Treatment options for PNET liver metastases. a systematic review

Pancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms. About 40-80% of patients with PNET are metastatic at presentation, usually involving the liver (40-93%). Liver metastasis represents the most significant prognostic factor. The aim of this study is to present an up-to-date review of treatment options for patients with liver metastases from PNETs

The staging of gastritis with the olga system in the italian setting. histological features and gastric cancer risk

BACKGROUND: Recently OLGA (Operative Link on Gastritis Assessment) classification has been proposed to identify high-risk forms of gastritis that can evolve in gastric cancer (stages III and IV). Helicobacter pylori infection and age older than 40 have been considered as independent risk factor for high-risk OLGA stages

Impact of sarcopenia on outcomes after pancreatectomy for malignancy. Preliminary results

INTRODUCTION: Sarcopenia, a subclinical loss of skeletal muscle mass, is commonly observed in patients with malignancy. Few studies have examined the association between sarcopenia and out- comes after pancreatic surgery. The aim of this study was to deter- mine the prevalence of sarcopenia among patients who underwent pancreatectomy for cancer and its correlation with morbidity and mortality. METHODS: Skeletal muscle index (SMI) was measured on preop- erative CT imaging in 75 patients undergoing pancreatectomy for cancer between 2010 and 2014. Sarcopenia was defined using pre- viously published sex-adjusted SMI cut-offs. The impact of sarco- penia on morbidity and mortality was assessed relative to other clinico-pathologic factors. RESULTS: Mean age was 66.35 years and 56% were female. Pancreatic adenocarcinoma represented 68% of all cases. Pancrea- ticoduodenectomy was performed in 77.3%. Fifty patients (66.7%) were sarcopenic, 37 (49.4%) were overweight/obese, and 21 (42%) were both (p1⁄4 0.044). Mean SMI among men (46.47 cm2/m2) was greater than among women (36.63 cm2/m2, p1⁄40.001). Univariate analysis found BMI (p1⁄40.001), female sex (p<0.001), and preoperative serum albumin (p1⁄40.004) as predic- tors of sarcopenia. On multivariate analysis, preoperative serum al- bumin was confirmed to be an independent predictor of sarcopenia (p1⁄40.0268). Sarcopenia was associated with a difference, although not significant, in terms of overall morbidity and 90-day mortality (p1⁄40.131 and p1⁄40.735, respectively). CONCLUSIONS: Sarcopenia was present in two-thirds of patients who underwent pancreatectomy for cancer. It is an occult condi- tion in overweight/obese patients, easily identified using CT scans. Preoperative serum albumin is a predictor of sarcopenia. This con- dition is not associated with increased risk of complications or 90- day death

Esophagectomy with esophagocoloplasty for malignancies. indications, technique (with Video), and results. systematic review of the literature

Introduction: Esophagocoloplasty represents a useful technique to restore the intestinal continuity after esophagogastrectomy. This technique has been used mainly after esophagogastric caustic injuries. The aim of this review is to assess the role of esophagogastrectomy with esophagocoloplasty for esophageal or gastric neoplasms. Methods: A systematic literature search was performed using Embase, Medline, Cochrane, and PubMed databases to identify all studies published in the previous 25 years (1991–2016) reporting cases of esophagocoloplasty after esophagogastrectomy for malignancies. The systematic review was conducted according to the PRISMA guidelines. Results: The systematic review of the literature shows a morbidity rate of 57% and a mortality rate of 15% in the 93 reported cases of esophagocoloplasty performed for malignant diseases. However, R0 rate ranged from 76.1 to 85%, and 5-year survival was obtained in 11.9–32.8% of patients in the different series. Conclusions: In highly selected cases of primary or relapsing gastric or esophageal neoplasms, esophagogastrectomy with esophagocoloplasty is a viable and useful option, which may guarantee complete tumor resection and long-term survival