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  • 1
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    Online Resource
    Clinical Significance of Mucinous Rectal Adenocarcinoma following Preoperative Chemoradiotherapy and Curative Surgery
    SAGE Publications ; 2016
    In:  Tumori Journal Vol. 102, No. 1 ( 2016-01), p. 114-121
    Details
    In: Tumori Journal, SAGE Publications, Vol. 102, No. 1 ( 2016-01), p. 114-121
    Abstract: To investigate the efficacy and prognosis associated with preoperative chemoradiotherapy in patients with locally advanced mucinous rectal cancer (MRC). Methods Our analysis included 412 patients who underwent preoperative chemoradiotherapy and curative surgery for locally advanced rectal cancer. Among these patients, 30 had MRC and 382 had nonmucinous rectal cancer (NMRC). Tumor downstaging, defined as a lower pathologic stage than clinical stage, and survival were compared between MRC and NMRC. Results Increased frequency of cT4 disease was seen in MRC compared to NMRC (23.3% vs 8.9%, p = 0.021). Complete pathologic response rate and tumor downstaging rate were 0% and 23.3% in MRC and 15.4% and 52.4% in NMRC, respectively (p = 0.025 and p = 0.002). There was no significant difference in disease-free survival between the 2 groups (62.1% vs 75.0% at 5 years, p = 0.170), while there was a significantly lower overall survival in MRC vs NMRC (67.4% vs 88.0% at 5 years, respectively; p = 0.012). When analyzed by stage, the overall survival difference between MRC and NMRC was significant in the cT3 group (71.1% vs 89.1% at 5 years, p = 0.047) and marginally significant in the cT4 group (51.4% vs 74.5% at 5 years, p = 0.053), but not significant in subgroups with the same pathologic stage. Conclusions Mucinous rectal cancer is related to a lower response rate to chemoradiotherapy and poorer prognosis compared to NMRC, even when corrected for clinical stage. The poor prognosis in MRC might be associated with poor responsiveness to preoperative chemoradiotherapy.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.5301/tj.5000439
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
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  • 2
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    Baseline neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in rectal cancer patients following neoadjuvant chemoradiotherapy
    SAGE Publications ; 2019
    In:  Tumori Journal Vol. 105, No. 5 ( 2019-10), p. 434-440
    Details
    In: Tumori Journal, SAGE Publications, Vol. 105, No. 5 ( 2019-10), p. 434-440
    Abstract: There is uncertainty over the effect of systemic inflammatory response on oncologic outcomes in patients who underwent neoadjuvant chemoradiotherapy and surgery for rectal cancer. We investigated the association between neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as markers of systemic inflammation and tumor response and prognosis after treatment. Methods: A total of 176 patients who underwent neoadjuvant chemoradiotherapy and curative surgery for rectal cancer were analyzed retrospectively. Pretreatment hematologic parameters and the main clinical factors for patients and tumors were investigated with respect to their relationship with tumor regression and survival. Results: In the receiver operating characteristic analysis, NLR 2.0 and PLR 133.4 had the highest sensitivity and specificity in predicting tumor response. NLR 〈 2.0 and PLR 〈 133.4 were significantly correlated with good tumor response (odds ratio [OR] 2.490, 95% confidence interval [CI] 1.264–4.904, p = .008; OR 3.009, 95% CI 1.477–6.127, p 〈 .001). Patients with NLR 〈 2.0 had significantly better 5-year disease-free survival rate and overall survival rate compared to patients with NLR ⩾2.0 in multivariate analysis (86.8% vs 70.7%, p = .014; 92.4% vs 71.9%, p = .027). Conclusions: Elevated NLR and PLR levels can be considered as predictors of poor pathologic response, and NLR can be considered a prognosticator in patients who underwent neoadjuvant chemoradiotherapy for locally advanced rectal cancer.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.1177/0300891618792476
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 3
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    The Clinical Significance of Neuroendocrine Differentiation in T3-T4 Node-Negative Colorectal Cancer
    SAGE Publications ; 2010
    In:  International Journal of Surgical Pathology Vol. 18, No. 3 ( 2010-06), p. 201-206
    Details
    In: International Journal of Surgical Pathology, SAGE Publications, Vol. 18, No. 3 ( 2010-06), p. 201-206
    Abstract: This study was conducted to determine the clinical significance of neuroendocrine differentiation in cases of T3—T4 node-negative colorectal cancer. Eighty-nine patients diagnosed with T3—T4 node-negative colorectal cancer who underwent curative resection were enrolled. Tumors expressing neuroendocrine markers were classified as either low expression (≤2% cells staining positive for a neuroendocrine marker) or high expression ( 〉 " xbd="1775" xhg="1752" ybd="1323" yhg="1286"/ 〉 2% cells staining positive for a neuroendocrine marker). Immunohistochemical staining for chromogranin A and synaptophysin revealed high expression in 27 (30.3%) and 69 (77.5%) of the 89 patients, respectively. All tumors that showed high expression of chromogranin A also displayed high expression of synaptophysin. With the exception of preoperative carcinoembryonic antigen, no statistically significant correlation was found between neuroendocrine differentiation and all other clinicopathologic variables. Analysis using the Kaplan—Meier method and multivariate Cox regression model demonstrated that neuroendocrine differentiation for chromogranin A and synaptophysin was not associated with disease-free survival. Therefore, neuroendocrine differentiation markers would not be useful variables for prognostic assessment of patients with T3—T4 node-negative colorectal cancer.
