption in H3.3 deposition and thus a failure in heterochromatin formation at rDNA repeats in the absence of ATRX. We also find that ATRX-depleted cells are reduced in ribosomal RNA transcription output and show increased sensitivity to RNA polymerase I (Pol I) transcription inhibitor CX5461. In addition, human ALT-positive cancer cell lines are also more sensitive to CX5461 treatment. Our study provides insights into the contribution of ATRX loss of function to tumorigenesis through the loss of rDNA stability and suggests the therapeutic potential of targeting Pol I transcription in ALT cancers.
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Nambiar, Sudheer, and Asha Karippot. "Multiple Cutaneous Metastases as Initial Presentation in Advanced Colon Cancer." Case Reports in Gastrointestinal Medicine 2018 (2018): 1–3. http://dx.doi.org/10.1155/2018/8032905.
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Skin metastases from advanced colorectal cancer are relatively rare and occur most often when the cancer is advanced, following the spread to other organs. Cutaneous metastases occur in about 3% of advanced colorectal cancers. We present an extremely rare case of a 68-year-old woman with advanced ascending colon adenocarcinoma that presented with multiple rapidly progressing painless cutaneous metastatic lesions with no other distant metastases. Of all the tumors, breast cancer most commonly spreads as cutaneous metastasis is followed by lung, colorectal, renal, ovarian, and bladder cancers. Cutaneous metastases can present in a variety of clinical manifestations, such as a rapidly growing painless dermal or subcutaneous nodule with intact overlying epidermis or as ulcers. In cases where the cutaneous deposit is isolated, as in visceral metastasis, there is a role for radical management such as wide local excision and reconstruction. In our patient, since she had multiple cutaneous metastases she began treatment with palliative systemic combination chemotherapy.
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Raldow, Ann, James Lamb, and Theodore Hong. "Proton beam therapy for tumors of the upper abdomen." British Journal of Radiology 93, no. 1107 (March 2020): 20190226. http://dx.doi.org/10.1259/bjr.20190226.
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Proton radiotherapy has clear dosimetric advantages over photon radiotherapy. In contrast to photons, which are absorbed exponentially, protons have a finite range dependent on the initial proton energy. Protons therefore do not deposit dose beyond the tumor, resulting in great conformality, and offers the promise of dose escalation to increase tumor control while minimizing toxicity. In this review, we discuss the rationale for using proton radiotherapy in the treatment of upper abdominal tumors—hepatocellular carcinomas, cholangiocarcinomas and pancreatic cancers. We also review the clinical outcomes and technical challenges of using proton radiotherapy for the treatment of these malignancies. Finally, we discuss the ongoing clinical trials implementing proton radiotherapy for the treatment of primary liver and pancreatic tumors.
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Al-Bahlani, Shadia, Buthaina Al-Dhahli, Kawther Al-Adawi, Abdurahman Al-Nabhani, and Mohamed Al-Kindi. "Platinum-Based Drugs Differentially Affect the Ultrastructure of Breast Cancer Cell Types." BioMed Research International 2017 (2017): 1–13. http://dx.doi.org/10.1155/2017/3178794.
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Breast cancer (BC) is the most common cause of cancer-related death worldwide. Although platinum-based drugs (PBDs) are effective anticancer agents, responsive patients eventually become resistant. While resistance of some cancers to PBDs has been explored, the cellular responses of BC cells are not studied yet. Therefore, we aim to assess the differential effects of PBDs on BC ultrastructure. Three representative cells were treated with different concentrations and timing of Cisplatin, Carboplatin, and Oxaliplatin. Changes on cell surface and ultrastructure were detected by scanning (SEM) and transmission electron microscope (TEM). In SEM, control cells were semiflattened containing microvilli with extending lamellipodia while treated ones were round with irregular surface and several pores, indicating drug entry. Prolonged treatment resembled distinct apoptotic features such as shrinkage, membrane blebs, and narrowing of lamellipodia with blunt microvilli. TEM detected PBDs’ deposits that scattered among cellular organelles inducing structural distortion, lumen swelling, chromatin condensation, and nuclear fragmentation. Deposits were attracted to fat droplets, explained by drug hydrophobic properties, while later they were located close to cell membrane, suggesting drug efflux. Phagosomes with destructed organelles and deposits were detected as defending mechanism. Understanding BC cells response to PBDs might provide new insight for an effective treatment.
