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Clin Lung Cancer 2021 May 16. Epub 2021 May 16.

Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia. Electronic address:

Background: Epidermal growth factor receptor gene (EGFR) exon 20 insertion (ex20-ins) mutations are an uncommon and heterogeneous group of non-small cell lung cancers (NSCLCs), resistant to conventional EGFR tyrosine kinase inhibitors (TKIs). Characteristics and outcomes of patients with EGFR ex20-ins have not been fully established; we sought to clarify them using a multinational patient database.

Patients And Methods: Patients with NSCLC from six Australian institutions with EGFR exon 20 mutations (ex20-mut), excluding T790M, were retrospectively reviewed. Read More

Hepatobiliary Pancreat Dis Int 2021 Jun 4. Epub 2021 Jun 4.

Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, B15 2TH, United Kingdom.

Background: Gold standard for colorectal liver metastases (CRLM) remains hepatic resection (HR). However, patients with severe comorbidities, unresectable or deep-situated resectable CRLM are candidates for ablation. The aim of the study was to compare recurrence rate and survival benefit of the microwave ablation (MWA), radiofrequency ablation (RFA) and HR by conducting the first network meta-analysis. Read More

Transfus Apher Sci 2021 May 31:103176. Epub 2021 May 31.

Transfusion Medicine Deparment, Hospital Italiano de Buenos Aires, Argentina.

Introduction: Factor XI (FXI) deficiency is a rare congenital hemostatic disorder associated with increased bleeding tendency in trauma, surgery or when other hemostatic defects are present. Perioperative hemostatic management of a patient with a severe FXI deficiency undergoing major oncological liver and colorectal surgery with therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) is reported.

Case Description: A 54-year-old male with severe FXI deficiency was scheduled for resection of synchronous rectal cancer and multiple liver metastases. Read More

Eur J Surg Oncol 2021 May 20. Epub 2021 May 20.

Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. Electronic address:

Background: Laparoscopic ablation (LA) of liver tumors is an increasingly performed procedure. However, LA is technically demanding, with inherent difficulties making LA more complex than percutaneous and open surgery ablations. This study aimed to characterize the learning curve (LC) of LAs. Read More

Ther Adv Gastrointest Endosc 2021 Jan-Dec;14:26317745211020279. Epub 2021 Jun 2.

Key Laboratory of Carcinogenesis and Translational Research, Hepatopancreatobiliary Surgery Department I, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, China.

Colorectal cancer is the third most common cancer worldwide, and its incidence continues to grow. Approximately one-third of patients with colorectal cancer develop liver metastases during the natural course of disease. Complete surgical resection is associated with very low mortality in colorectal liver metastasis patients, but only a small fraction of colorectal liver metastasis patients fulfill the selection criteria for surgical treatment. Read More

Eur Heart J Case Rep 2021 May 7;5(5):ytab172. Epub 2021 May 7.

Division of Cardiology, Department of Medicine, McGill University, 1009 rue de Bleury, Apt 1009, Montréal, QC H2Z 0A3, Canada.

Background: Primary cardiac lymphoma (PCL) is rare and can present with a wide variety of clinical symptoms, frequently leading to a delay in diagnosis.

Case Summary: We report a case of a PCL in an 81-year-old man. Cardiac magnetic resonance imaging showed multiple masses in the right atrium and a mass in the right ventricular outflow tract extending to the pulmonary artery. Read More

Eur Heart J Case Rep 2021 May 14;5(5):ytaa536. Epub 2021 May 14.

Department of Cardiology, St George Hospital, Gray Street, Kogarah 2217, NSW, Australia.

Background: Carcinoid heart disease is a potential sequela of metastatic neuroendocrine tumour that has characteristic valve appearances. Patients can present with symptoms of carcinoid syndrome or be relatively asymptomatic until symptoms of progressive heart failure manifest.

Case Summary: We present a case of a 54-year-old male who was admitted to the hospital for investigation of hypoxia. Read More

Front Oncol 2021 27;11:676135. Epub 2021 May 27.

