Journal of surgical oncology
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Gastrointestinal stromal tumor (GIST), the most common sarcoma arising in the gastrointestinal tract, typically expresses the tyrosine-kinase receptor, C-KIT, and contains activating mutation in the c-kit or platelet-derived growth factor receptor (pdgfr) gene. Recently, development of small molecules that inhibit the kinase activity of mutant C-KIT and PDGFR proteins has radically changed treatment and prognosis of patients diagnosed with advanced GIST as this molecularly "targeted" therapy has demonstrated remarkable high-level of activity in this disease.
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Progression on first-line therapy with imatinib in gastrointestinal stromal tumors (GIST) is caused by either initial resistance or more often a secondary mutation in tyrosine kinases KIT or PDGFR. Therapies in development for imatinib-resistant GIST include agents that target KIT/PDGFR with greater potency or possess broader kinase inhibition profiles including VEGFR. To circumvent secondary mutations in KIT/PDGFR, inhibition of the downstream signaling in PI3K/Akt/mTOR pathway and enhanced degradation of KIT/PDGFR are also under investigation.
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The correlation between perioperative CEA, CA 19-9, and CA 72-4 and recurrence of gastric cancer has not been clarified. The aim of this study was to investigate the relationships between perioperative CEA, CA 19-9, and CA 72-4 and recurrence of gastric cancer. ⋯ For patients with advanced gastric cancer, CEA, CA 19-9, and CA 72-4 are considered useful for follow-up tests. Although, CEA is considered useful for follow-up test for patients with early gastric cancer, but CA19-9 and CA72-4 are less useful due to their low sensitivity.
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Anastomotic leakage is a major complication of rectal surgery and controversy about its risk factors still exists. The aim of present study was to identify risk factors for anastomotic leakage following sphincter-sparing resection of rectal cancer, focusing on the role of tissular lymphatic vessel density (LVD) in tumorous margin and distal clearance margin. ⋯ Tissular LVD in tumorous or distal clearance margin and lower tumor location are important risk factors for anastomotic leakage.
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Optical imaging using near-infrared (NIR) fluorescence provides new prospects for general and oncologic surgery. ICG is currently utilised in NIR fluorescence cancer-related surgery for three indications: sentinel lymph node (SLN) mapping, intraoperative identification of solid tumours, and angiography during reconstructive surgery. Therefore, understanding its advantages and limitations is of significant importance. Although non-targeted and non-conjugatable, ICG appears to be laying the foundation for more widespread use of NIR fluorescence-guided surgery.