j****i
发帖数: 496 | 1 Can you please recommend a good hospital/cancer center with experience for
presacral tumor resection with intraoperative radiation therapy? Need name
for surgeon and rad onc. Thank you so much!
★ 发自iPhone App: ChineseWeb 8.2.2 |
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j*****g
发帖数: 8 | 2 Adjuvant systemic therapy in resectable non-small cell lung cancer
Author
Nasser Hanna, MD
Section Editors
Rogerio C Lilenbaum, MD, FACP
James R Jett, MD
Deputy Editor
Sadhna R Vora, MD
Contributor disclosures
All topics are updated as new evidence becomes available and our peer review
process is complete.
Literature review current through: May 2016. | This topic last updated: Nov
30, 2015.
MOLECULARLY TARGETED AGENTS — Despite the activity of tyrosine kinase
inhibitors in patients with metastat... 阅读全帖 |
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l*h
发帖数: 4124 | 3 what i was saying was that surgical resection, if possible, should be done
at the same time of open biopsy, unless the frozen sections were too
inclusive. but as long as a tumor can be determined from frozen and anatomy
allows, you usually do a subtotal resection in the same procedure of open
biopsy. the reason is that the subtotal resection will be the only surgery
in short term in many cases, in cases of hgg later confirmed by H-E, if a
subtotal is done, there will also be more time to prepare... 阅读全帖 |
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l*h
发帖数: 4124 | 4 the most important treatment in esophageal cancer is surgical resection (
except for a few very rare pathology types).
for the vast majority, if surgical resection is not possible, other
treatments are mainly palliative. some novel methods, such as laser and
thermoablation, though, can function similar to surgical resection. if tumor
is relatively small, resection can be achieved through endoscopy. |
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yf
发帖数: 272 | 5 If it's R0 resection, no need for chemo, if it's R1 or R2 resection,
adjuvant chemoradiation(fluopyramidine based chemo with concurrent radiation)
R0= No cancer at resection margins, R1= Microscopic residual cancer, R2=
Macroscopic residual cancer or M1 resection,
1 cycle before and 2 cycles after chemoradiation
Capecitabine 750-1000 mg/m PO BID on Days 1-14
Cycled every 28 days
With radiation
Capecitabine 625-825 mg/m PO BID on Days 1-5 or 1-7
Weekly for 5 weeks |
|
yf
发帖数: 272 | 6 If it's R0 resection, no need for chemo, if it's R1 or R2 resection,
adjuvant chemoradiation(fluopyramidine based chemo with concurrent radiation)
R0= No cancer at resection margins, R1= Microscopic residual cancer, R2=
Macroscopic residual cancer or M1 resection,
1 cycle before and 2 cycles after chemoradiation
Capecitabine 750-1000 mg/m PO BID on Days 1-14
Cycled every 28 days
With radiation
Capecitabine 625-825 mg/m PO BID on Days 1-5 or 1-7
Weekly for 5 weeks |
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l*h
发帖数: 4124 | 7 the technical aspect of GBM resection, in most brain areas, is not hard.
see my previous reply, in this multiple location case, usually try once to
reduce tumor burden (subtotal resection, not total or extended resection).
not much more can be done surgically. |
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a***u
发帖数: 318 | 8 小妹正在攻读NP，前不久完成导师给的case study，等批下来发现分数不理想，原因似
乎是我理解错误（因果不分），读了导师给我的“完美答案”，我心里依然固执地认为
我没错。知道这里的高手如云，所以想来讨个公道，当然输也要输的心服口服。
CASE STUDY
A young woman was admitted with 28 weeks of intermittent abdominal pain and
leg spasms. She had also noted increasing left leg pain for a few weeks
before admission. The leg pain had in-creased resulted in 14 days bedrest
before admission. The leg spasms were related to the movement of the lower
extremities. Review of systems was remarkable for in-creased irritabilit... 阅读全帖 |
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g******p
发帖数: 111 | 9 Update:
I attended an webinar by NCCN on adjuvant therapy for NSCLC pts and asked the case. The presenter is leaning towards using adjuvant chemo therapy. I am still collecting more openion on this. My mom will have first first follow up CT in Aug. I guess (guess only) if obvious disease progression were seen, chemo should be used. I still have the hope that if she can rest well and build up her immuine system, she will be able to keep the cancer in check.
