RESULTS OF SURGICAL TREATMENT OF LOCALLY ADVANCED PROXIMAL GASTRIC CANCER

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "RESULTS OF SURGICAL TREATMENT OF LOCALLY ADVANCED PROXIMAL GASTRIC CANCER"

Transcription

1 Yu.A. Vinnik V.V. Оlеksеnkо S.V. Efetov 3 K.A. Aliyev Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine SI «Crimea State Medical University named after S.I. Georgievsky» 3 CRI «Oncologic Clinical Dispensary named after V.M. Efetov», Simferopol, AR of Crimea Key Words: locally advanced proximal gastric cancer, multivisceral resections, longterm outcome. RESULTS OF SURGICAL TREATMENT OF LOCALLY ADVANCED PROXIMAL GASTRIC CANCER Summary. Objective: to analyze the postoperative and longterm results of surgical treatment in patients with locally advanced proximal gastric cancer. Object and methods: the study included 80 patients with tumor in the proximal part of the stomach type II and III by J.R. Siewert, of whom 73 patients (study group) underwent multivisceral resection, 07 (control group) the standard surgical intervention. The average age of the study group was 60,5 ± 7,9 years (44 76), control 6,9 ± 7,3 years (34 76). Results: performing multivisceral resection, 3 (43,9 ± 5,8%) patients underwent en bloc resection or ectomy of one adjacent to the stomach organ, in 0 (7,4 ± 5,%) patients of two organs, in 6 (8, ± 3,%) three, 3 (7,8 ± 4,5%) four and five organs (,7 ±,9%) in two patients. Conclusions: it is defined that multivisceral resections in case of locally advanced proximal gastric cancer was accompanied with the increase in postoperative morbidity and mortality. Pancreatectomy was significantly associated with a greater number of postoperative complications. The regional lymph node metastasis in locally advanced proximal gastric cancer impairs longterm outcome. In absence of early diagnosis surgical treatment in patients stage pt4 remains the only chance prolonging life, due to that developing efforts aimed to improve the outcomes of these patients remain relevant. INTRODUCTION Gastric cancer (GC) remains one of the leading causes of death in the structure of cancer mortality in many countries of the world, occupying second place after lung cancer [], in Ukraine third place after lung tumors and colorectal cancer (death rate constitutes 0.7%) [5]. Over the last decade, some decrease of GC incidence due to the tumors of distal localization has been noticed. At the same time, frequency of proximal gastric cancer (PGC) strongly tends to grow. PGC constitutes 037% among all GC localizations; according to the data of the most of international cancerregisters, there is no tumor of other localization demonstrating such intensive increase of incidence that determines permanent high GC death rate []. Results of PGC treatment cannot be recognized satisfactory. Rates of operability of this malignant neoplasm vary from 40 to 70%, resectability from 38 to 69% that has an effect on the longterm results of treatment [8]. Causes of fatal course of PGC are complications of diagnostics of preclinical stages Tis and T. Early diagnostics is one of the priority and effective means of mortality decrease. In contrast to Japan, where more than half of newly diagnosed cases are related to the early cancer, most patients in Ukraine on the moment of diagnosis have advanced stage: III 4.9%, IV 30.8% [5]. PGC with involvement of zone of esophagogastric junction in ptis and ptstage does not exceed 89% of all new cases, in 65% of patients IIIIV stages are diagnosed [4]. Surgical treatment of GC still remains in the center of attention. Despite certain progress in anesthetic and reanimation facilities, prognosis in extensive local dissemination of GC with invasion of tumor in adjacent anatomic structures remains complicated surgical problem and in number of cases remains the cause of unreasonable rejection of radical surgeries, especially in unspecialized health care institutions [3]. When analyzing published data of modern literature concerning direct and longterm results of surgical treatment of advanced forms of GC, inconsistence of these data becomes obvious. For instance, frequency of complications after combined radical surgeries varies from 5 to 59.4%, postoperative lethality from 3.3 to 4.% [9, 0, 3]. Such wide range of rates does not allow to make clear conclusion. Series of studies contain no longterm results demonstrating 5year survival of radically treated patients,

2 and in other studies it is not higher than 49.3% [, 3, 7, 0,, 3]. Localization of tumor in proximal part determines most pessimistic results of treatment compared with other GC localizations. The lowest rates of survival are marked at locally advanced PGC in pt4 stage. Mean lifespan (MLS) constituted.5 ± 5.3 months, median survival (MS) 9 months, e.g. more than half of patients die during the first year of observation. At invasion of tumor in surrounding organs, the frequency of lymphogenous metastasis increases: from 6.% at pn0 to 33.8% at pn3. At the same time, the involvement of the remote lymphcollectors, to which mediastinal and paraaortic lymph nodes (LN) are referred, reaches 3.5% [8] that raises the issue concerning the optimal volume of lymphodissection or expediency of its enhancement to the D3 volume. Lack of the common surgical tactics, contradictory direct and longterm results of treatment have determined relevance of the present study. The aim of the study was to analyze the direct and longterm results of surgical treatment of patients with locally advanced PGC. OBJECT AND METHODS OF STUDY According to the R.J. Siewert [4], PGC are divided into 3 types: I tumor in distal part of esophagus (Barrett s adenocarcinoma of the distal esophagus); II tumor in gastroesophageal junction; III subcardiac tumor. In this research are represented results of treatment of patients with tumors of II and III type. Stratification of the present data is based on the A.A. Rusanov classification [6], which became most popular in CIS: cardiac cancer tumor of cardiac stomach; b) gastrocardiac cancer tumor of cardiac and downstream regions of stomach; c) cardioesophageal cancer tumor of cardiac region of stomach with dissemination in esophagus; d) gastroesophageal cancer most large involvement of stomach, which includes downstream regions of stomach and esophagus. Analysis of the results of surgical treatment of 80 PGC patients, who underwent treatment on the basis of clinics of cancer of CRI «Oncologic Clinical Dispensary named after V.M. Efetov» over the period from 999 to 008, became the basis of our retrospective study. Taking into account the volume of surgical intervention, patients have been divided into comparable groups: the study group 73 patients, who underwent combined surgery due to the local dissemination of gastric tumor, and control 07 patients, who underwent standard by volumes surgical interventions. Mean age of patients of the study group has constituted 60.5 ± 7.9 years, control 6.9±7.3 years (p = 0.4). Ratio of men to women in the study group has constituted 49 (67.%) to 4 (3.9%), in control 73 (68.%) to 34 (3.8%). Program of study was the same for the all patients of both groups and included application of clinical, instrumental and laboratory methods of examination. For evaluation of dissemination of tumor process, fibroesophagogastroscopy, ultrasound investigation of abdominal cavity, radioscopy, computer tomography of organs of thoracic cage and abdominal cavity has been applied (Table ). Table Features of observation groups Rate Study group (n = 73), n (%) Control group (n = 07), n (%) Total number of patients (n =80), n (%) Tumor is stage pt* (0.9) (0.5) Tumor is stage pt (.) (6.7) Tumor is stage pt3 7 (3.3) 94 (87.9) (6.7) Tumor is stage pt4 56 (76.7) 56 (3.) Regional LN pn0 3 (3.5) 47 (43.9) 70 (38.9) Regional LN pn 30 (4.) 45 (4.) 75 (4.7) Regional LN pn 0 (7.4) 5 (4.0) 35 (9.4) Note: *according to the international TNM classification (006 edition) Adenocarcinoma of different stage of differentiation has been diagnosed in 58 (79.4%) patients of the study and 78 (7.9%) patients of control group: signetring cell cancer in (6.4%) and (9.7%) patients correspondingly; by case of epidermoid cancer, lymphoma, sarcoma in every group (.4 and 0.9% correspondingly) has been detected; in control group in 4 (3.8%) patients the dimorphous cancer has been diagnosed and in (0.9%) patient carcinoid. Radical surgeries in R0 volume have been performed in 66 (90.4 ± 3.4%) patients of the study and 0 (95.3 ±.0%) control group. Surgeries in R, R volume referred to palliative have been performed in 7 (9.6 ± 3.4%) patients of the study group and in 5 (4.7 ±.0%) patients of the control group.

