5,346 results match your criteria metastases unresectable


The Impact of Primary Tumor Resection on Survival in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases.

Ann Coloproctol 2021 Apr 30;37(2):94-100. Epub 2021 Apr 30.

Department of Surgery, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea.

Purpose: This study was conducted to evaluate the effectiveness of primary tumor resection (PTR) in asymptomatic colorectal cancer (CRC) patients with unresectable metastases using the inverse probability of treatment weighting (IPTW) method to minimize selection bias.

Methods: We selected 146 patients diagnosed with stage IV CRC with unresectable metastasis between 2001 and 2018 from our institutional database. In a multivariate logistic regression model using the patients' baseline covariates associated with PTR, we applied the IPTW method based on a propensity score and performed a weighted Cox proportional regression analysis to estimate survival according to PTR. Read More

View Article and Full-Text PDF

Primary Tumor Resection in Asymptomatic Colorectal Cancer Patients With Unresectable Metastases: Can It Improve Survival?

Authors:
Myong Hoon Ihn

Ann Coloproctol 2021 Apr 30;37(2):71-72. Epub 2021 Apr 30.

Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

View Article and Full-Text PDF

[A Case of HER2 Positive Unresectable Gastric Cancer Leading to Conversion Therapy with Chemotherapy].

Gan To Kagaku Ryoho 2021 Apr;48(4):593-595

Dept. of Surgery, Tokyo Metropolitan Health and Medical Corporation Toshima Hospital.

A 72‒year‒old man visited our hospital with a chief complaint of epigastralgia. Upper gastrointestinal endoscopy revealed type 3 advanced gastric cancer at the body of the stomach. Following an investigation, he was diagnosed with human epidermal growth factor receptor 2‒positive gastric cancer with invasion to the pancreas as well as the paraaortic lymph node, and multiple liver metastases were also observed. Read More

View Article and Full-Text PDF

The emergence of pressurized intraperitoneal aerosol chemotherapy as a palliative treatment option for patients with diffuse peritoneal metastases: a narrative review.

J Gastrointest Oncol 2021 Apr;12(Suppl 1):S259-S270

Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is an emerging palliative treatment for patients with unresectable peritoneal metastases. Potential advantages of PIPAC over current treatment options are a homogeneous intraperitoneal distribution, low local and systemic toxicity, and enhanced tumour penetration. Given these possible benefits, PIPAC is increasingly implemented in many centres worldwide. Read More

View Article and Full-Text PDF

Outcomes and limitations of endoscopic ultrasound-guided hepaticogastrostomy in malignant biliary obstruction.

BMC Gastroenterol 2021 May 5;21(1):202. Epub 2021 May 5.

Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum Nicolaus Copernicus University, 53-59 Św. Józefa St, 87-100, Toruń, Poland.

Background: Transpapillary biliary drainage in ERCP is an established method for symptomatic treatment of patients with unresectable malignant biliary obstruction. Percutaneous transhepatic biliary drainage frequently remains the treatment of choice when the transpapillary approach proves ineffective. Recently, EUS-guided extra-anatomical anastomoses of bile ducts to the gastrointestinal tract have been reported as an alternative to percutaneous biliary drainage. Read More

View Article and Full-Text PDF

Infantile Rhabdomyosarcomas With VGLL2 Rearrangement Are Not Always an Indolent Disease: A Study of 4 Aggressive Cases With Clinical, Pathologic, Molecular, and Radiologic Findings.

Am J Surg Pathol 2021 Jun;45(6):854-867

Genetics Unit, Department of Tumor Biology.

VGLL2-rearranged rhabdomyosarcomas (RMS) are rare low-grade tumors with only favorable outcomes reported to date. We describe 4 patients with VGLL2-rearranged RMS confirmed by molecular studies, who experienced local progression and distant metastases, including 2 with fatal outcomes. Tumors were diagnosed at birth (n=3) or at 12 months of age (n=1), and were all localized at initial diagnosis, but unresectable and therefore managed with chemotherapy and surveillance. Read More

View Article and Full-Text PDF

Short- and long-term outcomes of hepatectomy combined with intraoperative radiofrequency ablation for patients with multiple primarily unresectable colorectal liver metastases: a propensity matching analysis.

HPB (Oxford) 2021 Apr 18. Epub 2021 Apr 18.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-biliary-pancreatic Surgery I, Peking University Cancer Hospital & Institute, China. Electronic address:

Background: Hepatectomy combined with intraoperative radiofrequency ablation (IORFA) is a strategy to eliminate all tumors in patients with multiple colorectal liver metastases (CRLM). This study aimed to evaluate the surgical and oncological outcomes of hepatectomy + IORFA for multiple unresectable CRLM.

