A 66-year-old man was diagnosed with a gastric submucosal tumor. Endoscopic ultrasound(EUS) revealed an iso/hypoechoic mass in the third layer. No malignant cells were detected in a histological examination. Yearly fo...A 66-year-old man was diagnosed with a gastric submucosal tumor. Endoscopic ultrasound(EUS) revealed an iso/hypoechoic mass in the third layer. No malignant cells were detected in a histological examination. Yearly follow-up endoscopy and EUS showed the slow growth of the tumor. Endoscopic submucosal dissection(ESD) was performed and a glistening tumor was resected. The lesion showed a multinodular plexiform growth pattern consisting of spindle cells with an abundant fibromyxoid stroma that was rich in small vessels. The tumor was diagnosed as plexiform fibromyxoma(PF) by immunohistochemistry. Although difficulties are associated with reaching a diagnosis preoperatively, chronological changes on EUS may contribute to the diagnosis of PF. ESD may also be useful in the diagnosis and treatment of PF.展开更多
AIM:To evaluate the differences in the treatment outcomes between the unresectable and recurrent biliary tract cancer patients who received chemotherapy.METHODS:Patients who were treated with gemcitabine and S-1 combi...AIM:To evaluate the differences in the treatment outcomes between the unresectable and recurrent biliary tract cancer patients who received chemotherapy.METHODS:Patients who were treated with gemcitabine and S-1 combination therapy in the previous prospective studies were divided into groups of unresectable and recurrent cases.The tumor response,time-toprogression,overall survival,toxicity,and dose intensity were compared between these two groups.RESULTS:Response rate of the recurrent group was higher than that of the unresectable group(40.0%vs25.5%;P=0.34).Median time-to-progression of the recurrent and unresectable groups were 8.7 mo(95%CI),1.2 mo,not reached)and 5.7 mo(95%CI:4.0-7.0 mo),respectively(P=0.14).Median overall survival of the recurrent and the unresectable groups were 16.1 mo(95%CI:2.0 mo-not reached)and 9.6 mo(95%CI:7.1-11.7 mo),respectively(P=0.10).Dose intensities were significantly lower in the recurrent groups(gemcitabine:recurrent group 83.5%vs unresectable group 96.8%;P<0.01,S-1:Recurrent group 75.9%vs unresectable group 91.8%;P<0.01).Neutropenia occurred more frequently in recurrent group(recurrent group 90%vs unresectable group 55%;P=0.04).CONCLUSION:Not only the efficacy but also the toxicity and dose intensity were significantly different between unresectable and recurrent biliary tract cancer.展开更多
文摘A 66-year-old man was diagnosed with a gastric submucosal tumor. Endoscopic ultrasound(EUS) revealed an iso/hypoechoic mass in the third layer. No malignant cells were detected in a histological examination. Yearly follow-up endoscopy and EUS showed the slow growth of the tumor. Endoscopic submucosal dissection(ESD) was performed and a glistening tumor was resected. The lesion showed a multinodular plexiform growth pattern consisting of spindle cells with an abundant fibromyxoid stroma that was rich in small vessels. The tumor was diagnosed as plexiform fibromyxoma(PF) by immunohistochemistry. Although difficulties are associated with reaching a diagnosis preoperatively, chronological changes on EUS may contribute to the diagnosis of PF. ESD may also be useful in the diagnosis and treatment of PF.
文摘AIM:To evaluate the differences in the treatment outcomes between the unresectable and recurrent biliary tract cancer patients who received chemotherapy.METHODS:Patients who were treated with gemcitabine and S-1 combination therapy in the previous prospective studies were divided into groups of unresectable and recurrent cases.The tumor response,time-toprogression,overall survival,toxicity,and dose intensity were compared between these two groups.RESULTS:Response rate of the recurrent group was higher than that of the unresectable group(40.0%vs25.5%;P=0.34).Median time-to-progression of the recurrent and unresectable groups were 8.7 mo(95%CI),1.2 mo,not reached)and 5.7 mo(95%CI:4.0-7.0 mo),respectively(P=0.14).Median overall survival of the recurrent and the unresectable groups were 16.1 mo(95%CI:2.0 mo-not reached)and 9.6 mo(95%CI:7.1-11.7 mo),respectively(P=0.10).Dose intensities were significantly lower in the recurrent groups(gemcitabine:recurrent group 83.5%vs unresectable group 96.8%;P<0.01,S-1:Recurrent group 75.9%vs unresectable group 91.8%;P<0.01).Neutropenia occurred more frequently in recurrent group(recurrent group 90%vs unresectable group 55%;P=0.04).CONCLUSION:Not only the efficacy but also the toxicity and dose intensity were significantly different between unresectable and recurrent biliary tract cancer.