    Type of Medium: Online Resource
    ISSN: 1066-8969 , 1940-2465
    URL: Article
    DOI: 10.1177/1066896909332112
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
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  • 4
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    MRI for prediction of hemorrhagic transformation in acute ischemic stroke: a systematic review and meta-analysis
    SAGE Publications ; 2020
    In:  Acta Radiologica Vol. 61, No. 7 ( 2020-07), p. 964-972
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 61, No. 7 ( 2020-07), p. 964-972
    Abstract: Hemorrhagic transformation increases mortality and morbidity in patients with acute ischemic stroke. Purpose The purpose of this study is to evaluate the diagnostic performance of magnetic resonance imaging (MRI) for prediction of hemorrhagic transformation in acute ischemic stroke. Material and Methods A systematic literature search of MEDLINE and EMBASE was performed up to 27 July 2018, including the search terms “acute ischemic stroke,” “hemorrhagic transformation,” and “MRI.” Studies evaluating the diagnostic performance of MRI for prediction of hemorrhagic transformation in acute ischemic stroke were included. Diagnostic meta-analysis was conducted with a bivariate random-effects model to calculate the pooled sensitivity and specificity. Subgroup analysis was performed including studies using advanced MRI techniques including perfusion-weighted imaging, diffusion-weighted imaging, and susceptibility-weighted imaging. Results Nine original articles with 665 patients were included. Hemorrhagic transformation is associated with high permeability, hypoperfusion, low apparent diffusion coefficient (ADC), and FLAIR hyperintensity. The pooled sensitivity was 82% (95% confidence interval [CI] 61–93) and the pooled specificity was 79% (95% CI 71–85). The area under the hierarchical summary receiver operating characteristic curve was 0.85 (95% CI 0.82–0.88). Although study heterogeneity was present in both sensitivity (I 2 =67.96%) and specificity (I 2 =78.93%), a threshold effect was confirmed. Studies using advanced MRI showed sensitivity of 92% (95% CI 70–98) and specificity of 78% (95% CI 65–87) to conventional MRI. Conclusion MRI may show moderate diagnostic performance for predicting hemorrhage in acute ischemic stroke although the clinical significance of this hemorrhage is somewhat uncertain.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185119887593
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 5
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    Perioperative and Oncologic Outcomes of Single-incision Laparoscopy Compared with Conventional Laparoscopy for Colon Cancer: An Observational Propensity Score-matched Study
    SAGE Publications ; 2015
    In:  The American Surgeon Vol. 81, No. 3 ( 2015-03), p. 316-323
    Details
    In: The American Surgeon, SAGE Publications, Vol. 81, No. 3 ( 2015-03), p. 316-323
    Abstract: Single-incision laparoscopic (SIL) surgery is a recent advance in minimally invasive surgical techniques. From May 2011 to August 2012, 77 patients underwent primary SIL surgery for colon cancer by one colorectal surgeon. Among them, 61 patients were one-to-one-matched to control patients who had undergone conventional laparoscopic (CL) surgery with a propensity-matched score, and the outcomes were compared. Two hundred forty-seven patients with colon cancer underwent radical colectomy. Of these, 77 patients underwent SIL colectomy. After matching, there were no significant differences in the general characteristics between the patients undergoing the two types of surgery. Operation time was significantly longer in SIL surgery (139 vs 121 minutes, P = 0.001), but procedure time (107 vs 99 minutes, P = 0.069) was not significantly longer than CL surgery after eliminating closure time (31 vs 22 minutes, P 〈 0.001) from the operation time. There was no significant difference in postoperative complications between the two groups (3.3 vs 1.6%, P = 1.000). The mean number of harvested lymph nodes was 23 and 22 for SIL and CL surgery, respectively ( P = 0.332). The mean follow-up period was 15.7 for the SIL group and 21.4 months for the CL group ( P 〈 0.001) with two recurrences in the SIL group (3.3%) and three recurrences in the CL group (4.9%, P = 1.000). Disease-free survival at 20 months did not differ significantly between the two groups (93.3 vs 94.7%, P = 0.939). SIL for colonic malignancy can be safely applied for various types of operations and can provide equivalent oncologic resection and perioperative outcomes compared with CL surgery.
