RESUMEN
During the period from April 2012 to December 2014 54 patients aged 29-76 years, 36 (66.6%) males and 18 (33.4%) females, with esophageal cancer underwent minimally invasive esophagectomy as final phase of treatment. Squamous cell carcinoma was diagnosed in 50 patients and adenocarcinoma identified in 4 patients. The disease was staged as follows: IA--5 (9.3%) patients, IB--11 (20.4%) patients, IIA-- (16,.%) cases, III -- (3,.%) cases, IIII --8 (33,.%), IIII -- (14,8%), III -- (1,.%). 37 (68,.%) patients had surgery after induction chemoradiation therapy. Of 54 surgical interventions there were 20 hybrid and 34 minimally invasive operations. 19 (35,.%) patients developed complications, postoperative mortality was 2 (3,.)%. Minimally invasive esophagectomy meets basic oncological principles and leads to tolerable short-term results.
Asunto(s)
Neoplasias Esofágicas/cirugía , Esofagectomía/métodos , Adenocarcinoma/cirugía , Adulto , Anciano , Carcinoma de Células Escamosas/cirugía , Quimioradioterapia Adyuvante , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/terapia , Esofagectomía/mortalidad , Femenino , Humanos , Quimioterapia de Inducción , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Estadificación de Neoplasias , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
In order to assess the effectiveness of compression elastography of the thyroid gland as a method for differential diagnosis to studies conducted in the pre-operative period, there were involved 34 patients with a mean age 46.6 +/- 2.7 years. Elastography in the real time was characterized, according to the method of estimating, by a relatively high sensitivity (85.2-92.5%) and accuracy (70.6-79.4%), but low (30%) specificity. The specificity of the method, as it turned out, could be improved by taking into account the level of thyroid stimulating hormone (TSH) in the blood or body mass index (BMI) of the patients and, therefore, reducing the number of false-positive findings. Further improvement in the pre-operative diagnosis of malignant tumors of the thyroid gland and the formation of appropriate risk groups could be based on a combination of cytologic, hormonal, genetic and instrumental methods, including the so-called shear wave elastography.
Asunto(s)
Diagnóstico por Imagen de Elasticidad , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/diagnóstico , Tirotropina/sangre , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Reacciones Falso Positivas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Preoperatorio , Sensibilidad y Especificidad , Neoplasias de la Tiroides/fisiopatologíaRESUMEN
High level of thyroglobulin (Tg) after thyroidectomy has been shown to be an early marker of either metastases or local recurrence of differentiated thyroid cancer (DTC). The aim of this study was to evaluate the relation between Tg level estimated on the third week after thyroidectomy and clinic-pathologic characteristics of DTC as a possible prognostic criterion used to mark the patients with radioiodine therapy indications. Research data on 45 patients (39 women, 6 men, age 22-75 years) with DTC and without high level of Tg autoantibodies have been included in the study. Eleven patients underwent surgical treatment due to disease recurrence. In all patients Tg and thyroid hormones levels were measured before the thyroidectomy and on the third week after it. The postoperative level of Tg as TTM coefficient (ratio of postoperative Tg to daily L-thyroxin dose in mcg to body weight in kg) was higher in patients with unfavorable prognosis: (a) capsular invasion, (b) cervical lymph nodes metastases, (c) advanced disease stage, (d) high risk of recurrence. The postoperative serum Tg levels were similar in primary disease patients and patients with DTC recurrence. There was no relation between preoperative Tg level and any prognostic factors although there was a tendency to higher (more than 2 ng/ml) Tg levels in patents with high preoperative Tg levels. Finally, the serum Tg level on the third week after thyroidectomy is a valuable prognostic criterion and can be used in DTC to determine the radioiodine therapy indications.
Asunto(s)
Biomarcadores de Tumor/sangre , Recurrencia Local de Neoplasia/diagnóstico , Tiroglobulina/sangre , Neoplasias de la Tiroides/diagnóstico , Tiroidectomía , Tiroxina/administración & dosificación , Adulto , Anciano , Femenino , Terapia de Reemplazo de Hormonas/métodos , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/cirugía , Valor Predictivo de las Pruebas , Pronóstico , Reoperación , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Factores de TiempoRESUMEN
Color Doppler mapping (CDM) of the regional lymph nodes was performed in 152 patients with primary skin melanoma without clinically determined regional and distant metastases. The patients were divided into 2 groups. The first group included 52 patients in whom biopsy was fulfilled after sonography and CDM of the regional lymph nodes. The second group (control) included 100 patients. After sonography and CDM biopsy of the lymph nodes was not fulfilled. Using CDM of the regional lymph nodes in the preoperative period allowed unjustified lymphadenectomies in patients with skin melanoma to be avoided. An algorithm of preoperative diagnosis of the degree of regional spreading of skin melanoma was developed which will give better results of treatment. The method of color Doppler mapping was first used for the detection of micrometastases of the tumor in the regional lymph system.
Asunto(s)
Ganglios Linfáticos/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Ultrasonografía Doppler en Color/métodos , Axila , Velocidad del Flujo Sanguíneo , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Ingle , Humanos , Ganglios Linfáticos/irrigación sanguínea , Metástasis Linfática , Masculino , Melanoma/secundario , Reproducibilidad de los Resultados , Neoplasias Cutáneas/patología , Factores de TiempoRESUMEN
Diagnostic procedures for skin melanoma in regional lymph nodes were compared in 250 patients. Doppler effect examination and sentinel biopsy were carried out in 60 patients with primary skin melanoma and clinically intact lymph nodes. Identical examination and regional lymphadenectomy were used in 80 patients with clinically detectable metastases to regional lymph nodes. The same procedures were performed in 110 healthy controls. Histological findings fully confirmed Doppler effect evidence. Regional lymphadenectomy was indicated only in patients with verified Doppler effect-related metastatic lesions to the lymph nodes.