) chemotherapy. Therefore, we conducted an analysis with propensity score matched patients to determine the role of perioperative and adjuvant chemotherapy in patients after D2 lymphadenectomy. Patients and methods Patients Since 1991, 1563 patients were operated for gastric cancer in the department for Abdominal and General Surgery at the University Clinical Centre Maribor, Slovenia. The demographic characteristics of patients, the characteristics of the surgical procedures, and the pathological characteristics of tumours were prospectively stored on a computer
Tomaz Jagric, Bojan Ilijevec, Vaneja Velenik, Janja Ocvirk and Stojan Potrc
Diana Opincariu, Monica Chițu, Nora Rat and Imre Benedek
The objective of this study was to study the integrated score of ST-segment resolution (ISSTE) and in-hospital death in patients undergoing primary percutaneous intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI).
Material and Methods: This prospective study included 586 consecutive patients admitted with STEMI to the Cardiology Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș, between January 1st, 2013 and December 31, 2014, who underwent pPCI in less than twelve hours after the onset of symptoms. Clinical and demographic data were analyzed in 539 (91.9%) survivors (Group 1) and 47 (8.1%) nonsurvivors (Group 2). The Integrated Score of ST elevation (ISSTE) was calculated by summing the amplitude of the ST segment elevation in all the 12 leads, before and at 2 hours after revascularization.
Results: The ISSTE score calculated at baseline, immediately before the primary percutaneous coronary intervention, was significantly higher in Group 2 as compared to Group 1 (13.9 ± 1.2 vs. 11.0 ± 0.2, p = 0.026). At the same time, the ISSTE score calculated at 2 hours after the coronary intervention was significantly higher for patients in Group 2 (7.36 ± 1.12 vs. 2.9 ± 0.1, p <0.0001). Analysis of the dynamics of the ISSTE score indicated that patients who survived presented a more expressed reduction in the ISSTE score following pPCI, as compared to those who subsequently died (73.5% reduction in Group 1 compared to 47.2% reduction in Group 2, p <0.0001). In-hospital mortality was significantly higher in the group of patients with >50% reduction in the ISSTE score. The in-hospital death rate was 5.4% in patients with >50% reduction in the ISSTE score, compared to 19.4% for those who presented less than 50% reduction in the ISSTE score following pPCI (p <0.0001). The rate of successful reperfusion rate, expressed by the reduction in ISSTE score, was 83.8% in Group 1, compared to 55.3% in Group 2 (p <0.0001), indicating that the absence of an efficient reperfusion after pPCI is associated with a higher mortality in STEMI patients, and could be evaluated using regression of the ISSTE score, which proved to be directly associated with mortality.
Conclusion: The ISSTE score is shown to be an effective ECG-derived marker of myocardial damage in STEMI patients. A high ISSTE score is associated with higher mortality, while a reduction in the ISSTE score after pPCI may indicate an efficient reperfusion and a decrease in mortality in the first days after infarction.
Satoshi Nagano, Yuhei Yahiro, Masahiro Yokouchi, Takao Setoguchi, Yasuhiro Ishidou, Hiromi Sasaki, Hirofumi Shimada, Ichiro Kawamura and Setsuro Komiya
Background. The utility of ultrasound imaging in the screening of soft-part tumours (SPTs) has been reported. We classified SPTs according to their blood flow pattern on Doppler ultrasound and re-evaluated the efficacy of this imaging modality as a screening method. Additionally, we combined Doppler ultrasound with several values to improve the diagnostic efficacy and to establish a new diagnostic tool.
Patients and methods. This study included 189 cases of pathologically confirmed SPTs (122 cases of benign disease including SPTs and tumour-like lesions and 67 cases of malignant SPTs). Ultrasound imaging included evaluation of vascularity by colour Doppler. We established a scoring system to more effectively differentiate malignant from benign SPTs (ultrasound-based sarcoma screening [USS] score).
Results. The mean scores in the benign and malignant groups were 1.47 ± 0.93 and 3.42 ± 1.30, respectively. Patients with malignant masses showed significantly higher USS scores than did those with benign masses (p < 1 × 10-10). The area under the curve was 0.88 by receiver operating characteristic (ROC) analysis. Based on the cut-off value (3 points) calculated by ROC curve analysis, the sensitivity and specificity for a diagnosis of malignant SPT was 85.1% and 86.9%, respectively.
Conclusions. Assessment of vascularity by Doppler ultrasound alone is insufficient for differentiation between benign and malignant SPTs. Preoperative diagnosis of most SPTs is possible by combining our USS score with characteristic clinical and magnetic resonance imaging findings.
