10 research outputs found
Genomics, microRNA, epigenetics, and proteomics for future diagnosis, treatment and monitoring response in upper GI cancers
COVID-19. Pandemic surgery guidance
Abstract – Based on high quality surgery and scientific data, scientists and surgeons are committed to protecting patients as well as healthcare staff and hereby provide this Guidance to address the special issues circumstances related to the exponential spread of the Coronavirus disease 2019 (COVID-19) during this
pandemic. As a basis, the authors used the British Intercollegiate General Surgery Guidance as well as recommendations from the USA, Asia, and Italy. The aim is to take responsibility and to provide guidance for surgery
during the COVID-19 crisis in a simplified way addressing the practice of surgery, healthcare staff and patient
safety and care. It is the responsibility of scientists and the surgical team to specify what is needed for the protection of patients and the affiliated healthcare team. During crises, such as the COVID-19 pandemic, the
responsibility and duty to provide the necessary resources such as filters, Personal Protective Equipment
(PPE) consisting of gloves, fluid resistant (Type IIR) surgical face masks (FRSM), filtering face pieces, class
3 (FFP3 masks), face shields and gowns (plastic ponchos), is typically left up to the hospital administration
and government. Various scientists and clinicians from disparate specialties provided a Pandemic Surgery
Guidance for surgical procedures by distinct surgical disciplines such as numerous cancer surgery disciplines,
cardiothoracic surgery, ENT, eye, dermatology, emergency, endocrine surgery, general surgery, gynecology,
neurosurgery, orthopedics, pediatric surgery, reconstructive and plastic surgery, surgical critical care, transplantation surgery, trauma surgery and urology, performing different surgeries, as well as laparoscopy, thoracoscopy and endoscopy. Any suggestions and corrections from colleagues will be very welcome as we are all
involved and locked in a rapidly evolving process on increasing COVID-19 knowledg
Barrett's esophagus:Treatments of adenocarcinomas II
The following topics are explored in this collection of commentaries on treatments of adenocarcinomas related to Barrett's esophagus: the importance of intraoperative frozen sections of the margins for the detection of high dysplasia; the preferable way for sentinel node dissection; the current role of robotic surgery and of video-endoscopic approach; the value of the Siewert's classification of adenocarcinomas; the indications of two-step esophagectomy; the evaluation of pathological complete response; the role of PET scan in staging and response assessment; the role of p53 in the selection of adenocarcinomas patients; chemotherapy regimens for adenocarcinomas; the use of monoclonal antibodies in the control of cell proliferation; he attempt to define a stage-specific strategy, and the possible indications of selective therapy; and changes in mortality rates from esophageal cancer.</p
Barrett's esophagus:Treatments of adenocarcinomas II
The following topics are explored in this collection of commentaries on treatments of adenocarcinomas related to Barrett's esophagus: the importance of intraoperative frozen sections of the margins for the detection of high dysplasia; the preferable way for sentinel node dissection; the current role of robotic surgery and of video-endoscopic approach; the value of the Siewert's classification of adenocarcinomas; the indications of two-step esophagectomy; the evaluation of pathological complete response; the role of PET scan in staging and response assessment; the role of p53 in the selection of adenocarcinomas patients; chemotherapy regimens for adenocarcinomas; the use of monoclonal antibodies in the control of cell proliferation; he attempt to define a stage-specific strategy, and the possible indications of selective therapy; and changes in mortality rates from esophageal cancer.</p
Imagine a world without cancer
Background: Since the “War on Cancer” was declared in 1971, the United States alone has expended some $300
billion on research, with a heavy focus on the role of genomics in anticancer therapy. Voluminous data have been
collected and analyzed. However, in hindsight, any achievements made have not been realized in clinical practice
in terms of overall survival or quality of life extended. This might be justified because cancer is not one disease but
a conglomeration of multiple diseases, with widespread heterogeneity even within a single tumor type.
Discussion: Only a few types of cancer have been described that are associated with one major signaling pathway.
This enabled the initial successful deployment of targeted therapy for such cancers. However, soon after this
targeted approach was initiated, it was subverted as cancer cells learned and reacted to the initial treatments,
oftentimes rendering the treatment less effective or even completely ineffective. During the past 30 plus years, the
cancer classification used had, as its primary aim, the facilitation of communication and the exchange of
information amongst those caring for cancer patients with the end goal of establishing a standardized approach for
the diagnosis and treatment of cancers. This approach should be modified based on the recent research to affect a
change from a service-based to an outcome-based approach. The vision of achieving long-term control and/or
eradicating or curing cancer is far from being realized, but not impossible. In order to meet the challenges in
getting there, any newly proposed anticancer strategy must integrate a personalized treatment outcome approach.
This concept is predicated on tumor- and patient-associated variables, combined with an individualized response
assessment strategy for therapy modification as suggested by the patient’s own results. As combined strategies
may be outcome-orientated and integrate tumor-, patient- as well as cancer-preventive variables, this approach is
likely to result in an optimized anticancer strategy