The Experts below are selected from a list of 13260 Experts worldwide ranked by ideXlab platform
Hong Seok Jang - One of the best experts on this subject based on the ideXlab platform.
-
palliative external beam radiotherapy for the treatment of Tumor Bleeding in inoperable advanced gastric cancer
BMC Cancer, 2017Co-Authors: Yun Hee Lee, Jeong Won Lee, Hong Seok JangAbstract:To assess the outcomes and prognostic factors associated with palliative external beam radiotherapy (EBRT), administered to patients with advanced gastric cancer. Forty-two patients with Bleeding gastric Tumors that received EBRT for palliation were analyzed. The response to EBRT was assessed by the palliation of Tumor Bleeding. Patients were classified as either responders, or non-responders to EBRT. The prognostic utility of clinical and dosimetric variables was examined in a multivariate logistic regression model. The optimal dose cutoff to classify the two groups was determined with receiver operating characteristic analysis. The palliation of gastric Tumor Bleeding after EBRT was achieved in 29 patients (69.0%). The time to resolve Tumor Bleeding ranged from 1 to 84 days (median, 15 days). The median duration of palliation was 14.9 weeks. The median EBRT dose was 40 Gy in responders vs. 21 Gy in non-responders, with the difference being significant (p < 0.001). The biologically effective dose (using α/β = 10, BED10) for responders was significantly higher than the BED10 for non-responders (median 48 Gy vs. 26.4 Gy, p < 0.001), and the optimal cut off value to separate the two groups was 36 Gy (p < 0.001). The absence of distant metastasis and the use of concurrent chemotherapy generally showed a better EBRT response (p = 0.079 and p = 0.079, respectively). In the multivariate analysis, BED10 ≥ 36 Gy was the most significant factor associated with EBRT response (p = 0.001). Overall survival (OS) and re-Bleeding-free survival was median 12.6 weeks and 14.9 weeks. The responders to EBRT showed superior OS (16.6 vs. 5.1 months, p < 0.001). Neither acute nor chronic toxicities of grade 3 or higher were observed. EBRT is an effective method for treating Tumor Bleeding in advanced gastric cancer, and does not induce severe toxicity.
-
palliative external beam radiotherapy for the treatment of Tumor Bleeding in inoperable advanced gastric cancer
BMC Cancer, 2017Co-Authors: Hong Seok JangAbstract:Background To assess the outcomes and prognostic factors associated with palliative external beam radiotherapy (EBRT), administered to patients with advanced gastric cancer.
Roger Willen - One of the best experts on this subject based on the ideXlab platform.
-
malignant esophageal strictures treatment with a self expanding nitinol stent
Radiology, 1993Co-Authors: Wojciech Cwikiel, H Stridbeck, Karlgoran Tranberg, C S Von Holstein, Goran Hambraeus, R Lillogil, Roger WillenAbstract:A self-expanding esophageal nitinol stent was implanted under fluoroscopic guidance in 40 patients with malignant esophageal strictures and clinically significant dysphagia. The strictures were caused by squamous cell carcinoma (n = 14), adenocarcinoma (n = 12), recurrent anastomotic carcinoma (n = 8), and mediastinal Tumors (n = 6). Eight stents were balloon dilated to maximum diameter immediately after insertion. Sixteen stents self-expanded to maximum diameter within 24 hours, and the other stents expanded to maximum diameter during further observation. There were no serious stent-related complications, and the dysphagia was reduced considerably in all patients immediately after stent insertion. Persistent Tumor Bleeding occurred in two patients, and ingrowth of Tumor into the stent was seen in eight patients. Two stents occluded due to Tumor ingrowth but were successfully recanalized with endoscopic laser coagulation. At the end of the study, 28 patients were dead with a mean survival of 2.9 months (r...
