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Paul H Sugarbaker - One of the best experts on this subject based on the ideXlab platform.
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Prevention and Treatment of Peritoneal Metastases: a Comprehensive Review
Indian Journal of Surgical Oncology, 2019Co-Authors: Paul H SugarbakerAbstract:Peritoneal metastases may occur from a majority of Cancers that occur within the abdomen or pelvis. When Cancer Spread to the peritoneal surfaces is documented, a decision regarding palliation versus an aggressive approach using cytoreductive surgery (CRS) and hyperthermic perioperative intraperitoneal chemotherapy (HIPEC) must be made. This decision is dependent on a well-defined group of prognostic indicators. In addition to treatment, prevention of peritoneal metastases may be an option. The clinical and pathologic features of a primary Cancer can be used to select perioperative treatments that may prevent Cancer cells within the abdomen and pelvis from progressing to established peritoneal metastases. In some clinical situations with appendiceal and colorectal Cancers, the clinical or histopathologic features may indicate that second-look surgery plus perioperative chemotherapy should occur. Peritoneal metastases should always be considered by the multidisciplinary team for treatment or prevention.
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Peritoneal Metastases from Gastrointestinal Cancer
Current Oncology Reports, 2018Co-Authors: Paul H SugarbakerAbstract:Purpose of Review Peritoneal metastases may occur from a majority of Cancers that occur within the abdomen or pelvis. When Cancer Spread to the peritoneal surfaces is documented, a decision regarding palliation vs. an aggressive approach using cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy must be made. The perioperative chemotherapy may be hyperthermic intraperitoneal chemotherapy (HIPEC) administered in the operating room or early postoperative intraperitoneal chemotherapy (EPIC) administered in the first 4 or 5 postoperative days. Recent Findings This decision is dependent on a well-defined group of prognostic indicators. In addition to treatment, the clinical and pathologic features of a primary Cancer can be used to select perioperative treatments that may prevent Cancer cells within the abdomen and pelvis from progressing to established peritoneal metastases. In some clinical situations with appendiceal and colorectal Cancers, the clinical or histopathologic features may indicate that second-look surgery plus perioperative chemotherapy should occur. Summary Peritoneal metastases should always be considered for treatment or prevention.
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observations concerning Cancer Spread within the peritoneal cavity and concepts supporting an ordered pathophysiology
Cancer treatment and research, 1996Co-Authors: Paul H SugarbakerAbstract:A primary Cancer arising within the abdomen or pelvis can disseminate by hematogenous routes, lymphatic routes, and through the peritoneal cavity. In this manuscript hematogenous and lymphatic dissemination are referred to as metastases while intraperitoneal dissemination is referred to as Spread. Spread may occur preoperatively as a spontaneous event from full-thickness invasion of the bowel wall by invasive Cancer or from a bursting of a structure’ by noninvasive Cancer. Iatrogenic Spread occurs by biopsy or surgical trauma, and is a result of Cancer mainpulation for diagnosis or treatment. With invasive (high-grade) Cancer, intraperitoneal Spread is characterized by randomly proximal distribution because these Cancer cells have surface adherence molecules. With low-grade mucinous Cancer, intraperitoneal Spread is characterized by a redistributed pattern of abdo-minopelvic Cancer accumulation. Large volumes of tumor are not found proximal to the primary malignancy; rather, they are on the omentum and beneath the hemidiaphragms as a result of peritoneal fluid resorption, in dependent areas such as the pelvis by gravity, and are excluded from small bowel surfaces as a result of bowel motility.
Hans Prenen - One of the best experts on this subject based on the ideXlab platform.
