jcru
Abstract : Neuroendocrine Tumors of the Pancreas: Molecular Pathogenesis and Perspectives on Targeted Therapies
|
|
Abstract: Pancreatic neuroendocrine tumors (PNETs) are a heterogeneous group of neoplasms that are the second most common among pancreatic neoplasms. Treatment of PNETs appears to be quite difficult because diagnosis in many patients occurs only at the latest stage when distant metastases are recognized. Therefore, treatment with drugs targeting PNET oncogenesis is a promising strategy in such patients. In this work, we review the present knowledge on the molecular nature of PNETs, and the genetic basis of PNET-associated hereditary syndromes, including multiple endocrine neoplasia type I, von Hippel–Lindau disease, neurofibromatosis type I, and tuberous sclerosis. In addition, the results of phase III, randomized, placebo-controlled trials of the efficacy of everolimus and sunitinib for treatment of extensive non-resectable PNETs are reviewed. Keywords: Neuroendocrine tumor, multiple endocrine neoplasia type I, von Hippel–Lindau disease, neurofibromatosis type I, tuberous sclerosis, targeted therapy, everolimus, sunitinib.Download Full Article |
Abstract : Patterns of Distant Failure and Second Primary Cancers in Patients with Oropharyngeal Squamous Cell Carcinoma: Implications for Surveillance Methodology
|
|
Abstract: Background: We analyzed the pattern of distant metastasis (DM) and secondary primary cancers (SPC) in patients with oropharyngeal squamous cell carcinoma (OPSCC) to develop surveillance guidelines. Methods: A retrospective review of 177 patients with OPSCC treated with intensity modulated radiation therapy ± chemotherapy between 2002 and 2012 was performed to characterize the rate, pattern, and timing of DM and SPC. Results: Sixteen patients (9.0%) developed DM and 9 patients (5.1%) developed a SPC. Overall, 24/177 patients (13.6%) developed a DM and/or SPC for a total of 27 events. 92.6% (25/27) of events were detectable on physical exam and/or chest CT. p16+ patients developed DM later than p16- tumors (23.4 months versus 8.7 months). Conclusions: Chest CT with physical examination detects the majority of DM and SPC in patients with OPSCC and would provide effective surveillance in these patients. A risk adapted surveillance strategy is proposed. Keywords: Oropharynx cancer, surveillance, survivorship care, distant metastasis, second primary cancer.Download Full Article |
Abstract : Radical Retropubic Prostatectomy on Outpatient Basis
|
|
Abstract: Introduction: This study evaluated the possibility of performing in our midst the open radical prostatectomy with discharge on the same day of the procedure, aiming the improvement of postoperative recovery and reduce hospital costs without loss of quality of care, or decreased patient satisfaction with treatment. Patients and Methods: We selected 27 patients with localized prostate cancer during the period from April 2011 to January 2012, which had a low surgical risk and opted for the open radical prostatectomy. We evaluated the feasibility of outpatient open radical prostatectomy, perioperative complications, and patient satisfaction with treatment. Results: Eleven (40.7%) patients were discharged on the same day of the procedure; thirteen were discharged in the morning after surgery and three in the second postoperative day. All patients underwent general anesthesia. The use of opioids in safe doses for epidural anesthesia was administered in 13 patients, improving pain control and enabling early discharge in 8 (61.5%) patients. Only 3 (21.4%) patients who did not receive epidural opioid achieved discharge on the same day of surgery (p = 0.04). No patient had a major complication or was readmitted to the hospital. There was no difference in patient satisfaction with treatment between the group of the same day surgery and the patients with longer hospitalization. Conclusion: The open radical prostatectomy can be performed with safety on an outpatient basis, in properly selected patients, with no decrease in patient satisfaction with treatment. Keywords: Prostate cancer, retropubic prostatectomy, day care, hospital costs, ambulatory surgical procedures.Download Full Article |
Abstract : Sildenafil Enhances the Anticancer Activity of Paclitaxel in an ABCB1-Mediated Multidrug Resistance Xenograft Mouse Model
|
|
Abstract: The overexpression of ATP-binding cassette (ABC) transporters can produce multidrug resistance (MDR) in cancer cells. Previous in vitro studies from our group reported that sildenafil significantly inhibits the efflux function of the ABCB1/P-glycoprotein transporter in vitro. This investigation examined the effect of sildenafil on the ABCB1 transporter-mediated MDR in vivo. A nude mouse ABCB1 overexpressing-xenograft model was used to examine the effect of sildenafil in vivo. The concentration of paclitaxel in tumors and plasma was analyzed using high performance liquid chromatography (HPLC). Sildenafil attenuated tumor growth synergistically, and this occurred without significant weight loss or other overt phenotypic changes. The action of sildenafil can be attributed to the inhibition of the ABCB1-mediated drug efflux, thereby increasing the concentration of paclitaxel in ABCB1-overexpressing tumors. The potentiation of the pharmacologic action of paclitaxel by sildenafil suggests that it may be useful in treating cancers that overexpress the ABCB1 transporter. Keywords: ABCB1, multidrug resistance, paclitaxel, sildenafil.Download Full Article |