3 Out of 73 patients of the study group, who underwent multivisceral resections, true invasion of tumor in adjacent with stomach organs (according to the data of postoperative morphological study) has been diagnosed in 56 patients that constituted 76.7%. In 7 (3.3%) patients, visually detected invasion of tumor in surrounding organs has no morphological confirmation and has been evaluated as inflammatory perigastric infiltration When performing combined surgical interventions, in 3 (43.9 ± 5.8%) patients en bloc resection or resection of one adjacent with stomach organ has been carried out, in 0 (7.4 ± 5.%) patients two, in 6 (8. ± 3.%) three, in 3 (7.8 ± 4.5%) four and in (.7 ±.9%) patients five organs. Volume of multivisceral resections included distal resection of pancreas (), splenopancreatogastrectomy (5), resection of crura and capula of diaphragm (), splenectomy (6), resection of left adrenal gland (6), resection of left lobe of liver (0), resection of mesentery transverse colon (6), planar resection of pancreas (7), resection colon (), nephrectomy (). Following the standards of performance of gastrectomy (proximal resection), independently from macroscopic features of lymph nodes (LN), sizes and form of growth of tumor, the resection of perigastric LN, cellular tissue with LN lengthwise the hepatoduodenal junction, common hepatic artery, left gastric artery, splenic artery has been performed that corresponded the lymphodissection in D volume performed in 75 (97. ±.%) patients. Macroscopic signs of metastasis in LN, which are located lengthwise the abdominal part of aorta, stipulated for the resection of the last ones, starting from retropancreatic part of aorta to zone of esophagealdiaphragm junction that corresponded lymphodissection in D3 volume performed in 5 (.8 ±.%) patients. At carrying out of gastrectomy with resection of esophagus by transtracheal access, additionally the cellular tissue of mediastinum with lower paraesophageal LN has been removed; such intervention has been performed in 30 (6.7 ±.8%) patients. Gastrectomy with resection of lower third of esophagus by abdominalthoracic access supposing performance of doublezone lymphodissection (by ISDE classification, 994) abdominal lymphodissection in volume D and removal of fatty tissue of mediastinum with mediastinal LN to the aortal segment of esophagus or level of bifurcation of thorax has been performed in 65 (36. ± 3.6%) patients. Features of performed surgeries at PGC dependently on localization of tumor in the study (I) and control (II) groups are represented in Table. Table Surgical intervention at PGC Type of surgery Gastrectomy (n = 88) Gastrectomy + resection of esophagus (n = 79) Proximal resection of stomach (n = 3) Localization of tumor I group II group I group II group I group II group Cardiac cancer n 4 5 % 4.5 ±. 5.7 ±.5.5 ± ± 0.0 Gastrocardiac cancer n % 4.0 ± ± ± ± ± ± 7.4 Cardioesophageal cancer n % 8.9 ± ± ± 3.8 Gastroesophageal cancer n 7 5 %.5 ± ± ± 0.0 Total n % 46.6 ± ± ± ± ± ± 7.4 Statistical analysis has been carried out using program of statistical calculations Excel 007, Statistica for Windows v.6.0. Study of direct results of treatment has been conducted using Ucriterion of MannWhitney, Yates corrected Chisquare, exact Fisher test (twotailed). For evaluation of connection between qualitative signs, the coefficient of association φ has been used. Statistical method of study of longterm results of treatment was analysis of survival by KaplanMeier. When comparing survival in several samplings, multisample Gehan test has been applied, at pairwise comparison of samplings twosample test of GehanWilkinson. As critical level of significance of null statistical hypothesis (if no significant intergroup differences were found) was taken Statistically significant was considered criterion of reliability p < 0.05 for all indexes. RESULTS AND DISCUSSION When analyzing indexes reflecting the process of surgical intervention (Table 3), it has been determined that multivisceral resections at performance of gastrectomy, gastrectomy with resection of the lower third of esophagus and proximal resection of stomach are accompanied with reliably higher volume of hemorrhage (р = ; р = 0.000; р = 0.0) compared with standard surgeries. Also the lifespan of patients increases, however, statistically significant difference by this index has been marked only at gastrectomy (р = 0.03).

