ABSTRACT

Colorectal malignancy is the third most common cancer and one of the prevalent causes of death globally. Around 20-25% of patients present with metastases at the time of diagnosis, and 50-60% of patients develop metastases in due course of the disease. Liver, followed by lung and lymph nodes, are the most common sites of colorectal cancer metastases. In such patients, the 5-year survival rate is approximately 19.2%. Although surgical resection is the primary mode of managing colorectal cancer metastases, only 10-25% of patients are competent for curative therapy. Hepatic insufficiency may be the aftermath of extensive surgical hepatectomy. Hence formal assessment of future liver remnant volume (FLR) is imperative prior to surgery to prevent hepatic failure. The evolution of minimally invasive interventional radiological techniques has enhanced the treatment algorithm of patients with colorectal cancer metastases. Studies have demonstrated that these techniques may address the limitations of curative resection, such as insufficient FLR, bi-lobar disease, and patients at higher risk for surgery. This review focuses on curative and palliative role through procedures including portal vein embolization, radioembolization, and ablation. Alongside, we deliberate various studies on conventional chemoembolization and chemoembolization with irinotecan-loaded drug-eluting beads. The radioembolization with Yttrium-90 microspheres has evolved as salvage therapy in surgically unresectable and chemo-resistant metastases.

PMID:37324012 | PMC:PMC10266282 | DOI:10.3389/fonc.2023.963966

11:52

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

11:52

In reply to this message

PubMed articles on: Cancer & VTE/PE

Utility of the intraflap perfusion procedure for abdominal free flap in unilateral breast reconstruction

J Plast Reconstr Aesthet Surg. 2023 May 19;84:54-61. doi: 10.1016/j.bjps.2023.05.039. Online ahead of print.

ABSTRACT

BACKGROUND: Heparin prophylaxis for venous thromboembolism can be used in microsurgery. If vein anastomosis is performed before the artery, heparin irrigation into the artery can be performed locally without systematic effect. This study aimed to introduce this "intraflap perfusion procedure" in autologous breast reconstruction.

METHODS: Among the 220 patients with unilateral breast cancer who had received the free abdominal flap, we retrospectively compared those that had undergone the intraflap perfusion procedure (n = 108) and those who did not (n = 112). A 10 mL injection of heparinized physiological saline solution (100 units/mL) was administered into the deep inferior epigastric artery. Intraflap perfusion was performed before, during, and after vein anastomosis, without the vessel clip of the vein. Artery anastomosis was performed without the use of a vein clamp. Further, vein anastomosis was performed tightly to prevent leakage from the vein anastomosis site during artery anastomosis.

RESULTS: The rates of superficial inferior epigastric vein (SIEV) superdrainage (18.5% vs. 42.0%, P < 0.001), and intraoperative flap congestion (0.9% vs. 8.0%, P = 0.01) were significantly lower in patients undergoing this procedure. There were no significant differences regarding other factors (age, BMI, laterality, comorbidities, and other operative details).

CONCLUSIONS: Intraflap perfusion prevented long-term stasis at the venous anastomosis site and capillary level. It could reduce flap congestion. SIEV superdrainage was performed to manage flap congestion, particularly in patients who did not undergo this procedure. Consequently, it can be inferred that this procedure reduces the rate of superdrainage.

PMID:37320952 | DOI:10.1016/j.bjps.2023.05.039

11:52

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

11:52

In reply to this message

PubMed articles on: Cancer & VTE/PE

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Reduction of Venous Thromboembolic Disease in Colorectal Surgery

Dis Colon Rectum. 2023 Jun 12. doi: 10.1097/DCR.0000000000002975. Online ahead of print.

NO ABSTRACT

PMID:37318130 | DOI:10.1097/DCR.0000000000002975

11:52

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

11:52

PubMed articles on: Cancer & VTE/PE

Thromboembolic complications associated to malignant diseases

Magy Onkol. 2023 Jun 13;67(2):139-145. Epub 2023 Apr 18.

