“
“Acinar cell carcinomas (ACCs) are a rare pancreatic tumor group with no standardized treatment.
selleck kinase inhibitor The aim of the study is to analyze the clinical and pathologic characteristics of our series and to review the current literature.
Retrospective review of prospectively collected data from 1990 to 2007 included patients who underwent pancreatic resection for histologically proven ACCs. All specimens of ACC were rereviewed by an expert pathologist. Follow-up was updated to October 2009. A literature search was performed by Pubmed and COCHRANE library.
Among 1,210 patients who underwent pancreatic resection, we identified nine ACCs. R0 resection was possible for all but one R1. We had no major complications and no mortality. All nine cases were diagnosed as pure ACCs. Five patients received adjuvant chemotherapy. Median overall survival was 31 months, while median disease-free survival was 18 months. All patients developed liver metastases, requiring modification of chemotherapeutic schema, radiofrequency ablation techniques, or reiterate surgery. Currently, only one patient is alive without evidence of disease 85 months after pancreatic resection. One patient is
alive 52 months after operation, with evidence of recurrent disease.
ACC represents a rare solid tumor of the pancreas. Prognosis is dismal, although, compared to the more common ductal adenocarcinoma, Selleck FK228 survival appears to be longer. Patients with metastatic disease might benefit from aggressive multimodality treatments.”
“Purpose: The aim of our study was to evaluate the outcomes of retrograde intrarenal surgery (RIRS) in elderly patients with stones of moderate size.
Patients and Methods: Between September 2008 and June 2011, a total of 28 patients over 65 years of age with single renal stones that measured 1.5 to 3 cm were treated with RIRS. The outcomes of these patients were compared with those of the patients who underwent percutaneous nephrolithotomy (PCNL) using matched-pair analysis (1: 1 scenario). The matching parameters were the size and location of the stone as well as age, sex, body mass index, degree of hydronephrosis,
presence of previous shockwave check details lithotripsy, and open surgery. SPSS version 16 was used for statistical analysis.
Results: Stone-free rates after a single procedure were achieved in 82.1% of patients for the RIRS and 92.8% of patients for the PCNL group. The second flexible ureterorenoscopy procedure was performed for five patients in the RIRS group. Finally, stone-free rates during the third month of the follow-up period were 92.8% in the RIRS group and 96.4% in the PCNL group. The mean operative time per patient was 64.5 +/- 20.9 minutes in the RIRS group after a total of 33 procedures, while it was 40.7 +/- 10.7 minutes in the PCNL groups (P < 0.0001). The overall complication rates for the RIRS and PCNL groups were 7.1% and 10.7%, respectively.