Hepatocellular carcinoma(HCC)is the sixth most common cancer worldwide,with an increasing diffusion in Europe and the United States.The management of such a cancer is continuously progressing and the objective of this...Hepatocellular carcinoma(HCC)is the sixth most common cancer worldwide,with an increasing diffusion in Europe and the United States.The management of such a cancer is continuously progressing and the objective of this paper is to evaluate innovation in the surgical treatment of HCC.In this review,we will analyze the modern concept of preoperative management,the role of laparoscopic and robotic surgery,the intraoperative use of three dimensional models and augmented reality,as well as the potential application of fluorescence.展开更多
AIM: To identify suitable biomarkers of response to bevacizumab(BV)- it remains an open question. The measurement of serum vascular endothelial growth factor(VEGF) has been proposed as a predictive factor for this dru...AIM: To identify suitable biomarkers of response to bevacizumab(BV)- it remains an open question. The measurement of serum vascular endothelial growth factor(VEGF) has been proposed as a predictive factor for this drug, even if literature data are contradictory. METHODS: We prospectively evaluated the role of BV, total and not BV-bound VEGF and angiopoietin-2(Ang-2) serum levels as potential predictive factors of response for BV in combination with an oxaliplatinbased chemotherapy. BV, Ang-2, total and not BVbound VEGF levels were measured at baseline, before 2^(nd) and 5^(th) cycle of oxaliplatin-based chemotherapy in 20 consecutive metastatic colorectal cancer patients. RESULTS: Results were correlated to response to treatment. Variability in BV levels have been found, with decreased level in less responding patients. In particular, the concentration of BV increased of 3.96 ± 0.69 folds in serum of responsive patients after 3 more cycles of therapy compared to those with stable or progressive disease with a 0.72 ± 0.25 and 2.10 ± 0.13 fold increase, respectively. The determination of free and total VEGF demonstrated that the ratio between the two values, evaluated immediately before the 2^(nd) and the 5^(th) cycle of therapy, decreased from 26.65% ± 1.33% to 15.50% ± 3.47% in responsive patients and from 53.41% ± 4.75 to 34.95% ± 2.88% in those with stable disease. Conversely, in those with progression of disease, the ratio showed the opposite behavior coming up from 25.99% ± 5.23% to 51.71% ± 5.28%. The Ang-2 levels did not show any relationship. CONCLUSION: Our data show that the ratio of not BV-bound VEGF to total VEGF serum and BV plasma concentrations for predicting the response to BV plus oxaliplatin-based chemotherapy could be a promising biomarker of response to BV.展开更多
Background:To evaluate the effectiveness and safety of cabazitaxel in castration-resistant prostate cancer patients aged>80 years,we performed a retrospective study on a sample of patients from 11 Italian cancer ce...Background:To evaluate the effectiveness and safety of cabazitaxel in castration-resistant prostate cancer patients aged>80 years,we performed a retrospective study on a sample of patients from 11 Italian cancer centers.Materials and methods:Fifty-seven patients aged>80 years were treated with cabazitaxel after previous failure with docetaxel;39 completed a comprehensive geriatric assessment questionnaire(34 fit and 5 vulnerable)and 8 patients(14%)had an Eastern Cooperative Oncology Group performance status(PS)>2,while most had a PS of 0-1(86%).Cabazitaxel was administered at a dose of 25 mg/m^(2)in 30(52%)patients and 20 mg/m^(2)or adapted schedules in 27(48%)patients.These schedules were adopted mainly in patients>85 years(75%),with a PS>2(87.5%),and those classified as vulnerable(100%).Results:The duration of treatment was 4.8 months and was comparable in all subgroups;disease control rate was reported in 36 patients(63%);prostate-specific antigen response was recorded in 18 patients(31.5%).Median overall survival was 13.1 months regardless of age(<85/>85 years),but overall survival was reduced in vulnerable(7.2 months)and PS>2 patients(6.8 months).The most frequently documented grade 3-4 toxicities were neutropenia(14%)and diarrhea(10.5%).Six patients(10.5%)dropped out due to severe toxicity.Conclusions:Octogenarian patients can be treated with cabazitaxel with reduced doses or alternative schedules that are associated with less toxicity and fewer treatment interruptions.Comprehensive geriatric assessment could facilitate more appropriate patient selection.展开更多
基金Correspondence to:Dr.Riccardo Memeo,MD,PhD,Depart-ment of Digestive Surgery,University Hospital of Strasbourg.1Place de l'Hopital,67091 Strasbourg.France.riccardo.memeo@chru-strasbourg.frTelephone:+33-3-69550552Fax:+33-3-69550532
文摘Hepatocellular carcinoma(HCC)is the sixth most common cancer worldwide,with an increasing diffusion in Europe and the United States.The management of such a cancer is continuously progressing and the objective of this paper is to evaluate innovation in the surgical treatment of HCC.In this review,we will analyze the modern concept of preoperative management,the role of laparoscopic and robotic surgery,the intraoperative use of three dimensional models and augmented reality,as well as the potential application of fluorescence.