Also I put together my mom's diagnosis ... 阅读全帖 |
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f******I
发帖数: 769 | 10
好。
just wait for the biopsy result, assume that he'd need a transurethral
resection, surgical result and path report would tell you how invasive the
tumor is and if there is any lym node involvement, if it's up to T1 lesion,
should have very good result from surgical resection, just need close
survilliance to prevent recurrence, |
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c********e
发帖数: 496 | 11 transsphenoidal resection of pituitary adenoma is good one, minor, no scar,
less invasive and less complication, but only indicated in the treatment of
small tumor.
roughly the indications include
if small and non functional, obeserve.
if small and functional, transsphenoidal resection or chemo
if big, surgery, but this is a tough one. there are many important
anatomical structure around pituitary gland.
if reoccur after operation, radiotherapy. |
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a**********2
发帖数: 3726 | 12 This is a very specific question. I am not neurosurgeon, so I really can't
give you the answer. That's why I said find an experienced neurosurgeon and
do surgery as early as possible if it's surgically resectable. If the
answer is no, then palliative care with radiation therapy, I do not
recommend chemo though many may do so, because it just destroys the quality
of life. For a surgically non-resectable GBM, palliative care to make
patient comfortably live for the rest of his life is more humani... 阅读全帖 |
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l*h
发帖数: 4124 | 13 as a general guideline, early stage gastric carcinoma, if properly resected,
doesn't require routine chemotherapy.
only the surgeon and the pathologist can tell how well the resection was
performed. |
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l*h
发帖数: 4124 | 14 this looks like his parietal lobe is affected. combined with male, 59yo, it
is >80% certain it is a high grade glioma.
if it's GBM, the median survival is ~3 mon w/o treatment, ~15 mon with
active treatment in the US. for active treatment, almost every day is spent
in some medical setting.
if it's anaplastic astrocytoma, the median survival is a little longer, up
to double that of GBM.
there is a much lower chance it's a mixed, but high grade glioma.
treatment includes surgery, chemo and radiati... 阅读全帖 |
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c*****l
发帖数: 739 | 15 Celsion Corporation and Zhejiang Hisun Pharmaceutical Company Enter Into
Technology Development Agreement for ThermoDox� for the Greater China
Territory - MarketWatch
LAWRENCEVILLE, N.J. and TAIZHOU CITY, China, Jan. 22, 2013 /PRNewswire via
COMTEX/ -- Celsion Corporation CLSN -81.17% , a leading oncology drug
development company, and Zhejiang Hisun Pharmaceutical Company Ltd. (sse
code:600267), a leading Chinese pharmaceutical company, today announced that
they have entered into a techno... 阅读全帖 |
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G***G
发帖数: 16778 | 16 现在有如下这些胃癌数据参数。老板让挖掘。我不知道挖掘什么。
有经验的请指点一下，这些临床数据中可以挖掘些什么？
how to do clinical analysis based on clinical data?
maybe this is a big question.
let's give an example. suppose we have the 200 gastric patients' data like
the following. What kind of analysis should be done? what parameters should
be focused
and what parameters should be ignored?
Classification by age
hospital days
Postoperation hospital day
Family history
Biopsy before surgery
Operation duration(min)
Surgeon
Anesthesia
Volume of blood tr... 阅读全帖 |
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G***G
发帖数: 16778 | 17 how to do clinical analysis based on clinical data?
maybe this is a big question.
let's give an example. suppose we have the 200 gastric patients' data like
the following. What kind of analysis should be done? what parameters should
be focused
and what parameters should be ignored?