ABSTRACT

Cancers are known to increase the tendency for thrombosis, both on the venous and arterial side, which to this day is an important factor in the management of oncology patients. Malignant disease is an independent risk factor for developing venous thromboembolism (VTE). Thromboembolic complications in addition to the disease worsen prognosis and are accompanied by significant morbidity and mortality. VTE is the second most common cause of death in cancer after disease progression. Tumors are characterized by hypercoagulability, in addition to which venous stasis and endothelial damage also occur in cancer patients promoting increased clotting. Treatment of cancer-associated thrombosis is often complex; therefore, it is important to identify patients who benefit from primary thromboprophylaxis. The importance of cancer-associated thrombosis is indisputable in everyday oncology. We briefly summarize the frequency and characteristics of their occurrence, the underlying mechanisms, risk factors, clinical appearance, laboratory diagnostics, and the possibilities of prevention and treatment.

PMID:37314075

11:52

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

11:52

In reply to this message

PubMed articles on: Cancer & VTE/PE

Association of D-dimer Levels with Complications after Subcutaneous Implantable Central Venous Port Placement in Combination Chemotherapy with Bevacizumab for Colorectal Cancer

Gan To Kagaku Ryoho. 2023 Jun;50(6):713-717.

ABSTRACT

Bevacizumab(BV)combination chemotherapy in colorectal cancer under subcutaneously implanted central venous port (CVP)implantation may cause complications after the implantation. Measurement of D-dimer is recommended to predict thromboembolism and other complications, but its relevance to complications after CVP implantation remains unclear. In this study, we investigated the association between D-dimer and complications after CVP implantation in 93 patients with colorectal cancer who received BV combination chemotherapy. Complications after CVP implantation occurred in 26 patients (28%), and those with VTE showed higher D-dimer values at the onset of the complication. The D-dimer values of the patients with VTE displayed a sharp increase at the onset of the disease, while those with an abnormal CVP implantation site showed a more variable course. Measurement of D-dimer levels appeared useful in estimating the incidence of VTE and abnormal CVP implantation sites in post-CVP implantation complications of BV combination chemotherapy for colorectal cancer. Further, monitoring not only the quantitative values but also the fluctuations over time is also important.

PMID:37317606

11:52

PubMed articles on: Cancer & VTE/PE

Cone-Beam Computed Tomography-Guided Marking of Small Pulmonary Nodules with Surgical Clips

Kurume Med J. 2023 Jun 14. doi: 10.2739/kurumemedj.MS6834006. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative computed tomography-guided marking can help identify small non-palpable pulmonary nodules during surgery. However, this technique is associated with the risk of air embolism. We retrospectively evaluated whether small pulmonary nodules could be intraoperatively localized using cone-beam computed tomography (CBCT).

METHODS: A hybrid operating room permitting stable lateral positioning and scanning from the pulmonary apex to the base was used in all patients. CBCT images were obtained using a 10-s protocol with 180º rotation of the C-arm flat panel detector around the patient. Clips were placed on the visceral pleura to help guide pulmonary nodule localization. Partial pulmonary resection was performed using video-assisted thoracoscopic surgery at the predicted nodule site.

RESULTS: Between July 2013 and June 2019, 132 patients with 145 lesions underwent this procedure at our center. The detection rate of lesions on CBCT was 100%. The pathological diagnoses were primary lung cancer, metastatic pulmonary tumors, and benign lesions. The average consolidation-to-tumor ratio was 0.65 for all nodules, with ratios of 0.33, 0.96, and 0.70 for primary lung cancer, metastatic pulmonary tumors, and benign lesions, respectively. No complications related to this localization method were observed.

CONCLUSIONS: CBCT-guided intraoperative localization is safe and feasible for non-palpable small pulmonary nodules. This technique may eliminate the risk of serious complications such as air embolism.

PMID:37316291 | DOI:10.2739/kurumemedj.MS6834006

11:52

PubMed articles on: Cancer & VTE/PE

Thromboembolism Triggered by a Combination of Electronic Cigarettes and Oral Contraceptives: A Case Report and Review of Literature

J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231181072. doi: 10.1177/23247096231181072.

ABSTRACT

Genetic predisposition, oral contraceptive (OCP) use, tobacco smoking, cancers, and trauma are well-known triggers for hypercoagulability and thromboembolism. Multiple reports have been published on the health risk of combining OCP and traditional cigarettes smoking in the context of thromboembolism. However, limited information is available on the health consequences of combining OCP use with electronic cigarettes. Here, we report a case of a young female patient with a past medical history of ovarian cysts and electronic cigarettes use who came into the hospital with a complaint of "recurrent seizures" and tachycardia. This patient was subsequently diagnosed with bilateral pulmonary emboli, subacute cerebrovascular accident (CVA), and possible patent foramen ovale. Therapeutic Lovenox was initiated. Reasons to educate young females on the risks of combining OCP and electronic cigarettes use were explained.

