[Show abstract][Hide abstract] ABSTRACT: Background: Leiomyosarcoma arising in the colorectum is a rare malignancy of the smooth muscles accounting for less than 1% of gastrointestinal tumors. Surgery remains the most accepted modality for the treatment of this entity however management of liver metastases remains controversial.
Methods & results: From 1998 to 2009 five patients diagnosed with primary leiomyosarcoma of colorectal origin with metastatic liver disease, underwent liver resections at the American University of Beirut Medical Center. The median overall survival was 47 months (range, 7-135 months).
Conclusions: Leiomyosarcoma of colorectal origin with liver metastasis is a very rare entity. Long-term survival can be achieved after surgical resection and should be considered for all patients.
Journal of gastrointestinal oncology 10/2015; 6(5).
[Show abstract][Hide abstract] ABSTRACT: Background
Pancreaticoduodenectomy is an increasingly common procedure performed for both benign and malignant disease. There are conflicting data regarding the safety of pancreatic resection in older patients. Potentially modifiable perioperative risk factors to improve outcomes in older patients have yet to be determined.
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database for 2008 to 2009 was used for this retrospective analysis. Patients undergoing pancreaticoduodenectomy were identified and divided into those above and below the age of 65. Preoperative risk factors and postoperative morbidity and mortality were evaluated.
Among 2,045 patients included in this analysis, 994 patients were >65 years (48.6%) while 1,051 were (less than or equal to) 65 years (51.4%). Thirty-day mortality was higher in the older age group compared to the younger age group 3.6% vs. 1.9% respectively, P = 0.017, odds ratio 1.94. Older patients had a higher incidence of unplanned intubation, ventilator support >48 h and septic shock compared with younger patients. On multivariate logistic regression, after adjusting for other 30-day postoperative occurrences (significant at the P <0.1 level) only septic shock was independently associated with a higher odds of mortality, unplanned intubation, and ventilator support >48 h in older patients compared with younger patients.
This report from a population-based database is the first to highlight postoperative sepsis as an independent risk factor for mortality and morbidity in older patients undergoing pancreatic resection. Careful perioperative management addressing this issue is essential for patients over the age of 65.
World Journal of Surgical Oncology 06/2013; 11(1):131. DOI:10.1186/1477-7819-11-131 · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The liver’s role in xenobiotic metabolism, i.e., the modification of drugs and toxic foreign compounds, has long served as
a putated explanation for inherent drug resistance of hepatocellular carcinoma (HCC). Therefore, it does not come as a surprise
that the initial discovery of the multiple-drug resistance gene (MDR) was in liver tissue , and hepatocyte cell lines are
a natural reservoir for the study of drug resistance.
KeywordsHCC targeted therapies-Sorafenib-Bevacizumab-Sunitinib-Tyrosine kinase inhibitors (TKIs)-Erlotinib-HCC etiology