Background: The optimal treatment strategy for biliary tract cancer(BTC) after curative?intent resection remains con?troversial. The purpose of this study was to evaluate the efficacy of fluoropyrimidine?based adjuvan...Background: The optimal treatment strategy for biliary tract cancer(BTC) after curative?intent resection remains con?troversial. The purpose of this study was to evaluate the efficacy of fluoropyrimidine?based adjuvant chemotherapy for BTC patients undergoing microscopically margin?negative(R0) resection.Methods: We retrospectively analyzed the clinical data of BTC patients who underwent curative?intent R0 resection. Patients were eligible if they received either fluoropyrimidine?based adjuvant chemotherapy or observation after R0 resection.Results: A total of 153 patients were included. In the entire patient cohort, no significant differences were observed in 5?year overall survival(OS) rates(48.4% vs. 39.6%, P = 0.439) or 3?year recurrence?free survival(RFS) rates(49.1% vs. 39.5%, P = 0.299) between patients who received fluoropyrimidine?based adjuvant chemotherapy or observation. However, for patients with stages Ⅱ and Ⅲ BTC, chemotherapy significantly improved 5?year OS rate(52.4% vs. 35.6%, P = 0.002) and 3?year RFS rate(55.5% vs. 39.1%, P = 0.021) compared with observation.Conclusion: Fluoropyrimidine?based adjuvant chemotherapy may prolong the survival of patients with stages Ⅱ and Ⅲ BTC after R0 resection.展开更多
Post-gastrectomy anastomosis site obstruction is a relatively rare complication after a subtotal gastrectomy.We present a case of a 75-year-old man who underwent a truncal vagotomy, omental patch, gastrojejunostomy, a...Post-gastrectomy anastomosis site obstruction is a relatively rare complication after a subtotal gastrectomy.We present a case of a 75-year-old man who underwent a truncal vagotomy, omental patch, gastrojejunostomy, and Braun anastomosis for duodenal ulcer perforation and a gastric outlet obstruction.Following the 10 th postoperative day, the patient complained of abdominal discomfort and vomiting.We diagnosed post-gastrectomy anastomosis site obstruction by an upper gastrointestinal series and an upper endoscopic examination.We inserted a self-expandable metallic stent(SEMS) at the anastomosis site.The stent was fully expanded after deployment.On the day following the stent insertion, the patient began to eat, and his abdominal discomfort was resolved.This paper describes the successful management of post-gastrectomy anastomosis site obstruction with temporary placement of a SEMS.展开更多
BACKGROUND Acute myeloid leukemia(AML)harboring 11q23 translocations is classified as therapy-related AML in patients who have undergone prior treatment with cytotoxic agents.There have been only a few reports of AML ...BACKGROUND Acute myeloid leukemia(AML)harboring 11q23 translocations is classified as therapy-related AML in patients who have undergone prior treatment with cytotoxic agents.There have been only a few reports of AML that subsequently developed during imatinib mesylate(IM)treatment for gastrointestinal stromal tumors(GISTs).CASE SUMMARY A 63-year-old woman was diagnosed with a hepatic GIST recurrence in April 2012;she was administered IM 400 mg/d.In November 2015,she developed dyspnea with pancytopenia while IM treatment was continued for 42 mo.A chromosome study using a bone marrow sample showed a 46,XX karyotype with t(11;19)(q23;p13.1)in 22 of 26 analyzed metaphase cells.Fluorescence in situ hybridization using the locus-specific indicator(11q23)gene break-apart probe showed positive rearrangement in 82%of interphase cells.Reverse-transcription polymerase chain reactions subsequently confirmed the KMT2A/ELL transcript.She achieved complete response with incomplete neutrophil recovery with two decitabine treatment cycles.After the third cycle of decitabine,the disease relapsed,and she refused further treatment.She died of hemorrhagic stroke 5 mo after diagnosis.To the best of our knowledge,this is the first report of AML with KMT2A gene rearrangements in a patient with a GIST receiving IM treatment.CONCLUSION Physicians should consider the potential risks of developing hematologic malignancies,including therapy-related AML,in patients with GISTs receiving IM treatment.展开更多
文摘Background: The optimal treatment strategy for biliary tract cancer(BTC) after curative?intent resection remains con?troversial. The purpose of this study was to evaluate the efficacy of fluoropyrimidine?based adjuvant chemotherapy for BTC patients undergoing microscopically margin?negative(R0) resection.Methods: We retrospectively analyzed the clinical data of BTC patients who underwent curative?intent R0 resection. Patients were eligible if they received either fluoropyrimidine?based adjuvant chemotherapy or observation after R0 resection.Results: A total of 153 patients were included. In the entire patient cohort, no significant differences were observed in 5?year overall survival(OS) rates(48.4% vs. 39.6%, P = 0.439) or 3?year recurrence?free survival(RFS) rates(49.1% vs. 39.5%, P = 0.299) between patients who received fluoropyrimidine?based adjuvant chemotherapy or observation. However, for patients with stages Ⅱ and Ⅲ BTC, chemotherapy significantly improved 5?year OS rate(52.4% vs. 35.6%, P = 0.002) and 3?year RFS rate(55.5% vs. 39.1%, P = 0.021) compared with observation.Conclusion: Fluoropyrimidine?based adjuvant chemotherapy may prolong the survival of patients with stages Ⅱ and Ⅲ BTC after R0 resection.
文摘Post-gastrectomy anastomosis site obstruction is a relatively rare complication after a subtotal gastrectomy.We present a case of a 75-year-old man who underwent a truncal vagotomy, omental patch, gastrojejunostomy, and Braun anastomosis for duodenal ulcer perforation and a gastric outlet obstruction.Following the 10 th postoperative day, the patient complained of abdominal discomfort and vomiting.We diagnosed post-gastrectomy anastomosis site obstruction by an upper gastrointestinal series and an upper endoscopic examination.We inserted a self-expandable metallic stent(SEMS) at the anastomosis site.The stent was fully expanded after deployment.On the day following the stent insertion, the patient began to eat, and his abdominal discomfort was resolved.This paper describes the successful management of post-gastrectomy anastomosis site obstruction with temporary placement of a SEMS.
文摘BACKGROUND Acute myeloid leukemia(AML)harboring 11q23 translocations is classified as therapy-related AML in patients who have undergone prior treatment with cytotoxic agents.There have been only a few reports of AML that subsequently developed during imatinib mesylate(IM)treatment for gastrointestinal stromal tumors(GISTs).CASE SUMMARY A 63-year-old woman was diagnosed with a hepatic GIST recurrence in April 2012;she was administered IM 400 mg/d.In November 2015,she developed dyspnea with pancytopenia while IM treatment was continued for 42 mo.A chromosome study using a bone marrow sample showed a 46,XX karyotype with t(11;19)(q23;p13.1)in 22 of 26 analyzed metaphase cells.Fluorescence in situ hybridization using the locus-specific indicator(11q23)gene break-apart probe showed positive rearrangement in 82%of interphase cells.Reverse-transcription polymerase chain reactions subsequently confirmed the KMT2A/ELL transcript.She achieved complete response with incomplete neutrophil recovery with two decitabine treatment cycles.After the third cycle of decitabine,the disease relapsed,and she refused further treatment.She died of hemorrhagic stroke 5 mo after diagnosis.To the best of our knowledge,this is the first report of AML with KMT2A gene rearrangements in a patient with a GIST receiving IM treatment.CONCLUSION Physicians should consider the potential risks of developing hematologic malignancies,including therapy-related AML,in patients with GISTs receiving IM treatment.