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Podoplanin-Expressing Macrophages Promote Lymphangiogenesis and Lymphoinvasion in Breast Cancer
Cell Metabolism, 2019Co-Authors: Pawel Bieniasz-krzywiec, Rosa Martín-pérez, Manuel Ehling, Sotiria Pinioti, Samantha Pretto, Roel Kroes, Chiara Aldeni, Mario Di Matteo, Melissa García-caballero, Hans PrenenAbstract:Summary Among mammary tumor-infiltrating immune cells, the highest expression of podoplanin (PDPN) is found in a subset of tumor-associated macrophages (TAMs). We hereby demonstrate that PDPN is involved in the attachment of this TAM subset to lymphatic endothelial cells (LECs). Mechanistically, the binding of PDPN to LEC-derived galectin 8 (GAL8) in a glycosylation-dependent manner promotes the activation of pro-migratory integrin β1. When proximal to lymphatics, PDPN-expressing macrophages (PoEMs) stimulate local matrix remodeling and promote vessel growth and lymphoinvasion. Anti-integrin β1 blockade, macrophage-specific Pdpn knockout, or GAL8 inhibition impairs TAM adhesion to LECs, restraining lymphangiogenesis and reducing lymphatic Cancer Spread. In breast Cancer patients, association of PoEMs with tumor lymphatic vessels correlates with incidences of lymph node and distant organ metastasis.
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Whole-body diffusion-weighted MRI for operability assessment in patients with colorectal Cancer and peritoneal metastases
Cancer Imaging, 2019Co-Authors: Raphaëla Carmen Dresen, Hans Prenen, Sofie Vuysere, Frederik Keyzer, Eric Cutsem, Ragna Vanslembrouck, Gert Hertogh, Albert Wolthuis, André D’hoore, Vincent VandecaveyeAbstract:Background Correct staging of patients with colorectal Cancer is of utmost importance for the prediction of operability. Although computed tomography (CT) has a good overall performance, estimation of peritoneal Cancer Spread is a known weakness, a problem that cannot always be overcome by Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (^18F-FDG-PET/CT); especially in infiltrative and miliary disease Spread. Due to its high spatial and contrast resolution magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) might have a better performance. Our aim was to evaluate the added value of whole-body diffusion-weighted MRI (WB-DWI/MRI) to CT for prediction of peritoneal Cancer Spread and operability assessment in colorectal Cancer patients with clinically suspected peritoneal carcinomatosis (PC). Methods This institutional review board approved retrospective study included sixty colorectal Cancer patients who underwent WB-DWI/MRI in addition to CT for clinically suspected peritoneal metastases. WB-DWI/MRI and CT were assessed for detecting PC following the peritoneal Cancer index (PCI), determination of PCI-score categorized as PC 15, detection of nodal and distant metastases and estimation of overall operability. Histopathology after surgery and biopsy and/or 6 months follow-up were used as reference standard. Results For detection of PC, CT had 43.2% sensitivity, 95.6% specificity, 84.5% positive predictive value (PPV) and 75.2% negative predictive value (NPV). WB-DWI/MRI had 97.8% sensitivity, 93.2% specificity, 88.9% PPV and 98.7% NPV. WB-DWI/MRI enabled better detection of inoperable distant metastases (all 12 patients) than CT (2/12 patients) and significantly improved prediction of PCI category [WB-DWI/MRI PCI 15: 16/17 patients (94.1%) versus CT PCI 15: 2/17 patients (11.8%); p
Prenen Hans - One of the best experts on this subject based on the ideXlab platform.
