8 research outputs found
Prognostic factors affecting survival after surgical resection of gastrointestinal stromal tumours: a two-unit experience over 10 years
BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal (GI) tract which has only been recently described based on their specific immunohistochemistry and the presence of particular KIT-related mutations which potentially make them targets for tyrosine kinase inhibition. METHODS: Sixty-one patients (29 M; 32 F, median age 60 years; range: 23–86 years) between June 1994 and March 2005, were analyzed from two allied institutions. Patient, tumour, and treatment variables were analyzed to identify factors affecting survival. RESULTS: Of the 61 patients, 55 (90%) underwent complete surgical resection of macroscopic disease. The 5-year overall survival (OS) rate in the 61 patients was 88% and the 5-year disease-free survival (DFS) in the 55 cases completely resected was 75%. Univariate analysis revealed that R0 resection was strongly associated with a better OSrate (p < 0.0001). Likewise, univariate analysis also showed high mitotic count of > 10 mitoses/per 50 HPF was a significant variable in worse prognosis for OS (≤ 10 mitoses/per 50 HPF 95% 5-year OS vs. > 10 mitoses/per 50 HPF 74% 5-year OS, respectively; p = 0.013). On subsequent multivariate analysis, only high mitotic count remained as a significant negative prognostic variable for OS (p = 0.029). Among patients resected for cure, there were 8 recurrences during follow-up. The mean time to recurrence was 21 ± 10 months (range: 4–36 months). Univariate analysis revealed that mitotic count of > 10 mitoses per 50 high power fields, intratumoural necrosis, and pathological tumour size (> 10 cm in maximal diameter) significantly correlated with DFS (p = 0.006, 0.002 and 0.02, respectively), with tumour necrosis and high mitotic count remaining as independent predictive variables affecting prognosis on subsequent multivariate analysis. CONCLUSION: Most GISTs are resectable with survival principally dependent upon mitotic count and completeness of resection. Future metabolic and genetic analyses will define the role of and resistance to induction or postoperative adjuvant targeted kinase inhibition therapy
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Maturation, Spawning and Larval Rearing Techniques of Pacific Yellowtail, Seriola mazatlana
Techniques for maturation, spawning and larval rearing of Pacific yellowtail, Seriola mazatlana, were developed in Ecuador during the last five years. Using the methodology described in this paper, we were able to obtain continuous and sustainable year-round spawning of both wild and captive reared broodstock fish in maturation tanks. After collection from the wild and acclimation for about one year at the hatchery facilities, one group of twelve broodstock fish was producing about 400, 000 fertilized eggs twice a week over a 18-month period. Another group of ten wild broodstock fish spawned 4, 500, 000 fertilized eggs per month from February to October, 1997. Similar results were achieved with a third group of twelve wild caught broodstock fish in another commercial hatchery in Ecuador. During 1997, 50 months after hatching, we were able to get a hatchery grown group of brood fish (first generation in captivity) to spawn about 200, 000 fertilized eggs twice a week in captivity. Larval husbandry was conducted using three different techniques: intensive, semiintensive and extensive. Results have been highly variable. Depending upon the egg quality from the different batches, survival rates ranging from 0-70% were achieved throughout larval rearing of Seriola until metamorphosis. High mortalities of fingerlings and early juveniles after metamorphosis have been lowering the average survival rates through the juvenile stage to 0.5-2.0%. Epitheliocystis has been shown to be the most important disease to occur during early developmental stages. Epizootics of this disease have caused mass mortalities of fingerlings. Other factors directly or indirectly related to the high mortality rates observed are broodstock nutrition, variability in egg quality among different batches, larval nutrition, weaning from live feeds onto artificial diets, as well as high levels of cannibalism after metamorphosis. Commercial production of Pacific yellowtail in Ecuador and other Latin American countries has been hampered exclusively by high mortalities of fingerlings and early juveniles. All other technicalities related to their aquaculture are thought to be mastered. The technological feasibility of Pacific yellowtail aquaculture has been proven. The commercial, economical viability of the operation remains uncertain