Classification by age
hospital days
Postoperation hospital day
Family history
Biopsy before surgery
Operation duration(min)
Surgeon
Anesthesia
Volume of blood transfusion
Ascites
Peritoneal metastasis
Hepatic metastas... 阅读全帖 |
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x*****g
发帖数: 82 | 18 Position 1 in Nanotechnology for Cancer Molecular Imaging
Description of project: A postdoctoral position is available immediately to
focus on using pH-activatable fluorescent nanoprobes to amplify tumor
contrast with significant background suppression for image-guided resection
of head and neck tumors (HNCA). Prospective candidates will have the
opportunity to work in a highly productive multi-disciplinary environment
with a team of experts in basic and translational research. In particular,
th... 阅读全帖 |
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r*******g
发帖数: 5495 | 19 现在最主流的传统的前列腺切除手术是：（TURP) TransUrethral Resection of the
Prostate
TURP对前列腺肥大导致的前列腺症状改善效果良好，远远好于药物治疗。但是副作用也
大。The risk of TURP include retrograde ejeculation (75%), erectile
dysfunction (5-10%), and urinary incontinence (< 1%). 所以手术的主要风险是导
致性功能障碍，尤其是dry orgasm (retrograde ejeculation). 到了高潮，不能内射
，颜射，口爆对一个男人是多么痛苦呀。
另外现在真正在开展许多微小创伤性治疗方法治疗良性前列腺肥大，我最看好一个FDA
2013 年批准的植入打通法 （Implant to open prosatatic urethra) ，手术简单，病
人恢复快， 见效快，关键是不伤害性功能。如图：
The delivery sequence of the Urolift device. (A) The device in... 阅读全帖 |
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发帖数: 1 | 20 GPS需要相对论是谣言，这种谣言一到具体，很容易不攻自破
GPS 不是广义相对论的实验证据
王令隽
有人宣称GPS全球定位系统必须进行相对论修正，否则就不干活。许多人也信了。
最近和孙南生教授通信，他推荐了一篇业内专家R Li 的不同意见：
作者：R Li
链接：http://www.zhihu.com/question/24796597/answer/45911638
来源：知乎
摘要如下：
GPS不是相对论的应用
相对论改正只是卫星钟误差中的一个影响很小的系统误差改正项。
GPS系统有两个用途
主要用途， to drop 5 bombs in the same hole – 定位用途（这也可以看出设计这
个系统时军方目标精度是米级）相对论影响对目标精度的影响可忽略不计。
–主要用途中衍生出来的高精度测绘级定位用差分观测法消掉卫星钟误差，不需考虑相
对论影响（直接被绕过了）。
GPS定位是从未知点观测观测已知点从而确定未知点的坐标方位（专业说法叫resection
后方交会），观测量是未知点，你手持的GPS到已知坐 标的卫星的距离（卫星发射基于
卫星钟时钟信号，其实是有长周... 阅读全帖 |
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发帖数: 1 | 21 ???????????????? google find
Medical Witness: Seth Rich was going to live, but he was allowed to die…
Sat 10:40 am UTC, 20 May 2017
posted by Gordon Logan
[According to this witness, a graduate surgery resident, Seth Rich was going
to survive. It seems that, like Princess Diana, Seth Rich was allowed to
die. – Gordon Logan]
“4th year surgery resident here who rotated at WHC (Washington Hospital
Center) last year, it won’t be hard to identify me but I feel that I
shouldn’t stay silent.