Dissertations / Theses on the topic "Cancerous deposit"
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Descôteaux, Caroline. "Développement de nouveaux composés anticancéreux pour le traitement des cancers féminins." Thèse, Université du Québec à Trois-Rivières, 2013. http://depot-e.uqtr.ca/6720/1/030492752.pdf.
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Déry, Marie-Claude. "Caractérisation d'une nouvelle lignée du cancer endométrial et l'implication de l'ocytocine dans l'invasion des cancers endométriaux." Thèse, Université du Québec à Trois-Rivières, 2013. http://depot-e.uqtr.ca/6719/1/030492762.pdf.
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Bélanger, Geoffroy. "Évaluation biologique de nouveaux composés de type hybride oestrogène-cisplatine pour le traitement des cancers du sein, de l'ovaire et de l'utérus." Thèse, Université du Québec à Trois-Rivières, 2008. http://depot-e.uqtr.ca/1435/1/030083695.pdf.
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Brasseur, Kevin. "Chimiorésistance et nouvelles cibles thérapeutiques au niveau des cancers gynécologiques." Thèse, 2017. http://depot-e.uqtr.ca/8020/1/031624511.pdf.
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Joncas, France-Hélène. "Localisation intracellulaire des isoformes d'Akt dans la chimiorésistance des cancers gynécologiques." Thèse, 2017. http://depot-e.uqtr.ca/8195/1/031872949.pdf.
Full textBooks on the topic "Cancerous deposit"
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Cattran, Daniel C., and Heather N. Reich. Membranous glomerulonephritis. Edited by Neil Turner. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0061_update_001.
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Membranous glomerulonephritis (MGN) usually presents as nephrotic syndrome, which may be severe. It is primarily a disease of adults, men more than women, with a peak incidence in the fourth and fifth decades. It is hoped that proven tests for the characteristic anti-PLA2R antibodies of primary MGN may become established, but the diagnosis currently rests on renal biopsy showing characteristic subepithelial granular immune deposits. These usually contain immunoglobulin G4 and complement. Other patterns may suggest secondary causes of MGN. Secondary membranous nephropathy occurs in lupus and some other immune or autoimmune disorders, in hepatitis B infection, after exposure to some drugs or toxins, and in some cancers. Secondary causes are more common at extremes of age, and are often made obvious by the history or clinical picture. How hard to look for malignancy is controversial, but malignancy is much more likely in patients over 60 years, and may be apparent at presentation.
Conference papers on the topic "Cancerous deposit"
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Arendt, Paul D., Wei Chen, and Wing Kam Liu. "Simulation of the Diffusion of Doxorubicin (DOX) in Polymer Pores for a Multiscale Nanodiamond Based Drug Delivery System." In ASME 2010 First Global Congress on NanoEngineering for Medicine and Biology. ASMEDC, 2010. http://dx.doi.org/10.1115/nemb2010-13209.
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A drug delivery system utilizing nanodiamonds has been proposed for the controlled release of the chemotherapeutic doxorubicin (DOX) [1,2]. The drug delivery system consists of a patch which is envisioned to be implanted immediately after a tumor removal surgery to target residual cancerous cells such that tumor reoccurrence can be effectively prevented. Therefore, long release times are desired for the patch to prevent any new cancerous tissue from forming. The patch is to be assembled in three different layers beginning with a bottom layer comprised of nonporous parylene. A layer of DOX loaded nanodimonds is deposited onto the base layer. Then a porous layer of parylene is accumulated on top of the nanodimonds. Nanodimonds are utilized because their release rates are based on pH, which changes near cancerous cells. Due to the complexity of the drug delivery system, models are created at several different scales.