Methods: We included patients who underwent combined hepatectomy and IORFA for multiple unresectable CRLM (n = 67) or hepatectomy alone (n = 268) for CRLM. Read More

View Article and Full-Text PDF

Systematic review of charged-particle therapy for chordomas and sarcomas of the mobile spine and sacrum.

Neurosurg Focus 2021 May;50(5):E17

1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Objective: Long-term local control in patients with primary chordoma and sarcoma of the spine and sacrum is increasingly reliant upon en bloc resection with negative margins. At many institutions, adjuvant radiation is recommended; definitive radiation is also recommended for the treatment of unresectable tumors. Because of the high off-target radiation toxicities associated with conventional radiotherapy, there has been growing interest in the use of proton and heavy-ion therapies. Read More

View Article and Full-Text PDF

TROPHY-U-01: A Phase II Open-Label Study of Sacituzumab Govitecan in Patients With Metastatic Urothelial Carcinoma Progressing After Platinum-Based Chemotherapy and Checkpoint Inhibitors.

J Clin Oncol 2021 Apr 30:JCO2003489. Epub 2021 Apr 30.

Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA.

Purpose: Patients with metastatic urothelial carcinoma (mUC) who progress on platinum-based combination chemotherapy (PLT) and checkpoint inhibitors (CPIs) have limited options that offer objective response rates (ORRs) of approximately 10% with a median overall survival (OS) of 7-8 months. Sacituzumab govitecan (SG) is a TROP-2-directed antibody-drug conjugate with an SN-38 payload that has shown preliminary activity in mUC.

Methods: TROPHY-U-01 (ClinicalTrials. Read More

View Article and Full-Text PDF

Radiological and Clinical Efficacy of Intra-Arterial Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms.

J Clin Med 2021 Apr 20;10(8). Epub 2021 Apr 20.

Department of Cardiology and Internal Medicine, School of Medicine, University of Warmia and Mazury, Warszawska 30, 10-082 Olsztyn, Poland.

This study was performed to determine if intra-arterial (i.a.) administration of Y DOTATATE can provide an effective and safe alternative to the accepted standard for i. Read More

View Article and Full-Text PDF

Multiple organ resection for large paraganglioma a case report.

Rozhl Chir 2021 ;100(3):138-142

Paragangliomas represent a group of neuroendocrine tumours which occur in various localizations. Most of them produce catecholamines, and in advanced cases present with typical symptoms and signs such as palpitations, headache and hypertension. The only curative treatment is radical resection. Read More

View Article and Full-Text PDF

Salvage liver transplantation after resection of colorectal cancer liver metastasis with favorable outcomes: a case report and review of the literature.

BMC Gastroenterol 2021 Apr 27;21(1):191. Epub 2021 Apr 27.

Hepatobiliary and Transplant Surgery, King Fahad Specialist Hospital - Dammam, Dammam, Saudi Arabia.

Background: Approximately 50% of patients with colorectal cancer (CRC) develop metastases most commonly in the liver. Liver transplantation (LT) can be used in certain cases of primary liver malignancy or in metastatic diseases, such as Neuroendocrine tumors. However, there are controversies regarding LT as a treatment option for liver metastasis from CRC due to poor outcomes in previously reported cases. Read More

View Article and Full-Text PDF

Impact of the development of immune related adverse events in metastatic melanoma treated with PD -1 inhibitors.

Melanoma Res 2021 06;31(3):258-263

Department of Oncology.

Some clinical trials have described improved outcomes in patients who develop immune-related adverse events (irAEs) while receiving immune checkpoint inhibitors for advanced melanoma. It is unknown if this effect would be seen in a real-world population. This is a single-center retrospective analysis of all patients receiving single-agent PD-1 inhibitor for unresectable stage III or stage IV melanoma between 2012 and 2018. Read More

View Article and Full-Text PDF

Nomogram including chemotherapy response for prediction of intrahepatic progression-free survival in patients with colorectal liver metastasis through chemotherapy followed by radiofrequency ablation.

Int J Hyperthermia 2021 ;38(1):633-639

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, China.

Background: Radiofrequency ablation (RFA) is being considered as the favorable treatment option for unresectable colorectal cancer liver metastases (CRLM) receiving chemotherapy, yet there still exist challenges for recurrence after RFA. The present study aims to establish an effective nomogram to predict intrahepatic progression-free survival (PFS) and select RFA candidates.