PMID:37314028 | DOI:10.1177/23247096231181072

11:52

In reply to this message

PubMed articles on: Cancer & VTE/PE

Analysis of the Incidence of Lower Limb Deep Venous Thrombosis and Its Related Risk Factors in the Postoperative Patients with Lung Cancer

Zhongguo Fei Ai Za Zhi. 2023 May 20;26(5):386-391. doi: 10.3779/j.issn.1009-3419.2023.102.16.

ABSTRACT

BACKGROUND: Lung cancer is the first leading cause of morbidity and mortality among the malignant tumors, which has become a hot issue in current research. Clinically, lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to the pathological types. NSCLC includes adenocarcinoma, squamous cell carcinoma and other types of lung cancer, accounting for about 80% of all lung cancer. Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE), which is a recognized complication in lung cancer patients with higher morbidity and mortality. The aim of this study is to determine the incidence of DVT and reveal the risk factors for DVT in the postoperative patients with lung cancer.

METHODS: We collected 83 postoperative patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from December 2021 to December 2022. All these patients were examined by color Doppler ultrasound of lower extremity vein upon admission and after operation to analyze the incidence of DVT. In order to explore the possible risk factors for DVT in these patients, we further analyzed the correlations between DVT and their clinical features. At the same time, the changes of coagulation function and platelet were monitored to investigate the value of blood coagulation in the patients with DVT.

RESULTS: DVT occurred in 25 patients after lung cancer operation, and the incidence rate of DVT was 30.1%. Further analysis found that the incidences of postoperative lower limb DVT were higher in lung cancer patients of stage III+IV or over 60 years of age (P=0.031, P=0.028). D-Dimer level in patients with thrombosis was significantly higher than that in non-thrombus patients on the 1st, the 3rd, and the 5th day after operation (P<0.05),0.05).

CONCLUSIONS: The overall incidence of DVT in our center after lung cancer patients operation was 30.1%. Late-stage and older postpatients were more likely to develop DVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.

PMID:37316448 | PMC:PMC10273146 | DOI:10.3779/j.issn.1009-3419.2023.102.16

11:52

PubMed articles on: Cancer & VTE/PE

Efficacy and safety of fondaparinux in preventing venous thromboembolism in Chinese cancer patients: a single-arm, multicenter, retrospective study

Front Oncol. 2023 May 29;13:1165437. doi: 10.3389/fonc.2023.1165437. eCollection 2023.

ABSTRACT

OBJECTIVE: Fondaparinux is a synthetic anticoagulant for the prevention of venous thromboembolism (VTE), and its administration in Chinese cancer patients is rarely reported. This study aimed to assess the efficacy and safety of fondaparinux in preventing VTE in Chinese cancer patients.

METHODS: A total of 224 cancer patients who received fondaparinux treatment were reviewed in this single-arm, multicenter, retrospective study. Meanwhile, VTE, bleeding, death, and adverse events of those patients in the hospital and at 1 month after treatment (M1) were retrieved, respectively.

RESULTS: The in-hospital VTE rate was 0.45% and there was no (0.00%) VTE occurrence at M1. The in-hospital bleeding rate was 2.68%, among which the major bleeding rate was 2.23% and the minor bleeding rate was 0.45%. Moreover, the bleeding rate at M1 was 0.90%, among which both the major and minor bleeding rates were 0.45%. The in-hospital death rate was 0.45% and the death rate at M1 was 0.90%. Furthermore, the total rate of adverse events was 14.73%, including nausea and vomiting (3.13%), gastrointestinal reactions (2.23%), and reduced white blood cells (1.34%).

CONCLUSION: Fondaparinux could effectively prevent VTE with low bleeding risk and acceptable tolerance in cancer patients.

PMID:37313468 | PMC:PMC10258345 | DOI:10.3389/fonc.2023.1165437

C

14:17

Cardiotoxicity News

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

14:17

Photo

Not included, change data exporting settings to download.

1200×1200, 39.0 KB

14:17

In reply to this message

PubMed articles on: Cardio-Oncology

Atrial fibrillation in cancer survivors - a systematic review and meta-analysis

Cardiooncology. 2023 Jun 17;9(1):29. doi: 10.1186/s40959-023-00180-3.