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Sztejnberg, Manuel L., and Tatjana Jevremovic. "Advanced Application of BNCT in Advanced Cancers." In 17th International Conference on Nuclear Engineering. ASMEDC, 2009. http://dx.doi.org/10.1115/icone17-75906.
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We present a new concept of one form of radiation binary targeted therapy that may offer hope for the often fatal relapsed and/or metastasized HER2+ cancers. The idea is to deliver boronated (boron-10 isotope) anti-HER2 monoclonal antibodies (mAbs) to the patient to be deposited preferentially into the tumor followed by one session of a low energy neutron irradiation. Based on actual computed tomography data, we present the comprehensive theoretical (numerical) modeling of the new approach in designing the treatment conditions for the boron neutron capture therapy (BNCT) using the MITRII-FCB neutron beam facility. The results show the effectiveness of the proposed treatment option for the advanced breast cancers and the metastasized breast cancers in the lungs of a patient. Our theoretical analysis concludes that with a boron concentration of ∼316 μg/g in tumor and a tumor-to-healthy tissue boron concentration ratio of 35:1, this new BNCT breast cancer treatment can be performed with very low doses to normal tissue and 50 Gy, or higher, doses delivered to the tumor regions. In particular, when applied to the breast cancer treatment, the resulting doses to skin and lung remain under the tolerance dose values. We also went beyond the traditional application of the BNCT and analyzed its applicability in targeting the metastasized breast cancer; using the same theoretical approach we determined the doses delivered into the patient lung with scattered cancer loci.
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Ryans, Jason, Bennett Welch, Sinjae Hyun, Zhe Zhang, and Clement Kleinstreuer. "Variations in Tracheobronchial Airway Morphology for Different Age Groups." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19452.
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Knowledge of the geometric characteristics of actual human tracheobronchial (TB) airways is crucial for realistic and accurate computer simulations and experimental studies. An area of particular interest is drug delivery in the respiratory system to combat various diseases, such as COPD/asthma, diabetes and certain cancers. Deposition in the upper TB region is significant because it may be related to clearance of deposited particulate matters (PM) [1] and drug-aerosol treatment for upper airway asthma such as bronchodilators and corticosteroids [2,3]. The air flow characteristics, which affect particle deposition in the lung, depend strongly upon the morphology of the respiratory system and the breathing pattern of the subject. Therefore, an accurate understanding of the lung airway morphology is a crucial first step for an accurate analysis of inhaled particle trajectories as well as local and regional deposition of PM due to the irregular and asymmetric branching pattern [4]. In this paper, the age group variations of TB morphology are evaluated using lung airway morphology data from the literature and PET/CT images of two adolescents, 4 adults, and 4 seniors.
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Silva, Lincoln, Giomar Oliveira, Tiago Borchartt, Roger Resmini, Alair Santos, Cristina Fontes, Débora Muchaluat-Saade, and Aura Conci. "Uma Análise Híbrida para Identificação de Câncer de Mama usando Sinais Térmicos." In ncipais do Simpósio Brasileiro de Computação Aplicada à Saúde. Sociedade Brasileira de Computação - SBC, 2015. http://dx.doi.org/10.5753/sbcas.2015.10367.
