In these patients with incidental colonic focal activity undergoing PET/CT (the largest series published to date), malignancies had significantly higher SUVmax values than all other types of lesions. However, SUVmax could not distinguish between benign lesions and adenomas. In conclusion, all incidental findings in the colon should be further evaluated and lesions with SUVmax ≥11.4 should be evaluated without delay.
Various treatments are available for the palliation of esophageal cancer, but the optimal therapeutic approach is unclear. This study aimed to assess the palliative treatment modalities used in patients with inoperable esophageal cancer and to identify factors associated with treatment decisions. A population-based, retrospective cohort study was conducted using data from the nationwide Netherlands Cancer Registry and medical records of seven participating hospitals. Patients diagnosed with stage III-IV inoperable esophageal or gastric cardia cancer in the central part of the Netherlands between 2001 and 2010 were included. Logistic regression analyses were performed to identify determinants of treatment choices. In total, 736 patients were initially treated with best supportive care (21%), stent placement (19%), chemotherapy (18%), external beam radiotherapy (EBRT) (16%), brachytherapy (6%), a combination of EBRT and brachytherapy (6%), a combination of chemotherapy and EBRT (5%) or another treatment (9%). The palliative approach varied for disease stage (P < 0.01) and hospital of diagnosis (P < 0.01). Independent factors affecting treatment decisions were age, degree of dysphagia, tumor histology, tumor localization, disease stage, and hospital of diagnosis. For example, patients diagnosed in one hospital were less likely to be treated with EBRT than with stent placement compared to patients in another hospital (odds ratio 0.20, 95% confidence interval 0.07-0.59). In conclusion, the initial palliative approach of patients with inoperable esophageal cancer varies widely and is not only associated with patient- and disease-related factors, but also with hospital of diagnosis. These findings suggest a lack of therapeutic guidance and highlight the need for more evidence on palliative care strategies for esophageal cancer.
SUMMARY One hundred and five stoma biopsy specimens and 108 corpus biopsy specimens from 108 patients who had undergone a partial gastrectomy because of peptic ulcer disease were examined retrospectively for the presence of Campylobacter-like organisms and gastritis. In the corpus biopsy specimens Campylobacter-associated gastritis was found in 55 (71 %) of the cases and in 42 (48%) of the stoma biopsy specimens. It is concluded that Campylobacter-like organisms have a role in gastritis afterpartial gastrectomy, although this role is more prominent in the corpus region. The role of Campylobacter pylori in peptic ulcer disease is not clinically important. One way to address the second question is to study the fate of C pylori in gastric mucosa after effective treatment for ulcers. If C pylori were of pathogenetic importance in the pathogenesis of peptic ulcers through induction of gastritis a pronounced decline in or absence of the micro-organism would be expected under these circumstances.In the era before the H2 receptor blocking drugs partial gastrectomy was regarded as the most effective treatment for peptic ulcer disease. Relapse of ulcers and the finding of gastritis in the gastric remnant was attributed to the reflux of bile. There are some data on the effect of treatment for gastritis on C pylori, and they show a decrease in Campylobacter colonisation and a decrease in gastritis score.8 The eradication of C pylori leads to a significant decrease in the relapse rate of duodenal ulcers.9 Little is known, however, about the fate of C pylori after gastric surgery carried out because of peptic ulcer disease.
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