In recent years, treatment techniques in which polyglycolic acid sheets are applied to various situations with fibrin glue have exhibited great clinical potential, and previous studies have reported safety and efficacy. We describe closure of a non-healing perforated duodenal ulcer with the use of a polyglycolic acid sheet and fibrin glue in an elderly patient who was not a candidate for surgery.

A case of a woman in her 60s with breast cancer, whose leptomeningeal metastasis (LM) of breast cancer improved remarkably with letrozole monotherapy, is reported. The patient complained of numbness of her left hand and hoarseness, followed by progressive asymmetric extremity weakness and a bladder and rectal disturbance. The patient had undergone surgery for left breast cancer 18 years earlier and was concerned about recurrence of breast cancer, but there were no typical findings with some imaging modalities. The third lumbar puncture showed the malignant cytology of breast cancer, and the patient was diagnosed with recurrent breast cancer. Her performance status was very poor, and it was difficult to administer systemic chemotherapy. Letrozole was started because immunohistochemistry was positive for estrogen and progesterone receptors. After 4 months of letrozole therapy, the symptoms improved gradually. LM has a poor prognosis, and there is little evidence on which to base treatment, but hormone therapy may be an option for LM when the tumor is hormone receptor-positive, slow growing, and has a small volume.

Objective: The Glasgow Prognostic Score (GPS) has been demonstrated to be a useful prognostic factor for various tumors. The aim of the current study was to clarify the significance of the GPS for predicting postoperative survival of patients with stage IV gastric cancer after receiving palliative surgery. Summary of background data:Generally stage IV gastric cancer is not considered for curative surgery. However, palliative surgery is often required to improve the quality of life of patients.Methods: 51 consecutive patients with stage IV gastric cancer was performed the association between GPS, clinicopathological factors and overall survival was assessed.Results: Peritoneal lavage cytology (CY), P0CY1 (no peritoneal dissemination and CY positive), surgical treatment, operative time and curability factors were correlated well with the GPS score. The number of metastatic sites (1 vs. ≧2), curability (R0, R1 vs. R2) and GPS score (0, 1 vs. 2) were found to be the independent prognostic factor. The prognosis of patients with a high GPS was significantly poor. Conclusion:In patients with a GPS of 2, surgical treatment offered only few benefits to the patients and, thus, less invasive treatment should be recommended for these patients.