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Gastrointestinal Tumors

Erik Soule, Jerry Matteo
Background: Major vessel invasion is a late manifestation of hepatocellular carcinoma, which may directly result in mortality if left untreated. Surgical resection may be an option for select patients; however, surgery may be contraindicated. Contraindications include multifocal disease, poor liver reserve, inability to tolerate surgery, and patient preference. Cryoablation is a minimally invasive therapy utilized for treating hepatic neoplasms by subjecting them to extreme cold temperatures...
September 2018: Gastrointestinal Tumors
Azadeh Yazdani Cherati, Yousef Yahyapour, Mohammad Ranaee, Mehdi Rajabnia, Javad Shokri Shirvani, Mahmoud Hajiahmadi, Farzin Sadeghi
Background: Helicobacter pylori (HP) infection is one of the hypothesized infectious etiologies of gastric cancer (GC) and other gastroduodenal diseases. It was suggested that other infectious agents, including oncogenic viruses, may increase the risk of gastroduodenal diseases. A number of reports regarding JC polyomavirus (JCPyV) have shown that JCPyV could be implicated in colorectal cancer and gastrointestinal carcinogenesis. Objective: The current investigation aimed to investigate whether JCPyV could have any association with the pathogenesis of gastroduodenal diseases either alone or together with HP...
September 2018: Gastrointestinal Tumors
Leonidas Apostolidis, Jan Pfeiffenberger, Daniel Gotthardt, Boris Radeleff, Arianeb Mehrabi, Peter Schemmer, Dirk Jäger, Peter Schirmacher, Wolfgang Stremmel, Henning Schulze-Bergkamen, Christoph Springfeld, Karl Heinz Weiss
Background/Aim: Sorafenib leads to improved survival in advanced hepatocellular carcinoma (HCC) patients. Continuation of sorafenib beyond progression has been a possible treatment strategy when further approved therapeutic agents are lacking. Methods: We performed a retrospective analysis of all HCC patients at our institution with documented disease progression under treatment with sorafenib. Overall survival (OS) from start of sorafenib treatment was compared between patients who received sorafenib for > 3 weeks beyond progression (group 1) and those who discontinued sorafenib ≤3 weeks after progression (group 2)...
September 2018: Gastrointestinal Tumors
Charbel Chater, Anne Bauters, Claire Beugnet, Lena M'Ba, Moshe Rogosnitzky, Philippe Zerbib
Background/Aim: Colorectal cancer (CRC) is associated with high incidence and mortality rates. Carcinoembryonic antigen (CEA), a prognostic biomarker for recurrent CRC following curative resection, suffers from low sensitivity, especially in early-stage screening. Intraplatelet angiogenesis regulators (IPAR), such as vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF), have been identified as important regulators of tumor growth in CRC. The aim of this study was to confirm the higher preoperative level of IPAR (VEGF and PDGF) in CRC patients compared to controls and to measure IPAR in CEA-negative CRC patients...
September 2018: Gastrointestinal Tumors
Paschalis Gavriilidis, Aurelio Tobias, Robert P Sutcliffe, Daniel Azoulay, Keith J Roberts
Objective: Six principal adjuvant chemotherapy treatments (ACTs) are currently available for patients with resected colorectal liver metastases. This meta-analysis was designed to determine the optimal ACT, as evaluated by 2-year disease-free survival (DFS) and 5-year overall survival (OS) rates as well as by hepatic recurrences and adverse events (AEs). Methods: A systematic literature search of the PubMed, EMBASE, Medline, Cochrane Library, and Google Scholar databases was performed...
September 2018: Gastrointestinal Tumors
Cinzia Baldessari, Fabio Gelsomino, Andrea Spallanzani, Giuseppe Pugliese, Luca Reggiani Bonetti, Stefania Bettelli, Stefano Cascinu
Background: Gastric cancer is the fourth cause of cancer-related death in Europe and the prognosis of these patients remains dismal. It has been demonstrated that chemotherapy improved survival compared with best supportive care and recently, subsequent lines of therapy, also with new drugs, obtained positive results. Summary: We present the case of a patient diagnosed with a de novo metastatic gastric cancer who experienced an extraordinary long response to multiple lines of chemotherapy (FOLFOX6, paclitaxel plus ramucirumab, FOLFIRI, rechallenge with FOLFOX6)...
