Journal of Surgical Oncology

Journal Information
ISSN / EISSN : 2674-3000 / 2674-3000
Published by: Science Repository OU (10.31487)
Total articles ≅ 66
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Lei Xue, Chuan Bin Wu
Journal of Surgical Oncology, Volume 2022, pp 1-4; https://doi.org/10.31487/j.jso.2022.02.01

Abstract:
Objectives: The aim of this study was to describe our experience in treating chronic obstructive parotitis related to diabetes. Methods: Twelve patients with chronic obstructive parotitis (COP) related to diabetes were selected for the study. A sialendoscope was introduced from the orifice to investigate the ductal wall and lumen. During the operation, chymotrypsin and gentamicin were injected. All patients were followed up for 6 months. Preoperative and postoperative visual analog scale (VAS) evaluations and salivary gland scintigraphy (SGS) examinations were applied to evaluate the therapeutic effect; differences were considered statistically significant at P < 0.05. Results: A sialendoscope was successfully used under local anaesthesia in all members of the cohort. As shown by the endoscope, mucus plugs were the most common feature. Some adhered tightly to the ductal wall. We also found ductal congestion in some cases. The postoperative VAS scores and SGS counts were both significantly lower than the preoperative values (P < 0.05). Conclusion: Chymotrypsin administration during interventional sialendoscopy is significantly effective in the treatment of diabetes-related COP.
Qing Zhou, Chuan Bin Wu, Tie Ma, Lin Ma
Journal of Surgical Oncology, Volume 2022, pp 1-6; https://doi.org/10.31487/j.jso.2022.01.03

Abstract:
Objective: To investigate the effect of splint combined with PRP injection in the treatment of temporomandibular joint osteoarthritis. Methods: Ninety-three patients with temporomandibular joint osteoarthritis were retrospectively analysed. They were divided into three groups according to different treatment methods: splint group, PRP group, and splint + PRP group. All patients were asked to have VAS scores before and 6 months after treatment and the maximum comfortable mouth opening was recorded either. All data were analysed by R×C test, and P<0.05 indicated statistically significant differences. Results: The maximum comfortable opening was significantly improved, and the VAS scores were decreased (P < 0.05). Conclusion: The treatment of splint+PRP is superior to the treatment of single splint or single PRP.
Xue-Dong Li, Peng Xie, Juan Zhang, Shi-Xin Du
Journal of Surgical Oncology, Volume 2022, pp 1-3; https://doi.org/10.31487/j.jso.2022.01.02

Abstract:
Although spinal tuberculosis and spinal tumors are difficult to distinguish in clinical manifestations, their respective imaging presentations are typical and specific, which makes it relatively easier to attain a correct diagnosis. Spinal tuberculosis is usually endemic in developing countries with conditions of poverty and malnutrition. Tuberculosis is also common in China, and we are experienced in diagnosing tuberculosis spondylitis. However, the diversification and the trend of tumor incidence in modern society are also increasing, which challenges our diagnosis of a spinal tumor. This article presents a case of spinal metastasis tumors whose imaging presentation is so similar to tuberculosis that we made a diagnostic error on it. Both computed tomography and magnetic resonance imaging of the thoracic spine highly supported the initial diagnosis of spinal tuberculosis. However, pathological examination of the excised specimen resulted in the diagnosis of spinal hemangioendothelioma.
Lobna Ouldamer, Emilie Serre, Christophe Destrieux, Gilles Body
Journal of Surgical Oncology, Volume 2022, pp 1-7; https://doi.org/10.31487/j.jso.2022.01.01

Abstract:
Objective: To investigate the lymphatic drainage of Bartholin’s gland and its therapeutic implications in Bartholin’s gland carcinoma. Materials and Methods: Data were obtained from the anatomical study of ten fresh female cadavers with groin and pelvic dissections after lymphatic channel and node staining by injection of Lipiodol dye solution into Bartholin’s gland. Results: We distinguished three different lymphatic pathways: i) the superficial inguinal pathway, identified in 61.5% of cases, ii) the internal pudendal pathway (towards the pararectal fossa), identified in 30.8% of cases, and iii) the pelvic pathway, identified in 15.4% of cases, one after an inguinal pathway and the other following the labiocrural fold. No evidence of stained lymphatic structures was found in 31.6% of cases. The principal pathway was always ipsilateral. Conclusion: Ipsilateral groin lymphadenectomy offers the most effective ratio between oncological safety and surgery-related complications.
Peter Kern, Ramachandramoorthy V, Bittner Ak, Rezai M, Kimmig R, Hoffmann O
Published: 31 December 2021
Journal of Surgical Oncology, Volume 2021, pp 1-8; https://doi.org/10.31487/j.jso.2021.03.04

