The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

Oncological outcomes of the oncoplastic breast surgery in patients with locally advanced breast cancer (LABC) are not well defined. This study examined the effects of oncoplastic techniques for LABC in terms of localized control and survival. We also evaluated the esthetic results of patients who had undergone oncoplastic breast conservation surgery (OBCS) and their satisfaction with the outcome

Comparison of Clinical and Pathological Differences of Breast Cancer Patients under 35 and above 55 Years of Age

Objective: In this study, we aimed to evaluate the clinical, pathologic and management differences between breast cancer patients under 35 years of age and postmenopausal patients above 55 years of age

Wpływ gastrektomii rękawkowej na poziom irisiny w surowicy pacjentów z chorobliwą otyłością

  Introduction: Irisin, a recently identified myokine, is associated with increased energy expenditure and has a potential role in obesity. Therefore, we investigated circulating irisin levels in morbidly obese patients undergoing sleeve gastrectomy (SG). Material and methods: Thirty morbidly obese patients undergoing SG and 30 healthy subjects were included. All participants were evaluated at baseline and again at three months post-SG. Body weight and height, the lipid profile, and plasma glucose, HbA1c, insulin, and irisin levels were measured at each visit. Results: The two groups had similar mean age and sex distribution. Serum irisin was significantly lower in the morbidly obese subjects compared with the controls (p = 0.003) and negatively correlated with BMI, body weight, insulin levels, and HOMA-IR (p = 0.006, p = 0.011, p = 0.046, p = 0.048, respectively). When the morbidly obese patients were re-evaluated three months post-SG, their weight and BMI had significantly decreased (both p = 0.001). Similarly, the insulin, HbA1c, HDL-cholesterol, and HOMA-IR values significantly decreased (p = 0.001, p = 0.028, p = 0.006, and p = 0.001, respectively). However, irisin levels remained unchanged (p = 0,267). Conclusion: Although the irisin levels were significantly lower in the morbidly obese subjects, they did not change after SG-induced weight loss. (Endokrynol Pol 2016; 67 (5): 481–486)    Wstęp: Irisina jest niedawno poznaną miokiną, która jest związana ze wzmożonym zużyciem energii i która odgrywa potencjalna rolę w rozwoju otyłości. Dlatego też autorzy pracy badali stężenie krążącej irisiny u pacjentów chorobliwie otyłych poddawanych rękawkowej gastrektomii (SG). Materiał i metody: Do badana włączono trzydziestu chorobliwie otyłych pacjentów poddanych SG oraz 30 zdrowych ochotników. U wszystkich badanych pacjentów dokonano oceny wyjściowej oraz ponownie po 3 miesiącach po wykonaniu SG. Podczas każdej wizyty mierzono: masę ciała i wzrost, profil lipidowy, stężenie glukozy w osoczu, poziom HbA1c, insuliny raz irisiny. Wyniki: W obu grupach stwierdzono zbliżony rozkład średniej wieku i płci. Stężenie irisiny w surowicy było istotnie niższe u pacjentów z chorobliwą otyłością w porównaniu z grupą kontrolną (p = 0,003) i negatywnie korelowało z BMI, masą ciała, stężeniem insuliny i HOMA-IR (odpowiednio: p = 0,006, p = 0,011, p = 0,046, p = 0,048). W momencie wykonywania oceny u chorobliwie otyłych pacjentów po 3 miesiącach od SG ich masa ciała i BMI uległy istotnej redukcji (dla obu parametrów p = 0,001). Również stężenie insuliny HbA1c , cholesterolu frakcji HDL i HOMA-IR uległy istotnemu obniżeniu (odpowiednio: p = 0,001, = 0,028, p = 0,006 i p = 0,001). Niemniej stężenie irisiny nie uległy zmianie (p = 0,267). Wnioski: Mimo że stężenie irisiny było istotnie niższe u pacjentów z chorobliwą otyłością nie uległo ono zmianie przy spadku masy ciała indukowanym SG. (Endokrynol Pol 2016; 67 (5): 481–486)

Does skip metastasis or other lymph node parameters have additional effects on survival of patients undergoing radical cystectomy for bladder cancer?

