Patterns of Relapse and Management Options in Unknown Primary Cervical Metastatic Carcinoma

Objective: To analyze the patterns of relapse and management options in unknown primary cervical metastatic carcinoma (UPCMC) as well as to discuss its treatment strategies. Methods: Clinical data of 111 cases of eligible UPCMC were retrospectively studied. Neck control, primary relapse and long-term survival were compared among different groups. Results: Primary carcinomas ultimately appeared in 12 cases (10.8%, 12/111). Neck control rate was 36.9%. Overall 5-year survival rate was 41.4%. Neck control, N stage and primary control were prognostic factors for UPCMC. Neck control was affected by N stage and whether or not comprehensive radiotherapy was administered. Conclusion: UPCMC should primarily be treated by radiotherapy except for cases with N1 or N2 insensitive to radiation. Bilateral necks radiotherapy is the optimal choice in terms of neck radiotherapy. Selective total pharyngeal irradiation is recommended for potential primary treatment.

New developments in the treatment of cutaneous leishmaniasis

Leishmaniasis,including the cutaneous form,poses an important public health threat around the world,while no vaccine is currently available against any form of leishmaniasis.The drugs used in the first line treatment of cutaneous leishmaniasis(CL)are commonly pentavalent antimonials despite their toxicities,long-term treatment duration and increasing resistance rates.Other alternatives are amphotericin B,pentamidine,miltefosine and paromomycine.Movement of the population,especially in endemic regions,increases the spread of the parasite and affectes the distribution of causative species,which requires re-evaluation the treatment regimen.Extensive researches are carried out on the treatment of leishmaniasis.The immunotherapeutic and targeted therapeutic approaches,formulations of carrier-loaded active drugs,local thermotherapeutic applications,the combination of antileishmanial drugs/compounds,the use of new synthetic and natural products are promising therapeutic options in the future.Herein,the author reviews the potential treatment modalities of CL with a brief overview of current treatments in the light of ongoing studies around the world.

The potential function of transhiatal esophagectomy in the treatment of esophageal carcinoma

Objective： To analyze the results and introduce the experiences of transhiatal esophagectomy in combined with different synthetic therapy. Methods： Seventy-one patients with esophageal carcinoma, median age was 62, 40 of stage Ⅰ, 26 of Ⅱa, 4 of stage Ⅱb, 1 of stage Ⅳ, were treated with transhiatal esophagectomy. 9 and 17 patients were treated with preoperative radiotherapy （4000 cGy） and postoperative adjuvant radiotherapy （6000 cGy） respectively; 5 patients were treated with preoperative chemotherapy. Results： The postoperative 1, 3 and 5 years survival rates were 100%, 91.43%, and 86.21% for stage Ⅰ; 92%, 83.33%, and 57.14% for stage Ⅱa; 75%, 50%, and 50% for stage Ⅱb; 100%, 0, and 0 for stag Ⅳ and 95.71%, 86.89%, and 71.70% as a whole, respectively. The incidence of complications was 12.68%. Conclusion： Transhiatal esophagectomy combined with chemotherapy or radiotherapy may be beneficial to patients with esophageal carcinoma at stage Ⅱa or earlier who can＇t tolerate or need not be treated by transthoracic esophagectomy.