4 Volume of surgery Intrasurgical indexes of studied groups Gastrectomy Gastrectomy with resection of esophagus Proximal resection of stomach I group II group I group II group I group II group Table 3 Loss of blood, ml 384. ± ± ± ± ± ± 43.7 р Length of surgery, min 00.0 ± ± ± ± ± ± 4.8 р Basing on the analysis of data reflecting direct results of different surgical interventions at PGC (Table 4), the conclusion can be made that frequency of postoperative complications and lethality at performance of multivisceral resection is slightly higher than at standard surgeries, however, no statistically significant differences were determined (p = 0.8 and p = 0.5 correspondingly). Postoperative complications and lethality among patients of studied groups Study group (n = 73) Control group (n = 07) Table 4 Type of complications Number of complications Died Number of complications Died n % (М ± m) n % (М ± m); n % (М ± m) n % (М ± m) Surgical ± 4.5; p = ± 3.; p = ± ±.6 Pancreonecrosis Abscess of abdominal cavity Inconsistence of EIA* Pancreatitis Ileus Wound abscess Mesenteric ischemia Lymphorrhagia Eventration ± ±.7.7 ±.9.3 ±.3.3 ±.3.3 ±.3.3 ±.3.3 ±.3.7 ±.9.3 ±.3.3 ±.3.3 ± ± ±.8.9 ±.3.9 ±.3 Therapeutic ±.9; p = ±.3; p = ± ±.6 Pulmonary embolism Pneumonia Plevritis Cardiac infarction.7 ±.9.3 ±.3.3 ±.3.3 ±.3.7 ±.9.3 ±.3.9 ±.3.9 ±.3.9 ±.3 Total ± ± ± ±. Note: *EIA esophagealintestinal anastamosis. Despite reliable fact of increase of hemorrhage at additional resection or ectomy of organ, it has been determined during stratification of data by number of resected organs and postoperative complications that increase of level of postoperative complications and lethality at increase of quantity of removed and resected organs is not statistically significant. For instance, postoperative complications and lethality at additional resection of one adjacent with stomach organ constituted.5 (р =.0) and 9.4% (р = 0.56) correspondingly, two organs 35 (р = 0.069) and 0% (р =.0), three 33.3 (р = 0.4) and 6.7% (р = 0.5) four 30.8 (р = 0.3) and 5.4% (р = 0.9), five 50.0 (р = 0.9) и 50.0% (р = 0.9). Most of postoperative complications in the study group were associated with resection of pancreas (planar, distal, splenopancreatogastrectomy). Resection of pancreas performed in 44 patients has been accompanied with development of complications in postoperative period in 5 (34.%) patients; at other multivisceral resections in 3 (0.3%) out of 9 cases. Coefficient of association φ has constituted 0.69 (Phisquare = ). Obtained value φ indicates quite weak association (at 0.0 < φ < 0.9) between resection of pancreas and development of postoperative complications, though indexes of this category of patients of the study group statistically significantly (p = 0.07) differ from the same at other surgeries.

5 When analyzing the longterm results of surgical treatment of PGC patients, data of 6 patients have been obtained: 63 from the study and 98 from the control group. In the study group in longterm terms, 46 patients have died, under dynamic observation are 7 patients, lifespan has constituted from to 40 months, MS and MLS 5.0 and 33.6 ± 4.6 months correspondingly. In control group in longterm terms, 7 patients have died, under dynamic observation are 7 patients; lifespan has constituted from to 4 months, MS and MLS 7.5 and 4.5 ± 39. months correspondingly. We have analyzed the survival of patients in studied groups by time intervals ( year, 3 years and 5 years) (Fig. ). Oneyear survival rate in the study group has constituted 59.3 ± 6.3%, in control group 70.4 ± 4.6%; 3year 33.0 ± 6. and 43.5 ± 5.0%; 5year 8.8 ± 6.0 and 35.8 ± 5.0% correspondingly. No statistically significant differences between groups by rates of and 5 year survival were determined (p = 0.3 and p = 0.0 correspondingly); by rate of 3year survival, insignificant tendency (p = 0.078) to the increase of survival after standard surgeries. Next stage of the research was analysis of survival of patients of study group dependently on involvement of LN pn0 (9 patients), pn (3), pn3 (3) (Fig. ). Most optimistic results of treatment have been obtained at lack of lymphogenous metastasis (pn0): MS 3.0 months, MLS 54.9 ± 5.4 months, year survival 69.4 ± 0.8%; 3year 50.0 ±.8%; 5year 44.4 ±.7%. Lymphogenous metastasis worsens prognostic chances. For instance, for patients with involvement of regional LN of category pn, MS has constituted months, MLS 0.8 ± 9.8 months, year survival 47. ±.% (p = 0.7), 3 year 9.0 ± 7.7% (p = 0.038), 5year 5.8 ± 8.4% (p = 0.04). For patients of category рn 3: MS months, MLS 33. ± 38.3 months, year survival 57.9 ± 3.7% (p = 0.39), 3year 30.8 ±.8% (p = 0.3), 5year 5.4 ± 0.0% (p = 0.3). Slightly better rates of survival of category N3 (absence of statistically significant differences from data of subgroup N0) we associate with small sampling of this category. Fig.. Function of survival for patients of the study and control groups

6 Fig.. Function of survival for patients of the study group of category pn0, pn, pn3. The question concerning the expediency of performance of palliative enlarged surgeries in patients of category N3 and M is still open. Though such cases are quite rare (7 observations), the problem needs solution. We follow such positions that if resectability of the main tumor lesion is possible without technical complications, also surgical intervention regarding metastatic involvement shall be performed. Correctness of such tactics is confirmed, firstly, by lack of lethal complications in such category of patients, secondly, by longterm results of treatment: MS 5.0 months, MLS 45.4 ± 58.4 months. These results undoubtedly are better compared with efficacy of symptomatic surgical interventions. CONCLUSIONS. Combined surgeries at locally advanced PGC are accompanied with higher number of postoperative complications and lethal outcomes.. Resection of pancreas is statistically significantly associated with high number of postoperative complications. 3. Regional lymphogenous metastasis at locally advanced PGC worsens longterm results of surgical treatment of patients. 4. Taking into account lack of early diagnostics, surgical treatment of patients in the pt4 stage remains the only chance for prolongation of life. Therefore, studies on improvement of the results of treatment of this category of patients are relevant. REFERENCES. Абдихакимов АН. Результаты хирургического лечения местнораспространенного рака желудка T4NM0. Анналы хирургии 003; : Давыдов МИ, ТерОванесов МД. Рак проксимального отдела желудка: современная классификация, тактика хирургического лечения, факторы прогноза. Рус мед журн 008; 3 (6): Давыдов МИ, ТерОванесов МД, Абдихакимов АН и др. Рак желудка: что определяет стандарты хирургического лечения. Практ онкол 00; 7: Киркилевский СИ, Кондрацкий ЮН, Притуляк СН. Восстановление пассажа пищи у больных с распространенным кардиоэзофагеальным раком. Клин онкол 0; 7 (3): Рак в Україні, Захворюваність, смертність, показники діяльності онкологічної служби. Бюл Нац канцерреєстру України 0; (): 38, Русанов АА. Рак пищевода и кардиального отдела желудка. Хирургия 978; 6: Скоропад ВЮ. Рациональная тактика лечения местнораспространенного рака желудка: место лучевой терапии. Практ онкол 009; (0): 8 35.