Abstract:
Introduction: Breast tumors such as cystosarcoma phylloides and fibroadenoma may show rapid growth and occur early in thelarche. In adolescents, tumor growth often remains unnoticed due to a lack of breast awareness or a sense of shame in these young girls. The necessity for surgical intervention may interfere with the normal development of the breast, however in certain cases has to be performed due to the threat of deformation of the growing breast or the malignant potential of some tumors like cystosarcoma phylloides. However, visible scars have to be avoided at any price in these young girls, as they are still in their pre-marital and psychologically vulnerable phase. The presumed size of the breast after completion of all Tanner stages of breast development has to be taken into consideration while planning the immediate or deferred reconstruction. Methods: We report on three young girls, 13, 14 and 16 years of age, who presented with a giant cystosarcoma phylloides of 9,6 cm (190 grams), a giant fibroadenoma of 14 cm (287 grams) and a giant PASH-tumor of 16,3 cm (957 grams). All patients were in their thelarche. The extension of the tumor was almost to the whole circumference of the breast with close borders to the skin envelope, resulting in a marked anisomastia due to the giant tumor size. We are proposing here scar-sparing procedures adapted to the form of the breast and the BMI of the patients. For access to the tumor, in two cases, we chose the anterior axillary line to avoid visible scars on the surface of the breast - one with autologous and one with heterologous, implant-based reconstruction. In the third case, the patient had a marked anisomastia with a massively ptotic breast with a huge broadening of the nipple-areolar-complex due to the growth of the tumor. Here we selected a tumor-size adapted, inferior-pedicled reduction mammaplasty according to Ribeiro in the modification of Rezai with a skin reduction and shortening of the diameter of the areola. Patient reported-outcome has been measured by validated Breast-Q-questionnaires. Results: We present three different types of access for the removal of giant tumors and three options for the reconstruction of patients in their thelarche. Two tumors were removed through axillary access to the breast to avoid scars in the developing breast. We achieved free margins at first surgical intervention in all three cases. One reconstruction was performed by autologous tissue through lateral thoracic wall advancement mammaplasty. Another patient had an implant-based reconstruction. The third patient – who presented with a macromastia with marked enlargement of the nipple-areola-complex was treated with a tumor-adapted reduction mammaplasty. All three young patients have reported a high degree of satisfaction in validated Breast QoL questionnaires with the outcome of the procedures.
Rene Aloisio Da Costa Vieira, Wesley Pereira Andrade, Sabas Carlos Vieira, Mauricio Romano, Gustavo Iglesias
Published: 22 December 2021
Journal of Surgical Oncology, Volume 2021, pp 1-10; https://doi.org/10.31487/j.jso.2021.03.03

Abstract:
The Brazilian Society of Oncological Surgery organized a group of oncological surgeons to discuss surgical aspects associated with locally advanced breast carcinoma. This article reviews the indications, the different surgeries (especially those associated with thoracoabdominal or myocutaneous flaps), and associated complications. It discusses special conditions such as invasion of the chest wall and interscapular thoracic disarticulation. It makes recommendations based on the literature regarding clinical findings, tumor conditions, response to neoadjuvant therapy, choice of flaps in surgery, and tumor biology.
Changku Jia, Zhuangming Yu, He Li, Fei Sun, Hongjian Chen, Fengbo Zhang, Linjiang Li, Ping Long, Yunjian Wei, Jun Wang, et al.
Published: 18 November 2021
Journal of Surgical Oncology, Volume 2021, pp 1-8; https://doi.org/10.31487/j.jso.2021.03.01

Abstract:
Background: Venous thromboembolic events (VTE) are common causes of morbidity and mortality in glioblastoma patients. Mutation in the isocitrate dehydrogenase 1 enzyme (IDH1) is frequent in secondary glioblastoma and results in altered metabolomics. Objectives: This study evaluates whether IDH-1 status correlates with incidence of VTE in glioblastoma patients. Methods: Observational study of 398 cases of patients with glioblastoma, who all underwent surgery in a regional Neurosurgical centre between April 2012 and December 2014. IDH -1 status and Tissue factor (F3) protein expression were assessed by immunohistochemistry. Deep venous thrombosis (DVT) and pulmonary embolism (PE) were diagnosed by Doppler ultrasound and pulmonary CT angiogram respectively. Results: 336 cases were wild type (WT) IDH-1 (94.1%) and 21 cases were IDH-1 mutated (R132H) (5.9%). 51 patients had a thromboembolic event (15.3%), with all cases of VTE in WT IDH-1 tumors, a rate of 21.8% within this group. IDH-1 status had a significant correlation with VTE (p=0.033 Fisher exact test). As expected, mutant IDH was associated with prolonged patient survival (p=0.024 Log rank). The mean expression in IDH-1 wild type GBM was 7.14 and in R132h mutant GBM was 4.87 (log2 scale). This was highly statistically significant with a corrected P value of less than 0.0001. Conclusion: A significant association exists between IDH1 status in glioblastoma patients and the risk of VTE. Patients with wild type IDH-1 appear at high risk of VTE and appropriate precautions should be considered.
Georgios Stefanakis, Vasileia Nyktari, Georgios Papastratigakis, Panagiotis Vardakis, Periklis Vasilos, Emmanouela Koutoulaki
Journal of Surgical Oncology, Volume 2021, pp 1-3; https://doi.org/10.31487/j.jso.2021.02.05

