Colorectal cancer(CRC)is one of the most common causes of death from cancer.Lung seeding occurs in approximately 10%of patients surgically treated for primary CRC with radical intent:the lung is the most common site o...Colorectal cancer(CRC)is one of the most common causes of death from cancer.Lung seeding occurs in approximately 10%of patients surgically treated for primary CRC with radical intent:the lung is the most common site of metastases after the liver.While surgical treatment of liver metastases is widely accepted to affect long-term outcomes,more controversial and not standardized is the therapy for CRC patients developing lung metastases.Experience suggests the potential curative role of pulmonary metastasectomy,especially in oligometastatic disease.However,the optimal strategy of care and the definition of prognostic factors after treatment still need to be defined.This review focused on the uncommon scenario of single pulmonary metastases from CRC.We explored pertinent literature and provide an overview of the epidemiology,clinical characteristics and imaging of single pulmonary metastases from CRC.Additionally,we identified the best available evidence for overall management.In particular,we analyzed the role and results of locoregional approaches(surgery,radiotherapy or ablative procedures)and their integration with systemic therapy.展开更多
BACKGROUND Esophageal perforation or postoperative leak after esophageal surgery remain a life-threatening condition.The optimal management strategy is still unclear.AIM To determine clinical outcomes and complication...BACKGROUND Esophageal perforation or postoperative leak after esophageal surgery remain a life-threatening condition.The optimal management strategy is still unclear.AIM To determine clinical outcomes and complications of our 15-year experience in the multidisciplinary management of esophageal perforations and anastomotic leaks.METHODS A retrospective single-center observational study was performed on 60 patients admitted at our department for esophageal perforations or treated for an anastomotic leak developed after esophageal surgery from January 2008 to December 2023.Clinical outcomes were analyzed,and complications were evaluated to investigate the efficacy and safety of our multidisciplinary management based on the preservation of the native or reconstructed esophagus,when feasible.RESULTS Among the whole series of 60 patients,an urgent surgery was required in 8 cases due to a septic state.Fifty-six patients were managed by endoscopic or hybrid treatments,obtaining the resolution of the esophageal leak/perforation without removal of the native or reconstructed esophagus.The mean time to resolution was 54.95±52.64 days,with a median of 35.5 days.No severe complications were recorded.Ten patients out of 56(17.9%)developed pneumonia that was treated by specific antibiotic therapy,and in 6 cases(10.7%)an atrial fibrillation was recorded.Seven patients(12.5%)developed a stricture within 12 months,requiring one or two endoscopic pneumatic dilations to solve the problem.Mortality was 1.7%.CONCLUSION A proper multidisciplinary approach with the choice of the most appropriate treatment can be the key for success in managing esophageal leaks or perforations and preserving the esophagus.展开更多
1(NUTM1)gene rearrangements(15q14).In 1991,two independent research teams reported NC cases characterized by the t(15;19)translo-cation.1,2 In vitro studies by French et al.3 led to the pivotal discovery of NC in 2003...1(NUTM1)gene rearrangements(15q14).In 1991,two independent research teams reported NC cases characterized by the t(15;19)translo-cation.1,2 In vitro studies by French et al.3 led to the pivotal discovery of NC in 2003 as a distinct disease entity driven by the fusion of bromodo-main and extraterminal domain(BET)protein 4(BRD4)and NUTM1.In 2004,the World Health Organization(WHO)classified tumors with t(15;19)translocation as a thymic malignancy and designated it“NUT midline carcinoma,”due to its predominant occurrence in midline organs.4 However,subsequent reports revealed NC’s emergence in numerous nonmidline organs,leading to its reclassification as the independent entity“NUT carcinoma of the thorax”by the WHO in 2015.5 NC exhibits rapid progression and profound resistance to conventional radiotherapy and chemotherapy.展开更多
文摘Colorectal cancer(CRC)is one of the most common causes of death from cancer.Lung seeding occurs in approximately 10%of patients surgically treated for primary CRC with radical intent:the lung is the most common site of metastases after the liver.While surgical treatment of liver metastases is widely accepted to affect long-term outcomes,more controversial and not standardized is the therapy for CRC patients developing lung metastases.Experience suggests the potential curative role of pulmonary metastasectomy,especially in oligometastatic disease.However,the optimal strategy of care and the definition of prognostic factors after treatment still need to be defined.This review focused on the uncommon scenario of single pulmonary metastases from CRC.We explored pertinent literature and provide an overview of the epidemiology,clinical characteristics and imaging of single pulmonary metastases from CRC.Additionally,we identified the best available evidence for overall management.In particular,we analyzed the role and results of locoregional approaches(surgery,radiotherapy or ablative procedures)and their integration with systemic therapy.