7 8. ТерОванесов МД. Факторы прогноза хирургического лечения рака проксимального отдела желудка [Автореф дис... док мед наук]. Москва: ГУ «Российский онкологический научный центр им. Н.Н. Блохина РАМН», 007; 3: 0 с. 9. Чиссов ВИ, Вашакмадзе ЛА, Бутенко АВ и др. Возможности хирургического лечения резектабельного рака желудка IV стадии. Рос онкол журн 003; 6: Carboni F, Lepiane P, Santoro R, et al. Extended multiorgan resection for T4 gastric carcinoma: 5year experience. J Surg Oncol 005; 90 (): Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 0; 6: Kobayashi A, Nakagohri Т, Konishi M, et al. Aggressive surgical treatment for T4 gastric cancer. J Gastrointest Surg 004; 8 (4): Martin RC, Jaques DP, Brennan MF, et al. Extended local resection for advanced gastric cancer: increased survival versus increased morbidity. Ann Surg 00; 63 (): Siewert JR, Feith M, Werner M, et al. Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in,00 consecutive patients. Ann Surg 000; 3:

Cancer of the Cardia/GE Junction: Surgical Options

Cancer of the Cardia/GE Junction: Surgical Options Cancer of the Cardia/GE Junction: Surgical Options Michael A Smith, MD Associate Chief Thoracic Surgery Center for Thoracic Disease St Joseph s Hospital and Medical Center Phoenix, AZ Michael Smith, MD

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

Keywords: advanced stage ovarian cancer, tertiary cytoreduction, debulking surgery

Keywords: advanced stage ovarian cancer, tertiary cytoreduction, debulking surgery CASE PRESENTATION ROJSP 2016, Vol. I (issue 1): E 45-53. Extended upper abdominal resections as part of debulking surgery at the time of tertiary cytoreduction for relapsed ovarian cancer a case report

More information

The Whipple Operation for Pancreatic Cancer: Optimism vs. Reality. Franklin Wright UCHSC Department of Surgery Grand Rounds September 11, 2006

The Whipple Operation for Pancreatic Cancer: Optimism vs. Reality. Franklin Wright UCHSC Department of Surgery Grand Rounds September 11, 2006 The Whipple Operation for Pancreatic Cancer: Optimism vs. Reality Franklin Wright UCHSC Department of Surgery Grand Rounds September 11, 2006 Overview Pancreatic ductal adenocarcinoma Pancreaticoduodenectomy

More information

The Royal Marsden. Surgery for Gastric and GE Junction Cancer: primary palliative where and when? William Allum

The Royal Marsden. Surgery for Gastric and GE Junction Cancer: primary palliative where and when? William Allum The Royal Marsden Surgery for Gastric and GE Junction Cancer: primary palliative where and when? William Allum Any surgeon can cure Surgeon - dependent No surgeon can cure EMR D2 GASTRECTOMY H N SN. WEDGE

More information

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D.

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D. Lung Cancer: Practical Application of Imaging In Determining Resectability Jeremy J. Erasmus, M. D. 62 year old man with a superior sulcus tumor. Which of the following precludes surgical resection in

More information

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA O.E. Stakhvoskyi, E.O. Stakhovsky, Y.V. Vitruk, O.A. Voylenko, P.S. Vukalovich, V.A. Kotov, O.M. Gavriluk National Canсer Institute,

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda Stomach (Gastric) Cancer Prof. M K Mahajan ACDT & RC Bathinda Gastric Cancer Role of Radiation Layers of the Stomach Mucosa Submucosa Muscularis Serosa Stomach and Regional Lymph Nodes Stomach and Regional

More information

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases.

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Abstract This paper describes the staging, imaging, treatment, and prognosis of renal cell carcinoma. Three case studies

More information

The Need for Accurate Lung Cancer Staging

The Need for Accurate Lung Cancer Staging The Need for Accurate Lung Cancer Staging Peter Baik, DO Thoracic Surgery Cancer Treatment Centers of America Oklahoma Osteopathic Association 115th Annual Convention Financial Disclosures: None 2 Objectives

More information

restricted to certain centers and certain patients, preferably in some sort of experimental trial format.

restricted to certain centers and certain patients, preferably in some sort of experimental trial format. Managing Pancreatic Cancer, Part 4: Pancreatic Cancer Surgery, Complications, & the Importance of Surgical Volume Dr. Matthew Katz, Surgeon, MD Anderson Cancer Center, Houston, TX I m going to talk a little

More information

Cancer Surgery Volume Study: ICD-9 and CPT Codes

Cancer Surgery Volume Study: ICD-9 and CPT Codes This paper contains the ICD-9 diagnostic and procedure codes and the CPT procedure codes used by researchers for a project of the California HealthCare Foundation (CHCF) and the California Office of Statewide

More information

A912: Kidney, Renal cell carcinoma

A912: Kidney, Renal cell carcinoma A912: Kidney, Renal cell carcinoma General facts of kidney cancer Renal cell carcinoma, a form of kidney cancer that involves cancerous changes in the cells of the renal tubule, is the most common type

More information

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012 Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro Joon H. Lee 9/17/2012 Malignant Pleural Mesothelioma (Epidemiology) Incidence: 7/mil (Japan) to 40/mil (Australia) Attributed secondary to asbestos

More information

PROTOCOL OF THE RITA DATA QUALITY STUDY

PROTOCOL OF THE RITA DATA QUALITY STUDY PROTOCOL OF THE RITA DATA QUALITY STUDY INTRODUCTION The RITA project is aimed at estimating the burden of rare malignant tumours in Italy using the population based cancer registries (CRs) data. One of

More information

SMALL CELL LUNG CANCER

SMALL CELL LUNG CANCER Protocol for Planning and Treatment The process to be followed in the management of: SMALL CELL LUNG CANCER Patient information given at each stage following agreed information pathway 1. DIAGNOSIS New

More information

Kidney Cancer OVERVIEW

Kidney Cancer OVERVIEW Kidney Cancer OVERVIEW Kidney cancer is the third most common genitourinary cancer in adults. There are approximately 54,000 new cancer cases each year in the United States, and the incidence of kidney

More information

Liver Cancer And Tumours

Liver Cancer And Tumours Liver Cancer And Tumours What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can

More information

Diagnosis and Prognosis of Pancreatic Cancer

Diagnosis and Prognosis of Pancreatic Cancer Main Page Risk Factors Reducing Your Risk Screening Symptoms Diagnosis Treatment Overview Chemotherapy Radiation Therapy Surgical Procedures Lifestyle Changes Managing Side Effects Talking to Your Doctor

More information

Challenges in gastric, appendiceal and rectal NETs Leuven, 29.11.2014

Challenges in gastric, appendiceal and rectal NETs Leuven, 29.11.2014 Challenges in gastric, appendiceal and rectal NETs Leuven, 29.11.2014 Prof. Dr. Chris Verslype, Leuven Prof. Dr. Aurel Perren, Bern Menue Challenges: 1. Gastric NET 2. Appendiceal NET 3. Rectal NET SEER,

More information

Work-up of Suspected Lung Cancer. Gordon Buduhan MD MSc FRCSC Section of Thoracic Surgery Lung Cancer Educational Program November 2013

Work-up of Suspected Lung Cancer. Gordon Buduhan MD MSc FRCSC Section of Thoracic Surgery Lung Cancer Educational Program November 2013 Work-up of Suspected Lung Cancer Gordon Buduhan MD MSc FRCSC Section of Thoracic Surgery Lung Cancer Educational Program November 2013 Presenter disclosure No conflicts to disclose Scope of the problem

More information

Key words: lung cancer, adjuvant chemotherapy, platinum-containing regimen.

