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Neoadjuvant treatment in non-metastatic pancreatic cancer (PaC) has the theoretical advantages of downstaging the tumor, sterilizing any present systemic undetectable disease, selecting patients for surgery and administering therapy to each patient. The aim of this systematic review is to analyze the state of the art on neoadjuvant protocols for non-metastatic PaC. A literature search over the last 10 years was conducted, and papers had to be focused on resectable, borderline resectable (BLR) or locally advanced (LA) histo- or cytologically proven PaC; to be prospective studies or prospectively collected databases; to report percentage of protocol achievement and survival data at least in an intention-to-treat (ITT) analysis. Twelve studies were eligible for systematic review. Studies included a total of 624 patients: 248 resectable, 268 BLR, 71 LA and 37 non-specified. All studies were included for meta-analysis. ITT overall survival (OS) was 16.7 months (95% CI 15.16-18.26 months); for resected patients OS was 22.78 months (95% CI 20.42-25.16), and for eventually non-resected patients it was 9.89 months (95% CI 8.84-10.96). Neoadjuvant approaches for resectable, BLR and LA PaC are spreading. Outcomes tend to be better outside an RCT context, but strong evidences are lacking. Actually such treatments should be performed only in a randomized clinical trial setting. [ABSTRACT FROM AUTHOR]

Background Multivisceral resections combined with pancreatectomy have been proposed in selected patients with tumor invasion into adjacent organs, in order to allow complete tumor resection. Some authors have also reported multivisceral resection combined with metastasectomy in very selected cases. The utility of this practice is debated. The aim of the review is to compare the postoperative results and survival of pancreatectomies combined with multivisceral resections with those of standard pancreatectomies. Methods A systematic literature search was performed to identify all studies published up to February 2017 that analyzed data of patients undergoing multivisceral and standard pancreatectomies. Clinical effectiveness was synthetized through a narrative review with full tabulation of results. Results Three studies were retrieved, including 713 (80%) patients undergoing standard pancreatectomies and 176 (20%) undergoing multivisceral resections (MVR). Postoperative morbidity ranged from 37% to 50% after standard resections and from 56% to 69% after MVR. In-hospital mortality ranged from 4% after standard pancreatectomies to 10% after MVR. Median survival ranged from 20 to 23 months in standard resections and from 12 to 20 months after MVR, without significant differences. Discussion The current literature suggests that multivisceral pancreatectomies are feasible and may increase the number of completely resected patients. Morbidity and mortality are higher than after standard pancreatectomies, and these procedures should be reserved to selected patients in referral centers. Further studies on the role of neoadjuvant therapy in this setting are advisable. [ABSTRACT FROM AUTHOR]

Background: Few data are available regarding metachronous liver metastases from gastric cancer. We aimed to identify data regarding the survival of these patients, considering the chosen treatment, with particular attention to the role of surgery., Materials and Methods: A systematic review was carried out from 2000 to 2020. We chose articles reporting data from patients with metachronous liver metastases after curative gastrectomy. Data regarding 1-, 3- and 5-year overall survival were analyzed., Results: Survival was improved in patients eligible for surgery (absence of extrahepatic non-curative factors and feasible complete macroscopic removal of liver deposits, i.e., H1 and H2 liver involvement, metastases less than 5 cm in size) when curative liver resection was performed, with a median overall survival of 24 months (vs. 3.13 in patients treated with chemotherapy). N Status, extent and maximum size of liver metastases, and hepatic surgical treatment were identified as independent prognostic factors., Conclusion: Selected patients with metachronous liver metastases from gastric cancer may benefit from multimodal 'aggressive' treatment. When hepatic involvement is limited (H1 and H2) and the size of metastases less than 5 cm, surgery was shown to increase survival., (Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: Primary colic lymphoma represents a rare disease accounting for the 0.2%-0.6% of all large-bowel malignancies. We here report a case of diffuse large B-cell lymphoma presenting as a left colic stenosis in a patient who had undergo renal transplant 23 years before., Case Report: A 67-years old man presented with recurrent abdominal pain, distension, nausea and constipation since 3 weeks. His past medical history included hepatic and renal polykystose with renal transplant 23 years before. Colonoscopy revealed a non-surmountable inflammatory left colic stenosis at 55 cm from the anal verge. Biopsies demonstrated inflammatory colic mucosa without neoplastic cells. Non-enhanced CT scan and CT virtual colonoscopy were performed, showing a left colon circumferential thickening of 4 cm. Laparoscopic left colectomy was performed to treat the colic obstructive syndrome and to have complete specimen analysis. After Pathological analysis and Immunohistochemistry the diagnosis of diffuse large B cell lymphoma was established. The resection was R0. The postoperative course was uneventfully., Conclusion: Large B-cell lymphoma represents a rare case of bowel tumor. However it has to be considered in the differential diagnosis of colic stenosis in immunosuppressed patients as transplant recipients., Key Words: Colorectal lymphoma, Diffuse large B-cell lymphoma, Immunosuppressed patients.

Introduction: CgA and testosterone are two serum markers that may be involved in prostate cancer. The objective of this study was to evaluate the relationship of testosterone and CgA to grades and stages of prostate cancer, particularly whether low-serum testosterone and high-serum CgA are associated with more aggressive grades, and higher pathological stages of the disease., Methods: This perspective study included 121 men (Caucasian only) presenting with -newly-diagnosed, untreated prostate cancer. All the patients underwent radical prostatectomy., Results: We subdivided the sample into two homogeneous groups, Group A with Gleason score ≤7 (3+4), and Group B with Gleason score ≥7 (4+3). Low testosterone (< 3 ng/ml) was most common among the members of Group B 80 % versus 12.6 % of Group A (p = 0.001). At the same time, elevated CgA (> 80 ng/ml) was present for a rate of 72 % in Group B, 28.1% in the Group A ( p = 0.001). The multivariate analysis we used revealed that low-serum testosterone and high-serum CgA are associated with higher pathological stages of the disease (p = 0.001)., Conclusion: The principal findings of this investigation were that low testosterone is correlated with elevated CgA levels, and these two parameters are associated with more aggressive grades and higher pathological stages of prostatic adenocarcinoma., Key Words: Chromogranin A, Prostate cancer, Risk factor for prostate cancer, Testosterone.