Department of Pathology, University of Pittsburgh, Pittsburgh, PA, United States.

Metastatic breast cancer remains a largely incurable and fatal disease with liver involvement bearing the worst prognosis. The danger is compounded by a subset of disseminated tumor cells that may lie dormant for years to decades before re-emerging as clinically detectable metastases. Pathophysiological signals can drive these tumor cells to emerge. Read More

Cureus 2021 May 2;13(5):e14801. Epub 2021 May 2.

Histopathology, Northern Care Alliance National Health Service (NHS) Trust, Oldham, GBR.

Endometrial stromal sarcoma is a rare tumour. It is even rarer to find it arising in the background of endometriosis in an extrauterine location. This case report describes a case of missed diagnosis of intestinal extra-uterine endometrial stromal sarcoma associated with endometriosis, and the subsequent presentation with distant metastases. Read More

World J Gastrointest Surg 2021 May;13(5):392-405

Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, United States.

Despite numerous advances and emerging data, liver transplantation in the setting of gastrointestinal malignancies remains controversial outside of certain accepted indications. In an era of persistent organ shortage and increasing organ demand, allocation of liver grafts must be considered carefully. While hepatocellular carcinoma and hilar cholangiocarcinoma have become accepted indications for transplantation, tumor size and standardized multi-disciplinary treatment protocols are necessary to ensure optimal patient outcomes. Read More

Front Genet 2021 28;12:561254. Epub 2021 May 28.

Liver Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, China.

Recently, growing evidence has revealed the significant effect of reprogrammed metabolism on pancreatic cancer in relation to carcinogenesis, progression, and treatment. However, the prognostic value of metabolism-related genes in pancreatic cancer has not been fully revealed. We identified 379 differentially expressed metabolic-related genes (DEMRGs) by comparing 178 pancreatic cancer tissues with 171 normal pancreatic tissues in The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression project (GTEx) databases. Read More

Front Pharmacol 2021 28;12:632076. Epub 2021 May 28.

Department of Colorectal Medicine, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.

After initial treatment, maintenance therapy is now commonly used in mCRC patients, which can help patients live longer, have lower side effects, and higher quality of life. The maintenance treatment may include chemotherapy, targeted therapy, or combined with chemotherapy and targeted therapy. But the evidence of cetuximab maintenance is still scant. Read More

Pediatr Dev Pathol 2021 Jun 14:10935266211018930. Epub 2021 Jun 14.

Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

Undifferentiated embryonal sarcoma of the liver (UESL) is a rare aggressive neoplasm that occurs predominantly in children. Like mesenchymal hamartoma of the liver (MHL), UESL harbors recurrent rearrangements involving 19q13.3 and 19q13. Read More

Endocrine 2021 Jun 12. Epub 2021 Jun 12.

Neuroendocrine Tumour Unit, Centre for Gastroenterology, ENETS Centre of Excellence, Royal Free Hospital, London, UK.

Purpose: Type III gastric neuroendocrine neoplasms (g-NENs) have historically been regarded as aggressive tumours, hence current guidelines advocate radical surgery with lymph node dissection. Data on the roles of endoscopic or less extensive surgical resections are more limited. The aim of our study is to evaluate the clinicopathological features and long-term outcomes of patients undergoing endoscopic or limited surgical resection for localised grade 1 or 2 type III g-NENs when compared to radical surgery. Read More

Eur J Radiol 2021 Jun 6;141:109806. Epub 2021 Jun 6.

Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.

Purpose: This study aims to compare the diagnostic values of mono-exponential, bi-exponential, and stretched exponential diffusion-weighted imaging (DWI) in differentiating hepatic hemangiomas and liver metastases.

Method: This prospective study was approved by our institutional review board, and written informed consent was obtained from all patients. In this study, 244 patients with known or suspected liver disease underwent magnetic resonance imaging. Read More

Eur J Surg Oncol 2021 Jun 6. Epub 2021 Jun 6.