文摘AIM: To identify suitable biomarkers of response to bevacizumab(BV)- it remains an open question. The measurement of serum vascular endothelial growth factor(VEGF) has been proposed as a predictive factor for this drug, even if literature data are contradictory. METHODS: We prospectively evaluated the role of BV, total and not BV-bound VEGF and angiopoietin-2(Ang-2) serum levels as potential predictive factors of response for BV in combination with an oxaliplatinbased chemotherapy. BV, Ang-2, total and not BVbound VEGF levels were measured at baseline, before 2^(nd) and 5^(th) cycle of oxaliplatin-based chemotherapy in 20 consecutive metastatic colorectal cancer patients. RESULTS: Results were correlated to response to treatment. Variability in BV levels have been found, with decreased level in less responding patients. In particular, the concentration of BV increased of 3.96 ± 0.69 folds in serum of responsive patients after 3 more cycles of therapy compared to those with stable or progressive disease with a 0.72 ± 0.25 and 2.10 ± 0.13 fold increase, respectively. The determination of free and total VEGF demonstrated that the ratio between the two values, evaluated immediately before the 2^(nd) and the 5^(th) cycle of therapy, decreased from 26.65% ± 1.33% to 15.50% ± 3.47% in responsive patients and from 53.41% ± 4.75 to 34.95% ± 2.88% in those with stable disease. Conversely, in those with progression of disease, the ratio showed the opposite behavior coming up from 25.99% ± 5.23% to 51.71% ± 5.28%. The Ang-2 levels did not show any relationship. CONCLUSION: Our data show that the ratio of not BV-bound VEGF to total VEGF serum and BV plasma concentrations for predicting the response to BV plus oxaliplatin-based chemotherapy could be a promising biomarker of response to BV.
文摘Background:To evaluate the effectiveness and safety of cabazitaxel in castration-resistant prostate cancer patients aged>80 years,we performed a retrospective study on a sample of patients from 11 Italian cancer centers.Materials and methods:Fifty-seven patients aged>80 years were treated with cabazitaxel after previous failure with docetaxel;39 completed a comprehensive geriatric assessment questionnaire(34 fit and 5 vulnerable)and 8 patients(14%)had an Eastern Cooperative Oncology Group performance status(PS)>2,while most had a PS of 0-1(86%).Cabazitaxel was administered at a dose of 25 mg/m^(2)in 30(52%)patients and 20 mg/m^(2)or adapted schedules in 27(48%)patients.These schedules were adopted mainly in patients>85 years(75%),with a PS>2(87.5%),and those classified as vulnerable(100%).Results:The duration of treatment was 4.8 months and was comparable in all subgroups;disease control rate was reported in 36 patients(63%);prostate-specific antigen response was recorded in 18 patients(31.5%).Median overall survival was 13.1 months regardless of age(<85/>85 years),but overall survival was reduced in vulnerable(7.2 months)and PS>2 patients(6.8 months).The most frequently documented grade 3-4 toxicities were neutropenia(14%)and diarrhea(10.5%).Six patients(10.5%)dropped out due to severe toxicity.Conclusions:Octogenarian patients can be treated with cabazitaxel with reduced doses or alternative schedules that are associated with less toxicity and fewer treatment interruptions.Comprehensive geriatric assessment could facilitate more appropriate patient selection.