September 2018: Gastrointestinal Tumors
Andrey Iskrenov Kotzev, Peter Vassilev Draganov
Background: Gastric cancer (GC) is characterized by aggressive behavior and a high mortality rate. The diagnosis of GC is challenging because the GC is often diagnosed in an advanced stage. The use of tumor markers is a putative way to improve the detection and treatment in patients with GC. Summary: In this article, we review the significance of serum carbohydrate antigen (CA) 19-9, carcinoembryonic antigen (CEA), and CA 72-4 in GC. The results from different studies regarding the diagnostic and prognostic role of CA 19-9, CEA, and CA 72-4 in GC are encouraging, but inadequate sensitivity and specificity obstruct their use as standardized and unconditionally reliable markers in GC...
September 2018: Gastrointestinal Tumors
(no author information available yet)
[This corrects the article DOI: 10.1159/000442831.].
February 2018: Gastrointestinal Tumors
Aris Plastiras, Michail Sideris, Andy Gaya, Amyn Haji, Joseph Nunoo-Mensah, Asif Haq, Savvas Papagrigoriadis
Background: Neoadjuvant chemoradiotherapy (CRT) is considered the standard approach before any surgical intervention for locally advanced rectal tumors and has been proven to significantly improve the local recurrence rates of rectal cancer. However, the optimal timing of surgical resection after neoadjuvant CRT remains debatable. Objective and Methods: We conducted a retrospective review of 65 consecutive patients with locally advanced rectal cancer who underwent preoperative CRT followed by surgical resection in order to evaluate the optimal time for surgical treatment...
February 2018: Gastrointestinal Tumors
Frederick H Koh, Aaron Seah, Dedrick Chan, Jingyu Ng, Ker-Kan Tan
Background/Aims: While colonoscopy is indicated in patients >50 years old presenting with hematochezia, its role in those ≤50 remains debatable. This study aims to evaluate the role of colonoscopy in patients presenting with hematochezia who are ≤50 years old. Methods: A retrospective review of all patients aged ≤50 years who underwent colonoscopy for hematochezia in 2012 was conducted. Patient demographics, endoscopic details, and histological results were analyzed...
February 2018: Gastrointestinal Tumors
Ryoichi Miyamoto, Yukio Oshiro, Ken Nakayama, Nobuhiro Ohkohchi
Background/Aims: Anatomical variations are frequently encountered during hepato-biliary-pancreatic surgeries, requiring surgeons to have a precise understanding of the surgical anatomy in order to perform a safe surgery. We evaluated the impact of novel three-dimensional (3D) surgical simulation on pancreatic surgeries to enhance surgical residents' understanding. Methodology: Between January 2013 and May 2014, 61 preoperative 3D surgical simulations were performed...
February 2018: Gastrointestinal Tumors
Tze-Yi Low, Ye-Xin Koh, Jin-Yao Teo, Brian K P Goh
Background/Aims: The International Study Group of Pancreatic Surgery recently published a consensus statement on the definition of extended pancreatectomy (EP). We aimed to determine the safety profile and short-term outcomes of EP compared to standard pancreatectomy (SP). To mitigate surgeon bias, only pancreatectomies performed by a single surgeon were included. Methods: Ninety consecutive patients who underwent pancreatectomy by a single surgeon over a period of 5 years and who met our study criteria were classified into an SP or an EP group...
February 2018: Gastrointestinal Tumors
Kenji Mimatsu, Nobutada Fukino, Yasuo Ogasawara, Yoko Saino, Takatsugu Oida
Background: Immunonutrition (IN) significantly reduces the incidence of postoperative infectious complications and the length of hospitalization in patients undergoing major elective surgery for gastrointestinal malignances. However, the clinical benefit of IN in patients who have undergone esophagectomy for esophageal cancer is unclear. Moreover, the effect of enteral IN in patients during preoperative adjuvant chemoradiotherapy and in patients treated with concurrent chemoradiotherapy for advanced esophageal cancer is unknown...
February 2018: Gastrointestinal Tumors
Erik Soule, Arya Bagherpour, Jerry Matteo
BACKGROUND: Neuroendocrine malignancy is indolent, yet relentless in its propensity to metastasize to the liver, where it may cause bizarre paraneoplastic syndromes. The pathophysiologic mechanism behind this predilection for hepatic metastasis is twofold: the portal venous system drains the most likely primary sites for neuroendocrine tumors, and the relatively immunosuppressed environment within the hepatic parenchyma is permissive for tumor growth. The standard of care for patients with metastatic neuroendocrine tumor is surgical resection of at least 90% of the tumor burden...