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Podoplanin-Expressing Macrophages Promote Lymphangiogenesis and Lymphoinvasion in Breast Cancer
'Elsevier BV', 2019Co-Authors: Bieniasz-krzywiec Pawel, Martin-perez Rosa, Ehling Manuel, Garcia-caballero Melissa, Pinioti Sotiria, Pretto Samantha, Kroes Roel, Aldeni Chiara, Di Matteo Mario, Prenen HansAbstract:Among mammary tumor-infiltrating immune cells, the highest expression of podoplanin (PDPN) is found in a subset of tumor-associated macrophages (TAMs). We hereby demonstrate that PDPN is involved in the attachment of this TAM subset to lymphatic endothelial cells (LECs). Mechanistically, the binding of PDPN to LEC-derived galectin 8 (GAL8) in a glycosylation-dependent manner promotes the activation of pro-migratory integrin β1. When proximal to lymphatics, PDPN-expressing macrophages (PoEMs) stimulate local matrix remodeling and promote vessel growth and lymphoinvasion. Anti-integrin β1 blockade, macrophage-specific Pdpn knockout, or GAL8 inhibition impairs TAM adhesion to LECs, restraining lymphangiogenesis and reducing lymphatic Cancer Spread. In breast Cancer patients, association of PoEMs with tumor lymphatic vessels correlates with incidences of lymph node and distant organ metastasis.status: publishe
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Podoplanin-Expressing Macrophages Promote Lymphangiogenesis and Lymphoinvasion in Breast Cancer.
'Elsevier BV', 2019Co-Authors: Bieniasz-krzywiec Pawel, Martin-perez Rosa, Ehling Manuel, Garcia-caballero Melissa, Pinioti Sotiria, Pretto Samantha, Kroes Roel, Aldeni Chiara, Di Matteo Mario, Prenen HansAbstract:peer reviewedAmong mammary tumor-infiltrating immune cells, the highest expression of podoplanin (PDPN) is found in a subset of tumor-associated macrophages (TAMs). We hereby demonstrate that PDPN is involved in the attachment of this TAM subset to lymphatic endothelial cells (LECs). Mechanistically, the binding of PDPN to LEC-derived galectin 8 (GAL8) in a glycosylation-dependent manner promotes the activation of pro-migratory integrin beta1. When proximal to lymphatics, PDPN-expressing macrophages (PoEMs) stimulate local matrix remodeling and promote vessel growth and lymphoinvasion. Anti-integrin beta1 blockade, macrophage-specific Pdpn knockout, or GAL8 inhibition impairs TAM adhesion to LECs, restraining lymphangiogenesis and reducing lymphatic Cancer Spread. In breast Cancer patients, association of PoEMs with tumor lymphatic vessels correlates with incidences of lymph node and distant organ metastasis
Hideki Ueno - One of the best experts on this subject based on the ideXlab platform.
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Histogenesis and prognostic value of myenteric Spread in colorectal Cancer: a Japanese multi-institutional study.
Journal of Gastroenterology, 2013Co-Authors: Hideki Ueno, Kazuo Shirouzu, Hideyuki Shimazaki, Hiroshi Kawachi, Yoshinobu Eishi, Yoichi Ajioka, Kiyotaka Okuno, Kazutaka Yamada, Toshihiko Sato, Takaya KusumiAbstract:Background The histogenesis of the pattern of Cancer Spread along Auerbach’s plexus (myenteric Spread: MS) remains unclear and its prognostic value in colorectal Cancer (CRC) has not been thoroughly investigated.
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actual status of distribution and prognostic impact of extramural discontinuous Cancer Spread in colorectal Cancer
Journal of Clinical Oncology, 2011Co-Authors: Hideki Ueno, Hidetaka Mochizuki, Kazuo Shirouzu, Hiroshi Kawachi, Kazutaka Yamada, Takaya Kusumi, Masahiro Ikegami, Shingo Kameoka, Yasuo Ohkura, Tadahiko MasakiAbstract:Purpose To clarify the prognostic impact of tumor nodules without residual lymph node (LN) structure (ND) in colorectal Cancer and to determine optimal categorization of ND in tumor staging. Patients and Methods A multicenter, retrospective pathologic review was performed for 1,716 patients with stages I to III curatively resected colorectal Cancer treated at 11 institutions between 1994 and 1998. An additional 2,242 patients from nine institutions were enrolled between 1999 and 2003 as a second cohort to validate the results. Results LN metastasis (LNM) and ND were observed in 33.7% and 16.0% (smooth-contour nodule [S-ND], 8.2%; irregular-contour nodule [I-ND], 10.7%) of patients in the first cohort. S-ND and I-ND were similarly distributed in the regional area. There was no considerable difference in the impact on survival between S-ND (hazard ratio [HR], 2.7; 95% CI, 1.9 to 3.8) and I-ND (HR, 4.3; 95% CI, 3.3 to 5.8) or between LNM (HR, 4.5; 95% CI, 3.4 to 6.0) and ND (HR, 4.0; 95% CI, 3.1 to 5.3). LNM...
