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Masahide Ikeguchi,Keisuke Goto,June Watanabe,Shoichi Urushibara,Tomohiro Osaki,Kanenori Endo,Shigeru Tatebe,Seiichi Nakamura 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.4
Backgrounds/Aims: The prognostic nutritional index (PNI) is based on the albumin concentration and absolute lymphocyte count and is designed to assess the nutritional and immunological status of patients. In this study, we evaluated the prognostic importance of the preoperative and postoperative PNI in patients who underwent curative resection of pancreatic ductal adenocarcinoma (PDAC). Methods: From 2006 to 2017, 50 patients with PDAC underwent curative resection at our hospital. We performed distal pancreatectomy (DP) with splenectomy in 15 patients, pancreaticoduodenectomy (PD) in 27 patients, PD combined with portal vein partial resection in 6 patients, and total pancreatectomy with splenectomy in 2 patients. We compared the preoperative PNI and postoperative PNI (1 and 2 months postoperatively) and analyzed the prognostic importance for these patients. Results: The mean PNI significantly decreased from 45.5 preoperatively to 39.8 at 1 month postoperatively (p<0.001), but recovered to 42.7 at 2 months postoperatively. In 23 patients, the PNI at 2 months postoperatively recovered to the preoperative level (recovered group), but in the remaining 27 patients, the PNI at 2 months postoperatively did not reach the preoperative level (non-recovered group). The overall median survival time in the recovered group (29 months) was significantly longer than that in the non-recovered group (12 months, p=0.003). The multivariate overall analysis demonstrated that good recovery of the postoperative PNI was strongly correlated with a better prognosis. Conclusions: Effective postoperative nutrition may have a prognostic benefit for patients with operable PDAC.
Gastric Adenocarcinoma with Thymic Metastasis after Curative Resection: A Case Report
Tomoyuki Matsunaga,Hiroaki Saito,Kozo Miyatani,Seigo Takaya,Yoji Fukumoto,Tomohiro Osaki,Masahide Ikeguchi 대한위암학회 2014 Journal of gastric cancer Vol.14 No.3
The peritoneum is the most frequent site of recurrence for gastric cancer after gastrectomy, followed by the liver and lymph nodes. Incontrast, metastasis to the thymus is rare. Annual surveillance with computed tomography was performed on a 67-year-old man whopreviously underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer at Tottori University. Five years after theinitial operation, an anterior mediastinal tumor was detected by computed tomography. The patient underwent video-assisted thoracicsurgery to remove the tumor. Histopathology revealed adenocarcinoma cells similar to those of the gastric cancer resected 5 years previously. Thymic metastasis was considered likely based on the location of the tumor. The recognition that gastric cancer can metastasizeto unusual anatomic locations, such as the thymus, can facilitate an accurate, prompt diagnosis and appropriate treatment.
Gastric Adenocarcinoma with Thymic Metastasis after Curative Resection: A Case Report
Matsunaga, Tomoyuki,Saito, Hiroaki,Miyatani, Kozo,Takaya, Seigo,Fukumoto, Yoji,Osaki, Tomohiro,Ikeguchi, Masahide The Korean Gastric Cancer Association 2014 Journal of gastric cancer Vol.14 No.3
The peritoneum is the most frequent site of recurrence for gastric cancer after gastrectomy, followed by the liver and lymph nodes. In contrast, metastasis to the thymus is rare. Annual surveillance with computed tomography was performed on a 67-year-old man who previously underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer at Tottori University. Five years after the initial operation, an anterior mediastinal tumor was detected by computed tomography. The patient underwent video-assisted thoracic surgery to remove the tumor. Histopathology revealed adenocarcinoma cells similar to those of the gastric cancer resected 5 years previously. Thymic metastasis was considered likely based on the location of the tumor. The recognition that gastric cancer can metastasize to unusual anatomic locations, such as the thymus, can facilitate an accurate, prompt diagnosis and appropriate treatment.