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Câncer de mama é o segundo tipo de câncer mais comum no mundo. Atualmente não existem métodos efetivos para prevenir esta doença. Porém, o diagnóstico e o tratamento em estágios iniciais aumentam as chances de cura. Depois de ser constatado que a temperatura de tecidos cancerosos é geralmente mais alta do que a de tecidos vizinhos saudáveis, a termografia passou a ser uma opção a ser considerada em estratégias para identificar esse tipo de câncer. Este artigo propõe um método híbrido de análise de Termografia Infravermelha Dinâmica com o objetivo de identificar pacientes com câncer de mama. Imagens desta modalidade de exame são processadas a fim de gerar sinais térmicos de ambas as mamas. Tais sinais são analisados por técnicas de aprendizagem de máquina supervisionada e não supervisionada. Na fase de testes, cinco modelos de classificação foram gerados, usando redes Bayesianas, redes neurais, tabelas de decisão, bagging e florestas randômicas. Os resultados dos testes mostraram que o método apresentado neste artigo é capaz de identificar pacientes com câncer de mama como também mostraram que redes Bayesianas é a melhor técnica de aprendizagem, pois apresentou acurácia de 100%. Além disso, foi obtida uma acurácia média de 93,63% entre todos os modelos de classificação testados.
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Gupta, Vivek, Amita Mishra, Namit Kalra, and Bhawna Narula. "A rare case report of incidental solitary uterine metastasis in primary invasive lobular carcinoma of breast." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685401.
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Introduction: Infiltrating Lobular carcinoma (ILC) of the breast is second most common cancer of breast next only to Infiltrating ductal carcinoma (IDC). It has a different metastatic pattern as compared to the IDC. Breast cancer is the most frequent primary site which spreads to gynaecologic organs. Case Presentation: A 40 yrs old Iraqi lady presented as a diagnosed case of lobular carcinoma of left breast. She had already undergone a lumpectomy at Iraq a month back and now had come for completion of treatment. On metastatic workup with PETCT scan, we found a multicentric residual disease in the left breast along with some ipsilateral axillary LN with significant uptake. The concurrent CECT done showed a uterine leiomyomam also. As she was strongly hormone receptor positive, had completed her family and was having mennorhagia probably attributable to uterine fibroids. She was offered hysterectomy with B/L salpingo-oophorectomy. She was keen for breast preservation but in view of her multicentricity of disease on the left breast she was counselled for mastectomy with upfront whole breast reconstruction with TRAM flap. She underwent left modified radical mastectomy with hysterectomy with BSO and TRAM flap reconstruction. The histopathological examination revealed a multicentric, multifocal ILC, grade II with heavy nodal involvement including extracapsular extension. The leiomyoma of uterus also showed tumor deposits from lobular carcinoma breast. Conclusion: We report a very rare case of metastatic pattern of carcinoma of breast. On literature review we found that it is common for the lobular carcinomas of breast to metastasise to gynaecologic organs. Uterine corpus is a very rare site of metastasis for extragenital cancers including breast. All the patients of primary lobular carcinoma of breast should be screened for gynaecologic secondaries in the preoperative workup with high degree of suspicion.
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Giri, Shveta, Swati Shah, Rupinder Sekhon, and Sudhir Rawal. "Clinical outcomes of cytoreductive surgery and HIPEC in advanced and recurrent epithelial ovarian cancers with peritoneal carcinomatosis." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685311.
