Category Archives: Oncology

Japanese Gastric Cancer Treatment Guidelines 2021

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“The sixth edition of the Japanese Gastric Cancer Treatment Guidelines was completed in July 2021, incorporating new evidence that emerged after publication of the previous edition. It consists of a text-based “Treatments” part and a “Clinical Questions” part including recommendations and explanations for clinical questions. The treatments parts include a comprehensive description regarding surgery, endoscopic resection and chemotherapy for gastric cancer. The clinical question part is based on the literature search and evaluation by an independent systematic review team.”

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Multi-Institutional Analysis of Pancreaticoduodenectomy for Nonfamilial Periampullary Adenoma: A Novel Risk Score to Guide Shared Decision-Making

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“Periampullary adenomas (PA), including both ampullary adenomas (AAs) and duodenal adenomas (DAs), are benign or premalignant mucosal lesions that are either hereditary, most associated with familial adenomatous polyposis (FAP) syndrome, or sporadic, with no known genetic predisposition. In both cases, these uncommon mucosal-based lesions carry malignancy risk and present management dilemmas when not amenable to endoscopic
removal requiring surgical resection. FAP-related PAs are typically large and multifocal and often managed using the Spigelman classification, a point-based system that alerts the clinician of malignancy risk. This classification guides the decision toward continued endoscopic surveillance vs resection vis-à-vis pancreaticoduodenectomy (PD, also known as the “Whipple procedure”). No such scoring system exists for non-FAP-related PAs.”

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Predictors for Anastomotic Leak, Postoperative Complications, and Mortality After Right Colectomy for Cancer

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“Right hemicolectomy is considered one of the simplest colorectal major procedures and is often considered an appropriate first step for residents and young fellows. Despite this, complications after right hemicolectomy for cancer are common, at ≈30%, and postoperative mortality is reported to be ≈3%. Anastomotic leak (AL) after right hemicolectomy for cancer is a major contributor to this short-term morbidity and mortality. The document AL rate after right hemicolectomy ranges widely, from 1.3% to 8.4%. This also has a significant impact on healthcare costs and major oncologic consequences, as demonstrated by the higher cancer recurrence rate after AL.”

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Association Among Blood Transfusion, Sepsis, and Decreased Long-term Survival After Colon Cancer Resection

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“Colorectal cancer is the second-leading cause of cancer-related mortality in both the United States and Europe. With respect to prognosis, increasing evidence has suggested that systemic inflammation is a key predictor of disease progression and survival for colorectal cancer patients undergoing surgery. Furthermore, whereas red blood cell (RBC) transfusions may be life-saving in some circumstances, there has been growing evidence that transfusions are associated with adverse postoperative outcomes, including infectious complications and cancer recurrence. These detrimental effects are thought to be related to systemic inflammation and transfusion-related immunomodulation (TRIM). Whereas the exact mechanisms remain unknown, TRIM seems to be related to various immunologic changes, including decreased interleukin (IL)-2 production, monocyte and cytotoxic cell activity inhibition, increased suppressor T-cell activity, and immunosuppressive prostaglandin release.”

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Primary versus Flap Closure of Perineal Defects following Oncologic Resection

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“Abdominoperineal resection and pelvic exenteration for resection of malignancies can lead to large perineal defects with significant surgical-site morbidity. Myocutaneous flaps have been proposed in place of primary closure to improve wound healing. A systematic review was conducted to compare primary closure with myocutaneous flap reconstruction of perineal defects following abdominoperineal resection or pelvic exenteration with regard to
surgical-site complications.”

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Clinical characteristics and outcomes of patients with hepaticangiomyolipoma

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“Angiomyolipoma (AML) is a solid mesenchymal tumor, mainly described in the
kidney, and belongs to the group of perivascular epithelioid cell tumors
(PEComas). Hepatic localization of AML, described for the first time in 1976, is
rare, since only around 600 cases were reported after an exhaustive search of the
literature up to the year 2017. Hepatic AML (HAML) poses a veritable diagnostic
challenge in radiological terms, especially when fat content is low, because this type of
tumor may appear as a hypervascular tumor associated with a washout phase that
mimics other, more common hypervascular hepatic tumors, such as hepatocellular
carcinoma”

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Management of Postoperative Complications Following Operations for Breast Cancer

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At bottom of post Surgical Clinics of North America issue on postoperative complications.

“The reported complication rates after breast cancer surgery are low, with rates ranging
from 2% to 50%, and are reportedly more common when performed in conjunction with axillary surgery and immediate breast reconstruction. A breakdown by procedure type has shown morbidity rates between 5% and 50% after mastectomy and from 3% to 35% after lumpectomy with or without reconstruction.”

Hilli
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