    Type of Medium: Online Resource
    ISSN: 0003-1348 , 1555-9823
    URL: Article
    DOI: 10.1177/000313481508100337
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
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  • 6
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    Autologous Adipose Tissue-Derived Stem Cells for the Treatment of Crohn's Fistula: A Phase I Clinical Study
    SAGE Publications ; 2013
    In:  Cell Transplantation Vol. 22, No. 2 ( 2013-02), p. 279-285
    Details
    In: Cell Transplantation, SAGE Publications, Vol. 22, No. 2 ( 2013-02), p. 279-285
    Abstract: The present study was designed to evaluate the safety and potential of adipose tissue-derived stem cells (ASCs) for the treatment of Crohn's fistula. In this dose escalation study, patients were sequentially enrolled into three dosing groups with at least three patients per group. The first three patients (group 1) were given 1 × 10 7 cells/ml. After 4 weeks, this dose was deemed safe, and so an additional four patients (group 2) were given 2 × 10 7 cells/ml. Four weeks later, after which this second dose was deemed safe, a third and final group of three patients were given 4 × 10 7 cells/ml. Each patient was followed for a minimum of 8 weeks. Patients who showed complete healing at week 8 were followed up for an additional 6 months. Efficacy endpoint was complete healing at week 8 after injection, defined as complete closure of the fistula track and internal and external openings without drainage or signs of inflammation. There were no grade 3 or 4 severity adverse events, and there were no adverse events related to the study drug. Two patients in group 2, treated with 2 × 10 7 ASCs/ml, showed complete healing at week 8 after injection. Of the three patients enrolled in group 3, treated with 4 × 10 7 ASCs/ml, one showed complete healing. Outcome in another patient was assessed as partial healing due to incomplete closure of the external opening, although the inside of fistula track was filled considerably and there was no drainage. All three patients with complete healing at week 8 showed a sustained effect without recurrence 8 months after injection. In conclusion, this study demonstrates the tolerability, safety, and potential efficacy of ASCs for the treatment of Crohn's fistula and provides support for further clinical study.
    Type of Medium: Online Resource
    ISSN: 0963-6897 , 1555-3892
    URL: Article
    DOI: 10.3727/096368912X656045
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
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  • 7
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    Outcomes in patients with late sequelae (healed stage) of Legg-Calvé-Perthes disease undergoing arthroscopic treatment: retrospective case series
    SAGE Publications ; 2018
    In:  HIP International Vol. 28, No. 3 ( 2018-05), p. 302-308
    Details
    In: HIP International, SAGE Publications, Vol. 28, No. 3 ( 2018-05), p. 302-308
    Abstract: The residual hip deformities after Legg-Calvé-Perthes disease (LCPD) cause mechanical symptoms and are associated with a pathomechanical environment that can feature femoroacetabular impingement (FAI). The aim of this study is to evaluate the clinical and radiological outcomes in residual or healed LCPD after arthroscopic treatment. Patients and methods: We retrospectively reviewed patients with LCPD amongst patients with FAI who underwent arthroscopic treatment between January 2009 and June 2013. We determined LCPD through 3-dimensional computed tomographic scans and simple radiography of the hip joint. The clinical outcomes were rated using a visual analogue scale pain score (VAS), the modified Harris Hip Score (mHHS) and hip range of motion (ROM) preoperatively and at the 2-year follow-up. All radiographs were assessed using the Tönnis classification system preoperatively and at the final follow-up of each patient. There were 23 patients (14 men, 9 women) with mean age 26.4 (range, 16-49) years undergoing arthroscopic treatment for FAI symptoms because of residual or healed LCPD. Results: At the 2-year follow-up, the mean VAS had improved significantly from 6.7 to 2.1, the mean mHHS had improved significantly from 62.6 to 87.4, and hip flexion and external rotation had improved significantly from 88.7° to 106.5° and from 20.4° to 33.5°, respectively (all p 〈 0.001). The Tönnis osteoarthritis grade had not changed in any patient at the latest follow-up. Conclusions: Arthroscopic treatment for sequelae of LCPD relieved symptoms and improved range of motion, making arthroscopic treatment a good option for the sequelae of LCPD.