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Introduction: The role of surgery for Peritoneal carcinomatosis (PC) has slowly evolved from palliation to potential curative intent. Attempting to remove all visible tumor deposits, “surgical cytoreduction” (CRS) was reported in 1930s for ovarian cancer and eventually became an accepted therapy with proven survival benefit. The new approach of combining CRS and Hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal metastasis offer hope for long term survival in this group of patients. The risk and benefit of this approach continued to be debated. A prospective study was conducted to understand the perioperative outcomes of CRS & HIPEC. Aim: To evaluate the perioperative outcomes associated with CRS & HIPEC in Advanced and Recurrent Epithelial Ovarian Cancer with PC. Methods: Prospective analysis of patients undergoing CRS & HIPEC from November 2014 to July 2015 was done. Inclusion criteria included localized disease in peritoneal cavity, no distant metastasis and PS <2. Grade 3/4 complications from day of surgery until 30 days postoperatively were recorded. Results: We performed CRS & HIPEC in 20 patients from Nov 2014 to June 2015. HIPEC Plus regimens included Cisplatin (50 mg/m2) and Lipodox (15 mg/m2) intraperitoneally and Ifosphamide (1300 mg/m2) & Mesna (260 mg/m2) Infusion time was 90 minutes with a temperature range of 41-43 °C. Out of 20 patients 6 (30%) underwent primary debulking surgery and 14(70%) underwent secondary debulking surgery. PCI score ranged from 2-26 (mean 13.65). Mean operating time was 6.42 hrs and average blood loss was 1046 ml. Average hospital stay was 8 days and SICU stay was 4.9 days (range 3-14 days). Total 26 adverse events were observed of which grade 1 were 11 (42%), grade 2 were 8 (30%), grade were 3 (11.5%) and grade4 were 2 (8%). Most common complication was hematological (8) followed by respiratory (6), sepsis (4) renal (2), GI (2). 4 patients (5 events) developed grade3 or 4 complications in the form of septicaemia, pulmonary embolism, GI fistula of which 2 patients expited and remaining recovered although required prolonged hospitalization. Increased morbidity were observed in cases with symptomatic relapse, higher PCI score and CA 125 level higher than 250 U/ml. Most of the adverse events were grade 1 and 2 and were managed by observation only or GCSF support, transfusions and other minor interventions. The combined grade 3-4 morbidity was 20% (4out of 20) which consisted of neutropenia, infection and respiratory complications. One patient required relaparotomy and two patients expired attributed to pulmonary embolism and septicaemia respectively. Conclusion: Enthusiasm associated with improvement in survival is often dampened by increased perioperative mortality and morbidity figures and therefore CRS & HIPEC has not yet been considered standard of care by many centres. HIPEC after extensive cytoreductive surgery for ovarian cancer is a procedure whth acceptable morbidity that patients can tolerate. More follow up is needed to determinr the effect of HIPEC on survival. Till such time more data are obtained by way of larger randomised trials, this approach remains investigational.
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Giri, Shveta, Swati Shah, Rupinder Sekhon, and Sudhir Rawal. "Clinical outcomes of cytoreductive surgery and HIPEC in advanced and recurrent epithelial ovarian cancers with peritoneal carcinomatosis." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685300.
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Introduction: The role of surgery for peritoneal carcinomatosis (PC) has slowly evolved from palliation to potential curative intent. Attempting to remove all visible tumor deposits, “surgical cytoreduction” (CRS) was reported in 1930s for ovarian cancer and eventually became an accepted therapy with proven survival benefit. The new approach of combining CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal metastasis offer hope for long term survival in this group of patients. The risk and benefit of this approach continued to be debated. A prospective study was conducted to understand the perioperative outcomes of CRS and HIPEC. Aim: To evaluate the perioperative outcomes associated with CRS and HIPEC in Advanced and Recurrent Epithelial Ovarian Cancer with PC. Method: Prospective analysis of patients undergoing CRS and HIPEC from November 2014 to July 2015 was done. Inclusion criteria included localized disease in peritoneal cavity, no distant metastasis and PS <2. Grade 3/4 complications from day of surgery until 30 days postoperatively were recorded. Results: We performed CRS and HIPEC in 20 patients from November 2014 to June 2015. HIPEC Plus regimens included Cisplatin (50 mg/m2) and Lipodox (15 mg/m2) intraperitoneally and Ifosphamide (1300 mg/m2) and Mesna (260 mg/m2). Infusion time was 90 minutes with a temperature range of 41-43°C. Out of 20 patients 6 (30%) underwent primary debulking surgery and 14 (70%) underwent secondary debulking surgery. PCI score ranged from 2-26 (mean 13.65). Mean operating time was 6.42 hrs and average blood loss was 1046 ml. Average hospital stay was 8 days and SICU stay was 4.9 days (range 3-14 days). Total 26 adverse events were observed of which grade 1 were 11 (42%), grade 2 were 8 (30%), grade were 3 (11.5%) and grade 4 were 2 (8%). Most common complication was hematological (8) followed by respiratory (6), sepsis (4) renal (2), GI (2). 4 patients (5 events) developed grade 3 or 4 complications in the form of septicaemia, pulmonary embolism, GI fistula of which 2 patients expited and remaining recovered although required prolonged hospitalization. Increased morbidity were observed in cases with symptomatic relapse, higher PCI score and CA 125 level higher than 250 U/ml. Most of the adverse events were grade 1 and 2 and were managed by observation only or GCSF support, transfusions and other minor interventions. The combined grade 3-4 morbidity was 20% (4 out of 20) which consisted of neutropenia, infection and respiratory complications. One patient required relaparotomy and two patients expired attributed to pulmonary embolism and septicaemia respectively. Conclusion: Enthusiasm associated with improvement in survival is often dampened by increased perioperative mortality and morbidity figures and therefore CRS and HIPEC has not yet been considered standard of care by many centres. HIPEC after extensive cytoreductive surgery for ovarian cancer is a procedure whth acceptable morbidity that patients can tolerate. More follow up is needed to determinr the effect of HIPEC on survival. Till such time more data are obtained by way of larger randomised trials, this approach remains investigational.