Department of Surgery, Northwest Clinics, PO Box 501, 1815 JD, Alkmaar, the Netherlands.

Introduction: Indeterminate pulmonary nodules (IPNs) are frequently encountered on staging computed tomography (CT) in colorectal cancer (CRC) patients and they create diagnostic dilemmas. This systematic review and pooled analysis aims to estimate the incidence and risk of malignancy of IPNs and provide an overview of the existing literature on IPNs in CRC patients.

Materials And Methods: EMBASE, Pubmed and the Cochrane database were searched for papers published between January 2005 and April 2020. Read More

Eur J Surg Oncol 2021 Jun 1. Epub 2021 Jun 1.

Division of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy.

Introduction: how best to manage patients with colorectal cancer and synchronous liver metastasis is still controversial, with specific concerns of increased risk of postoperative complications following combined resection. We aimed at analyzing the influence of combined liver resection on the risk of anastomotic leak (AL) following colorectal resection.

Methods: we reviewed the iCral prospectively maintained database to compare the relative risk of AL of patients undergoing colorectal resection for cancer to that of patients receiving simultaneous liver and colorectal resection for cancer with isolated hepatic metastases. Read More

Clin J Gastroenterol 2021 Jun 11. Epub 2021 Jun 11.

Department of Surgery, National Hospital Organization, Higashihiroshima Medical Center, 513 Jike, Saijo-cho, Higashihiroshima, Hiroshima, 739-0041, Japan.

Duodenal gastrointestinal stromal tumors (dGISTs) are rare, and a lack of consensus exists regarding their treatment, particularly for recurrent disease. We herein report a rare case of liver metastasis 7 years after resection of a low-risk duodenal gastrointestinal stromal tumor. A 45-year-old woman revealed positive fecal occult blood. Read More

Br J Surg 2021 Jun 12. Epub 2021 Jun 12.

Division of Surgery, Inflammatory Diseases and Transplantation, Experimental Transplantation and Malignancy Research Group, Oslo University Hospital, Oslo, Norway.

J Visc Surg 2021 Jun 8. Epub 2021 Jun 8.

Department of Digestive Surgery and Transplantation, Lille University Hospital, Lille, France.

Goal Of The Study: Concomitant liver metastases are discovered at the time of diagnosis in 25% of patients with colorectal cancers. The appropriate time to restore digestive continuity after stoma creation during rectal surgery has not yet been established. The objective of this study is to assess the morbidity of stoma reversal during the secondary hepatectomy procedure. Read More

Cancer Radiother 2021 Jun 8. Epub 2021 Jun 8.

Université Claude-Bernard Lyon 1, Lyon, France; Département d'hépatologie, groupement hospitalier Lyon Nord, Hospices civils de Lyon, Lyon, France.

Haemangioma is the most frequent benign hepatic tumour. Haemangioma is generally asymptomatic but it can sometimes cause disabling symptoms depending on its size and location. Surgery and interventional radiology are the cornerstone of the treatment in this situation. Read More

J Hepatobiliary Pancreat Sci 2021 Jun 11. Epub 2021 Jun 11.

Department of Surgery, Memorial Sloan Kettering Cancer Cancer, New York, NY, USA.

Background: Although the value of RAS mutation status in predicting long-term outcomes in patients with colorectal liver metastases (CRLM) is widely accepted, the magnitude of its impact has recently been challenged by three large cohort studies. The aim of this meta-analysis is to reevaluate the impact of RAS mutations on Overall Survival (OS) and Disease-Free Survival (DFS) in patients who underwent curative-intent resection of CRLM.

Methods: A comprehensive literature search was performed for studies reporting outcomes of patients undergoing curative-intent surgery stratified by RAS mutation status. Read More

Onco Targets Ther 2021 3;14:3567-3581. Epub 2021 Jun 3.

Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.