Seth Rich... 阅读全帖 |
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w***i
发帖数: 4 | 22 Since your dad already had two courses of radiation for NPC. It is not
likely to delivery another course of radiation for curative intent. Small
field RT for palliative purpose may be possible. You shall see if there is
someone is able to do a resection with free flap or bone graft. Otherwise,
palliative chemotherapy and local palliative radiation are the only choices
left. |
|
f******I
发帖数: 769 | 23
查,
if it's solitary lesion on liver, even if it's metastatic disease, you could
still have the liver tumor resected, bony metastatic disease is often
treated with radiation,
need to know what type of cancer and where is the primary, his age and other
co-morbidity factors also play a role in deciding whether to pursue chemo
or not had it been confirmed that it is malignant, chemotherapy in general
is very very toxic, |
|
b**********r
发帖数: 213 | 24 我爸爸已经作了活体检查，结果还没出来。我还没有跟我爸的医生谈，但是我爸说肿瘤
2。1厘米大，像菜花，问题是比较靠近输尿管，如果transurethral resection可能不
好做而且有可能损伤输尿管，现在医生有可能考虑开腹切除部分膀胱，重新连接导尿管
和膀胱。
我觉得这个当地医院的医生意见是不是值得商榷，现在希望能找到武汉同济医学院的泌
尿外科专家复诊，版上如果有朋友认识或者知道武汉同济医学院的那个泌尿外科专家可
以推荐，请务必告知我一声，感激涕零。我的信箱l************[email protected]
万分感激！
, |
|
m*********y
发帖数: 1735 | 25 不要太担心啊，膀胱癌在美国很普遍的，男性中所有癌症发病率第四，而且治愈率也高
很多的，尤其是早期的，如果没有muscle invasive，没有转移，Transurethral
Resection of the Bladder Tumor（TURBT）之后定期观察检测没有什么问题的，放心
啊，不要太担心了 |
|
f******I
发帖数: 769 | 26
my understanding is that if you don't have any ysmptoms, the osteochondroma
can just be monitored, but you have symptoms, ie, pain, then it needs to be
resected, |
|
f******I
发帖数: 769 | 27
depends on cell type, adenocarcinoma, lymphoma, carcinoid, or leimyosarcoma,
also depends on if it's localized or metastatic, if localized, surgical
resection is always the treatment of choice, |
|
m****a
发帖数: 98 | 28 melluloblastoma occurs mostly in children. prognosis depends on complete
resection of the tumor, radiation and chemotherapy, which allows for 5 year
survival in more than 80% of cases.北京天坛医院 is famous for its
neurosurgery. bless! |
|
g***r
发帖数: 285 | 29
less than 5mm is mostly benign, i would think you need another ulatrsound
and get another one 1 yr later and if the size increased, just have a
cholecystectomy then and take the whole thing off, and need to take the
liver tissues surrounding it as well the ensure a clean resection,
想起来中国式离婚里面，大款说，我没胆可不行啊， |
|
g***r
发帖数: 285 | 30
not enough details, but assume he does not have wide spread disease since it
appears surgical resection was at least once considered, if his albumin and
platelet are too low, or he is too weak for invasive surgery, then you can
consider radiofrequency ablation or arterial chemoembolization, |
|
e*******9
发帖数: 261 | 31 thanks a lot!!
training in breast cancer, probably all of the previous comments, because
not a single one mentioned one of the most important pieces of information:
its histological type.
aggressive but rarely metastasize until very late. It can be quite
accurately diagnosed by mammogram. Therefore the surgery should not proceed
to extensive lymph node purge unless cryosection histology says otherwise.
medullary carcinoma (until very late) is how complete the resection is. It
appears your mom r |
|
J****C
发帖数: 20 | 32 要做一个眼睑下垂的手术，见医生也就见了一次，总觉得有点不靠谱，觉得交流太少。
约在手术前一天再见一次医生，但是可能对手术程序也没改变了。
这个手术是external levator resection，我看网上，对levator还有internal的手术
方法，不知道为啥医生都不跟我商量下就默认是external的。
我觉得我有点疤痕体质，因为我阑尾动过手术，那个疤痕最终横着扩张，都有半厘米到
一厘米。所以我非常担心，如果眼皮从外面拉了一刀，会不会疤痕也会扩张着长。请问
有没有稍微知情点儿的人，能帮我解答一点点疑问呢？而且不知道这个手术术后恢复要
多久，现在是越来越担心，很有可能都会在手术当天cancel掉，实在是不想爱美不成反
倒多了一个疤。
谢谢你们了！ |
|
g*****j
发帖数: 1211 | 33 There is no magic cure for small cell carcinoma currently. Surgical
resection does not work in small cell carcinoma. Chemical therapy is highly
effective initially, and can extend survival for 1-2 years. However,
almost all patients relapse eventually. |
|
d*w
发帖数: 384 | 34 As I mentioned medulloblastoma, its standard care in the U.S. is:
1. surgical resection if possible
2. followed by radiation therapy, for the primary site up to 60 Gy total
dose (1.8Gy/f), the neuraxis up to 30 Gy total dose (1.8Gy/f)
It would be a very tough decision for the family to make whether to receive
the radiation therapy. There is very limited experience of stereotactic
radiation therapy in children so young in China. Besides, it requires
general anesthesia in the radiation therapy cha |
|
y*****g
发帖数: 193 | 35 There is a surgery called transsphenoidal resection of pituitary adenoma. It
's a relative easy surgery done by neurosurgery team. Patient checks in on
the same operation day, surgery about 1 or 2 hours, stays in ICU for one day
, then stay in regular floor for one or two days, then go home.
