Introduction: Chordoma are rare, slowly growing, locally aggressive neoplasms of bone that arise from embryonic remnants of the notochord. This work aimed to evaluate the treatment results of a series of chordoma patients in our institute. More also, we try to clarify the importance of approaching such patients through a multidisciplinary team to maximize the oncologic and functional outcomes and to improve the patient's quality of life. Patients and Methods: This study was conducted at SECI, surgical department during a period of 6 years duration. Patients were treated through multi-disciplinary team specialists of our cancer institute. Surgery and postoperative radiation therapy was offered to all patients. Results: Results involves 8 patients with an average follow-up interval of 38.5 months. We had four cases of local recurrence which was salvaged with re-surgery and/or adjuvant radiotherapy. We had no postoperative motor neurologic deficit, with an excellent sphincter control in all patients. The 3-year survival rate in this study is 87.5%. Conclusions: Multi-disciplinary treatment approach for chordoma is fundamental to improve overall outcomes. Surgery continues to be the primary modality in the management of chordoma. Rates of local recurrence, as well as survival, appear to be dependent on the achievement of negative surgical margins. Patients who relapse locally may have a poor prognosis but both radiation and surgery can be used as salvage therapy.

Introduction: Chordoma are rare, slowly growing, locally aggressive neoplasms of bone that arise from embryonic remnants of the notochord. This work aimed to evaluate the treatment results of a series of chordoma patients in our institute. More also, we try to clarify the importance of approaching such patients through a multidisciplinary team to maximize the oncologic and functional outcomes and to improve the patient's quality of life. Patients and Methods: This study was conducted at SECI, surgical department during a period of 6 years duration. Patients were treated through multi-disciplinary team specialists of our cancer institute. Surgery and postoperative radiation therapy was offered to all patients. Results: Results involves 8 patients with an average follow-up interval of 38.5 months. We had four cases of local recurrence which was salvaged with re-surgery and/or adjuvant radiotherapy. We had no postoperative motor neurologic deficit, with an excellent sphincter control in all patients. The 3-year survival rate in this study is 87.5%. Conclusions: Multi-disciplinary treatment approach for chordoma is fundamental to improve overall outcomes. Surgery continues to be the primary modality in the management of chordoma. Rates of local recurrence, as well as survival, appear to be dependent on the achievement of negative surgical margins. Patients who relapse locally may have a poor prognosis but both radiation and surgery can be used as salvage therapy.

Introduction: Chordoma are rare, slowly growing, locally aggressive neoplasms of bone that arise from embryonic remnants of the notochord. This work aimed to evaluate the treatment results of a series of chordoma patients in our institute. More also, we try to clarify the importance of approaching such patients through a multidisciplinary team to maximize the oncologic and functional outcomes and to improve the patient's quality of life. Patients and Methods: This study was conducted at SECI, surgical department during a period of 6 years duration. Patients were treated through multi-disciplinary team specialists of our cancer institute. Surgery and postoperative radiation therapy was offered to all patients. Results: Results involves 8 patients with an average follow-up interval of 38.5 months. We had four cases of local recurrence which was salvaged with re-surgery and/or adjuvant radiotherapy. We had no postoperative motor neurologic deficit, with an excellent sphincter control in all patients. The 3-year survival rate in this study is 87.5%. Conclusions: Multi-disciplinary treatment approach for chordoma is fundamental to improve overall outcomes. Surgery continues to be the primary modality in the management of chordoma. Rates of local recurrence, as well as survival, appear to be dependent on the achievement of negative surgical margins. Patients who relapse locally may have a poor prognosis but both radiation and surgery can be used as salvage therapy.

Introduction: Chordoma are rare, slowly growing, locally aggressive neoplasms of bone that arise from embryonic remnants of the notochord. This work aimed to evaluate the treatment results of a series of chordoma patients in our institute. More also, we try to clarify the importance of approaching such patients through a multidisciplinary team to maximize the oncologic and functional outcomes and to improve the patient's quality of life. Patients and Methods: This study was conducted at SECI, surgical department during a period of 6 years duration. Patients were treated through multi-disciplinary team specialists of our cancer institute. Surgery and postoperative radiation therapy was offered to all patients. Results: Results involves 8 patients with an average follow-up interval of 38.5 months. We had four cases of local recurrence which was salvaged with re-surgery and/or adjuvant radiotherapy. We had no postoperative motor neurologic deficit, with an excellent sphincter control in all patients. The 3-year survival rate in this study is 87.5%. Conclusions: Multi-disciplinary treatment approach for chordoma is fundamental to improve overall outcomes. Surgery continues to be the primary modality in the management of chordoma. Rates of local recurrence, as well as survival, appear to be dependent on the achievement of negative surgical margins. Patients who relapse locally may have a poor prognosis but both radiation and surgery can be used as salvage therapy.

NULL

NULL

Analgesics had been suspected of impairing various immune functions either directly or indirectly. Our primary objective was to compare the effects of intravenous (IV) morphine, tramadol, and ketorolac on stress and immune responses in patients who underwent modified radical mastectomy. Patients: Sixty patients randomly assigned to receive IV morphine 5mg (group M, n=20), tramadol 100mg (group T, n=20), or ketorolac 60mg (group K, n=20) at the end of surgery. Methods: Serum cortisol, prolactin were measured immediately, 40 minutes, and 24 hours postoperatively. Expressions of peripheral T lymphocytes (CD3+, CD3+CD4+, CD3+CD8+) and natural killer cells (CD3+, CD56+) were measured as percentages of total lymphocytes by flow cytometry immediately, 90 minutes, and 24 hours postoperatively. Results: After 40 minutes, cortisol level increased but prolactin decreased significantly (P=0.001), then both decreased after 24 hours (P=0.001) compared with baseline within the 3 groups. CD3, CD4, CD8, and CD56 significantly decreased at 90 minutes and 24 hours (Pr0.033) compared with baseline in the 3 groups. CD4, CD8, and CD56 significantly decreased in group M, compared with group T and K (Pr0.016) and CD3, CD8, and CD56 in group T compared with group K at 90 minutes (Pr0.024) postoperatively. After 24 hours, CD4, and CD8 decreased in group M compared with group T (Pr0.048) and CD4 and CD56 in groups M and T compared with group K (Pr0.049). Conclusions: IV morphine, tramadol, and ketorolac suppressed stress and immune responses. Ketorolac was the least immunosuppressive among the 3 drugs.