-
malignant esophageal strictures treatment with a self expanding nitinol stent
Radiology, 1993Co-Authors: Wojciech Cwikiel, H Stridbeck, Karlgoran Tranberg, Goran Hambraeus, R Lillogil, C S Von Holstein, Roger WillenAbstract:A self-expanding esophageal nitinol stent was implanted under fluoroscopic guidance in 40 patients with malignant esophageal strictures and clinically significant dysphagia. The strictures were caused by squamous cell carcinoma (n = 14), adenocarcinoma (n = 12), recurrent anastomotic carcinoma (n = 8), and mediastinal Tumors (n = 6). Eight stents were balloon dilated to maximum diameter immediately after insertion. Sixteen stents self-expanded to maximum diameter within 24 hours, and the other stents expanded to maximum diameter during further observation. There were no serious stent-related complications, and the dysphagia was reduced considerably in all patients immediately after stent insertion. Persistent Tumor Bleeding occurred in two patients, and ingrowth of Tumor into the stent was seen in eight patients. Two stents occluded due to Tumor ingrowth but were successfully recanalized with endoscopic laser coagulation. At the end of the study, 28 patients were dead with a mean survival of 2.9 months (range, 0.1-7.0 months), and 12 patients were alive with a mean follow-up of 8.8 months (range, 4.0-15.0 months).
Hwoonyong Jung - One of the best experts on this subject based on the ideXlab platform.
-
clinical outcomes of Tumor Bleeding in duodenal gastrointestinal stromal Tumors a 20 year single center experience
Surgical Endoscopy and Other Interventional Techniques, 2021Co-Authors: Gyu Young Pih, Ji Yong Ahn, Ji Young Choi, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoonyong JungAbstract:Duodenal gastrointestinal stromal Tumors (GISTs) are rare, and reports on duodenal GIST Bleeding are few. We analyzed the risk factors and clinical outcomes of hemorrhagic duodenal GISTs and compared them with those of gastric GISTs. Primary duodenal GISTs surgically diagnosed between January 1998 and December 2017 were retrospectively reviewed. Furthermore, patients with duodenal GIST were compared with those with primary gastric GIST histopathologically diagnosed between January 1998 and May 2015 using previously published data. Of the 170 total patients with duodenal GISTs, 48 (28.2%) exhibited Tumor Bleeding. Endoscopic intervention, embolization, and non-interventional conservative treatment were performed for initial hemostasis in 17, 1, and 30 patients, respectively. The 5-year survival rate was 81.9% in the Bleeding group and 89.4% in the non-Bleeding group (P = 0.495). Multivariate analysis showed that p53 positivity was a significant risk factor for duodenal GIST Bleeding (hazard ratio [HR] 2.781, P = 0.012), and age ≥ 60 years (HR 3.163, P = 0.027), a large maximum diameter (comparing four groups: < 2, 2–5, 5–10, and ≥ 10 cm), and mitotic count ≥ 5/high-power field (HPF) (HR 3.265, P = 0.032) were risk factors for overall survival. The incidence of Bleeding was significantly higher in duodenal GISTs than in gastric GISTs (28.2% vs. 6.6%, P < 0.001), and the re-Bleeding rate after endoscopic hemostasis was also higher in duodenal GISTs than in gastric GISTs (41.2% vs. 13.3%, P = 0.118). In patients with duodenal GIST with old age, large Tumor diameter, and mitotic count ≥ 5/HPF, a treatment plan should be established in consideration of the poor prognosis, although Tumor Bleeding does not adversely affect the prognosis. Duodenal GISTs have a higher incidence of Tumor Bleeding and re-Bleeding rate after endoscopic hemostasis than gastric GISTs.
