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Borderline resectable for colorectal liver metastases:Present status and future perspective

World Journal of Gastrointestinal Surgery 2021年第8期13卷 756-763页

作者： Yuki Kitano Hiromitsu Hayashi Takashi Matsumoto Shotaro Kinoshita Hiroki Sato Yuta Shiraishi yosuke nakao Takayoshi Kaida Katsunori Imai Yo-ichi Yamashita Hideo Baba Department of Gastroenterological Surgery Graduate School of Medical SciencesKumamoto UniversityKumamoto 860-8556Japan

Surgical resection for colorectal liver metastases(CRLM)may offer the best opportunity to improve ***,only about 20% of CRLM cases are indicated for resection at the time of diagnosis(initially resectable),and the remaining cases are treated as unresectable(initially unresectable).Thanks to recent remarkable developments in chemotherapy,interventional radiology,and surgical techniques,the resectability of CRLM is ***,some metastases are technically resectable but oncologically questionable for upfront *** pancreatic cancer,such cases are categorized as"borderline resectable",and their definition and treatment strategies are ***,in CRLM,although various poor prognosis factors have been identified in previous reports,no clear definition or treatment strategy for borderline resectable has yet been *** the efficacy of hepatectomy for CRLM was reported in the 1970 s,multidisciplinary treatment for unresectable cases has improved resectability and prognosis,and clarifying the definition and treatment strategy of borderline resectable CRLM should yield further improvement in *** review outlines the present status and the future perspective for borderline resectable CRLM,based on previous studies.

关键词： Borderline resectable Colorectal liver metastases Adjuvant chemotherapy Hepatectomy Colorectal cancer

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Risk factors for lymph node metastasis in patients with pancreatic neuroendocrine neoplasms

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World Journal of Clinical Oncology 2022年第6期13卷 520-528页

作者： yosuke nakao Hiromitsu Hayashi Yo-ichi Yamashita Ofuchi Takashi Kazuki Matsumura Norio Uemura Fumimasa Kitamura Rumi Itoyama Toshihiko Yusa Katsunobu Taki Tatsunori Miyata Takaaki Higashi Shigeki Nakagawa Hirohisa Okabe Katsunori Imai Hideo Baba Department of Gastroenterological Surgery Kumamoto UniversityKumamoto 860-8556Japan

BACKGROUND Although PNENs generally have a better prognosis than pancreatic cancers,some PNENs display malignant behavior including lymph node(LN)*** tumor resection can be the only potentially curative treatment for patients with resectable ***,the indications for LN dissection are still *** the last decade,minimally invasive surgery such as laparoscopic pancreatic surgery(LPS)has been increasingly performed for pancreatic tumors including *** To investigate the risk factors for LN metastasis in PNENs and to select appropriate patients for limited surgery by *** From April 2001 to December 2019,92 patients underwent pancreatic resection for PNENs at Kumamoto University ***,82 patients were enrolled in this *** perioperative factors,we examined the predictive factors for LN metastasis in *** Among the 82 patients,the percentage of LN metastasis according to the pathological findings was 12%(10/82 cases).The median tumor size was 12 mm(range:5-90 mm).The median tumor size in the LN-positive group(37 mm)was significantly larger than that in the LN-negative group(12 mm)(P=0.0001).Multivariate analyses revealed that larger tumor size(≥20 mm)was an independent risk factor for LN metastasis(odds ratio 16.8,P=0.0062).In patients with small tumors(≤10 mm),LN metastasis was not *** Larger tumor size(≥20 mm)is an independent risk factor for LN metastasis in *** smaller PNENs(≤10 mm),we may be able to choose limited surgery without LN dissection.

关键词： Lymph node metastasis Pancreatic neuroendocrine neoplasms Risk factor Tumor size

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