scholarly journals Workload and Resource Implications of Upper Gastrointestinal Cancer Surgical Centralisation in South East Wales

2008 ◽  
Vol 90 (6) ◽  
pp. 467-471 ◽  
Author(s):  
MA Morgan ◽  
M Goodson ◽  
X Escofet ◽  
GWB Clark ◽  
WG Lewis
Keyword(s):  
Radical Surgery ◽  
National Guidelines ◽  
Upper Gi ◽  
Upper Gastrointestinal Cancer ◽  
Number Of Patients ◽  
Training Opportunities ◽  
And Training ◽  
Upper Gastrointestinal ◽  
Oesophagogastric Cancer

INTRODUCTION The aim of this study was to determine whether one specialist unit could manage all patients diagnosed with oesophagogastric cancer in Gwent and Cardiff and Vale NHS Trusts over a 6-month period with regard to workload, resource and training opportunities. PATIENTS AND METHODS All patients diagnosed with oesophagogastric (OG) cancer in Gwent and Cardiff and Vale NHS Trusts and referred to the regional South East Wales Upper GI multidisciplinary team over the 6-month period from 1 July to 31 December 2005 were studied prospectively and compared with the previous 6-month caseload at Cardiff and Vale. RESULTS Out-patient workload increased from 160 new (33 OG cancers) and 533 follow-up patients (161 OG cancers) between 1 January and 30 June 2005, to 290 new (68 OG cancers, 106% increase) and 865 follow-up patients (230 OG cancers, 43% increase) between 1 July, and 31 December 2005. The number of patients undergoing radical surgery increased from 14 to 23 (D2 gastrectomy 8 versus 13; oesophagectomy 6 versus 10). Cancer-related workload in the latter period generated 118 intermediate equivalents (IEs) of operative work for two specialist surgeons and one SpR occupying 38% of the total time available on 104 scheduled operating lists, compared with 64 IEs in the previous 6 months, representing an 84% increase in cancer-related operative training opportunities. CONCLUSIONS Centralisation of oesophagogastric cancer surgery is feasible and desirable if national guidelines are to be satisfied, and this strategy has significant positive implications for surgical training and audit.

Upper Gastrointestinal Langerhans Cell Histiocytosis: A Report of 2 Adult Cases and a Literature Review

2020 ◽  
pp. 106689692096456
Author(s):  
Yui Matsuoka ◽  
Yoshiki Iemura ◽  
Masakazu Fujimoto ◽  
Shinsuke Shibuya ◽  
Atsushi Yamada ◽  
...  
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Mononuclear Cells ◽  
Malignant Neoplasm ◽  
Langerhans Cell ◽  
Braf V600e ◽  
Gi Tract ◽  
Upper Gi ◽  
Upper Gastrointestinal ◽  
Upper Gi Tract

Langerhans cell histiocytosis (LCH) with primary involvement of the upper gastrointestinal (GI) tract is rare. We report 2 adult cases of localized LCH in the upper-GI tract, including the second reported adult case of esophageal LCH and review 11 previously reported cases. Case 1 involved the esophagus of a 61-year-old man; histiocytosis was detected when endoscopy was performed for an examination of epigastric pain. Case 2 involved the stomach of a 56-year-old woman wherein the lesion was detected during a follow-up endoscopy after Helicobacter pylori infection. Both biopsy specimens exhibited diffuse proliferation of mononuclear cells with nuclear convolution and a background of eosinophilic infiltrate. The cells were immunohistochemically positive for CD1a and langerin, and BRAF V600E mutation was detected in Case 2. Follow-up endoscopy for both cases revealed that the lesions disappeared without any treatment. It is important to avoid misdiagnosing LCH of the upper-GI tract as a malignant neoplasm.

scholarly journals Nurse-Led Follow-Up at Home vs. Conventional Medical Outpatient Clinic Follow-Up in Patients With Incurable Upper Gastrointestinal Cancer: A Randomized Study

