Patterns of initial disease recurrence after resection of gallbladder carcinoma and hilar cholangiocarcinoma

Abstract

Accurate prediction of future blood glucose trends has the potential to significantly improve glycemic regulation in type 1 diabetes patients. A model‐based controller for an artificial β‐cell, for example, would determine the most efficacious insulin dose for the current sampling interval given available input–output data and model predictions of the resultant glucose trajectory. The two inputs most influential to the glucose concentration are bolused insulin and meal carbohydrates, which in practice are often taken simultaneously and in a specified ratio. This linear dependence has adverse effects on the quality of linear dynamic models identified from such data. On the other hand, inputs with greater degrees of excitation may force the subject into extreme hypoglycemia or hyperglycemia, and thus may be clinically unacceptable. Inputs with good excitation that do not endanger the subject are shown to result in models that can predict glucose trends reasonably accurately, 1–2 h ahead. © 2009 American Institute of Chemical Engineers AIChE J, 2009

Adjuvant chemoradiation therapy in gallbladder cancer

“…Even after radical resection of GB cancer, not only locoregional recurrence but also distant metastasis is common, especially in advanced stages [6,[8][9][10][11]. Thus, the multidisciplinary approach in addition to surgical resection may be necessary to treat advanced GB cancers.…”

“…Recurrence developed in 12 of the 20 patients with T3N1M0 stage; four (80.0%) of the five patients from the NCRTx group (2 recurrences in the liver, both 1 month after surgery, respectively; 1 recurrence in the peritoneum, 2 months after surgery; and 1 recurrence in the lung, 17 months after surgery) and 8 (53.3%) of the 15 patients from the CRTx group (4 recurrences in the liver, 3,8,16, and 18 months after surgery, respectively; 3 recurrences in the lymph nodes, 4, 6, and 20 months after surgery, respectively; and 1 recurrence in the peritoneum, 18 months after surgery). The DFS rate was higher in the CRTx group than in the NCRTx group (P ¼ 0.006) (Fig.…”

Current Management of Gallbladder Carcinoma

“…In a large study from Memorial Sloan-Kettering Cancer Center, 97 patients with GBC and 76 patients with hilar CC who underwent potentially curative resection were evaluated for patterns of initial disease recurrence [38]. In comparison with hilar CC, patients with GBC had a significantly shorter time to recurrence (11.5 months for GBC, versus 20.3 months; p ϭ .007).…”

Effect of Adjuvant Gemcitabine Combined with Low-dose 5-Fluorouracil and Cisplatin Chemotherapy for Advanced Biliary Carcinoma

“…One meta-analysis revealed that chemotherapy or chemoradiotherapy had a statistically greater benefit than radiotherapy alone (32). It has also been reported that remote organ metastasis is more frequently observed than locoregional recurrence of biliary carcinoma after surgery (28)(29)(30)(31). Therefore, adjuvant treatment with systemic chemotherapy might have some advantage in the regulation of recurrences after drastic local treatment such as surgery as compared with local radiotherapy.…”