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Suhas, K. R. "Audit on the role and efficacy of PET/CT in recurrent ovarian cancer settings in a tertiary care centre in India." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685301.
Full textAbstract:
Ovarian cancers tend to recur in 15-70% cases. CA-125 - is a tumor marker used for monitoring therapeutic response, and in surveillance, for recurrent disease. However, it has a limited role as a persistent high level can signify either recurrence or persistence of residual tumor. Metastases from ovarian cancer primarily involve the peritoneum rather than parenchymal sites; thus, the presence of small-volume recurrence or metastatic deposits on the visceral surfaces poses a challenge for interpretation of CT and MR images. PET/CT utilizes its property of higher accumulation in malignant cells to provide both anatomic and functional information for diagnosing malignant tumors. Objectives: The objectives of the study were to find the correlation between PET/CT findings and final histopathological diagnosis after a secondary cytoreductive surgery in suspected ovarian cancer recurrences. Materials and Methods: PET/CT was done in cases with rising or above normal CA-125 and no radiological findings. These patients with abnormal PET/CT findings were taken up for a secondary cytoreductive surgery and histopathological proven were taken as the standard against which PET/CT positive findings was compared. Results: The mean age in our group of patients with suspected recurrence was 53 years (Range 39-74 years). Of the 52 patients with suspected recurrence, 40 patietnts with a PET-CT scan with findings suggestive of an avid uptake underwent surgery. 22 patients had serous histology, 12 mucinous and 8 had clear cell carcinoma. Stage-wise distribution at the time of primary surgery is as follows stage I-3, stage II-7, stage III-26, stage IV-4. Of the 40 patients who underwent a second look surgery 32 had histopathologically confirmed recurrence. PET-CT detected a total of 86 lesions in the 40 patients who underwent surgery. Of these, 38 were in the lymph nodes 28 in para-aortic and 10 in pelvic, 32 were peritoneal lesions and 14 were pelvic, 2 were metastatic in the parenchyma of liver. Detection of the lesion on PET-CT was size dependant, of the 9 lesions were missed on PET-CT, 7 were less than 0.5 cm. The mean diameter of the lesions detected was 2.2 cm (range 0.3-6.2 cm). PET-CT accurately identified 62 of 70 histopathologically proven lesions. The overall lesion-based sensitivity of PET-CT is 88.6%, specificity 56.2%, Positive predictive value being 72.1%, negative predictive value of 69.2%. Accuracy of detecting lesions greater than 1 cm is 78.6% (44 of 56 lesions). Conclusions: Corelation between PET/CT and histopathologicaldisease: k (cohen value) = 0.81 which suggests excellent correlation. For selected patients with ovarian cancer recurrence may benefit from a comprehensive radiographic imaging survey (PET-CT) at the time of even no or minimal CA-125 elevation in early detection and successful cytoreductive surgical resection and an increase in overall survival.