Key words: lung cancer, adjuvant chemotherapy, platinum-containing regimen. The role of adjuvant chemotherapy in treatment of non-small cell lung cancer I.A. Kryachok, E.M. Aleksyk, A.A.Gubareva, E.C.Filonenko National cancer institute, Kyiv Summary: Lung cancer is the most common

More information

Frequently Asked Questions About Ovarian Cancer

Frequently Asked Questions About Ovarian Cancer Media Contact: Gerri Gomez Howard Cell: 303-748-3933 gerri@gomezhowardgroup.com Frequently Asked Questions About Ovarian Cancer What is ovarian cancer? Ovarian cancer is a cancer that forms in tissues

More information

Number. Source: Vital Records, M CDPH

Number. Source: Vital Records, M CDPH Epidemiology of Cancer in Department of Public Health Revised April 212 Introduction The general public is very concerned about cancer in the community. Many residents believe that cancer rates are high

More information

Luis D. Carcorze Soto, MD PGY-3

Luis D. Carcorze Soto, MD PGY-3 Luis D. Carcorze Soto, MD PGY-3 Peritoneal Surface Malignancies Peritoneum Patient Selection Operative Technique HIPEC EPIC Primary: Primary Peritoneal Carcinoma Malignant Peritoneal Mesothelioma Metastatic:

More information

Lenox Hill Hospital Department of Surgery General Surgery Goals and Objectives

Lenox Hill Hospital Department of Surgery General Surgery Goals and Objectives Lenox Hill Hospital Department of Surgery General Surgery Goals and Objectives Medical Knowledge and Patient Care: Residents must demonstrate knowledge and application of the pathophysiology and epidemiology

More information

EMR Can anyone do this?

EMR Can anyone do this? EMR Can anyone do this? Norio Fukami, MD University of Colorado Piecemeal resection? 1 Endoscopic mucosal resection (EMR) and Endoscopic submucosal dissection (ESD) Endoscopic removal of premalignant or

More information

Image. 3.11.3 SW Review the anatomy of the EAC and how this plays a role in the spread of tumors.

Image. 3.11.3 SW Review the anatomy of the EAC and how this plays a role in the spread of tumors. Neoplasms of the Ear and Lateral Skull Base Image 3.11.1 SW What are the three most common neoplasms of the auricle? 3.11.2 SW What are the four most common neoplasms of the external auditory canal (EAC)

More information

How to treat early gastric cancer. Surgery

How to treat early gastric cancer. Surgery How to treat early gastric cancer Surgery Mark I. van Berge Henegouwen Department of Surgery, AMC, Amsterdam Director upper GI surgical unit Academic Medical Center Upper GI surgery at AMC 100 oesophagectomies

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

Microwave ablation for the treatment of liver metastases

Microwave ablation for the treatment of liver metastases Microwave ablation for the treatment of liver Issued: August 2011 guidance.nice.org.uk/ipg NICE has accredited the process used by the NICE Interventional Procedures Programme to produce interventional

More information

The Whipple Procedure. Sally Hodges, Ph.D.(c) Given the length and difficulty of the procedure, regardless of the diagnosis, certain

The Whipple Procedure. Sally Hodges, Ph.D.(c) Given the length and difficulty of the procedure, regardless of the diagnosis, certain The Whipple Procedure Sally Hodges, Ph.D.(c) Preoperative procedures Given the length and difficulty of the procedure, regardless of the diagnosis, certain assurances must occur prior to offering a patient

More information

LIVER CANCER AND TUMOURS

LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS Healthy Liver Cirrhotic Liver Tumour What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood

More information

Treatment Guide Lung Cancer Management

Treatment Guide Lung Cancer Management Treatment Guide Lung Cancer Management The Chest Cancer Center at Cleveland Clinic, which includes specialists from the Respiratory Institute, Taussig Cancer Institute and Miller Family Heart & Vascular

More information

HER2 Status: What is the Difference Between Breast and Gastric Cancer?

HER2 Status: What is the Difference Between Breast and Gastric Cancer? Ask the Experts HER2 Status: What is the Difference Between Breast and Gastric Cancer? Bharat Jasani MBChB, PhD, FRCPath Marco Novelli MBChB, PhD, FRCPath Josef Rüschoff, MD Robert Y. Osamura, MD, FIAC

More information

Adiuwantowe i neoadiuwantowe leczenie chorych na zaawansowanego raka żołądka

Adiuwantowe i neoadiuwantowe leczenie chorych na zaawansowanego raka żołądka Adiuwantowe i neoadiuwantowe leczenie chorych na zaawansowanego raka żołądka Neoadiuvant and adiuvant therapy for advanced gastric cancer Franco Roviello, IT Neoadjuvant and adjuvant therapy for advanced

More information

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj.

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj. PSA Testing 101 Stanley H. Weiss, MD Professor, UMDNJ-New Jersey Medical School Director & PI, Essex County Cancer Coalition weiss@umdnj.edu September 23, 2010 Screening: 3 tests for PCa A good screening

More information

The TV Series. www.healthybodyhealthymind.com INFORMATION TELEVISION NETWORK

The TV Series. www.healthybodyhealthymind.com INFORMATION TELEVISION NETWORK The TV Series www.healthybodyhealthymind.com Produced By: INFORMATION TELEVISION NETWORK ONE PARK PLACE 621 NW 53RD ST BOCA RATON, FL 33428 1-800-INFO-ITV www.itvisus.com 2005 Information Television Network.

More information

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY Dr. Shailesh V. Shrikhande Associate Professor & Consultant Surgeon GI and HPB Surgical Oncology Tata Memorial Hospital, Mumbai INDIA HELICAL

More information

Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer.

Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer. Renal cell cancer Renal cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney. Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which

More information

LUNG CANCER the new Staging System G.KIROVA TOKUDA HOSPITAL SOFIA

LUNG CANCER the new Staging System G.KIROVA TOKUDA HOSPITAL SOFIA LUNG CANCER the new Staging System G.KIROVA TOKUDA HOSPITAL SOFIA STAGING SYSTEM Provides standardized nomenclature for exchanging information Groups patients according to the biologic behavior of their

More information

Current Status and Perspectives of Radiation Therapy for Breast Cancer

Current Status and Perspectives of Radiation Therapy for Breast Cancer Breast Cancer Current Status and Perspectives of Radiation Therapy for Breast Cancer JMAJ 45(10): 434 439, 2002 Masahiro HIRAOKA, Masaki KOKUBO, Chikako YAMAMOTO and Michihide MITSUMORI Department of Therapeutic

More information

Pancreatic Cancer. The Killer that must be discovered early. Dr Alfred Kow Wei Chieh

Pancreatic Cancer. The Killer that must be discovered early. Dr Alfred Kow Wei Chieh Pancreatic Cancer The Killer that must be discovered early 27 th June 2015 Dr Alfred Kow Wei Chieh Consultant Department of Surgery Division of HPB Surgery & Liver Transplantation & Assistant Dean (Education)

More information

Evidence tabel Lokaal palliatieve behandelingen

Evidence tabel Lokaal palliatieve behandelingen Auteurs, jaartal Mate van bewijs Studie type Follow-up Populatie (incl. steekproef-grootte) Patienten kenmerken Interventie Controle Resultaten Conclusie Opmerkingen, commentaar Hartgrink, 2002 The Netherlands

More information

OCCULT PRIMARY CANCER

OCCULT PRIMARY CANCER OCCULT PRIMARY CANCER พญ.ครองกมล ส หบ ณฑ หน วยมะเร งว ทยา INTRODUCTION Occult primary cancers or cancer of unknown primary (CUPS) Histologically proven metastatic malignant tumors whose primary site cannot

More information

CHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc.

CHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc. Neoplasms (C00-D49) March 2014 2014 MVP Health Care, Inc. CHAPTER SPECIFIC CATEGORY CODE BLOCKS C00-C14 Malignant neoplasms of lip, oral cavity and pharynx C15-C26 Malignant neoplasms of digestive organs

More information

SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD

SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD SUNY DOWNSTATE MEDICAL CENTER SURGERY GRAND ROUNDS February 28, 2013 VERENA LIU, MD ROSEANNA LEE, MD Case Presentation 35 year old male referred from PMD with an asymptomatic palpable right neck mass PMH/PSH:

More information

Treatment and prognosis of primary esophageal small cell carcinoma

Treatment and prognosis of primary esophageal small cell carcinoma [Chinese Journal of Cancer 28:3, 254-258; March 2009]; 2009 Landes Bioscience Clinical Research Paper Treatment and prognosis of primary esophageal small cell carcinoma A report of 151 cases Yan Song,

More information

Pancreatic Carcinoma Recurrence in the Remnant Pancreas after a Pancreaticoduodenectomy

Pancreatic Carcinoma Recurrence in the Remnant Pancreas after a Pancreaticoduodenectomy CASE REPORT Pancreatic Carcinoma Recurrence in the Remnant Pancreas after a Pancreaticoduodenectomy Raffaele Dalla Valle 1, Cristina Mancini 2, Pellegrino Crafa 2, Rodolfo Passalacqua 3 1 Department of

More information

Stage IV Renal Cell Carcinoma. Changing Management in A Comprehensive Community Cancer Center. Susquehanna Health Cancer Center

Stage IV Renal Cell Carcinoma. Changing Management in A Comprehensive Community Cancer Center. Susquehanna Health Cancer Center Stage IV Renal Cell Carcinoma Changing Management in A Comprehensive Community Cancer Center Susquehanna Health Cancer Center 2000 2009 Warren L. Robinson, MD, FACP January 27, 2014 Introduction 65,150

More information

Surgical Margins and follow up of Squamous Cell Carcinoma. Steve Keohane

Surgical Margins and follow up of Squamous Cell Carcinoma. Steve Keohane Surgical Margins and follow up of Squamous Cell Carcinoma Steve Keohane Poor registration Well established projected increase in incidence for next 2 decades Significant morbidity but relatively low mortality

More information

An Introduction to Cancer and Basic Cancer Vocabulary

An Introduction to Cancer and Basic Cancer Vocabulary An Introduction to Cancer and Basic Cancer Vocabulary Marc B. Garnick, MD Beth Israel Deaconess Medical Center Harvard Medical School, Boston Medical Director Cancer Programs Northeast Hospital Corporation,

More information

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011 Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer Shannon Acker April 4, 2011 Rectal Cancer 40,870 new cases in the US in 2009 49,920 deaths from colorectal cancer Second leading cause

More information

SURGICAL TREATMENT AND TRENDS IN DESMOID TUMORS

SURGICAL TREATMENT AND TRENDS IN DESMOID TUMORS SURGICAL TREATMENT AND TRENDS IN DESMOID TUMORS November 13, 2010 Marcovalerio Melis, MD Assistant Professor NYU School of Medicine New York, NY Desmoid Tumors Rare, slow growing, mesenchymal proliferations

More information

Contact Maryann Verrillo Diane Shnitzler (703) 691-1805. Interventional Radiology Treatments for Kidney Cancer

Contact Maryann Verrillo Diane Shnitzler (703) 691-1805. Interventional Radiology Treatments for Kidney Cancer Interventional Radiology Treatments for Kidney Cancer FACT SHEET Contact Maryann Verrillo Diane Shnitzler (703) 691-1805 Kidney cancer is the eighth most common cancer in men and the tenth in women. 1

More information

PET/CT Imaging in Lung Cancer

PET/CT Imaging in Lung Cancer PET/CT Imaging in Lung Cancer Mylene T. Truong, MD Mylene T. Truong M.D. Objectives To discuss the role of PET/CT in the staging of lung cancer To review the recommendations from American Society of Clinical

More information

Mesothelioma. Malignant Pleural Mesothelioma

Mesothelioma. Malignant Pleural Mesothelioma Mesothelioma William G. Richards, PhD Brigham and Women s Hospital Malignant Pleural Mesothelioma 2,000-3,000 cases per year (USA) Increasing incidence Asbestos (50-80%, decreasing) 30-40 year latency

More information

9. Discuss guidelines for follow-up post-thyroidectomy for cancer (labs/tests) HH

9. Discuss guidelines for follow-up post-thyroidectomy for cancer (labs/tests) HH 9. Discuss guidelines for follow-up post-thyroidectomy for cancer (labs/tests) HH Differentiated thyroid cancer expresses the TSH receptor on the cell membrane and responds to TSH stimulation by increasing

