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Sphincter Saving Surgeries for Locally Advanced Low Rectal Cancer after Neoadjuvant Chemoradiation

Research Abstract
Background: Rectal cancer accounts for the largest distribution within one anatomical region of the large bowel, with approximately one third of all CRC located within the rectum. The Golden standard treatment of primary rectal cancer is curative surgical resection; however, a fine balance remains between disease cure and restoration of gastrointestinal continuity. Combined modality has proven efficacy in many malignant tumors with advantage of organ preservation. Methods: Forty nine (49) patients with low rectal carcinoma were included in a prospective study, between Jan 2007 and Jan 2012. Preoperative chemoradiation was administrated to all patients and subjected to different techniques of sphincter saving surgery. Stage I and Stage IV disease at diagnosis were excluded from the study. Results: Forty nine patients were included in the study. 27 (55%) patients were male and 22 (45%) were female; the age ranges from 23 years to 70 years with the median age 46 years. The main presenting symptoms were bleeding per rectum and tenesmus, Stage II 18 patients (36.7%), stage III 31 patients (63.3%). Complete clinical and pathological response in 3 patients (6%), and complete clinical response with only microscopically residual carcinoma in 20 patients (41%), partial re- sponse in 18 patients (36.7%), and no significant response in 8 patients (16%) 7 from 8 were mucoid carcinoma. Low anterior resection (LAR) in 22 patients (44.9%), Hartman’s procedure in 4 patients (8.1%), Coloanal pull-through (COP) was done in 19 patients (38.9%) and perineal colostomy in 4 patients (8.1%). For patients with colo-anal pull-through technique complete dehiscent and retraction observed in 2 cases, Major leakage in one case, stenosis in 4 cases. Conclusion: There is tendency of colorectal cancers to affect younger groups. Most patients presented in advanced stage. Neadjuvant chemo radiation is an excellent tool in sphincter saving surgery. Coloanal pull-through technique is not a widely spread technique for low rectal cancer with good oncological safety and acceptable functional outcome.
Research Authors
Mohamed A. E. Salem1*, Hamza A. Hamza2, Gamal Amira3, Abeer E. Ibrahim4, Ahmed A. S. Salem1
Research Journal
Journal of Cancer Therapy, 2013, 4, 1228-1235
Research Member
Research Rank
1
Research Vol
4, 1228-1235 http://dx.doi.org/10.4236/jct.2013.47143 September 2013
Research Year
2013

Sphincter Saving Surgeries for Locally Advanced Low Rectal Cancer after Neoadjuvant Chemoradiation

Research Abstract
Background: Rectal cancer accounts for the largest distribution within one anatomical region of the large bowel, with approximately one third of all CRC located within the rectum. The Golden standard treatment of primary rectal cancer is curative surgical resection; however, a fine balance remains between disease cure and restoration of gastrointestinal continuity. Combined modality has proven efficacy in many malignant tumors with advantage of organ preservation. Methods: Forty nine (49) patients with low rectal carcinoma were included in a prospective study, between Jan 2007 and Jan 2012. Preoperative chemoradiation was administrated to all patients and subjected to different techniques of sphincter saving surgery. Stage I and Stage IV disease at diagnosis were excluded from the study. Results: Forty nine patients were included in the study. 27 (55%) patients were male and 22 (45%) were female; the age ranges from 23 years to 70 years with the median age 46 years. The main presenting symptoms were bleeding per rectum and tenesmus, Stage II 18 patients (36.7%), stage III 31 patients (63.3%). Complete clinical and pathological response in 3 patients (6%), and complete clinical response with only microscopically residual carcinoma in 20 patients (41%), partial re- sponse in 18 patients (36.7%), and no significant response in 8 patients (16%) 7 from 8 were mucoid carcinoma. Low anterior resection (LAR) in 22 patients (44.9%), Hartman’s procedure in 4 patients (8.1%), Coloanal pull-through (COP) was done in 19 patients (38.9%) and perineal colostomy in 4 patients (8.1%). For patients with colo-anal pull-through technique complete dehiscent and retraction observed in 2 cases, Major leakage in one case, stenosis in 4 cases. Conclusion: There is tendency of colorectal cancers to affect younger groups. Most patients presented in advanced stage. Neadjuvant chemo radiation is an excellent tool in sphincter saving surgery. Coloanal pull-through technique is not a widely spread technique for low rectal cancer with good oncological safety and acceptable functional outcome.
Research Authors
Mohamed A. E. Salem1*, Hamza A. Hamza2, Gamal Amira3, Abeer E. Ibrahim4, Ahmed A. S. Salem1
Research Department
Research Journal
Journal of Cancer Therapy, 2013, 4, 1228-1235
Research Rank
1
Research Vol
4, 1228-1235 http://dx.doi.org/10.4236/jct.2013.47143 September 2013
Research Year
2013

