negative surgical margins

  • 文章类型: Case Reports
    鳞状细胞癌(SCC)的“金标准”治疗是根治性膀胱切除术,并且尝试了在新辅助或辅助环境中结合化疗和放疗的不同管理方法,效果不同。对某些人来说,膀胱部分切除术为肌层浸润性膀胱癌提供了足够的局部控制。由于可能致命的晚期复发,建议进行膀胱镜检查的终身随访。
    膀胱鳞状细胞癌(SCC)是一种罕见的泌尿系恶性肿瘤,估计会影响3%-5%的膀胱病例。膀胱SCC仍然是整个非洲最常见的亚型。大多数文献集中在尿路上皮癌(UC)的治疗,关于SCC管理的讨论较少。UC通常表现为无痛性血尿,而SCC表现为疼痛性血尿,膀胱肿块,和死尿症.SCC主要是耐放射性的,对化疗没有反应。主要治疗方法是膀胱部分切除术或根治性膀胱切除术,可以通过开放手术或腹腔镜或机器人辅助方法进行,所有这些都有可以接受的结果。我们报告了一名膀胱部分切除术后结果良好的患者,该患者通过开放手术进行了治疗。在12个月的随访中,患者仍无症状,手术效果良好.
    UNASSIGNED: The \"gold standard\" treatment for Squamous cell carcinoma (SCC) is radical cystectomy and different management approaches that combine chemotherapy and radiation in a neoadjuvant or adjuvant setting have been attempted with varying degrees of effectiveness. For certain individuals, partial cystectomy offers sufficient local control for muscle-invasive bladder cancer. Lifelong follow-up with cystoscopy is advised due to the possibility of potentially fatal late recurrence.
    UNASSIGNED: Squamous cell carcinoma (SCC) of the bladder is a rare urologic malignancy that is estimated to affect 3%-5% of the bladder cases. SCC of the bladder remains the most common subtype throughout Africa. Most of the literatures focused on the management of Urothelial carcinoma (UC), with fewer discussions on SCC management. UC typically presents with painless hematuria, whereas SCC presents with painful hematuria, bladder mass, and necroturia. SCC is mostly radioresistant and does not respond to chemotherapy. The mainstay treatment is partial cystectomy or radical cystectomy, which can be performed through open surgery or laparoscopic or robot-assisted approaches, all of which have acceptable results. We report a patient with a favorable outcome following partial cystectomy who was managed by open surgery. At the 12-month follow-up, the patient remained asymptomatic with good surgical outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的介绍有关腹膜后肉瘤患者的集体数据的经验,这些患者在Rion的Patras大学总医院进行了手术和随访,希腊,2009年至2020年。方法回顾性分析我院诊断为原发性腹膜后肉瘤并接受肿瘤切除术的成人患者。结果分析29例患者的数据。诊断时的平均年龄为56.1岁;55.2%的患者为男性(n=16)。在19例(65.5%)患者中发现了脂肪肉瘤(组织学),平滑肌肉瘤6(20.7%),4例(13.8%)患者的其他组织学亚型。肿瘤>5cm的患者有27例(93.1%)。在所有接受手术切除的患者中,有13例(44.8%)获得了阴性切缘。5例(17.2%)患者接受新辅助放疗,四(13.8%)术后放疗,3例(10.3%)患者在手术前接受了化疗和放疗,其余患者仅接受手术切除治疗。21例(72.4%)患者成功进行了3年的随访;5例(23.8%)患者死亡。总的来说,16例(55.2%)患者被发现有局部复发,患者年龄无显著差异,性别,肿瘤大小,组织学,阴性手术切缘(Ro)切除,新辅助化疗,或者放射治疗.手术切缘阳性或阴性的患者的3年生存率存在显着差异(p=0.027)。结论腹膜后肉瘤患者在实现Ro切除后的3年生存率较高,需要在不同机构中进行更大的样本量进一步调查。
    Aim To present the experience from collective data regarding patients with retroperitoneal sarcomas that have been operated in and followed up by the University General Hospital of Patras in Rion, Greece, between 2009 and 2020. Methods A retrospective analysis of adult patients treated at our hospital with a diagnosis of primary retroperitoneal sarcoma who underwent tumour resection. Results Data from 29 patients were analysed. The mean age at diagnosis was 56.1 years; 55.2% of patients were male (n=16). Liposarcomas (on histology) were identified in 19 (65.5%) patients, leiomyosarcoma six (20.7%), and other histologic subtypes in four (13.8%) patients. Tumours >5cm were presented in 27 (93.1%) patients. Negative margins were attained in 13 (44.8%) of all patients who underwent surgical resection. Five (17.2%) patients received neoadjuvant radiation, four (13.8%) postoperative radiation, and three (10.3%) patients received both chemotherapy and radiation prior to surgery with the rest of the patients being treated with surgical excision alone. A 3-year follow-up was successful in 21 (72.4%) patients; five (23.8%) patients died. In total, 16 (55.2%) patients were found to have a local recurrence, with no significant difference in patients\' age, gender, tumour size, histology, negative surgical margin (Ro) resection, neoadjuvant chemotherapy, or radiation therapy. There was a significant difference in the 3-year survival rate between patients having positive or negative surgical margins (p=0.027). Conclusion The higher 3-year survival rate in patients with retroperitoneal sarcomas when achieving Ro resection warrant further investigation with a larger sample size across different institutions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    BACKGROUND: The development process of recurrence in prostate cancer patients with pathologically organ-confined (pT2) disease and negative surgical margins is unclear. The aim of the present study was to determine factors associated with the development of biochemical recurrence following robot-assisted radical prostatectomy among those prostate cancer patients.
    METHODS: We retrospectively reviewed the data of patients who underwent robot-assisted radical prostatectomy without neoadjuvant endocrine therapy. We evaluated prognostic factors in 1096 prostate cancer patients with pT2 disease and negative surgical margins. Univariate and multivariate Cox proportional hazards regression analyses were used to identify independent predictors for biochemical recurrence.
    RESULTS: Of the 1096 patients, 55 experienced biochemical recurrence during the follow-up period. The 5-year biochemical recurrence-free survival rate for patients with pT2 and negative surgical margins was 91.8%. On univariate analysis, clinical stage, biopsy Gleason score, percent of positive core, pathological Gleason score, and the presence of micro-lymphatic invasion were significantly associated with biochemical recurrence. On a multivariate analysis, the presence of micro-lymphatic invasion and a pathological Gleason score ≥ 4 + 3 were significant prognostic factors for biochemical recurrence. Based on these factors, we developed a risk stratification model. The biochemical recurrence-free survival rate differed significantly among the risk groups.
    CONCLUSIONS: The prognosis of prostate cancer patients with pT2 disease and negative surgical margins is favorable. However, patients with the presence of micro-lymphatic invasion and a pathological Gleason score ≥ 4 + 3 tend to experience biochemical recurrence more often after surgery. Therefore, careful follow-up might be necessary for those patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号