More information

Metastatic Cancer: Questions and Answers. Key Points

Metastatic Cancer: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Metastatic Cancer: Questions

More information

THYROID CANCER. I. Introduction

THYROID CANCER. I. Introduction THYROID CANCER I. Introduction There are over 11,000 new cases of thyroid cancer each year in the US. Females are more likely to have thyroid cancer than men by a ratio of 3:1, and it is more common in

More information

OBJECTIVES By the end of this segment, the community participant will be able to:

OBJECTIVES By the end of this segment, the community participant will be able to: Cancer 101: Cancer Diagnosis and Staging Linda U. Krebs, RN, PhD, AOCN, FAAN OCEAN Native Navigators and the Cancer Continuum (NNACC) (NCMHD R24MD002811) Cancer 101: Diagnosis & Staging (Watanabe-Galloway

More information

ESD for colorectal lesions I am in favour. Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy

ESD for colorectal lesions I am in favour. Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy ESD for colorectal lesions I am in favour Alessandro Repici, MD Digestive Endoscopy Unit IRCCS Istituto Clinico Humanitas Milano, Italy Surgery for early colonic lesions 51 pts referred for lap colectomy

More information

Survival analysis of 220 patients with completely resected stage II non small cell lung cancer

Survival analysis of 220 patients with completely resected stage II non small cell lung cancer 窑 Original Article 窑 Chinese Journal of Cancer Survival analysis of 22 patients with completely resected stage II non small cell lung cancer Yun Dai,2,3, Xiao Dong Su,2,3, Hao Long,2,3, Peng Lin,2,3, Jian

More information

DELRAY MEDICAL CENTER. Cancer Program Annual Report

DELRAY MEDICAL CENTER. Cancer Program Annual Report DELRAY MEDICAL CENTER Cancer Program Annual Report Cancer Statistical Data From 2010 TABLE OF CONTENTS Chairman s Report....3 Tumor Registry Statistical Report Summary...4-11 Lung Study.12-17 Definitions

More information

Multidisciplinary discussion of: Early staged NSCLC

Multidisciplinary discussion of: Early staged NSCLC Multidisciplinary discussion of: Early staged NSCLC 2 different classes of patients Stage IIIA pt2pn2 Stage IIB pt3pn0 2 different classes of patients 50% 40% 30% 20% 10% 3y survival 50% 40% 30% 20% 10%

More information

Multimodal Treatment of Resectable Gastric Cancer with Intensive Neoadjuvant Radiation Therapy: Obninsk Radiological Center Experience

Multimodal Treatment of Resectable Gastric Cancer with Intensive Neoadjuvant Radiation Therapy: Obninsk Radiological Center Experience The Open Surgical Oncology Journal, 2011, 3, 1-6 1 Open Access Multimodal Treatment of Resectable Gastric Cancer with Intensive Neoadjuvant Radiation Therapy: Obninsk Radiological Center Experience V.

More information

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD Epidemiology, Staging and Treatment of Lung Cancer Mark A. Socinski, MD Associate Professor of Medicine Multidisciplinary Thoracic Oncology Program Lineberger Comprehensive Cancer Center University of

More information

Surgeons Role in Symptom Management. A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND

Surgeons Role in Symptom Management. A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND Surgeons Role in Symptom Management A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND Conditions PLEURAL Pleural effusion Pneumothorax ENDOBRONCHIAL Haemoptysis

More information

Liver Cancer What is the liver? What is liver cancer?

Liver Cancer What is the liver? What is liver cancer? Liver Cancer What is the liver? The liver is the largest internal organ in the body and is important in digesting food. The liver performs many other functions, including collecting and filtering blood

More information

Tumour Markers. What are Tumour Markers? How Are Tumour Markers Used?

Tumour Markers. What are Tumour Markers? How Are Tumour Markers Used? Dr. Anthony C.H. YING What are? Tumour markers are substances that can be found in the body when cancer is present. They are usually found in the blood or urine. They can be products of cancer cells or

More information

Introduction. Case History

Introduction. Case History NAOSITE: Nagasaki University's Ac Title Author(s) A Case Report of Renal Cell Carcino Shimajiri, Shouhei; Shingaki, Yoshi Masaya; Tamamoto, Tooru; Toda, Taka Citation Acta Medica Nagasakiensia. 1992, 37

More information

The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options

The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options Why We re Here The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options What Are Lungs? What Do They Do? 1 Located in the chest Allow you to breathe Provide oxygen

More information

Directly Coded Summary Stage Is Back

Directly Coded Summary Stage Is Back Directly Coded Summary Stage Is Back Donna M. Hansen, CTR Auditor & Training Coordinator California Cancer Registry June 30, 2015 1 Outline What is SEER Summary Stage 2000 (SS2000)? Summary Stage Housekeeping

More information

Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof.

Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof. Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof. Alberto Riccardi SMALL CELL LUNG CARCINOMA Summary of treatment approach * limited

More information

The New International Staging System Lung Cancer

The New International Staging System Lung Cancer The New International Staging System Lung Cancer Valerie W. Rusch, MD Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center Chair, Lung and Esophagus Task Force, American Joint Commission on Cancer

More information

Adenocarcinoma: follow-up and interventional radiology

Adenocarcinoma: follow-up and interventional radiology ESGAR-Pancreas Workshop Adenocarcinoma: follow-up and interventional radiology Marc Zins Groupe Hospitalier Paris saint-joseph Dublin, May 15-16, 2014 Learning Objectives To learn Normal post operative

More information

Hepatocellular Carcinoma (HCC)

Hepatocellular Carcinoma (HCC) Abhishek Vadalia Introduction Chemoembolization is being used with increasing frequency in the treatment of solid hepatic tumors such as Hepatocellular Carinoma (HCC) & rare Cholangiocellular Carcinoma

More information

Colorectal cancer. A guide for journalists on colorectal cancer and its treatment

Colorectal cancer. A guide for journalists on colorectal cancer and its treatment Colorectal cancer A guide for journalists on colorectal cancer and its treatment Contents Contents 2 3 Section 1: Colorectal cancer 4 i. What is colorectal cancer? 4 ii. Causes and risk factors 4 iii.

More information

THE SURGICAL TREATMENT OF ESOPHAGEAL CANCER. INDICATIONS, COMPARATIVE ANALYSIS OF SURGICAL TECHNIQUES.

