Bivalent HPV vaccine has cross-protective effect, but could wane over time

The bivalent vaccine for human papillomavirus types 16 and 18 appears to be more efficacious against outcomes associated with nonvaccine types 31, 33, and 45 than its quadrivalent counterpart, show results of a systematic review and meta-analysis.

via Med Wire News

Age, not just comorbidity, affects breast cancer surgery rates in elderly

The high rates of elderly UK women with breast cancer who do not undergo surgical treatment are not entirely explained by the presence of comorbidities, report UK researchers.

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Prognostic significance of solitary lymph node metastasis in patients with squamous cell carcinoma of middle thoracic esophagus

Background: The aim of this study is to compare clinical outcomes between patients with solitary lymph node metastasis and node-negative (N0) patients in squamous cell carcinoma of the middle thoracic esophagus. Methods: A series of 135 patients with squamous cell carcinoma of the middle thoracic esophagus were retrospectively investigated. There were 33 patients with solitary lymph node metastasis and 102 N0 patients. Skip metastasis in 33 patients with solitary lymph node metastasis was defined according three criteria: Japanese Society for Esophageal Disease (JSED), American Joint Commission on Cancer (AJCC), and the anatomical compartment. Results: In 33 patients with solitary lymph node metastasis, skip metastasis was shown in 13, 23, and 8 patients according JSED, AJCC and anatomical compartment respectively. The 5-year survival rates for N0 patients and patients with solitary lymph node metastasis were 58 % and 32 % respectively (P =0.008). Multivariate analysis revealed that skip metastasis was not an independent prognostic factor. Conclusions: For patients with middle thoracic esophageal squamous cell carcinoma, solitary lymph node metastasis has a negative impact on survival compared with N0 disease; skip metastasis, however, is comparable to N0 diseases in predicting prognosis.

via World Journal of Surgical Oncology

Rectosigmoid adenocarcinoma revealed by metastatic anal fistula. The visible part of the iceberg: a report of two cases with literature review

Colonic adenocarcinoma revealed by metastatic anorectal fistula is rare, with few cases in the literature. Such lesions can be taken for the more common manifestation of a benign perianal abscess or fistula. Once diagnosed, the management of such conditions remains controversial. We herein report two cases with perianal fistula that were subsequently found to have developed perianal adenocarcinoma on biopsy. Further colonic investigation revealed a rectosigmoid adenocarcinoma. Histology and immunohistochemical staining was identical in both primary and metastatic tumors. Preoperative chemoradiation with further rectal low anterior resection and local excision of metastatic anal fistula was performed. There is no recurrence after 3 years of follow-up.

via World Journal of Surgical Oncology

BMI concerns raised for childhood stem cell transplantation survivors

Childhood survivors of hematologic malignancies treated with allogeneic hematopoietic stem cell transplantation should undergo long-term monitoring of their body mass index and lean body mass, US researchers recommend.

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Routine screening influences outcomes in prostate cancer after surgery

Men who undergo radical prostatectomy for a tumor that was detected by screening show better long-term outcomes than their peers who undergo the surgery after opportunistic diagnosis, study results show.

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Isolated Crohn's disease of the esophagus with esophago-mediastinal fistula formation

Isolated Crohn's disease of the esophagus is rare, and accurate diagnosis and treatment in its early course are difficult. Most cases are often found very late, when severe strictures or other complications have occurred. We report the case of a male 60-year-old patient with complaints of progressive dysphagia for more than two months and the sudden appearance of heartburn for seven consecutive days. Clinical examination revealed severe esophageal stricture with a suspected fistula and mediastinitis. The patient received a successful esophagectomy. The resected specimen and pathological results confirmed a deep linear ulcer, chronic and noncaseating granulomatous inflammation, as well as a circular stricture of the esophagus with fistula into the mediastinum due to isolated esophageal Crohn's disease.

via World Journal of Surgical Oncology