2014 ◽  
Vol 47 (3) ◽  
pp. 518-530 ◽  
Author(s):  
Madeleen J. Uitdehaag ◽  
Paul G. van Putten ◽  
Casper H.J. van Eijck ◽  
Els M.L. Verschuur ◽  
Ate van der Gaast ◽  
...  
Keyword(s):  
Outpatient Clinic ◽  
Gastrointestinal Cancer ◽  
Randomized Study ◽  
Upper Gastrointestinal Cancer ◽  
Upper Gastrointestinal ◽  
At Home

scholarly journals Comparative study between open and laparoscopic lymphadenectomy (pelvic and para-aortic) in gynecological malignancies

2018 ◽  
Vol 5 (5) ◽  
pp. 1657
Author(s):  
Hytham R. Yassin ◽  
Soliman ALShakhs ◽  
Mohammed Hamed ◽  
Adel Karam ◽  
Mohammed Mouneer
Keyword(s):  
Comparative Study ◽  
Radical Surgery ◽  
Safe Procedure ◽  
Gynecological Malignancies ◽  
Number Of Patients ◽  
Significant Difference ◽  
Operative Complications ◽  
Group 2 ◽  
Group 1

Background: Objective of present study was to compare the results of lymphaenectomy (pelvic and para-aortic) between laparoscopy and laparotomy in gynecological malignancies.Methods: Authors analyze the results of 30 patients suffering from gynecological malignancies (Enometrial, Ovarian and cervical) submitted to surgery as apart of treatment. Patients were classified in Two Groups Group (1) included15 patients were submitted to open radical surgery and group (2) included 15 patients Were submitted to laparoscopic radical surgery between May 2016 and October 2017.Results: In present comparative study, there was significant difference regarding intra operative blood loss, operative time and post operative hospital stay (P<0.001) and there was no significant difference regarding intra-operative complications, post-operative complications, total number of lymph node harvested, number of positive lymphnodes (P>0.05).Conclusions: Laparoscopic lymphadenectomy is a technically feasible and safe procedure. Authors recommend further study in large number of patients with longer duration and follow up period for assessment of oncological out-come.

Prognostic significance of LINE-1 methylation level in the upper gastrointestinal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10523-10523
Author(s):  
Yoshifumi Baba ◽  
Masayuki Watanabe ◽  
Shiro Iwagami ◽  
Hironobu Shigaki ◽  
Takatsugu Ishimoto ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Gastrointestinal Cancer ◽  
Methylation Level ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Dna Hypomethylation ◽  
Cancer Specific Survival ◽  
Upper Gastrointestinal Cancer ◽  
Upper Gastrointestinal

10523 Background: Genome-wide DNA hypomethylation plays a role in genomic instability and carcinogenesis. DNA methylation in long interspersed nucleotide element-1 (LINE-1) is a good indicator of global DNA methylation level. Although LINE-1 methylation level is attracting interest as a useful marker for predicting cancer prognosis, the prognostic significance of LINE-1 hypomethylaiton in the upper gastrointestinal cancer [i.e., esophageal squamous cell carcinoma (ESCC) and gastric cancer (GC)] remains unclear. Methods: Using 217 ESCC and 207 GC specimens, we quantified the LINE-1 methylation using bisulfite-pyrosequencing technology. During the follow-up, there were a total of 63 ESCC recurrences, 51 ESCC deaths and 56 GC deaths. The median follow-up time for censored patients was 2.8 years. A Cox proportional hazards model was used to calculate the hazard ratio (HR), adjusted for the clinical, epidemiological, and pathological variables. The term “prognostic marker” is used throughout this study according to the REMARK Guidelines. Results: ESCCs and GCs showed significantly lower LINE-1 methylation levels compared to matched normal mucosa (p<0.0001). In ESCC, LINE-1 hypomethylation was significantly associated with disease-free survival [log-rank p=0.0008; univariate HR= 2.32, 95% confidence interval (CI) 1.38-3.84, p=0.0017; multivariate HR=1.81, 95% CI 1.06-3.05, p=0.031] and cancer-specific survival (log-rank p=0.0020; univariate HR=2.21, 95% CI 1.33-3.60, p=0.0026; multivariate HR=1.87, 95% CI 1.12-3.08, p=0.018]. We found a significant modifying effect of the tumor stage on the relationship between LINE-1 methylation and the recurrence rate (P for interaction = 0.031). In GC, LINE-1 hypomethylation was significantly associated with cancer-specific survival (log-rank p=0.029; univariate HR=2.01, 95% CI 1.09-3.99). Conclusions: LINE-1 hypomethylation is associated with shorter survival in both ESCC and GC, suggesting that it has potential for use as a prognostic biomarker.