THE SURGICAL TREATMENT OF ESOPHAGEAL CANCER. INDICATIONS, COMPARATIVE ANALYSIS OF SURGICAL TECHNIQUES. UNIVERSITY OF MEDICINE AND PHARMACY OF CRAIOVA FACULTY OF MEDICINE THE SURGICAL TREATMENT OF ESOPHAGEAL CANCER. INDICATIONS, COMPARATIVE ANALYSIS OF SURGICAL TECHNIQUES. Scientific coordinator : Prof.

More information

Cancer treatment. TOP EUROPEAN CANCER EXPERTISE The path to recovery

Cancer treatment. TOP EUROPEAN CANCER EXPERTISE The path to recovery Cancer treatment TOP EUROPEAN CANCER EXPERTISE The path to recovery 0% LAND OF HIGH QUALITY HEALTHCARE Located in Finland, a land of high quality healthcare, Helsinki University Hospital is regarded as

More information

Treatment of mesothelioma in Bloemfontein, South Africa

Treatment of mesothelioma in Bloemfontein, South Africa European Journal of Cardio-thoracic Surgery 24 (2003) 434 440 www.elsevier.com/locate/ejcts Treatment of mesothelioma in Bloemfontein, South Africa W.J. de Vries*, M.A. Long Cardiothoracic Department,

More information

Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer

Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer PREAMBLE The following recommendations regarding the safe performance of laparoscopic resection for curable colon and rectal cancer

More information

Learning Luncheon 7: Endoscopic Mucosal Resection: When, Where and How?

Learning Luncheon 7: Endoscopic Mucosal Resection: When, Where and How? Endoscopic Mucosal Resection (EMR): When, Where, and Charles J. Lightdale, MD Columbia University New York, NY Endoscopic Mucosal Resection (EMR) EMR developed for removal of sessile or flat neoplasms

More information

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain Changes in Breast Cancer Reports After Second Opinion Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain Second Opinion in Breast Pathology Usually requested when a patient is referred

More information

Cancer is the leading cause of death for Canadians aged 35 to 64 and is also the leading cause of critical illness claims in Canada.

Cancer is the leading cause of death for Canadians aged 35 to 64 and is also the leading cause of critical illness claims in Canada. Underwriting cancer In this issue of the Decision, we provide an overview of Canadian cancer statistics and the information we use to make an underwriting decision. The next few issues will deal with specific

More information

Cancer of the Pancreas

Cancer of the Pancreas Cancer of the Pancreas James H. North Jr., M.D., F.A.C.S. It is estimated that in 2007, 37,170 patients will be diagnosed with cancer of the pancreas and 33,370 patients will die of this disease. 1 The

More information

Interventional Tumor Therapy Minimally Invasive, Maximally Effective

Interventional Tumor Therapy Minimally Invasive, Maximally Effective Cover Story Interventional Oncology Interventional Tumor Therapy Minimally Invasive, Maximally Effective There is a continuous expansion of indications for interventional therapies in oncology. Thanks

More information

PSA Screening for Prostate Cancer Information for Care Providers

PSA Screening for Prostate Cancer Information for Care Providers All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits

More information

TNM Staging Fact Sheet

TNM Staging Fact Sheet TNM Staging Fact Sheet Jan 2010 This document provides answers to some of the frequently asked questions posed by physicians, health information management professionals, and cancer program administrators,

More information

From ICD-9-CM to ICD-10-CM. Coding for Neoplasms

From ICD-9-CM to ICD-10-CM. Coding for Neoplasms From ICD-9-CM to ICD-10-CM Presented by: Kay Kostal, M.Ed., RHIT, CCS Deborah A. Balentine, M.Ed., RHIA, CCS-P North American Association of Central Cancer Registries July 12, 2012 1 Case Studies Case

More information

Ching-Yao Yang, Yu-Wen Tien

Ching-Yao Yang, Yu-Wen Tien Ching-Yao Yang, Yu-Wen Tien Division of General Surgery, Department of Surgery, National Taiwan University Hospital Oct-30-2010 Pancreatic NET have poorer prognosis when presence of liver metastases at

More information

Renal Cancer: Symptoms, diagnosis, pathology & prognosis

Renal Cancer: Symptoms, diagnosis, pathology & prognosis Renal Cancer: Symptoms, diagnosis, pathology & prognosis Mark Johnson Consultant Urological Surgeon Newcastle upon Tyne Hospitals NHS Foundation Trust Plan for today: How renal tumours present What investigations

More information

Surgical Staging of Endometrial Cancer

Surgical Staging of Endometrial Cancer Surgical Staging of Endometrial Cancer I. Endometrial Cancer Surgical Staging Overview Uterine cancer types: carcinomas type I and type II, sarcomas, carcinosarcomas Hysterectomy with BSO Surgical Staging

More information

7. Prostate cancer in PSA relapse

7. Prostate cancer in PSA relapse 7. Prostate cancer in PSA relapse A patient with prostate cancer in PSA relapse is one who, having received a primary treatment with intent to cure, has a raised PSA (prostate-specific antigen) level defined

More information

Lung Cancer: Diagnosis, Staging and Treatment

Lung Cancer: Diagnosis, Staging and Treatment PATIENT EDUCATION patienteducation.osumc.edu Lung Cancer: Diagnosis, Staging and Treatment Cancer begins in our cells. Cells are the building blocks of our tissues. Tissues make up the organs of the body.

More information

Update on Mesothelioma

Update on Mesothelioma November 8, 2012 Update on Mesothelioma Intro incidence and nomenclature Update on Classification Diagnostic specimens Morphologic features Epithelioid Histology Biphasic Histology Immunohistochemical

More information

LYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis

LYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis LYMPHOMA IN DOGS Lymphoma is a relatively common cancer in dogs. It is a cancer of lymphocytes (a type of white blood cell) and lymphoid tissues. Lymphoid tissue is normally present in many places in the

More information

Locoregional & advanced esophagus or esophagogastric junction cancer

Locoregional & advanced esophagus or esophagogastric junction cancer Eloxatin (oxaliplatin) Prior Authorization Request (For Maryland Only) Send completed form to: Case Review Unit CVS/caremark Specialty Programs Fax: 866-249-6155 CVS/caremark administers the prescription

More information

Malignant Mesothelioma Current Approaches to a Difficult Problem. Raja M Flores, MD Thoracic Surgery Memorial Sloan-Kettering Cancer Center

Malignant Mesothelioma Current Approaches to a Difficult Problem. Raja M Flores, MD Thoracic Surgery Memorial Sloan-Kettering Cancer Center Malignant Mesothelioma Current Approaches to a Difficult Problem Raja M Flores, MD Thoracic Surgery Memorial Sloan-Kettering Cancer Center Malignant Pleural Mesothelioma Clinical Presentation Insidious

More information