Methods: Patients with unresectable CRLM treated with chemotherapy followed by RFA between 2010 and 2016 were enrolled in this study. Read More

View Article and Full-Text PDF
January 2021

Metastatic Mixed Adeno-Neuroendocrine Carcinoma of the Colon to the Liver with Multiple Peritoneal Deposits: A Case Report.

Am J Case Rep 2021 Apr 15;22:e929099. Epub 2021 Apr 15.

Department of General Surgery, Colorectal Surgery Section, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

BACKGROUND Metastatic mixed adeno-neuroendocrine carcinoma (MANEC) is a rare malignancy. It is characterized by the presence of both neuroendocrine and epithelial components, each of which constitute at least 30% of the lesion to establish the diagnosis. CASE REPORT A 48-year-old man presented with a 1-month history of right upper-quadrant pain and unintentional weight loss of 18 kg. Read More

View Article and Full-Text PDF

Neoadjuvant Cytoreductive Treatment with BRAF/MEK Inhibition of prior Unresectable Regionally Advanced Melanoma to Allow Complete Surgical Resection, REDUCTOR: A Prospective, Single Arm, Open-label Phase II Trial.

Ann Surg 2021 Apr 9. Epub 2021 Apr 9.

Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Biometrics, Princes Máxima Centrum, Utrecht, the Netherlands Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.

Objective: To evaluate the potency of short-term neoadjuvant cytoreductive therapy with dabrafenib plus trametinib (BRAF and MEK inhibitor) to allow for radical surgical resection in patients with unresectable locally advanced melanoma.

Summary Background Data: Approximately 5% of stage III melanoma patients presents with unresectable locally advanced disease, making standard of care with resection followed by adjuvant systemic therapy impossible. Although neoadjuvant targeted therapy has shown promising results in resectable stage III melanoma, its potency to enable surgical resection in patients with primarily unresectable locally advanced stage III melanoma is still unclear. Read More

View Article and Full-Text PDF

Significance of postoperative adjuvant chemotherapy with an oxaliplatin-based regimen after simultaneous curative resection for colorectal cancer and synchronous colorectal liver metastasis: a propensity score matching analysis.

BMC Surg 2021 Apr 9;21(1):188. Epub 2021 Apr 9.

Department of Hepatobiliary-Pancreatic Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.

Background: Expansion of the indication for liver resection and new regimens for systemic chemotherapy have improved postoperative outcomes for synchronous colorectal liver metastases (CRLM). However, such cases can still have a high recurrence rate, even after curative resection. Therefore, there is a need for postoperative adjuvant chemotherapy (POAC) after liver resection in patients with CRLM. Read More

View Article and Full-Text PDF

Prognostic value of an inflammation-based nutritional score for patients with initially unresectable pancreatic adenocarcinoma undergoing conversion surgery following chemo-/radiotherapy.

Surg Today 2021 Apr 7. Epub 2021 Apr 7.

Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.

Purpose: To clarify the prognostic value of the preoperative nutrition status of patients undergoing conversion surgery (CS) for initially unresectable pancreatic adenocarcinoma (UR-PA).

Methods: The subjects of this retrospective study were 41 consecutive patients with initially UR-PA treated with chemo-/radiotherapy and subsequent CS between 2007 and 2014, at Tohoku University Hospital. The preoperative Glasgow Prognostic Score (GPS) was 0, conveying normal nutrition, in 25 patients (N group) and 1-2, conveying malnutrition, in 16 patients (M group). Read More

View Article and Full-Text PDF

Case Report: Cytoreductive Surgery and HIPEC Associated With Liver Electrochemotherapy in a Cholangiocarcinoma Patient With Peritoneal Carcinomatosis and Liver Metastasis Case Report.

Front Surg 2021 19;8:624817. Epub 2021 Mar 19.

General and Emergency Surgery Department, Azienda Unità Sanitaria Locale Romagna Trauma Center "Maurizio Bufalini" Hospital, Cesena, Italy.

Cholangiocarcinoma (CCA) is the second most common primary tumor of the liver, and the recurrence after hepatic resection (HR), the only curative therapy, is linked with a worse prognosis. Systemic chemotherapy (SC) and liver loco-regional treatments, like trans-arterial chemoembolization (TACE) or radio embolization (TARE), have been employed for the treatment of unresectable intrahepatic metastasis (IM) with benefit on overall survival (OS), but SC has a limited effect on peritoneal metastasis (PM). In the last years, novel treatments like electrochemotherapy (ECT) with bleomycine (BLM) for IM and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) for PM have been applied in small series but with encouraging results. Read More

View Article and Full-Text PDF

Concurrent Chemoradiotherapy With Docetaxel, Cisplatin, and 5-Fluorouracil (DCF-RT) . Cisplatin and 5-Fluorouracil (CF-RT) for Patients With Unresectable Locally Advanced Esophageal Cancer in a Real-world Clinical Setting.