    Type of Medium: Online Resource
    ISSN: 1120-7000 , 1724-6067
    URL: Article
    DOI: 10.5301/hipint.5000563
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 8
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    Importance of the Circumferential Extent of Tumors and Clinical Lymph Node Status as Prognostic Factors after Preoperative Chemoradiotherapy and Surgery in Patients with Rectal Cancer
    SAGE Publications ; 2010
    In:  Tumori Journal Vol. 96, No. 4 ( 2010-07), p. 568-576
    Details
    In: Tumori Journal, SAGE Publications, Vol. 96, No. 4 ( 2010-07), p. 568-576
    Abstract: To evaluate the clinical factors that influence pathological and clinical outcomes after preoperative concurrent chemoradiotherapy in patients with rectal cancer. Methods Between 1999 and 2004, 121 patients with cT3-4 or node-positive rectal cancer received preoperative chemoradiotherapy and surgery. Preoperative radiation therapy with 45 Gy was delivered. Fluorouracil-based chemotherapy was administered to most of the patients. Results Pathological complete remission was 14.3% after preoperative chemoradiotherapy. More than 60% tumor circumferential extent was an independent adverse factor for complete remission (P = 0.011, HR 4.643, 95% CI 1.415–15.231). Local recurrence developed in 9.9% of the cases. Serum CEA level ≥5 ng/ml (P = 0.057, HR 3.022, 95% CI 0.967–9.441) and 〉 60% circumferential extent of tumor (P = 0.064, HR 4.232, 95% CI 0.918–19.531) were marginal adverse factors for local recurrence. Five-year disease-free survival and overall survival were 72.2% and 86.6%, respectively. Disease-free survival was poor for patients with the lymph nodes ≥1 cm in diameter (P = 0.028), cN2 stage disease (P = 0.047) and 〉 60% circumferential extent of tumor (P = 0.058). Multivariate analysis for disease-free survival showed that the lymph node size ≥1 cm was an adverse factor (P = 0.019, HR 2.380, 95% CI 1.115–4.906). Patients with 〉 60% circumferential extent of tumor and cN2 stage had a more unfavorable survival than the other patients (disease-free survival, P = 0.018; overall survival, P = 0.015). Patients with 〉 60% circumferential extent of tumor and/or lymph node ≥1 cm also had an unfavorable survival (disease-free survival, P = 0.016; overall survival, P = 0.049). Conclusions In rectal cancer, circumferential extent of tumor and clinical lymph node status were important factors for preoperative chemoradiotherapy and surgery. A further prospective study is needed to confirm and expand these findings.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.1177/030089161009600409
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
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  • 9
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    Correlation between T stage and lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy
    SAGE Publications ; 2022
    In:  Therapeutic Advances in Medical Oncology Vol. 14 ( 2022-01), p. 175883592211326-
    Details
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 14 ( 2022-01), p. 175883592211326-
    Abstract: Depth of tumor is a risk factor for lymph node metastasis in rectal cancer, but impact of yield pathologic T (ypT) stage on lymph node involvement in rectal cancer remains unclear. The aim of this study was to evaluate the correlation between ypT stage and lymph node metastasis. Methods: From January 2010 to December 2015, 602 patients who were diagnosed with rectal cancer and treated with neoadjuvant chemoradiotherapy (CRT) followed by radical operation were reviewed retrospectively. The correlations between ypT stage and lymph node status and survival were evaluated. Results: On pathology, 179 (29.7%) patients exhibited regional lymph node metastasis. Lymph node metastasis was seen in 8.5% of ypT0 patients, 20% of ypT1, 18.4% of ypT2, 47.5% of ypT3, and 27.3% of ypT4. Positive lymph node metastasis was correlated with ypT stage. In addition, the difference of lymph node metastasis in ypT stage subgroups was statistically significant ( p  〈  0.001). Five-year disease-free survival was significantly different in the ypT stage subgroups (88.7% versus 86.7% versus 82.6% versus 64.7% versus 72.7%, p  〈  0.001), as was 5-year overall survival (96.2% versus 90.0% versus 95.8% versus 80.0% versus 90.9%, p  〈  0.001). Conclusion: YpT stage is associated with lymph node metastasis in rectal cancer treated with neoadjuvant CRT and radical operation, and ypT0 patients exhibited an 8.5% lymph node metastasis rate. Therefore, the decision for local excision or the watch-and-wait strategy for rectal cancer treated with neoadjuvant CRT and predicted to show a pathologic complete response should be considered with caution.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    URL: Article
    DOI: 10.1177/17588359221132620
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 10
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    Repair integrity and functional outcomes of arthroscopic repair for intratendinous partial-thickness rotator cuff tears
    SAGE Publications ; 2019
    In:  Journal of Orthopaedic Surgery Vol. 27, No. 2 ( 2019-05), p. 230949901984722-
    Details
    In: Journal of Orthopaedic Surgery, SAGE Publications, Vol. 27, No. 2 ( 2019-05), p. 230949901984722-
    Type of Medium: Online Resource
    ISSN: 2309-4990 , 2309-4990
    URL: Article
    DOI: 10.1177/2309499019847227
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2128854-9
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