Outcome of young age at diagnosis of breast cancer in South Egypt

Research Abstract
Background: Incidence of breast cancer in patients 40 years old accounts for 20% of the total breast cancer patients in Egypt. Several studies considered young age as bad prognostic factor .This study was conducted to evaluate the differences in survival between age groups below and above the age of 40. Methods: 170 patients 40 years and 500 patients ≥40 years were evaluated retrospectively to assess the differences in disease free survival (DFS) and overall survival (OS) between age groups after adjustment of other risk factors like stage, lymph node status, tumor size, and hormonal positivity. Results: After median follow up of 49 months, there was no significant difference between the 2 age groups with regards to DFS p= 0.6 and OS P=0.7 and there was no significant difference between the 2 groups when we stratified the patients according to stages, hormonal status and number of metastatic lymph nodes. However, we found significant increase in local recurrence after breast conserving surgery in patients 40 years compared to patients ≥40 years. Conclusion: Patients 40 years exhibited more often at advanced stage and large tumors size compared to patients ≥ 40 years; However, there was no significant difference in DFS and OS when we adjusted other risk factors. On the other hand, our analysis revealed that age 40 years can be considered as an adverse prognostic factor for the locoregional failure after breast conserving surgery.
Research Authors
Abeer. Ibrahim1, Mohamed .Abo elmaged. Salem2, Rehab. Hassan1
Research Department
Research Journal
Gulf journal of clinical oncology issue 15 2014
Research Rank
1
Research Vol
issue 15 2014
Research Year
2014

Sphincter Saving Surgeries for Locally Advanced Low Rectal Cancer after Neoadjuvant Chemoradiation

Research Abstract
Background: Rectal cancer accounts for the largest distribution within one anatomical region of the large bowel, with approximately one third of all CRC located within the rectum. The Golden standard treatment of primary rectal cancer is curative surgical resection; however, a fine balance remains between disease cure and restoration of gastrointestinal continuity. Combined modality has proven efficacy in many malignant tumors with advantage of organ preservation. Methods: Forty nine (49) patients with low rectal carcinoma were included in a prospective study, between Jan 2007 and Jan 2012. Preoperative chemoradiation was administrated to all patients and subjected to different techniques of sphincter saving surgery. Stage I and Stage IV disease at diagnosis were excluded from the study. Results: Forty nine patients were included in the study. 27 (55%) patients were male and 22 (45%) were female; the age ranges from 23 years to 70 years with the median age 46 years. The main presenting symptoms were bleeding per rectum and tenesmus, Stage II 18 patients (36.7%), stage III 31 patients (63.3%). Complete clinical and pathological response in 3 patients (6%), and complete clinical response with only microscopically residual carcinoma in 20 patients (41%), partial re- sponse in 18 patients (36.7%), and no significant response in 8 patients (16%) 7 from 8 were mucoid carcinoma. Low anterior resection (LAR) in 22 patients (44.9%), Hartman’s procedure in 4 patients (8.1%), Coloanal pull-through (COP) was done in 19 patients (38.9%) and perineal colostomy in 4 patients (8.1%). For patients with colo-anal pull-through technique complete dehiscent and retraction observed in 2 cases, Major leakage in one case, stenosis in 4 cases. Conclusion: There is tendency of colorectal cancers to affect younger groups. Most patients presented in advanced stage. Neadjuvant chemo radiation is an excellent tool in sphincter saving surgery. Coloanal pull-through technique is not a widely spread technique for low rectal cancer with good oncological safety and acceptable functional outcome.
Research Authors
Mohamed A. E. Salem1*, Hamza A. Hamza2, Gamal Amira3, Abeer E. Ibrahim4, Ahmed A. S. Salem1
Research Department
Research Journal
Journal of Cancer Therapy, 2013, 4, 1228-1235
Research Member
Research Rank
1
Research Vol
4, 1228-1235 http://dx.doi.org/10.4236/jct.2013.47143 September 2013
Research Year
2013

Self-Expandable Metal Stents in Palliation of Inoperable Esophageal
& Gastro-Oesophageal Carcinoma

Research Authors
Ahmed A. S. Salem1
, Ashraf Al-yamany2
, Esam Abd-el Mohsen3
& Amen H. Zaky2
Research Department
Research Journal
Cancer and Clinical Oncology Vol. 1, No. 1; 2012
Research Member
Research Rank
1
Research Year
2012

Rearrangement of the Myeloid/Lymphoid Leukemia
Gene in Therapy-Related Myelodysplastic Syndrome
in Patients Previously Treated with Agents Targeting
DNA Topoisomerase II

Research Authors
Eman Mosad

Madleen Abdou
Amen Hamdy Zaky

Research Department
Research Journal
Oncology 2012;83:128–134
Research Member
Research Rank
1
Research Year
2012
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