Anticancer Res 2021 Apr;41(4):2141-2145

Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Japan.

Background/aim: We compared the outcome of docetaxel, cisplatin, and 5-fluorouracil as combination chemoradiotherapy (DCF-RT) for unresectable locally advanced thoracic esophageal cancer (EC) with that of cisplatin (CDDP) and 5-fluorouracil (5-FU) as combination chemoradiotherapy (CF-RT) in clinical settings.

Patients And Methods: Seventy-three patients with unresectable locally advanced thoracic EC were included in this study. CF (n=38) consisted of intravenous CDDP at 70 mg/m (day 1) and 5-FU at 700 mg/m (days 1 to 4), repeated every four weeks for two cycles. Read More

View Article and Full-Text PDF

The Feasibility Study of Hypofractionated Radiotherapy with Regional Hyperthermia in Soft Tissue Sarcomas.

Cancers (Basel) 2021 Mar 16;13(6). Epub 2021 Mar 16.

Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.

Introduction: Management of marginally resectable or unresectable soft tissue sarcomas (STS) in patients who are not candidates for neoadjuvant chemotherapy due to chemoresistant pathology or contraindications remains a challenge. Therefore, in these indications, we aimed to investigate a feasibility of 10x 3.25 Gy radiotherapy combined with regional hyperthermia (HT) that could be followed by surgery or 4x 4 Gy radiotherapy with HT. Read More

View Article and Full-Text PDF

Primary Tumor Resection for Rectal Cancer With Unresectable Liver Metastases: A Chance to Cut Is a Chance for Improved Survival.

Front Oncol 2021 15;11:628715. Epub 2021 Mar 15.

Department of Colon and Rectal Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

About half of the patients with rectal cancer will develop liver metastasis during the course of their illness. Unfortunately, a large proportion of these metastases are unresectable. Surgical resection of the primary tumor vs. Read More

View Article and Full-Text PDF

[A Case of Complete Resection Using the Liver-First Approach after Systemic Chemotherapy in a Patient with Synchronous Colorectal Liver and Lung Metastases].

Gan To Kagaku Ryoho 2021 Mar;48(3):416-418

Dept. of Gastroenterological Surgery, Hyogo Cancer Center.

Conversion surgery for patients with initially unresectable colorectal liver metastases is increasingly being performed because of effective systemic chemotherapy. Additionally, many studies have reported the benefit of the liver-first approach for advanced liver metastasis. We report a case of an initially unresectable advanced colon cancer with multiple liver and lung metastases that was successfully treated with the liver-first approach following chemotherapy. Read More

View Article and Full-Text PDF

Leptomeningeal disease from melanoma-Poor prognosis despite new therapeutic modalities.

Eur J Cancer 2021 May 28;148:395-404. Epub 2021 Mar 28.

Department of Dermatology, Essen University Hospital, West German Cancer Center, University of Duisburg-Essen and the German Cancer Consortium (DKTK), University of Duisburg-Essen, Essen, Germany. Electronic address:

Objective: The development of leptomeningeal disease (LMD) among melanoma patients is associated with short survival. Unspecific clinical symptoms and imprecise diagnostic criteria often delay diagnosis. Because melanoma patients with LMD have been excluded from most clinical trials, the efficacy of immune checkpoint blockade (ICB) and targeted therapies (TTs) has not been adequately investigated among these patients. Read More

View Article and Full-Text PDF

Conversion therapy combined with individualized surgical treatment strategy improves survival in patients with colorectal cancer liver metastases.

Authors:
Rui Ma Tao Li

Int J Clin Exp Pathol 2021 1;14(3):314-321. Epub 2021 Mar 1.

Department of Hepatobiliary Surgery, Peking University People's Hospital No. 11 Xizhimen South Street, West District, Beijing 100044, P. R. China.

Objective: To explore surgical treatment strategies for patients with liver metastases from colorectal cancer (CRLM), and analyze the prognosis and influencing factors.