We had a lot of patients like this, it's piece of cake in ICU. I have never
seen patients failed the surgery in my hospital. |
|
l*****O
发帖数: 402 | 36 This is Herceptin. It's not cheap here in US. Cost 3,000+ each. And it's
refrigerated solution and needs overnight shipping. Prognosis of breast
cancer is more related with cleanliness of surgical resection. As long as
she had mastectomy and all the conventional therapies (chemo and radiation
therapy), I guess she will be fine. |
|
d*w
发帖数: 384 | 37 If it's grade 2, it is low grade glioma (胶质瘤), not gliolastoma (胶质母细
胞瘤). Those patients typically survive for 7-10 years if treated with
complete resection and irradiation.
The decision about surgery mainly depends on the patient's general health
condition. Age is not that important. We recently did a 91 year old.
Chemotherapy in glioma doesn't do much good. |
|
|
c**i
发帖数: 6973 | 39 发信人: choi (choi), 信区: Hardware
标 题: Surgical Robotics
发信站: BBS 未名空间站 (Thu Dec 9 17:14:30 2010, 美东)
David Von Drehle, Meet Dr. Robot. Your next surgeon may not be human. Why
that should make you hppy--and a little wary. Time, Nov. 22, 2010.
http://www.time.com/time/specials/packages/article/0,28804,2032747_2033111_2033133,00.html
Quote:
"The instrument [robot]grew out of a U.S. Armysponsored project in the 1980s
to develop a remote-controlled laparoscopic robot for battlefield surgery.
That pro... 阅读全帖 |
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l*****O
发帖数: 402 | 40 if arm and surgical site are on the same side (for example, right arm, right
breast), most likely it's lymphedema. caused by injury to the lymphatic
vessels due to surgery. though lymphedema can be managed and is not really
serious, i just don't understand how a surgical resection of a benign breast
lump will cause it. the surgeon should be responsible for that. |
|
l*****O
发帖数: 402 | 41 if arm and surgical site are on the same side (for example, right arm, right
breast), most likely it's lymphedema. caused by injury to the lymphatic
vessels due to surgery. though lymphedema can be managed and is not really
serious, i just don't understand how a surgical resection of a benign breast
lump will cause it. the surgeon should be responsible for that. |
|
W***M
发帖数: 50 | 42 It is the most common liver cancer in children but it is still a very rare
pediatric cancer.
The treatment is surgery + chemotherapy. The most important thing is to
achieve complete reaction by surgery. Pre and post surgery is also needed
for long term survival. Cisplatin is the most effective drug for treatment -
I am sure they are using that in Beijing. If surgery can not resect all
tumor, liver transplant is another option.