scholarly journals Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up of Exocrine Pancreatic Ductal Adenocarcinoma: Evidence Evaluation and Recommendations by the Italian Association of Medical Oncology (AIOM)

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1681 ◽  
Author(s):  
Nicola Silvestris ◽  
Oronzo Brunetti ◽  
Alessandro Bittoni ◽  
Ivana Cataldo ◽  
Domenico Corsi ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Medical Oncology ◽  
Scientific Evidence ◽  
Ductal Adenocarcinoma ◽  
National Guidelines ◽  
Italian Association ◽  
Clinical Recommendations ◽  
Upper Gastrointestinal Cancer ◽  
Evidence Evaluation

Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related death in women (7%) and the sixth in men (5%) in Italy, with a life expectancy of around 5% at 5 years. From 2010, the Italian Association of Medical Oncology (AIOM) developed national guidelines for several cancers. In this report, we report a summary of clinical recommendations of diagnosis, treatment and follow-up of PDAC, which may guide physicians in their current practice. A panel of AIOM experts in upper gastrointestinal cancer malignancies discussed the available scientific evidence supporting the clinical recommendations.

scholarly journals Upper Gastrointestinal Symptoms in General Population of a District in Bangladesh

2014 ◽  
Vol 4 (2) ◽  
pp. 79-88
Author(s):  
Irin Perveen ◽  
Mufti Munsurar Rahman ◽  
Madhusudan Saha
Keyword(s):  
General Population ◽  
Gastrointestinal Symptoms ◽  
Duration Of Symptoms ◽  
Upper Gi ◽  
Number Of Patients ◽  
Gi Symptoms ◽  
Number Frequency ◽  
Symptom Prevalence ◽  
Upper Abdominal ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal (GI) symptoms are common complaints affecting 25--40% of the general population and are common causes of health care utilisation and substantially affect the quality of life. In day-to-day practice our clinicians have to face good number of patients with various upper GI symptoms. But we have limited data on the prevalence of different upper GI symptoms in our community. Objective: The present study aimed to find out the prevalence of different upper GI symptoms in the general population of a district in Bangladesh. Materials and Methods: This population-based observational study was conducted in a selected district of Bangladesh. Three thousand subjects selected by cluster sampling method were interviewed by a valid bowel disease questionnaire. Student’s t test and chi-square tests were used for comparison of different variables with significance level set at 0.05. Results: Among the study population 1523 were men and 1477 were women with a mean age of 33.91 ± 16.43 years. A total of 2273 (75.8%) persons had at least one upper GI symptom, 2072 (69.1%) had 2 or more symptoms and 1705 (56.8%) had 3 or more symptoms in the prior 3 months. Nine hundred sixty three subjects (32.1%) had upper abdominal pain, 1265 (42.16%) had bloating, 1354 (45.13%) had heart-burn, 1166 (38.87%) had chest pain, 1347 (44.9%) had early satiation and 258 (8.6%) had vomiting. Around 249 (8.3%, male 123, female 126, P=0.691) was diagnosed as functional dyspepsia, 187 (6.2%, male 82, female 105, P=0.059) as gastroesophageal reflux disease (GERD) and 55 (1.83%, male 27, female 28, P=0.892) as upper abdominal bloating. Only one woman fulfilled the criteria for functional gallbladder or sphincter of Oddi dysfunction. Approximately 40.56% dyspeptic patients had overlapping GERD symptoms. Symptom prevalence was found to decrease with increased number, frequency and duration of symptoms. Conclusion: Upper GI symptoms are prevalent in our community. Multiple upper GI symptoms do exist simultaneously. Symptom prevalence varies with number, frequency and duration of symptoms. DOI: http://dx.doi.org/10.3329/jemc.v4i2.19458 J Enam Med Col 2014; 4(2): 79--88

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