Linfoadenectomia nei tumori dello stomaco

Il ruolo della estensione della linfoadenectomia, ovvero della asportazione dei linfonodi, nel carcinoma dello stomaco e' un problema molto dibattuto in particolare in Europa dove la maggiore morbidita' e mortalita' perioperatoria associata ad una linfoadenectomia piu' estesa (D2) aveva di fatto messo in dubbio il vantaggio di questa procedura rispetto ad una linfoadenectomia limitata (D1).

Un follow-up a 15 anni dello stesso studio olandese che aveva messo in dubbio il vantaggio della D2, ora dimostra che una linfoadenectomia piu' estesa e' vantaggiosa in termini di minore incidenza di ripresa di malattia locale e locorgionale.

In conclusione, in tumori operabili ricevere una linfoadenectomia estesa D2 con risparmio della milza e' vantaggioso. Come ridurre il rischo legato alle maggiori complicanze di questa procedura? Rivolgersi a centri oncologici di riferimento dove vengano operati un numero cospicuo di pazienti per carcinoma gastrico.

fonte

The Lancet Oncology

Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial

Ilfet Songun, Hein Putter, Elma Meershoek-Klein Kranenbarg, Mitsuru Sasako, Cornelis J H van de Velde

Immagine tratta da http://www.hopkins-gi.org/GDL_Disease.aspx?CurrentUDV=31&GDL_Cat_ID=AF793A59-B736-42CB-9E1F-E79D2B9FC358&GDL_Disease_ID=DB2F8EAC-4421-41DD-B04E-684AFEF2AD94

Terapie Molecolari: nuove prospettive per i tumori Neuroendocrini del pancreas

Lo studio Radiant-3 presentato al 12' World Congress of Gastrointestinal Cancer da Yao e colleghi (Huston, Texas USA) ha dimostrato l'efficacia dell'Everolimus (un inibitore del pathway di mTOR) nel rallentare la progressione di malattia in pazienti con tumori pancreatici neuroendocrini in cui vi era stata progressione nei 12 mesi precedenti.


da The Lancet Oncology
http://www.thelancet.com/journals/lanonc/issue/current

Targeted therapies: pancreatic neuroendocrine tumors join the club

In the RADIANT-3 study, a randomised, placebo-controlled phase 3 trial, James Yao (Houston, TX, USA) and colleagues assessed the efficacy and safety of everolimus (an inhibitor of the mTOR pathway) plus best supportive care versus placebo plus best supportive care in 410 patients with advanced intermediate or low-grade pancreatic neuroendocrine tumours (PNET) with disease progression within the previous 12 months. Everolimus showed a significant improvement in progression-free survival—the primary endpoint—over placebo, with a median progression-free survival of 11 months for everolimus compared with 4·6 months for placebo (HR 0·35, 95% CI 0·27–0·45, p<0·0001). The Lancet Oncology reports.

http://www.thelancet.com/journals/lanonc/issue/current

Dove si curano i tumori del Pancreas

Un link a sportello cancro del Corriere della Sera, per trovare le informazioni sui centri di eccellenza per la cura dei tumori del pancreas, fegato e vie biliari. Il servizio e' curato dalla Fondazione Veronesi.

http://www.corriere.it/sportello-cancro/db/mdc/tutte/2008/mdc07.shtml.

Late fees for Pancreatic cancer

Pancreatic adenocarcinoma is a lethal disease, with a less then 3% five year survival. Our failure in treating this cancer led to the generally accepted assumption that pancreatic cancer is indeed an extremely aggressive disease. Latest studies from Yachida and colleagues (Nature, 2010) using whole genome sequencing on a well characterized series of human primary and metastatic pancreatic cancer tissues and primary cell lines, unveiled a much milder picture of pancreatic cancer, a slow growing tumor whose natural history takes about 20 years to complete. Furthermore metastasis occurs only at the very end (2,7 years before death). Interestingly all mutations found in metastases could be found in the primary tumor, suggesting that metastases heterogeneity reflects primary tumor heterogeneity. Still early diagnosis and local control are the way to go and pancreatic cancer is no exception.

Cancer as Old Foe and Goad to Science

Good Cancer literature

Cancer as Old Foe and Goad to Science from NYTimes

Perspective: Put Integrity High on Your To-Do List - Science Careers - Biotech, Pharmaceutical, Faculty, Postdoc jobs on Science Careers

Perspective: Put Integrity High on Your To-Do List - Science Careers - Biotech, Pharmaceutical, Faculty, Postdoc jobs on Science Careers