The rate of colorectal cancer (CRC) has altered. Early-onset CRC patients are increasing, and it is one of the main causes of cancer-related death. Based on epidemiologic change, the CRC screening program needs to be changed. To increase compliance, non-invasive screening techniques are developed. Although CRC survival has increased, the oncologic prognosis of metastatic CRC is remains poor. Even in metastatic CRC, which is the most difficult to treat, attempts are being made to increase the survival rate by active surgical therapy with the creation of chemotherapeutic regimens and targeted treatment based on genomic information. Due to the introduction of aggressive chemotherapy regimens, targeted therapy based on genomic features, and improvements in surgical technique, the role of surgical treatment in metastatic CRC has expanded. Metastatic CRC surgery was indicated for liver, lung, and even peritoneal seeding. Local ablation therapy was also effectively used for liver and lung metastasis. Cytoreductive surgery and intraperitoneal chemotherapy were tried for peritoneal seeding and demonstrated good results in a subgroup of patients, although the right indication was carefully assessed. At the same time, one of the key goals of treatment for CRC was to maintain functional outcomes. Neoadjuvant treatment, in particular, helped rectal cancer patients preserve functional results while maintaining oncologic safety. Rectal cancer organ preservation techniques are now being researched heavily in a variety of neoadjuvant treatment settings, including immunotherapy and whole neoadjuvant therapy. Precision medicine based on patient and disease characteristics is currently being used for the diagnosis and treatment of CRC.
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Brain metastases are a leading cause of morbidity and mortality for patients with systemic cancer and are among the most common intracranial tumors in adults. Its incidence increases as cancer therapies improve, and patients live longer, providing new challenges to the multidisciplinary teams that manage these patients. The contemporary neurosurgical treatment of intracranial metastases has become gradually more complex as the available therapeutic options increase. For the past 50 years, whole brain radiotherapy and systemic corticosteroids have been considered as the standard of care for patients with brain metastases. However, in recent years, stereotactic radiosurgery is spotlighted as an alternative therapeutic modality for these patients because of its relatively short, convenient, and non-invasive treatment course. Stereotactic radiosurgery is a radiation therapy technique in which multiple focused radiation beams intersect over a target, which results in the delivery of highly conformal, high-dose of radiation to the target and minimal radiation to surrounding normal parenchyma. The purpose of this review is to provide an overview of stereotactic radiosurgery as a treatment modality for patients with brain metastases.
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, Chung Nam Kang, Jin Man Wang, Kwon Jae Roh, Hong Suk Kim Metastatic tumors involving the spine cause severe pain and paraplegia. Vertebral body collapse results in spinal collapse results in spinal instability. In order to promote stability and improve pain, anterior fusion with bone cement and posterior fusion with instruments were used. Retrospective study was carried out of 16 cases of the metastatic tumor of the spine in Ewha Womans University Hospital Orthopedic Surgical dept. from Jan. 1982 to Dec. 1988. We have analyzed the results of treatment and obtained following conclusions.
The results were as follows :
1) Of the 16 patients, the ratio of men to women approximately 3:5 and the high incidence was over 5th. decades.
2) According to tumor classification, reproductive tract tumor was in 4 cases(25%), gastric, lung and hepato-biliary tumors in 2 cases each(12%), thyroid tumor in 1 case(7%) unknown origin in 5 cases(31%).
3) The thoracic spine commonly involved in 12 cases(75%).
4) Anterior fusion with bone cement was in 11 cases and posterior fusion with instrument in 4 cases. Both anterior and posterior fusion was in 1 case.
5) In functional results, the ambulation was achieved in 14 cases postoperatively, in 12 cases at 6 months, and 10 cases finally.
6) The surgical treatment was valuable, because the good results were appeared in 62.5% finally with loss of pain.
, Hye-Kyung Jung, Min-Sun Cho, Min-Jin Lee, Myung-Eun Song, Da-Yeon Oh, Ha Eung Song Sunitinib an inhibitor of the vascular endothelial growth factor receptor, is highly effective against renal cell carcinoma and is now widely used in patients with metastatic disease. Gastroesophageal reflux disease (GERD) is rarely reported as a side effect of sunitinib. We report two cases of GERD with upper gastrointestinal bleeding related to sunitinib administration. Both cases responded well to conservative management. Microscopic findings in both cases showed cellular atypia such as hyperchromasia, increases in nuclear size, and multinucleation. The cellular atypia of the squamous mucosa appears to be associated with reparative processes.
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