Background and objective Signet ring cell carcinoma of the appendix (SRCCA) is an exceedingly rare tumor, and very limited data are available regarding its characteristics and survival probabilities. Our objective in this study was to utilize the Surveillance, Epidemiology, and End Results (SEER) database to explore the patient and tumor characteristics and to characterize the three-and five-year cancer-specific survival (CSS) probabilities of SRCCA. Methods Patients with SRCCA diagnosed between 2000 and 2015 were analyzed using the SEER database. The three-and five-year CSS probabilities were estimated by the Kaplan-Meier method, and the groups were compared using log-rank comparisons and multivariable Cox hazard regression analysis.
e22528 Background: Among the types of soft tissue sarcomas (STS), liposarcoma is the most common malignant STS. Considering therapeutic options, surgical resection is the most utilized therapeutic option. In this study, we aim to explore the effects of varying degrees of surgical margins on survival in patients with dedifferentiated liposarcoma. Methods: The National Cancer Database (NCDB) was used to select patients with dedifferentiated liposarcoma to determine if surgical margins and other variables were associated with worse overall survival after accounting for age, gender, race, Charlson-Deyo score, anatomic site, treatment approach, tumor size, tumor grade, and presence of metastases through multivariable analysis. Results: Of the 1,004 patients, 64.4% were male, 87.0% were white, and the median age was 63 years. Approximately 95% had no metastases at the time of diagnosis, and 91.5% had high grade liposarcoma. For the status of surgical margins, 50.8% had no residual tumors, 26.1% had microscopic residual tumors, and 4.3% had macroscopic residual tumors. In general, the risk of death was higher for older males (25.8% increased risk of mortality) and those with metastases (312.9% increased risk of mortality) as well as patients with high grade liposarcoma (112.4% increased risk of mortality). When compared to no residual tumor after surgery, patients with macroscopic residual tumors, had a 96.7% increased risk of death (HR 95% CI:1.24 to 3.13; p= 0.004). Conclusions: Older age, presence of metastasis, male patients, retroperitoneal/abdomen primary site, high grade tumors, and macroscopic or residual tumor present after surgery led to an increased risk of mortality.
Background: Liposarcoma is the most common malignant soft tissue sarcoma for which surgical resection is the most utilized therapeutic option. In this study, we aimed to explore the associations of surgical margins among other risk factors on survival in patients with dedifferentiated liposarcoma. Patients and Methods: The National Cancer Database (NCDB) was used to select patients with dedifferentiated liposarcoma to determine if surgical margins were associated with worse overall survival after controlling for age, gender, race, Charlson-Deyo score, anatomic site, treatment approach, tumor size, tumor grade, and presence of metastases through multivariable analysis. Results: Multivariable analyses showed that mortality risk increased for dedifferentiated liposarcoma patients with the following: older age, male, metastasis, high tumor grade, macroscopic residual tumor compared to no residual tumor. Conclusion: Older age, male sex, presence of metastasis, retroperitoneal/abdomen primary site, high grade tumors, and macroscopic residual tumor present after surgery led to an increased risk of mortality.
INTRODUCTION: Bevacizumab is a recombinant humanized monoclonal antibody which inhibits vascular endothelial growth factor. It has been added to chemotherapy for the treatment of various solid tumors including cervical cancer, ovarian cancer, renal cell cancer, colon cancer, and glioblastoma. Several side effects have been attributed to bevacizumab of which the most common are hypertension, bleeding, infection, fatigue. However, one case of bevacizumab- linked acute pancreatitis has been reported in the literature in combination with cisplatin and gemcitabine for metastatic ovarian cancer as reported by Onder et al. CASE DESCRIPTION/METHODS: We herein present the case of a 78-year-old man with metastatic colon cancer treated with Leucovorin, 5- fluorouracil and irinotecan plus bevacizumab. After seven days of treatment, he suffered nausea, vomiting, and loss of appetite followed by epigastric and right upper quadrant pain. Imaging studies demonstrated evidence of acute pancreatitis and a pancreatic pseudocyst. As hypertriglyceridemia, hypercalcemia, alcohol and biliary etiologies and trauma were excluded, the most likely etiology of the patient's pancreatitis was felt to be an adverse reaction to bevacizumab. DISCUSSION: To date, this is the second bevacizumab-linked acute pancreatitis reported in the literature and the first in a patient with metastatic colon cancer. Due to the widespread use of bevacizumab in patients with a variety of malignancies, it is important that health care providers be aware of acute pancreatitis as a possible side effect of bevacizumab. Our aim is to raise awareness among gastroenterologists and other medical professionals to consider acute pancreatitis as a possible side effect of bevacizumab.
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