Tag Archives: carcinoma

Survival Analysis after Cephalic Pancreatoduodenectomy for Carcinoma of the Ampulla of Vater

Tudor A1, Molnar C1, Man A2, Tudor Bianca2, Roşca C3, Copotoiu C4

1 Department of Anatomy and Embriology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Microbiology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Surgery Clinic 1, Emergency County Hospital, Tîrgu Mureş, Romania
4 Department of Surgery, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Background: Ampulla Vater carcinoma is a rare condition, having the best prognosis in periampullary malignant tumors. The purpose of this paper is to analyze the factors involved in long term survival after duodenopancreatectomy for carcinoma of the ampulla of Vater.
Material and method: This paper is a retrospective study across a 15-year period (1995–2009), during which 130 interventions for ampullary vaterian carcinoma were performed in Surgery Clinic I Tîrgu Mureş and Surgery Clinic III Cluj-Napoca. Cephalic pancreatoduodenectomy was performed in 86 cases, and we have obtained informations regarding late postoperative survival in 63 cases. The data was processed in Microsoft Excel, and the statistical analysis was performed with SPSS v. 17 for Windows. The threshold of significance was p <0.05.
Results: Survival at 5 years after cephalic pancreatoduodenectomy, in the group analyzed (63 cases) was 43.1%. We found a higher percentage of survival rate at 5 years for stage T1 tumors (tumor limited to the ampulla of Vater or sphincter of Oddi) – 68.3%, in the absence of regional adenopathies N0 – 68.3%, well differentiated tumors G1 – 90.5%, in tubulo-papillary adenocarcinoma histological type – 66.6%, in patients without lymphovascular invasion – 91.3% and in those without perineural invasion – 82.3%. Multivariate analysis of prognostic factors shows a high risk of death in the presence of lymphovascular invasion (p = 0.0031).
Conclusions: 1. Survival at 5 years after cephalic pancreatoduodenectomy was 43.1%, which is influenced by tumor extension, the presence of regional lymphadenopathy, the histopathological type of tumor, the degree of tumor differentiation, the lymphovascular or perineural invasion. 2. Multivariate analysis of prognostic factors shows that lymphovascular invasion is statistically significant in postoperative survival.

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Tumors of the Oro-Facial System

Biriş Carmen1, Brînzaniuc Klara2, Cerghizan Diana1, Jánosi Kinga1, Kovács Alpárd3

1 Department of Prosthetic Dentistry and Oral Rehabilitation, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Anatomy and Embriology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
3 Dentist in private practice

The increasing number of malignant cases in the oro-facial area represents by their increasing number lately a new problem regarding the treatment and diagnosis. This cases present an increased difficulty of diagnostic and treatment, because they are usually diagnosticated in lately stages. Patients are often unaware of the gravity of their situation due to the lack of specific or almost absent symptomatology.
The incriminated factors and co-factors incriminated in the development of the malignant manifestations are of multiple origins: use of tobacco products, especially associated to alcohol abuse, chronical topic irritation of the oral mucosa, genetic predisposition or some types of viruses (human papilloma virus type 16 and 18 and herpes virus). Also factors like: environmental modifications, age, alimentation or pharmaceutical drug usage can be incriminated for the increasing pathology of the last decades, especially in well developed countries both from Europe and North America.
Our presentation is based on the case of a 61 years old male, showing almost the typical premises of a malignant pathology starting from the evolution of the oral lesion and the general and dental pathology status with the correlation of the objective and subjective examination.
The lesion usually benefits of surgical treatment, followed by radiotherapy and oro-facial reconstruction, that can imply both plastic surgery and prosthetic rehabilitation, as was the case of our patient. Of most importance remains the moment of the prosthetic treatment and its correlation with radiotherapy, regarding the tissue modification that irradiation has on this level.

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Colon Adenomas and Polyps Developing Synchronously, Without Carcinoma

Pap Zsuzsanna1, Dénes L1, Şipos R1, Brînzaniuc Klara1, Pávai Z1, Jung J2

1 Department of Anatomy and Embryology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Pathology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Background: Prevention of colorectal carcinomas is based on early detection and removal of precancerous lesions. Our goal was to perform a comparison between clinicopathological features of adenomas/polyps developed in the presence and in the absence of a colon carcinoma. Materials and methods: We studied a total of 117 colon adenomas and polyps selected from the material of the Pathology Department of the Emergency County Hospital of Tîrgu Mureș. We compared and correlated through statistic analysis the clinicopathological factors, gender, age of the patients, localization, histological type, grade of dysplasia.
Results: 24.6% of A/P develop synchronously with a carcinoma and affect especially women and patients between 50–60 and 70–80 years; these are mainly tubular adenomas, localized more frequently in the left colon. Adenomas and polyps developed without a carcinoma are more frequent in males, in patients between 60–70 years, and are mainly tubulovillous adenomas.
Conclusions: One out of 4 colon carcinomas are associated with one or more precancerous lesions.

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