-
clinical outcomes of upper gastrointestinal Bleeding in patients with gastric gastrointestinal stromal Tumor
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: Gyu Young Pih, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Sung Jin Jeon, Hwoonyong JungAbstract:Upper gastrointestinal Bleeding (UGIB) is one of the major manifestations of gastrointestinal stromal Tumor (GIST) of the stomach. Several studies have reported that GIST Bleeding is associated with poor prognosis. However, only case reports have reported hemostasis modalities for treating hemorrhagic gastric GIST. To identify clinical outcome of gastric GIST Bleeding, we analyzed risk factors and prognosis of hemorrhagic GIST evaluating hemostasis methods. Total 697 patients histopathologically diagnosed with primary gastric GIST between January 1998 and May 2015 were enrolled to the study, retrospectively. Of 697 total patients, 46 (6.6%) patients had UGIB. Endoscopic intervention, transarterial embolization, or surgical intervention was performed for initial hemostasis in 15, 2, and 1, respectively. Over a median of 68 months of follow-up, 16 patients in Bleeding group and 88 patients in non-Bleeding group died; the 5-year survival rate was 79.4% in Bleeding group and 91.8% in non-Bleeding group (p = 0.004). Multivariate analysis showed that significant risk factors for gastric GIST Bleeding included the maximal Tumor diameter > 5 cm and Ki-67 positivity. Age ≥ 60 [hazard ratio (HR) = 8.124, p = 0.048], necrosis (HR = 5.093, p = 0.027), and Bleeding (HR 5.743, p = 0.034) were significant factors for overall survival of gastric GIST patients. Bleeding risk of gastric GIST was higher when Tumor had diameter > 5 cm or Ki-67 positivity. In addition, Tumor Bleeding, necrosis, and age ≥ 60 years were associated with poor overall survival. Endoscopic intervention can be considered as an effective method for initial hemostasis of hemorrhagic gastric GIST.
Wojciech Cwikiel - One of the best experts on this subject based on the ideXlab platform.
-
malignant esophageal strictures treatment with a self expanding nitinol stent
Radiology, 1993Co-Authors: Wojciech Cwikiel, H Stridbeck, Karlgoran Tranberg, C S Von Holstein, Goran Hambraeus, R Lillogil, Roger WillenAbstract:A self-expanding esophageal nitinol stent was implanted under fluoroscopic guidance in 40 patients with malignant esophageal strictures and clinically significant dysphagia. The strictures were caused by squamous cell carcinoma (n = 14), adenocarcinoma (n = 12), recurrent anastomotic carcinoma (n = 8), and mediastinal Tumors (n = 6). Eight stents were balloon dilated to maximum diameter immediately after insertion. Sixteen stents self-expanded to maximum diameter within 24 hours, and the other stents expanded to maximum diameter during further observation. There were no serious stent-related complications, and the dysphagia was reduced considerably in all patients immediately after stent insertion. Persistent Tumor Bleeding occurred in two patients, and ingrowth of Tumor into the stent was seen in eight patients. Two stents occluded due to Tumor ingrowth but were successfully recanalized with endoscopic laser coagulation. At the end of the study, 28 patients were dead with a mean survival of 2.9 months (r...
-
malignant esophageal strictures treatment with a self expanding nitinol stent
Radiology, 1993Co-Authors: Wojciech Cwikiel, H Stridbeck, Karlgoran Tranberg, Goran Hambraeus, R Lillogil, C S Von Holstein, Roger WillenAbstract:A self-expanding esophageal nitinol stent was implanted under fluoroscopic guidance in 40 patients with malignant esophageal strictures and clinically significant dysphagia. The strictures were caused by squamous cell carcinoma (n = 14), adenocarcinoma (n = 12), recurrent anastomotic carcinoma (n = 8), and mediastinal Tumors (n = 6). Eight stents were balloon dilated to maximum diameter immediately after insertion. Sixteen stents self-expanded to maximum diameter within 24 hours, and the other stents expanded to maximum diameter during further observation. There were no serious stent-related complications, and the dysphagia was reduced considerably in all patients immediately after stent insertion. Persistent Tumor Bleeding occurred in two patients, and ingrowth of Tumor into the stent was seen in eight patients. Two stents occluded due to Tumor ingrowth but were successfully recanalized with endoscopic laser coagulation. At the end of the study, 28 patients were dead with a mean survival of 2.9 months (range, 0.1-7.0 months), and 12 patients were alive with a mean follow-up of 8.8 months (range, 4.0-15.0 months).
Gyu Young Pih - One of the best experts on this subject based on the ideXlab platform.