Analgesics had been suspected of impairing various immune functions either directly or indirectly. Our primary objective was to compare the effects of intravenous (IV) morphine, tramadol, and ketorolac on stress and immune responses in patients who underwent modified radical mastectomy. Patients: Sixty patients randomly assigned to receive IV morphine 5mg (group M, n=20), tramadol 100mg (group T, n=20), or ketorolac 60mg (group K, n=20) at the end of surgery. Methods: Serum cortisol, prolactin were measured immediately, 40 minutes, and 24 hours postoperatively. Expressions of peripheral T lymphocytes (CD3+, CD3+CD4+, CD3+CD8+) and natural killer cells (CD3+, CD56+) were measured as percentages of total lymphocytes by flow cytometry immediately, 90 minutes, and 24 hours postoperatively. Results: After 40 minutes, cortisol level increased but prolactin decreased significantly (P=0.001), then both decreased after 24 hours (P=0.001) compared with baseline within the 3 groups. CD3, CD4, CD8, and CD56 significantly decreased at 90 minutes and 24 hours (Pr0.033) compared with baseline in the 3 groups. CD4, CD8, and CD56 significantly decreased in group M, compared with group T and K (Pr0.016) and CD3, CD8, and CD56 in group T compared with group K at 90 minutes (Pr0.024) postoperatively. After 24 hours, CD4, and CD8 decreased in group M compared with group T (Pr0.048) and CD4 and CD56 in groups M and T compared with group K (Pr0.049). Conclusions: IV morphine, tramadol, and ketorolac suppressed stress and immune responses. Ketorolac was the least immunosuppressive among the 3 drugs.

Analgesics had been suspected of impairing various immune functions either directly or indirectly. Our primary objective was to compare the effects of intravenous (IV) morphine, tramadol, and ketorolac on stress and immune responses in patients who underwent modified radical mastectomy. Patients: Sixty patients randomly assigned to receive IV morphine 5mg (group M, n=20), tramadol 100mg (group T, n=20), or ketorolac 60mg (group K, n=20) at the end of surgery. Methods: Serum cortisol, prolactin were measured immediately, 40 minutes, and 24 hours postoperatively. Expressions of peripheral T lymphocytes (CD3+, CD3+CD4+, CD3+CD8+) and natural killer cells (CD3+, CD56+) were measured as percentages of total lymphocytes by flow cytometry immediately, 90 minutes, and 24 hours postoperatively. Results: After 40 minutes, cortisol level increased but prolactin decreased significantly (P=0.001), then both decreased after 24 hours (P=0.001) compared with baseline within the 3 groups. CD3, CD4, CD8, and CD56 significantly decreased at 90 minutes and 24 hours (Pr0.033) compared with baseline in the 3 groups. CD4, CD8, and CD56 significantly decreased in group M, compared with group T and K (Pr0.016) and CD3, CD8, and CD56 in group T compared with group K at 90 minutes (Pr0.024) postoperatively. After 24 hours, CD4, and CD8 decreased in group M compared with group T (Pr0.048) and CD4 and CD56 in groups M and T compared with group K (Pr0.049). Conclusions: IV morphine, tramadol, and ketorolac suppressed stress and immune responses. Ketorolac was the least immunosuppressive among the 3 drugs.

Analgesics had been suspected of impairing various immune functions either directly or indirectly. Our primary objective was to compare the effects of intravenous (IV) morphine, tramadol, and ketorolac on stress and immune responses in patients who underwent modified radical mastectomy. Patients: Sixty patients randomly assigned to receive IV morphine 5mg (group M, n=20), tramadol 100mg (group T, n=20), or ketorolac 60mg (group K, n=20) at the end of surgery. Methods: Serum cortisol, prolactin were measured immediately, 40 minutes, and 24 hours postoperatively. Expressions of peripheral T lymphocytes (CD3+, CD3+CD4+, CD3+CD8+) and natural killer cells (CD3+, CD56+) were measured as percentages of total lymphocytes by flow cytometry immediately, 90 minutes, and 24 hours postoperatively. Results: After 40 minutes, cortisol level increased but prolactin decreased significantly (P=0.001), then both decreased after 24 hours (P=0.001) compared with baseline within the 3 groups. CD3, CD4, CD8, and CD56 significantly decreased at 90 minutes and 24 hours (Pr0.033) compared with baseline in the 3 groups. CD4, CD8, and CD56 significantly decreased in group M, compared with group T and K (Pr0.016) and CD3, CD8, and CD56 in group T compared with group K at 90 minutes (Pr0.024) postoperatively. After 24 hours, CD4, and CD8 decreased in group M compared with group T (Pr0.048) and CD4 and CD56 in groups M and T compared with group K (Pr0.049). Conclusions: IV morphine, tramadol, and ketorolac suppressed stress and immune responses. Ketorolac was the least immunosuppressive among the 3 drugs.