WOS: 000358440100005PubMed ID: 25964836Purpose: To investigate the effects of lymph node metastasis, skip metastasis, and other factors related to lymph node status on survival in patients who underwent radical cystectomy (RC) and extended lymph node dissection (eLND). Materials and Methods: RC and eLND were performed in 85 patients with a diagnosis of bladder cancer. Disease-free survival (DFS) and overall survival (OS) were determined by using a Cox proportional hazards model that included the number of excised lymph nodes, the presence of pathological lymph node metastasis, the anatomical level of positive nodes, the number of positive lymph nodes, lymph node density, and the presence of skip metastasis. Results: The mean number of lymph nodes removed per patient was 29.4 +/- 9.3. Lymph node positivity was detected in 85 patients (34.1%). The mean follow-up duration was 44.9 +/- 27.4 months (2-93 months). Five-year estimated OS and DFS for the 85 patients were 62.6% and 57%, respectively. Three of 29 lymph node-positive patients (10.3%) had skip metastasis. Only lymph node positivity had a significant effect on 5-year OS and DFS (p<0.001). No difference in OS and DFS was found between the three patients with skip metastasis and other lymph node-positive patients. Other factors related to lymph node status had no significant effect on 5-year OS and DFS. Conclusions: No factors related to lymph node status predict DFS and OS, except for lymph node positivity. OS and DFS were comparable between patients with skip metastasis and other lymph node-positive patients

Evaluation of potential tumor markers that may predict neoadjuvant treatment efficiency in rectal cancer

Objectives: The recurrence of rectal cancer or its resistance to neoadjuvant treatment develops due to the adaptation to hypoxia, apoptosis or autophagy. Survivin, one of the inhibitors of apoptosis; Beclin 1, which is a positive regulator in the autophagy pathway; and hypoxia-inducible factor-1 alpha (HIF-1 alpha) and carbonic anhydrase-9 (CA9), which are associated with tumor tissue hypoxia, may be related to resistance to treatment. Our aim was to evaluate the potential tumor markers that may help to monitor the response to neoadjuvant treatment in locally advanced rectal cancer (RC)

A prospective randomized multicenter study of Turkish Society of Urooncology comparing two different mechanical bowel preparation methods for radical cystectomy

WOS: 000321597600023PubMed ID: 21546277Objective: To investigate the outcomes and complication rates of urinary diversion using mechanical bowel preparation (BP) with 3 day conventional and limited BP method through a standard perioperative care plan. Materials and methods: This study was designed as a prospective randomized multicenter trial. All patients were randomized to 2 groups. Patients in standard 3-day BP protocol received diet restriction, oral antibiotics to bowel flora, oral laxatives, and saline enemas over a 3-day period, whereas limited the BP arm received liberal use of liquid diet, sodium phosphate laxative, and self administered enema the day before surgery. All patients received same perioperative treatment protocol. The endpoints for the assessment of outcome were anastomotic leakage, wound infection, wound dehiscence, intraperitoneal abscess, peritonitis, sepsis, ileus, reoperation, and mortality. Bowel function recovery, including time to first bowel movement, time to first oral intake, time to regular oral intake, and length of hospital stay were also assessed. Results: Fifty-six patients in 3-day BP and 56 in limited BP arm were evaluable for the study end points. Postoperatively, 1 patient in limited BP and 2 patients in 3-day BP arm died. There was no statistical difference in any of the variables assessed throughout the study, however, a favorable return of bowel function and time to discharge as well as lower complication rate were observed in limited BP group. Conclusions: Regarding all endpoints, including septic and nonseptic complications, current clinical research offers no evidence to show any advantage of 3-day BP over limited BP. (C) 2013 Elsevier Inc. All rights reserved