-
clinical outcomes of Tumor Bleeding in duodenal gastrointestinal stromal Tumors a 20 year single center experience
Surgical Endoscopy and Other Interventional Techniques, 2021Co-Authors: Gyu Young Pih, Ji Yong Ahn, Ji Young Choi, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoonyong JungAbstract:Duodenal gastrointestinal stromal Tumors (GISTs) are rare, and reports on duodenal GIST Bleeding are few. We analyzed the risk factors and clinical outcomes of hemorrhagic duodenal GISTs and compared them with those of gastric GISTs. Primary duodenal GISTs surgically diagnosed between January 1998 and December 2017 were retrospectively reviewed. Furthermore, patients with duodenal GIST were compared with those with primary gastric GIST histopathologically diagnosed between January 1998 and May 2015 using previously published data. Of the 170 total patients with duodenal GISTs, 48 (28.2%) exhibited Tumor Bleeding. Endoscopic intervention, embolization, and non-interventional conservative treatment were performed for initial hemostasis in 17, 1, and 30 patients, respectively. The 5-year survival rate was 81.9% in the Bleeding group and 89.4% in the non-Bleeding group (P = 0.495). Multivariate analysis showed that p53 positivity was a significant risk factor for duodenal GIST Bleeding (hazard ratio [HR] 2.781, P = 0.012), and age ≥ 60 years (HR 3.163, P = 0.027), a large maximum diameter (comparing four groups: < 2, 2–5, 5–10, and ≥ 10 cm), and mitotic count ≥ 5/high-power field (HPF) (HR 3.265, P = 0.032) were risk factors for overall survival. The incidence of Bleeding was significantly higher in duodenal GISTs than in gastric GISTs (28.2% vs. 6.6%, P < 0.001), and the re-Bleeding rate after endoscopic hemostasis was also higher in duodenal GISTs than in gastric GISTs (41.2% vs. 13.3%, P = 0.118). In patients with duodenal GIST with old age, large Tumor diameter, and mitotic count ≥ 5/HPF, a treatment plan should be established in consideration of the poor prognosis, although Tumor Bleeding does not adversely affect the prognosis. Duodenal GISTs have a higher incidence of Tumor Bleeding and re-Bleeding rate after endoscopic hemostasis than gastric GISTs.
-
clinical outcomes of upper gastrointestinal Bleeding in patients with gastric gastrointestinal stromal Tumor
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: Gyu Young Pih, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Sung Jin Jeon, Hwoonyong JungAbstract:Upper gastrointestinal Bleeding (UGIB) is one of the major manifestations of gastrointestinal stromal Tumor (GIST) of the stomach. Several studies have reported that GIST Bleeding is associated with poor prognosis. However, only case reports have reported hemostasis modalities for treating hemorrhagic gastric GIST. To identify clinical outcome of gastric GIST Bleeding, we analyzed risk factors and prognosis of hemorrhagic GIST evaluating hemostasis methods. Total 697 patients histopathologically diagnosed with primary gastric GIST between January 1998 and May 2015 were enrolled to the study, retrospectively. Of 697 total patients, 46 (6.6%) patients had UGIB. Endoscopic intervention, transarterial embolization, or surgical intervention was performed for initial hemostasis in 15, 2, and 1, respectively. Over a median of 68 months of follow-up, 16 patients in Bleeding group and 88 patients in non-Bleeding group died; the 5-year survival rate was 79.4% in Bleeding group and 91.8% in non-Bleeding group (p = 0.004). Multivariate analysis showed that significant risk factors for gastric GIST Bleeding included the maximal Tumor diameter > 5 cm and Ki-67 positivity. Age ≥ 60 [hazard ratio (HR) = 8.124, p = 0.048], necrosis (HR = 5.093, p = 0.027), and Bleeding (HR 5.743, p = 0.034) were significant factors for overall survival of gastric GIST patients. Bleeding risk of gastric GIST was higher when Tumor had diameter > 5 cm or Ki-67 positivity. In addition, Tumor Bleeding, necrosis, and age ≥ 60 years were associated with poor overall survival. Endoscopic intervention can be considered as an effective method for initial hemostasis of hemorrhagic gastric GIST.
