Novel Treatment of a Malignant Peripheral Nerve Sheath Tumor of the Median Nerve

Summary:. Malignant peripheral nerve sheath tumors are rare, associated with a poor prognosis and uncertainty regarding the appropriate management. We report a novel oncologic and reconstructive treatment of a young patient with a malignant peripheral nerve sheath tumor of the median nerve of the left hand. The patient underwent a wide local excision, an opponensplasty, a nerve reconstruction by nerve allografts followed by brachytherapy treatment. Two years later, the patient remains disease free with preserved function of her hand

Association between tumor response and postoperative morbidity after neoadjuvant chemotherapy for gastroesophageal adenocarcinoma?

Aim: The recommended treatment for locally advanced gastroesophageal adenocarcinoma has changed to a multimodal approach including neoadjuvant chemotherapy. The aim of this study was to assess potential associations between response to neoadjuvant therapy and post-operative morbidity in patients with gastroesophageal adenocarcinoma.Methods: Sixty-one patients undergoing surgical resection of gastroesophageal adenocarcinoma following neoadjuvant chemotherapy were analyzed. Patients were dichotomized into histopathological responders (Becker grade Ia-II, n = 37) and nonresponders (Becker grade III, n = 24). Perioperative complications were assessed according to the Clavien-Dindo classification. An association between response to neoadjuvant chemotherapy and surgical complications was evaluated with the chi-square or Fisher test where appropriate.Results: Twenty over thirty-seven responders (54.1%) and 17/24 non-responders (70.8%) had perioperative complications of any grade (P = 0.19). The most frequent complications were anastomotic leakage, which had a higher incidence among non-responders (4/24; 16.7%) than responders (1/37; 2.7%; Fisher's test: P = 0.07); and pulmonary complications, which showed no difference in incidence between non-responders (11/24; 45.8%) and responders (13/37; 35.1%; P = 0.57).Conclusion: In patients undergoing resection of gastroesophageal adenocarcinoma after neoadjuvant chemotherapy, there was no association between response and incidence of perioperative complications. However, there was a borderline significant higher incidence of anastomotic leakage among non-responders