September 2017: Gastrointestinal Tumors
Kenji Matsuda, Shozo Yokoyama, Tsukasa Hotta, Katsunari Takifuji, Takashi Watanabe, Koichi Tamura, Yasuyuki Mitani, Hiromitsu Iwamoto, Yuki Mizumoto, Hiroki Yamaue
BACKGROUND: The level of inferior mesenteric artery (IMA) ligation for anterior resection of rectal cancer has several considerations concerning oncological outcomes. The primary endpoint of this randomized controlled trial (RCT) was to assess bowel function between high and low ligation. This study was intended to clarify oncological outcome as the secondary endpoint. OBJECTIVE: The aim of this study was to assess in a prospective RCT whether the ligation level of the IMA in rectal cancer influences oncological outcomes...
September 2017: Gastrointestinal Tumors
Jyrki Tapani Mäkelä, Kai Hans Klintrup, Tero Tapani Rautio
OBJECTIVE: The purpose of this study was to identify the clinical factors and tumor characteristics that predict the outcome of colorectal cancer patients aged >80 years. MATERIALS AND METHODS: The data of 186 patients aged >80 years with colorectal cancer were collected from a computer database, and the variables were analyzed by both uni- and multivariate analyses. RESULTS: The 30-day mortality was 4% and the 90-day mortality 10%. The 1-year survival was 76%, and 27 (61%) of the 44 deaths were unrelated to cancer...
September 2017: Gastrointestinal Tumors
Ken-Ichi Okada, Seiko Hirono, Manabu Kawai, Shinya Hayami, Shinichi Asamura, Yoshitaka Wada, Masaki Ueno, Motoki Miyazawa, Atsushi Shimizu, Yuji Kitahata, Hiroki Yamaue
BACKGROUND/AIMS: Ischemic gastropathy remains as a persistent problem after left gastric artery (LGA) resection in distal pancreatectomy with celiac axis en-bloc resection (DP-CAR). The middle colic artery (MCA) was found to be a useful vessel for compromised collateral flow. However, intraoperative gross evaluation of gastric ischemia is technically difficult even after artery reconstruction. METHODS: We performed LGA reconstruction by MCA-LGA bypass after LGA-resecting DP-CAR assisted by intraoperative indocyanine green fluorescence imaging (ICG) blood flow evaluation in a clinical trial (UMIN000020414)...
September 2017: Gastrointestinal Tumors
Rohan C Siriwardana, Chandika A H Liyanage, Bhagya Gunetilleke, Madunil A Niriella, Janaka de Silva, Anuradha S Dassanayake, Subani P Jayatunge
BACKGROUND: Data on diffuse-type hepatocellular carcinoma (HCC) are rare. HCC in Sri Lanka is rising, and the majority is related to nonalcoholic fatty liver disease. This study was planned to compare nodular- and diffuse-type HCC in this cohort. METHODS: CT scans of 227 patients with HCC negative for infective hepatitis were analyzed and grouped as nodular and diffuse from July 2011 to July 2014. Diffuse-type cancer was defined as a tumor without convex/distinct margin, diffusely infiltrating the hepatic parenchyma...
September 2017: Gastrointestinal Tumors
Ulrich Nitsche, Christian Stöss, Helmut Friess
BACKGROUND: Adjuvant chemotherapy has become the standard form of treatment for all patients with stage III colorectal cancer and is also recommended for patients with stage II disease and defined risk factors. However, clinical studies that evaluate the effect of adjuvant treatment regimens have a selection bias in favor of younger patients, so that even retrospective subgroup analyses cannot define the best therapeutic procedure in elderly patients with comorbidities. SUMMARY: As long as the role of adjuvant chemotherapy in elderly colorectal cancer patients is not investigated in comprehensive trials, no clear recommendations are possible...
September 2017: Gastrointestinal Tumors
Chushu Li, Huanbin Wang, Han Yao, Jing-Yuan Fang, Jie Xu
BACKGROUND: The development of cancer involves uncontrolled cell proliferation, and multiple signaling pathways that regulate cell proliferation have been found to be dysregulated in cancers. Extracellular signal-regulated protein kinase (ERK) is one of three major subtypes in the mitogen-activated protein kinase (MAPK) families. The MAPK/ERK pathway (RAS/RAF1/MEK/ERK) plays an important part in promoting cell proliferation in response to growth factors, thereby serving as a driving signal in gastrointestinal (GI) tumors...
September 2017: Gastrointestinal Tumors
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