Neuroendocrine tumors of the pancreas (pNET) range from 1 to 2% of pancreatic oncological pathology, the frequency during lifetime diagnostics is 12e15 cases per 1 million of population. Aim: Introduce the largest experience of surgical treatment of neuroendocrine tumors of the pancreas in Ukraine. Methods: In the National Institute of Surgery and Transplantology from January 2004 to December 2014 were treated 173 patients with neuroendocrine tumors of the pancreas, to whom were performed 181 surgeries. Nonfunctioning pNET were diagnosed in 103 patients (59.5%), hormone-active were in 70 (40.5%). In non-functioning NET (dominated resection surgeries (Whipple procedure, left-side pancreatectomy), at hormone-active were performed mostly organ-preserving surgeries (enucleation of tumor). Results: Postoperative complications occurred in 18.4% of patients with pNET, the most common complication was external pancreatic fistula (9.8%). Total postoperative mortality was 1.2%. The overall 5-year survival was 82.3%, NET G1-100%, NET G2-84.3%, neuroendocrine carcinoma, NEC G3 e 38.7%. Conclusion: The level of postoperative complications and mortality indicators complies with all tumors of the pancreas. The level of the overall 5-year survival is quite high, allowing for organ-preserving and laparoscopic surgeries for localized forms of pNET. Advance forms of pNET are not a contraindication to surgical treatment, but such cases must be evaluated individually. Relatively few of occurrences of pNET, the complexity and importance of preoperative diagnostic to choose the optimal treatments strategy, justifying perform the treatment of these patients in specialized centers.
ResumenIntroducción: La obesidad es reconocida como un importante problema de salud pública en todo el mundo, la prevalencia de sobrepeso y obesidad está aumentando a un ritmo alarmante tanto en países desarrollados como en vía de desarrollo, tanto así, que la obesidad ha sido considerada como la epidemia del siglo XXI. El exceso de peso corporal es un factor de riesgo importante en la aparición de enfermedades crónicas y determinados tipos de cáncer, tales como el cáncer de colon, mama en mujeres menopáusicas, endometrio, riñón y cáncer de esófago. Métodos: En junio del 2015, se realizó una búsqueda sistemática de la literatura científica en las principales bases de datos biomédicas: PUBMED, EMBASE, MEDLINE, LILACS, IMBIOMED, COCHRANE, entre el año 1980 y 2015. Utilizando las siguientes palabras clave: cáncer, obesidad, neoplasia, sobrepeso, epidemiologia, asociación y revisión. Resultados: se encontró que existe una asociación estadísticamente significativa entre la obesidad y diversos tipos de cáncer, tales como el cáncer de colon, de mama en mujeres posmenopáusico, de endometrio, de riñón, y de esófago. La obesidad y el sobrepeso pueden tener efectos notables sobre varios sistemas fisiológicos que pueden posteriormente aumentar el riesgo de cáncer. Conclusión: Existe una asociación entre la obesidad y la aparición de diversos tipos de cáncer, la comprensión de los mecanismos causales de esta asociación es importante para la implementación de medidas de salud pública y cambios en el estilo de vida, que busquen prevenir la aparición del cáncer y la obesidad. Palabras clave: cáncer, obesidad, neoplasia, sobrepeso, epidemiologia, asociación y revisión. Obesity and cancer: pathophysiology and epidemiological evidenceBackground: Obesity is said to be a major public health issue around the globe. The prevalence of overweight and obesity is increasing at an alarming rate in developed and developing countries, to the extend that obesity is being regarded as the epidemic of the XXI century. Overweight is an important risk factor in the acquisition of chronic diseases and certain types of cancer such as; colorectal cancer, esophageal cancer, endometrial cancer, kidney cancer, and breast cancer in menopausal women. Methods: In June 2015, a systematic search for scientific literature in the main biomedical databases was performed: PUBMED, EMBASE, MEDLINE, LILACS, IMBIOMED and COCHRANE, making use of the following key words: cancer, obesity, neoplasm, overweight, epidemiology, associations and review, between 1980 and 2015. Results: There is a significant statistical relationship between obesity and several types of cancer, such as; colorectal cancer, esophageal cancer, endometrial cancer, kidney cancer, and breast cancer in post-menopausal women.Obesity and overweight may have considerable effects on several physiological systems that may subsequently increase the risk of cancer. Conclusions: There is a relationship between obesity and the onset of several types of cancer. The understanding of this mechanism is important...
POEMS syndrome is a rare condition of paraneoplasic origin characterized by the presence of a sensorimotor polyneuropathy associated with the presence of a proliferative disorder of plasmatic monoclonal cells and overproduction of vascular endothelial growth factor. The acronym “POEMS” represents multisystem findings including polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder and skin changes; nevertheless, clinical presentation is heterogeneous. We describe a clinical case, the diagnostic and therapeutic approach in a patient with sensorimotor polyneuropathy in whom POEMS syndrome was diagnosed; to understand this pathology, its clinical and paraclinical manifestations in order to make a diagnosis or to avoid a delayed one and to provide an adequate treatment.
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