If your cousin want to come to US, let me know where she wants to go,... 阅读全帖 |
|
g******p
发帖数: 111 | 43 妈妈四月家乡体检发现左上肺磨玻璃阴影（GGO,Ground glass opacity)，约1.5cm,无
任何其他症状。
60岁，从不吸烟，家庭成员无吸烟。
五月在上海肿瘤医院薄层CT,发现两肺更多结节。穿刺怀疑肺腺癌。未发现远端转移。
五月底对左肺的三个结节作了契形切除wedge resection，手术后石蜡病理报告如下。
基本上是“双肺多发性肺腺癌，以肺泡细胞癌为主”。
分子检测 EFFR 未见肯定突变。
医院多学科会诊不建议术后的放化疗，建议3个月后CT随访。
目前手术后两个半月，偶有干咳，无痰，无发烧。生活卖菜做饭可以自理。
请问
1）是否需要进行术后辅助化疗adjvant chemotherapy？什么方案比较有用。
2) 有什么中药或者中医有效？
3）我想接妈妈到美国生活，她只有B2 VISA，有什么办法给她买保险？
4）有在cancer center工作的朋友吗？请推荐哪些专家在这个领域比较擅长阿？
非常感谢！
-----------病理报告---------------------
标本名称：左肺肿块切除术标本
临床诊断：左上肺癌
病理诊断：
（左上肺叶肿块，左下肺... 阅读全帖 |
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l*h
发帖数: 4124 | 44 first option is still surgery. some surgeons may still be able to perform
resection.
if surgery is not possible, then chemotherapy. RCCs typically have abnormal
RTK activation which provides therapeutic targets. |
|
l*h
发帖数: 4124 | 45 first option is still surgery. some surgeons may still be able to perform
resection.
if surgery is not possible, then chemotherapy. RCCs typically have abnormal
RTK activation which provides therapeutic targets. |
|
l*h
发帖数: 4124 | 46 very little information but there are some indication for prognosis:
1. desmoplastic medulloblastoma tends to have better prognosis than other
types.
2. young (can be as young as 3 - 4 yo) patients tend to have good
therapeutic response to chemotherapy. in this age group, chemo after total
resection produces a high percentage of cure (> 5 yrs disease-free survival)
. chemo regimens typically include a -platin or topoisomerase inhibitor and
other drugs.
3. radiation therapy in ≤3 yo is up to deba... 阅读全帖 |
|
l*h
发帖数: 4124 | 47 most GISTs are benign on histology but almost all are malignant in
biological behavior. they have a high recurrence rate. on average, one in 5
or 6 recur in a year after complete surgical resection if not treated with
TKIs.
based on the size, this one should have a fairly high recurrence probability
. imatinib can be considered for recurrence reduction. |
|
l*h
发帖数: 4124 | 48 craniopharyngioma is one of the tumors with benign histology but malignant
behavior.
if at all possible, perform a total or subtotal resection. she will likely
need hormone replacement therapy. she will possibly need radiotherapy too.
for the surgery, the approach depends on the location and size of the tumor.
the most commonly used two approaches are subfrontal and transphenoid for
this area.
"十年存活率才有70%左右" is about right. |
|
l*h
发帖数: 4124 | 49 I think I need to clarify what I meant in the other post:
喉部肉芽肿 is common and I DO think it is possible this is a 喉部肉芽肿.
What makes people mad is the contradictory description by the surgeon and
the pathologist. Additional questions are:
1. the vast majority of laryngal granulomas can be resected fairly
completely, unless it is too big and gets deep into the vocal cords. so don'
t know why the surgeon says 由于她长的是肉芽组织且是良性，据国内的医生说不太
好治疗.
2. what was actually done? what's the use of 氩氦刀 here? "氩氦刀进... 阅读全帖 |
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u*****t
发帖数: 292 | 50 I agree with the impression, most likely germ cell tumor. I would recommend
a CT for chest, abdomen and pelvis with contrast to look for possible
primaries. And if found, they may be able to do a CT guided biopsy.
I am not a pediatric oncologist, but BEP (bleomycin, etoposide, and
cisplatin) x 4 or VIP (etoposide, ifosfamide and cisplatin) x 4 works well
in adult patients. Armstrong had brain mets too and he got the VIP regimen
because he wanted to preserve his lung function. He is cured BT... 阅读全帖 |
|
