Cancer of the biliary confluence also known as hilar cholangiocarcinoma(HC)or Klatskin tumor,is a rare type of neoplastic disease constituting approximately 40%-60%of intrahepatic malignancies,and 2% of all cancers.Th...Cancer of the biliary confluence also known as hilar cholangiocarcinoma(HC)or Klatskin tumor,is a rare type of neoplastic disease constituting approximately 40%-60%of intrahepatic malignancies,and 2% of all cancers.The prognosis is extremely poor and the majority of Klatskin tumors are deemed unresectable upon diagnosis.Most patients with unresectable bile duct cancer die within the first year after diagnosis,due to hepatic failure,and/or infectious complications secondary to biliary obstruction.Curative treatments include surgical resection and liver transplantation in highly selected patients.Nevertheless,very few patients are eligible for surgery or transplant at the time of diagnosis.For patients with unresectable HC,radiotherapy,chemotherapy,photodynamic therapy,and liver-directed minimally invasive procedures such as percutaneous image-guided ablation and intra-arterial chemoembolization are recommended treatment options.This review focuses on currently available treatment options for unresectable HC and discusses future perspectives that could optimize outcomes.展开更多
The coronavirus disease 2019(COVID-19)pandemic has impacted hospital organization,with the necessity to quickly react to face the pandemic.The management of the oncological patient has been modified by necessity due t...The coronavirus disease 2019(COVID-19)pandemic has impacted hospital organization,with the necessity to quickly react to face the pandemic.The management of the oncological patient has been modified by necessity due to different allocation of nurses and doctors,requiring new strategies to guarantee the correct assistance to the patients.Hepatocellular carcinoma,considered as one of the most aggressive types of liver cancer,has also required a different management during this period in order to optimize the management of patients at risk for and with this cancer.The aim of this document is to review recommendations on hepatocellular carcinoma surveillance and management,including surgery,liver transplantation,interventional radiology,oncology,and radiotherapy.Publications and guidelines from the main scientific societies worldwide regarding the management of hepatocellular carcinoma during the COVID-19 pandemic were reviewed.展开更多
Pancreatic cancer is the 7th leading cause of death due to cancer in industrializedcountries and the 11th most common cancer globally, with 458918 new cases (2.5%of all cancers) and 432242 deaths (4.5% of all cancer d...Pancreatic cancer is the 7th leading cause of death due to cancer in industrializedcountries and the 11th most common cancer globally, with 458918 new cases (2.5%of all cancers) and 432242 deaths (4.5% of all cancer deaths) in 2018. Unfortunately,80% to 90% of the patients present with unresectable disease, and thereported 5-year survival rate range between 10% and 25%, even after successfulresection with tumor-free margins. Systemic chemotherapy, radiotherapy, andminimally invasive image-guided procedures that have emerged over the pastyears, are used for the management of non-operable PC. This review focuses oncurrently available non-surgical options of locally advanced pancreatic cancer.展开更多
Objective: To analyze the correlations among comorbidity and overall survival (OS), biochemical progression-free survival (b-PFS) and toxicity in elderly patients with localized prostate cancer treated with 125 I brac...Objective: To analyze the correlations among comorbidity and overall survival (OS), biochemical progression-free survival (b-PFS) and toxicity in elderly patients with localized prostate cancer treated with 125 I brachytherapy. Methods: Elderly men, aged ≥65 years, with low-intermediate risk prostate cancer, were treated with permanent 125 I brachytherapy as monotherapy. Comorbidity data were obtained from medical reports using age-adjusted Charlson comorbidity index (a-CCI). The patients were categorized into two age groups (<75 and ≥75 years old), and two comorbidity score groups (a-CCI ≤3 and >3). Toxicity was scored with Radiation Therapy Oncology Group (RTOG) scale. Results: From June 2003 to October 2009, a total of 92 elderly patients underwent prostate brachytherapy, including 57 men (62%) with low-risk prostate cancer, and 35 men (38%) with intermediate-risk prostate cancer. The median age of patients was 75 years (range, 65-87 years). Forty-seven patients (51%) had a-CCI ≤3 and 45 patients (49%) a-CCI >3. With a median follow-up period of 56 months (range, 24-103 months), the 5-year actuarial OS and b-PFS were 91.3% and 92.4% respectively, without statistical significance between two Charlson score groups. Toxicity was mild. None of the patients experienced gastrointestinal (GI) toxicity, and only 4 patiens (4%) experienced late genitourinary (GU) grade-3 (G3) toxicity. No correlation between acute GU and GI toxicity and comorbidity was showed (P=0.50 and P=0.70, respectively). Conclusions: Our data suggest that elderly men with low-intermediate risk prostate cancer and comorbidity can be considered for a radical treatment as 125 I low-dose rate brachytherapy.展开更多