Matjaz Vrtovec, Ajda Anzic, Irena Preloznik Zupan, Katja Zaletel and Ales Blinc
plaques, which were defined as focal lesions exceeding the intima-media thickness by at least 50% or reaching an absolute thickness of at least 1.5 mm in two orthogonal projections. Scoring of atherosclerotic plaques was performed by a modification of the methodology used in the Rotterdam Study. 24 The extracranial carotid arteries were divided into three sectors on each side: the common carotid artery and its bulb, the internal carotid artery, and the external carotid artery. At least one plaque in any sector was scored 1 point, while the absence of plaques was scored
Victoria Rus, Diana Opincariu, Roxana Hodas, Tiberiu Nyulas, Marian Hintea and Theodora Benedek
-0959.2004.17603.x. 15. Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20:38-45. 16. Iwakami N, Nagai T, Furukawa TA, et al. Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure. Int J Cardiol. 2017;230:529-536. doi: 10.1016/j.ijcard.2016.12.064. 17. Toyokawa T, Kubo N, Tamura T, et al. The pretreatment Controlling Nutritional Status (CONUT) score is
Arpad Ivanecz, Bojan Krebs, Andraz Stozer, Tomaz Jagric, Irena Plahuta and Stojan Potrc
study was to compare the surgical and oncological outcomes of patients undergoing simultaneous resection of primary colorectal cancer and SCLM by laparoscopic or open surgery using propensity score matching. Patients and methods Patient selection and study design All patients with SCLM were discussed by the multidisciplinary team. Treatment decisions were based on location and complexity of resection of the primary tumor, extent of liver resection, liver function and physical condition of the patients. The policy of the institution is not to combine a
Ji Chen, Yong Zhao, Xin Li, Peng Sun, Muwen Wang, Ridong Wang and Xunbo Jin
Imaging primary prostate cancer with 11C-Choline PET/CT: relation to tumour stage, Gleason score and biomarkers of biologic aggressiveness
Background. As a significant overlap of 11C-Choline standardized uptake value (SUV) between prostate cancer and benign prostate hyperplasia (BPH) tissue, controversy exists regarding the clinical value of 11C-Choline PET/CT scan in primary prostate cancer. In this study, the SUVmax of the prostate lesions and the pelvic muscles were measured and their ratios (SUVmax-P/M ratio) were calculated. Then we evaluated whether the tracer 11C-Choline uptake, quantified as SUVmax-P/M ratio, correlated with tumour stage, Gleason score, and expression levels of several biomarkers of aggressiveness.
Methods. Twenty-six patients with primary prostate cancer underwent 11C-Choline PET/CT. Tumour specimens from these patients were graded histopathologically, and immunnohistochemistry for Ki-67, CD31, androgen receptor (AR), Her-2/neu, Bcl-2, and PTEN were performed.
Results. Both SUVmax and SUVmax-P/M ratio showed no significant difference between patients with tumour stage II and III, but significantly elevated in patients with tumour stage IV. SUVmax-P/M ratio was also significantly higher in lesions with Gleason score of 4+3 or higher versus less than or equal to 3+4. SUVmax-P/M ratio was found significantly correlated with expression levels of Ki-67 and CD31. In addition, a higher SUVmax-P/M ratio was demonstrated in Her-2/neu positive subgroup than negative subgroup. At the same time, Gleason score and expression levels of these biomarkers showed no significant association with SUVmax.
Conclusions. Using the parameter SUVmax-P/M ratio, 11C-Choline PET/CT may be a valuable non-invasive imaging technology in the diagnosis of primary prostate cancer.
Tomoya Hasegawa, Naoaki Kuji, Fumiaki Notake, Tetsu Tsukamoto, Toru Sasaki, Motohiro Shimizu, Kazunori Mukaida, Hiroe Ito, Keiichi Isaka and Hirotaka Nishi
of liver tissues is considered to relatively increase with an increase in the density of vessels. In particular, the severity of hepatic fibrosis, as determined by biopsy, actually showed a correlation with a color score found using elastography in the liver area. 7 , 8 Small neonates who did not reach an appropriate weight according to gestational age in weeks are referred to as small for gestational age (SGA). Perinatal mortality and the incidence of mental deficiency are high for SGA infants compared with non-SGA infants. Therefore, a fetus with SGA represents
Stefan Janssen, Heinke C Hansen, Liesa Dziggel, Steven E Schild and Dirk Rades
Introduction Breast cancer patients account for about 25% of patients developing cerebral metastases. 1 , 2 , A considerable proportion of these patients present with multiple lesions when the cerebral lesions are detected or a low performance score. These patients often receive whole-brain radiotherapy (WBRT) alone. Common WBRT-regimens include 20.0 Gy in 5 fractions (duration = one week), 30.0 Gy in 10 fractions (two weeks), 35.0–37.5 Gy in 14–15 fractions (three weeks) and 40.0 Gy in 20 fractions (four weeks). 1 In general, patients with a short expected
Vaneja Velenik, Ajra Secerov-Ermenc, Jasna But-Hadzic and Vesna Zadnik
questionnaire, which consists of 30 questions (EORTC QLQ-C30), is supplemented by disease-specific modules and is translated into 81 languages, including Slovene. 6 To assist the overall interpretation of results from clinical research of HRQL the population-based reference values are used; the scores of the general population can be used as guidelines in the interpretation of HRQL scores from different patients’ populations. The normative (reference) values of the QLQ-C30 questionnaire for a generally healthy population are already available for some countries: Denmark