Methods: The clinical data of 156 inpatients with CRLM admitted to our hospital from January 2009 to June 2019 were retrospectively analyzed. Patients were divided into initially resectable group (80 cases) and initially unresectable group (76 cases). Read More

View Article and Full-Text PDF

First-line palliative systemic therapy alternated with electrostatic pressurised intraperitoneal aerosol chemotherapy (oxaliplatin) for isolated unresectable colorectal peritoneal metastases: protocol of a multicentre, single-arm, phase II study (CRC-PIPAC-II).

BMJ Open 2021 Mar 30;11(3):e044811. Epub 2021 Mar 30.

Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands

Introduction: Despite its increasing use, first-line palliative systemic therapy alternated with electrostatic pressurised intraperitoneal aerosol chemotherapy with oxaliplatin (ePIPAC-OX), hereinafter referred to as first-line bidirectional therapy, has never been prospectively investigated in patients with colorectal peritoneal metastases (CPM). As a first step to address this evidence gap, the present study aims to assess the safety, feasibility, antitumour activity, patient-reported outcomes, costs and systemic pharmacokinetics of first-line bidirectional therapy in patients with isolated unresectable CPM.

Methods And Analysis: In this single-arm, phase II study in two Dutch tertiary referral centres, 20 patients are enrolled. Read More

View Article and Full-Text PDF

Discordant Uptake Between Diagnostic 68Ga-HA-DOTATATE PET/CT and Posttherapy 177Lu-HA-DOTATATE SPECT/CT in Patients With Neuroendocrine Tumors.

Clin Nucl Med 2021 Mar 16. Epub 2021 Mar 16.

From the Department of Nuclear Medicine, Netherlands Cancer Institute, ENETS Center of Excellence, Amsterdam, the Netherlands.

Abstract: Patients with unresectable or metastasized neuroendocrine tumors are assumed eligible for PRRT (peptide receptor radionuclide therapy) with 177Lu-HA-DOTATATE if tumor uptake on somatostatin receptor imaging is higher than normal liver tissue. In our clinic, 2 patients presented with sufficient uptake of 68Ga-HA-DOTATATE in most metastases but with limited uptake in liver lesions. Posttherapy 177Lu imaging, however, showed good uptake in all neuroendocrine tumor lesions, including all liver metastases. Read More

View Article and Full-Text PDF

Rate of Curative Surgery in Real-world Patients with Unresectable Metastatic Colorectal Cancer Treated with FOLFOXIRI ± Bevacizumab: A Western Canadian Province Experience.

J Gastrointest Cancer 2021 Mar 29. Epub 2021 Mar 29.

Saskatoon Cancer Centre, University of Saskatchewan, Saskatoon, Canada.

Background: Recent evidence from randomized trials suggests that FOLFOXIRI (fluorouracil, oxaliplatin, and irinotecan) ± bevacizumab is associated with higher response rates, with the potential for conversion of unresectable to resectable disease in metastatic colorectal cancer (mCRC). However, limited evidence is available on the efficacy and safety of this regimen in real-world patients with mCRC. The current study aims to evaluate the conversion rate and safety of FOLFOXIRI ± bevacizumab in real-world patients with unresectable mCRC. Read More

View Article and Full-Text PDF

Calcitonin-Negative Neuroendocrine Carcinoma of the Thyroid Gland: Case Report and Literature Review.

Case Rep Oncol 2021 Jan-Apr;14(1):112-122. Epub 2021 Mar 1.

Department of Surgery Oncology, Medica Sur Clinic & Foundation, Mexico, Mexico.

Calcitonin-negative neuroendocrine tumor (CNNET) of the thyroid is an extremely rare entity. In some of the previously reported cases within the literature, the terms "atypical medullary thyroid carcinoma," "calcitonin-free oat cell carcinoma," and "a distinct clinical entity" were applied to NETs without definitive evidence of calcitonin production. In the English-language literature, not only are there only few reported cases of CNNET, but the criteria for diagnosis in these cases are also controversial. Read More

View Article and Full-Text PDF

Clinical outcome of patients with metastatic melanoma of unknown primary in the era of novel therapy.

Cancer Immunol Immunother 2021 Mar 27. Epub 2021 Mar 27.

Departments of Medical Oncology and Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.

Melanoma of unknown primary (MUP) is considered different from melanoma of known primary (MKP), and it is unclear whether these patients benefit equally from novel therapies. In the current study, characteristics and overall survival (OS) of patients with advanced and metastatic MUP and MKP were compared in the era of novel therapy. Patients were selected from the prospective nation-wide Dutch Melanoma Treatment Registry (DMTR). Read More

View Article and Full-Text PDF