Background: Primary pancreatic mucoepidermoid carcinoma (MEC) is an extremely rare malignant tumor with unclear etiology and pathogenesis. There are only eleven reported cases in English papers published from 1959 to 2020. MEC generally occurs in the salivary gland, but cases in the pancreas have also been reported. Read More

BMC Urol 2021 Jun 10;21(1):91. Epub 2021 Jun 10.

Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Background: Wilms' tumor (nephroblastoma) is mostly unilateral; however, bilateral Wilms' tumors are seen in about 5-8% of patients. This can be synchronous or metachronous. It is uncommon to get liver metastasis from bilateral Wilms' tumor. Read More

J Am Coll Surg 2021 Jun 3. Epub 2021 Jun 3.

Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Electronic address:

Background: Understanding of signaling pathways has not been fully incorporated into prognostication and therapeutic options. We evaluated the hypothesis that information about cancer-related signaling pathways can improves prognostic stratification and explains some of the clinical heterogeneity in patients with metastatic colorectal cancer.

Study Design: We analyzed prognostic relevance of signaling pathways in patients undergoing colorectal liver metastases (CLM) resection during 2004-2017 and clinical actionability of gene alterations in seven signaling pathways: p53, Wnt, RTK-RAS, PI3K, TGFβ, Notch, and cell cycle. Read More

Hepatology 2021 Jun 10. Epub 2021 Jun 10.

Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.

Background & Aims: Liver metastasis is a frequent occurrences in patients with colorectal cancer (CRC), 15%-25% of CRC patients have liver metastases at the time of initial diagnosis (1). Specifically, some regional-stage patients with mild symptoms (stage Ⅰ or II) will also advance to liver metastases rapidly, even CRC lesion in situ is resected in time. Nevertheless, the precise mechanism of liver metastasis is still unclear. Read More

J Cancer Res Clin Oncol 2021 Jun 10. Epub 2021 Jun 10.

Department of Measurement and Electronics, AGH University of Science and Technology, al. Mickiewicza 30, Kraków, Poland.

Background: The purpose of this study was to investigate the potential of a combination of 3D mixed-reality visualization of medical images using CarnaLife Holo (MedApp, Poland) system as a supporting tool for innovative, minimally invasive surgery/irreversible electroporation-IRA, Nano-Knife), microwave ablation (MWA)/for advanced gastrointestinal tumors. Eight liver and pancreatic tumor treatments were performed. In all of the patients undergoing laparoscopy or open surgery volume and margin were estimated by preoperative visualization. Read More

J Cancer Res Clin Oncol 2021 Jun 10. Epub 2021 Jun 10.

Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.

Purpose: Lu-Dotatate is an emerging treatment modality for patients with unresectable or metastatic well-differentiated NETs. This study examines survival predictors in patients who received Lu-Dotatate.

Methods: A retrospective single-center review was conducted, examining 47 individuals with progressive well-differentiated NETs treated with Lu-Dotatate (four induction cycles of 5. Read More

Nihon Shokakibyo Gakkai Zasshi 2021 ;118(6):549-554

Department of Gastroenterological Surgery and Oncology, Tazuke Kofukai Medical Research Institute, Kitano Hospital.

The Japanese guidelines for the treatment of gastric cancer recommend nivolumab as third-line chemotherapy for metastatic gastric adenocarcinoma. We report a case in which long-term control of metastatic gastric adenocarcinoma was achieved with nivolumab after pseudoprogression. A man in his late 70s with advanced HER2-negative gastric cancer and liver metastasis underwent total gastrectomy to control tumor bleeding. Read More

Clin Epigenetics 2021 Jun 9;13(1):126. Epub 2021 Jun 9.

Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Beijing, 100021, China.

Background: Liver metastases can occur even in CRC patients who underwent curative surgery. While evidence suggested that adjuvant chemotherapy can help to reduce the occurrence of liver metastases for certain patients, it is not a recommended routine as the side effects outweigh the potential benefits, especially in Stage II CRC patients. This study aims to construct a model for predicting liver metastasis risk using differential methylation signals in primary CRC tumors, which can facilitate the decision for adjuvant chemotherapy. Read More