Міні-інвазивні транспапілярні втручання в ургентній аб-домінальній хірургії

Results of endoscopic treatment of 2305 patients with common bile duct stones and periampullary tumors for a 6 year period were studied. There were 1690 transpapillary interventions in patients with choledocholithiasis, and 615 endoscopic operations in patients with periampullary malignancy. Complications of endoscopic operations in patients with choledocholithiasis occurred in 7.5 % patients, and in patients with periampullary malignancy occurred in 11.7 % cases. Endoscopic transpapillary interventions were performed as a matter of urgency to treat suppurative cholangitis and obstructive jaundice.Изучены результаты эндоскопического лечения 2305 больных с холедохолитиазом и иктерогеннимы опухолями периампулярнои зоны, находившихся на лечении в отделе лапароскопической хирургии и холелитиаза с 2010 до 2016 г.. Из них малоинвазивные транспапилярни вмешательства при холедохолитиазе выполнено в 1690 больных, при периампулярних опухолях - в 615 пациентов. Осложнения после эндоскопических вмешательств по поводу холедохолитиаза возникли в 7,5% больных, при периампулярних опухолях - в 11,7% пациентов. Все транспапилярни вмешательства выполняли в ургентной порядке с целью ликвидации явлений гнойного холангита и обтурационной желтухи.Вивчено результати ендоскопічного лікування 2305 хворих з холедохолітіазом та іктерогенними пухлинами періампулярної зони, що перебували на лікуванні у відділі лапароскопічної хірургії та холелітіазу з 2010 до 2016 р. З них малоінвазивні транспапілярні втручання при холедохолітіазі виконано у 1690 хворих, при періампулярних пухлинах – у 615 пацієнтів. Ускладнення після ендоскопічних втручань з приводу холедохолітіазу виникли у 7,5 % хворих, при періампулярних пухлинах – у 11,7 % пацієнтів. Усі транспапілярні втручання виконували в ургентному порядку з метою ліквідації явищ гнійного холангіту та обтураційної жовтяниці

Anthracycline rechallenge using pegylated liposomal doxorubicin in patients with metastatic breast cancer: a pooled analysis using individual data from four prospective trials

BACKGROUND: The aim of this study was to determine the activity of anthracycline rechallenge using pegylated liposomal doxorubicin (PLD) in patients with metastatic breast cancer (MBC) previously treated with conventional anthracyclines. METHODS: Pooled individual data from four prospective trials were used, and the primary end point of the pooled analysis was clinical benefit rate (CBR). The studies comprised 935 patients, of whom 274 had received PLD in the metastatic setting after prior exposure to conventional anthracyclines (rechallenge population). RESULTS: The majority of patients were heavily pretreated. Previous anthracycline therapy was administered in the adjuvant (14%) or metastatic setting (46%), or both (40%). The overall CBR from rechallenge with PLD was 37.2% (95% CI, 32.4-42.0). In univariate analyses, the CBR was significantly higher in patients with less exposure to prior chemotherapy, in taxane-naive patients, and in patients with a favourable Eastern Cooperative Group performance status of 0 vs 1 vs 2 (53.3 vs 35.5 vs 18.2%; P<0.001). In multivariate analyses, performance status proved to be the only independent predictor of the CBR achieved with PLD rechallenge (P=0.038). There was no statistically significant difference in CBR regarding the setting, cumulative dose of and/or resistance to prior anthracyclines, or time since prior anthracycline administration. CONCLUSION: Anthracycline rechallenge using PLD is effective in patients with MBC who have a favourable performance status, regardless of setting, resistance, cumulative dose or time since prior conventional anthracycline therapy. British Journal of Cancer (2010) 103, 1518-1523. doi:10.1038/sj.bjc.6605961 www.bjcancer.com Published online 26 October 2010 (C) 2010 Cancer Research U

The value of progression-free survival to patients with advanced-stage cancer

Progression-free survival (PFS) is frequently used as a primary end point in oncology clinical trials. Employing PFS instead of overall survival as the primary outcome has the advantage that trial completion can be quicker with fewer patients required, and it is cheaper. PFS is sensitive to cytostatic as well as cytotoxic mechanisms of therapeutic intervention and directly measures the effect of the investigational treatment. Despite these practical advantages, it is unclear whether or not extending PFS provides discernable clinical benefit. New treatments that increase PFS may not be of sufficient value to patients with advanced-stage cancer unless accompanied by tangible quantity or quality of life advantages. Any symptom relief that patients gain from treatment resulting in tumor shrinkage or stabilization must be balanced against the toxic effects that drug therapy itself creates. Consequently, improved assessment of new treatments using patient-reported outcomes alongside PFS is crucial to enable communication between clinicians and patients and optimal decision-making about therapeutic options