文摘Cancer of the biliary confluence also known as hilar cholangiocarcinoma(HC)or Klatskin tumor,is a rare type of neoplastic disease constituting approximately 40%-60%of intrahepatic malignancies,and 2% of all cancers.The prognosis is extremely poor and the majority of Klatskin tumors are deemed unresectable upon diagnosis.Most patients with unresectable bile duct cancer die within the first year after diagnosis,due to hepatic failure,and/or infectious complications secondary to biliary obstruction.Curative treatments include surgical resection and liver transplantation in highly selected patients.Nevertheless,very few patients are eligible for surgery or transplant at the time of diagnosis.For patients with unresectable HC,radiotherapy,chemotherapy,photodynamic therapy,and liver-directed minimally invasive procedures such as percutaneous image-guided ablation and intra-arterial chemoembolization are recommended treatment options.This review focuses on currently available treatment options for unresectable HC and discusses future perspectives that could optimize outcomes.
文摘The coronavirus disease 2019(COVID-19)pandemic has impacted hospital organization,with the necessity to quickly react to face the pandemic.The management of the oncological patient has been modified by necessity due to different allocation of nurses and doctors,requiring new strategies to guarantee the correct assistance to the patients.Hepatocellular carcinoma,considered as one of the most aggressive types of liver cancer,has also required a different management during this period in order to optimize the management of patients at risk for and with this cancer.The aim of this document is to review recommendations on hepatocellular carcinoma surveillance and management,including surgery,liver transplantation,interventional radiology,oncology,and radiotherapy.Publications and guidelines from the main scientific societies worldwide regarding the management of hepatocellular carcinoma during the COVID-19 pandemic were reviewed.
文摘Pancreatic cancer is the 7th leading cause of death due to cancer in industrializedcountries and the 11th most common cancer globally, with 458918 new cases (2.5%of all cancers) and 432242 deaths (4.5% of all cancer deaths) in 2018. Unfortunately,80% to 90% of the patients present with unresectable disease, and thereported 5-year survival rate range between 10% and 25%, even after successfulresection with tumor-free margins. Systemic chemotherapy, radiotherapy, andminimally invasive image-guided procedures that have emerged over the pastyears, are used for the management of non-operable PC. This review focuses oncurrently available non-surgical options of locally advanced pancreatic cancer.
文摘Objective: To analyze the correlations among comorbidity and overall survival (OS), biochemical progression-free survival (b-PFS) and toxicity in elderly patients with localized prostate cancer treated with 125 I brachytherapy. Methods: Elderly men, aged ≥65 years, with low-intermediate risk prostate cancer, were treated with permanent 125 I brachytherapy as monotherapy. Comorbidity data were obtained from medical reports using age-adjusted Charlson comorbidity index (a-CCI). The patients were categorized into two age groups (<75 and ≥75 years old), and two comorbidity score groups (a-CCI ≤3 and >3). Toxicity was scored with Radiation Therapy Oncology Group (RTOG) scale. Results: From June 2003 to October 2009, a total of 92 elderly patients underwent prostate brachytherapy, including 57 men (62%) with low-risk prostate cancer, and 35 men (38%) with intermediate-risk prostate cancer. The median age of patients was 75 years (range, 65-87 years). Forty-seven patients (51%) had a-CCI ≤3 and 45 patients (49%) a-CCI >3. With a median follow-up period of 56 months (range, 24-103 months), the 5-year actuarial OS and b-PFS were 91.3% and 92.4% respectively, without statistical significance between two Charlson score groups. Toxicity was mild. None of the patients experienced gastrointestinal (GI) toxicity, and only 4 patiens (4%) experienced late genitourinary (GU) grade-3 (G3) toxicity. No correlation between acute GU and GI toxicity and comorbidity was showed (P=0.50 and P=0.70, respectively). Conclusions: Our data suggest that elderly men with low-intermediate risk prostate cancer and comorbidity can be considered for a radical treatment as 125 I low-dose rate brachytherapy.