Abstract:
We report a case of pulmonary embolism during resection of a mediastinal mass requiring intraoperative thrombolysis. The diagnosis, although difficult to establish due to simultaneous bleeding and technical difficulties with transthoracic echocardiography, was based on the patient’s history and clinical evidence of low cardiac output and was confirmed by clinical improvement post thrombolysis. When awakened in the intensive care unit, the patient was found to be blind and also required a tracheostomy. We present this case, as it requires complex clinical reasoning throughout different stages of its management and it demonstrates that, when facing an imminent disaster, a risky decision not necessarily conforming to current practice but based on individualisation of treatment can be life-saving.
Shi Bing Su, Xiaole Chen, Peng Wang, Yunquan Luo, Yi Yu Lu, Wenjun Zhou, Mengdie Yang, Jian Chen, Zhi Qiang Meng
Published: 22 September 2021
Journal of Surgical Oncology, Volume 2021, pp 1-11; https://doi.org/10.31487/j.jso.2021.02.04

Abstract:
Objective: The aim of this study was to assess the therapeutic effects of Jianpi Liqi decoction (JPLQD) in hepatocellular carcinoma (HCC) and explore its underlying mechanisms. Methods: The characteristics and outcomes of HCC patients with intermediate stage B who underwent sequential conventional transcatheter arterial chemoembolization (cTACE) and radiofrequency ablation (RFA) only or in conjunction with JPLQD were analysed retrospectively. The plasma proteins were screened using label-free quantitative proteomics analysis. The effective mechanisms of JPLQD were predicted through network pharmacology approach and partially verified by ELISA. Results: Clinical research demonstrated that the Karnofsky Performance Status (KPS), traditional Chinese medicine (TCM) syndrome scores, neutropenia and bilirubin, median progression-free survival (PFS), and median overall survival (OS) in HCC patients treated with JPLQD were superior to those in patients not treated with JPLQD (all P<0.05). The analysis of network pharmacology, combined with proteomics, suggested that 52 compounds targeted 80 potential targets, which were involved in the regulation of multiple signaling pathways, especially affecting the apoptosis-related pathways including TNF, p53, PI3K-AKT, and MAPK. Plasma IGFBP3 and CA2 were significantly up-regulated in HCC patients with sequential cTACE and RFA therapy treated with JPLQD than those in patients not treated with JPLQD (P<0.001). The AUC of the IGFBP3 and CA2 panel, estimated using ROC analysis for JPLQD efficacy evaluation, was 0.867. Conclusion: These data suggested that JPLQD improves the quality of life, prolongs the overall survival, protects liver function in HCC patients, and exhibits an anticancer activity against HCC. IGFBP3 and CA2 panels may be potential therapeutic targets and indicators in the efficacy evaluation for JPLQD treatment, and the effective mechanihsms involved in the regulation of multiple signaling pathways, possibly affected the regulation of apoptosis.
Je García Villayzán, Mt Marichal de la Fuente, J Utrilla Layna Trigo, J Garcia Foncillas Lopez, L. Chiva de Agustin, M. Albi Gonzalez
Published: 10 September 2021
Journal of Surgical Oncology, Volume 2021, pp 1-10; https://doi.org/10.31487/j.jso.2021.02.02

Abstract:
Background: Sentinel Lymph Node Biopsy is a technique developed to predict lymphatic involvement in patients with early endometrial cancer, decreasing the morbimortality associated with routine systematic lymphadenectomy and improving quality of life. Main Objective: To determine the detection rate and negative predictive value of the Sentinel Lymph Node Biopsy by Immunofluorescence in patients with early endometrial cancer. Methods: A descriptive observational study in patients with early endometrial cancer (FIGO stage I-II) for all histological types and grades, who underwent the Sentinel Lymph Node by immunofluorescence Technique, between June 2019 and March 2020 at the Fundación Jiménez Díaz University Hospital. We used indocyanine green powder for injection, with a concentration of 25 milligrams (mg). We proceeded to dissolve it in 10 cubic centimeters (cc) of distilled water to. After which, we injected 2 cc of the prepared solution into the cervix at the 3 and 9 o’clock positions at a depth of 1 centimeter. Results: Eighteen patients were included, analysing a total of 26 sentinel nodes: 24 pelvic and 2 paraortic; and a total of 273 lymph nodes (sentinel and non-sentinel nodes): 83 right pelvic, 86 left pelvic and 104 paraortic. All nodes were negative for metastasis. Global and bilateral detection rates were 77.78% and 50% respectively. The Negative Predictive Value and sensitivity were 100%. No significant difference in morbimortality was found between performing only Sentinel Lymph Node technique or systematic lymphadenectomy, but the association with quality of life was significant, with better results for those who only underwent the sentinel lymph node technique versus systematic lymphadenectomy (0% vs 77%). Conclusion: The global and bilateral detection rates of the Sentinel Lymph Node Technique by immunofluorescence were 77.78% and 50% respectively, obtaining a Negative Predictive Value and Sensitivity of 100%. Sentinel Node Biopsy is a valid technique to predict lymphatic affectation in early endometrial cancer, with lower morbimortality than systematic lymphadenectomy.
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