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Clinicopathological study of intrapelvic Cancer Spread to the iliac area in lower rectal adenocarcinoma by serial sectioning.
British Journal of Surgery, 1999Co-Authors: Hideki Ueno, C. Yamauchi, Kazuo Hase, Takashi Ichikura, Hidetaka MochizukiAbstract:Background: The role of iliac lymphadenectomy in surgery for rectal Cancer remains unknown. Detailed clinicopathological data on lateral Cancer extension may be needed to determine the true role of this procedure. Methods: Seventy consecutive patients with low rectal Cancer who underwent systematic iliac lymphadenectomy between 1991 and 1995 were reviewed. The iliac area was divided into five regions: (1) middle rectal root, (2) internal iliac, (3) obturator, (4) common iliac and (5) external iliac. Iliac lymph nodes that were Cancer-free based on conventional pathological examination were serially sectioned at 100-µm intervals and re-examined for occult microscopic involvement. Results: Occult microscopic foci were detected in five (7 per cent) of the 70 patients, and the overall incidence of lateral Cancer Spread was 24 per cent (17 of 70). Among patients without other sites of distant metastasis or circumferential involvement of the margin, the 5-year survival rate of those with lateral Spread was 35 per cent. Although the prognosis of patients with Cancer involving multiple iliac regions was poor, three of six patients with metastasis to only a single region were alive without disease at 3 years. Conclusion: Surgeons should be aware of the possibility of localized lateral Spread, including microscopic metastasis, when determining the optimum procedure for iliac lymphadenectomy in patients with rectal Cancer. © 1999 British Journal of Surgery Society Ltd
Shinichi Miyagawa - One of the best experts on this subject based on the ideXlab platform.
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impact of tumor Spread to the cystic duct on the prognosis of patients with gallbladder carcinoma
World Journal of Surgery, 2007Co-Authors: Takenari Nakata, Akira Kobayashi, Shiro Miwa, Junpei Soeda, Shinichi MiyagawaAbstract:Introduction The importance of gallbladder carcinoma Spread to the cystic duct has not yet been described. Although the cystic duct is contiguous with the gallbladder, it is located in the hepatoduodenal ligament and differs in structure from the gallbladder. The incidence and prognostic significance of Cancer Spread to the cystic duct in patients with gallbladder Cancer is unclear.
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Impact of Tumor Spread to the Cystic Duct on the Prognosis of Patients with Gallbladder Carcinoma
World Journal of Surgery, 2006Co-Authors: Takenari Nakata, Akira Kobayashi, Shiro Miwa, Junpei Soeda, Shinichi MiyagawaAbstract:The importance of gallbladder carcinoma Spread to the cystic duct has not yet been described. Although the cystic duct is contiguous with the gallbladder, it is located in the hepatoduodenal ligament and differs in structure from the gallbladder. The incidence and prognostic significance of Cancer Spread to the cystic duct in patients with gallbladder Cancer is unclear. Surgical specimens from 42 patients who underwent resection for advanced gallbladder carcinoma were examined retrospectively. Altogether, 13 (31%) of the patients had Cancer Spread to the cystic duct. The incidences of perineural invasion, lymph node metastasis, and venous invasion were significantly higher in these patients than in the other 29 patients without Cancer Spread to the cystic duct (P = 0.027, 0.034, and 0.034, respectively). The 3- and 5-year survival rates of these 13 patients were significantly lower than those of the other 29 patients (15.4% vs. 51.0% and 7.7% vs. 46.6%, respectively, P
