Outcome of laparoscopic vs wide open gastrostomy in youngsters

AIM To evaluate the efficacy and safety of third-line chemotherapy (CTx) for patients with unresectable or recurrent gastric cancer (GC) refractory to S-1 with or without platinum and taxanes. PATIENTS AND METHODS We retrospectively analyzed clinicopathological and survival data of 26 patients who underwent third-line CTx. RESULTS Irinotecan therapy (odds ratio=0.12, 95% confidence interval=0.02-0.38; p less then 0.01) and ≥2 cycles of third-line CTx (odds ratio=0.01, 95% confidence intervaI=0.01-0.11; p less then 0.01) were independent predictors of longer progression-free survival in multivariate Cox regression analysis. In 18 patients (69%) receiving irinotecan, the overall response rate was 11%, and the disease control rate was 44%. Median progression-free and overall survival were 3.5 and 11.3 months, respectively. Ten patients (56%) had grade 3-4 toxicities, which were managed. CONCLUSION Irinotecan therapy may become optimal and tolerated in the third-line setting to prolong progression-free survival by increasing the number of treatment cycles. BACKGROUND Concurrent chemoradiotherapy (CCRT) is the gold standard for limited-stage small-cell lung cancer (LS-SCLC); however, most patients inevitably experience relapse. We hypothesized consolidation amrubicin following CCRT to be a potential treatment for LS-SCLC. PATIENTS AND METHODS All enrolled patients were treated using induction CCRT consisting of four cycles of etoposide and cisplatin plus concurrent thoracic radiotherapy. Eligible patients then received three cycles of amrubicin as consolidation therapy (consolidation population). The primary endpoint was the 2-year progression-free survival rate in the consolidation population. RESULTS Of the 36 intention-to-treat patients, 28 (78%) received amrubicin and 24 (67%) completed all planned treatments. The 2-year progression-free survival rate and overall response rate were 35.7% and 86%, respectively. The median progression-free and overall survival were 14.3 and 60.9 months, respectively. There were no treatment-related deaths in the intention-to-treat population. CONCLUSION This study was terminated due to slow patient accrual; however, this treatment strategy was feasible and demonstrated promising efficacy. BACKGROUND/AIM Despite advances in the treatment strategies of patients with atrial fibrillation (AF), the risk of AF recurrences is still over 50%. An increased left atrial volume index (LAVI) reflects left ventricular diastolic dysfunction (DD) and deterioration of the LA function. This study aims to determine AF recurrence following cardioversion (CV) or catheter ablation for AF (pulmonary vein isolation; PVI) in dependence of DD and LAVI. PATIENTS AND METHODS One hundred and sixty-two patients with paroxysmal or persistent AF in whom either CV or PVI were performed were included and followed over a mean of 22.9±3.8 months. Recurrence was defined as any recurrence of AF that occurred 3 months following the procedure. DD and LAVI were assessed using transthoracic echocardiography (TTE). RESULTS Recurrent AF occurred in 100 (61.7%) patients, predominantly following CV [CV 41 (76.2%) vs. PVI 59 (54.6%), p36 ml/m2 with HR=2.1, 95%CI=1.8-2.7, p less then 0.0001) could be identified as independent predictors of AF recurrence after attempting to control the heart rhythm. CONCLUSION LA enlargement and DD are independent risk factors associated with AF recurrence after initial successful rhythm control attempt. These findings have implications for timing of either ablation or CV. BACKGROUND/AIM Several immunoinflammatory and nutritional measures have been reported to be good prognostic indicators for esophageal cancer (EC). However, the association between those markers and the postoperative survival of EC patients remains unclear due to varying study designs and treatment strategies. The aim of this study was to compare the significance of preoperative immunoinflammatory and nutritional measures in patients with EC. PATIENTS AND METHODS One hundred and five patients with EC who underwent McKeown esophagectomy with gastric tube reconstruction without neoadjuvant therapy between 2006 and 2014 were included in this study. ALLN research buy The prognostic values of preoperative modified Glasgow prognostic score (mGPS), controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), C-reactive protein (CRP)-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were investigated using univariate and multivariate survival analyses. RESULTS Multivariate analysis revealed that CAR and pathological stage are independent prognostic factors for overall survival (OS). CAR was significantly associated with more advanced pathological stage as both a subject and a continuous variable. CONCLUSION Preoperative CAR was an independent prognostic factor for the OS of EC patients who underwent McKeown esophagectomy. The tumor-stage related increase in CAR demonstrated that a high CAR is associated with tumor progression in EC patients. BACKGROUND/AIM Thrombocytopenia, one of many immune-related adverse events (irAEs), is a rare entity about which little is known on its treatment, outcomes, and patient demographics. Herein we present a case of severe thrombocytopenia after administration of pembrolizumab as an anti-programmed death-1 (PD-1) antibody. CASE REPORT A 66-year-old man with advanced non-small cell lung cancer (NSCLC) received pembrolizumab; 21 days later, his platelet count was progressively decreased and he experienced severe thrombocytopenia (grade 4; platelet count 0.4×109/l). With oral steroids 1 mg/kg/day, the platelet count improved sufficiently; thus, a definite diagnosis of severe irAE-related thrombocytopenia was performed. CONCLUSION Several reports have described the management and occurrence of severe thrombocytopenia after immune checkpoint inhibitor administration in patients with different neoplasms. Physicians should be alert to the potential of rare irAEs, such as severe thrombocytopenia. BACKGROUND/AIM To report cases in which we achieved sufficient width of the keratinized gingiva using a coronally advanced flap in combination with a subepithelial connective tissue graft (SCTG) obtained by the 'CO2 laser de-epithelization technique' (CODE). PATIENTS AND METHODS Eleven patients with 21 Miller Class I, II, and III gingival recessions had surgery. To prepare SCTG, free gingival grafts were harvested and de-epithelialized extra-orally. De-epithelialization was conducted by irradiation of CO2 laser. Postoperative examinations were performed at 12 months. RESULTS At 12 months, statistically highly significant root coverage was achieved in all recessions. Complete root coverage was obtained in 7 of the 21 recessions. The treatment yielded mean root coverage of 41.0%, and was associated with a mean gain of keratinized gingiva of 2.9±0.3 mm. CONCLUSION The use of CODE allows harvesting grafts of excellent quality and quantity and increases the keratinization of the overlying mucosal epithelium.