文摘BACKGROUND Esophageal perforation or postoperative leak after esophageal surgery remain a life-threatening condition.The optimal management strategy is still unclear.AIM To determine clinical outcomes and complications of our 15-year experience in the multidisciplinary management of esophageal perforations and anastomotic leaks.METHODS A retrospective single-center observational study was performed on 60 patients admitted at our department for esophageal perforations or treated for an anastomotic leak developed after esophageal surgery from January 2008 to December 2023.Clinical outcomes were analyzed,and complications were evaluated to investigate the efficacy and safety of our multidisciplinary management based on the preservation of the native or reconstructed esophagus,when feasible.RESULTS Among the whole series of 60 patients,an urgent surgery was required in 8 cases due to a septic state.Fifty-six patients were managed by endoscopic or hybrid treatments,obtaining the resolution of the esophageal leak/perforation without removal of the native or reconstructed esophagus.The mean time to resolution was 54.95±52.64 days,with a median of 35.5 days.No severe complications were recorded.Ten patients out of 56(17.9%)developed pneumonia that was treated by specific antibiotic therapy,and in 6 cases(10.7%)an atrial fibrillation was recorded.Seven patients(12.5%)developed a stricture within 12 months,requiring one or two endoscopic pneumatic dilations to solve the problem.Mortality was 1.7%.CONCLUSION A proper multidisciplinary approach with the choice of the most appropriate treatment can be the key for success in managing esophageal leaks or perforations and preserving the esophagus.
基金supported by the China Postdoctoral Science Foundation(grant number 2022M723207)the Medical Scientific Research Foundation of Zhejiang Province,China(grant number 2023KY666)+8 种基金Zhejiang Traditional Chinese Medicine Science Fund Project(grant number 2024ZL372)Qiantang Cross Fund Project(grant number 2023-16)the National Natural Science Foundation of China of Zhejiang Cancer Hospital Cultivation Project(grant number PY2023006)the Medical Scientific Research Foundation of Zhejiang Province,China(grant number 2024KY812)the Natural Science Foundation of Zhejiang Province(grant number Q24H160110)the National Natural Science Foundation of China(grant number NSFC82371851)the Science and Technology Foundation of Guizhou Province(Outstanding Young Scientists of Guizhou Province)(grant number Qiankeherencai-YQK(2023)021)the Science and Technology Foundation of Guizhou Province(grant number Qiankehejichu-ZK(2023)General 212)the Science and Technology Foundation of Guizhou Province(grant number Qiankehechengguo-LC(2025)General 068).
文摘1(NUTM1)gene rearrangements(15q14).In 1991,two independent research teams reported NC cases characterized by the t(15;19)translo-cation.1,2 In vitro studies by French et al.3 led to the pivotal discovery of NC in 2003 as a distinct disease entity driven by the fusion of bromodo-main and extraterminal domain(BET)protein 4(BRD4)and NUTM1.In 2004,the World Health Organization(WHO)classified tumors with t(15;19)translocation as a thymic malignancy and designated it“NUT midline carcinoma,”due to its predominant occurrence in midline organs.4 However,subsequent reports revealed NC’s emergence in numerous nonmidline organs,leading to its reclassification as the independent entity“NUT carcinoma of the thorax”by the WHO in 2015.5 NC exhibits rapid progression and profound resistance to conventional radiotherapy and chemotherapy.
