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Poster 2: Posterpräsentationen 2
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Präsentationen | ||
Metachronic lung metastasis following operated PDAC of the pancreatic head. Is surgery still offering a therapeutic possibility ? Chronology of a success through an aggressive surgical treatment sequence. 1Klinik Oberwart, Abteilung für Allgemein-, Thorax-, Viszeral- und Gefäßchirurgie Österreich; 2Privatklinik Villach, Österreich Einleitung/Background Although therapeutic recommendations for the surgical treatment of synchronously occurring liver metastases in the treatment of PDAC are existing, a metachronous metastasis after resection of the primum continues to pose major challenges for the treating physicians. Even if large-scale case-series and randomized trials on this topic are missing, small case series and case reports already show a benefit for resections of metachronous isolated lung metastases. On the basis of a case study, we are presenting an (aggressive) surgical therapy approach which led to a significant OAS increase. Material and methods: We are presenting the case of a 79-year-old female patient with newly emerged pulmonary nodules in both lungs 42 months after initial surgical treatment of neoadjuvant treated PDAC. The nodules were surgically removed (with histological confirmation of the PDAC metastasis). After another 12 months, the patient showed new nodules in the right lung which were treated with microwave ablation. 27 months after this treatment, we detected another three foci in the left lung which were surgically removed. (with the histological confirmation of PDAC metastases). Result: After this last treatment the patient is now free of signs of disease Conclusion: Despite the lack of corresponding literature recommendations, the clinical oncological course, in this case, is justifying the repeated surgical procedures. This case underlines that there must be an opinionated and willful surgical representative in the tumor board. Molecular patterns, laboratory values and clinical parameters which help to identify patients who are more likely to benefit from such therapies are desirable. Is the K-ras mutation status a prognostical tool to predict metastasis formation for CRC patients?? 1Klinik Oberwart, Abteilung für Allgemein-, Thorax-, Viszeral- und Gefäßchirurgie, Österreich; 2Klinikum Augsburg, Abteilung für Onkologie Introduction CRC is the third most common tumor entity in the Western world. New CRC cases will increase from 1.9 million to 3.2 million untill 2040. Although environmental factors are an increasing risk factor today, genetic aberrations play a key role in CRC development and tumorigenesis. In particular, the K-ras oncogene seems to be of immense importance as a "gatekeeper" of the adenoma-carcinoma sequence. Whether the mutation status per se has a prognostic power for overall survival or leeds to a higher probability of metastatic formations remains unclear. Methods The aim of our study was to find out whether the K-ras mutation status itself influences the probability for metastatic formations or not. We performed a retrospective workup of over 600 patients treated in three centers. Primarily, the distributions were represented by means of descriptive statistics. Statistical analyses were then used to show a difference in cancer-specific survival and metastasis formation for patients with or without K-ras mutation. Results The hypothesis that K-RAS status affects the cancer-specific survival was evaluated and rejected using Kaplan-Meier curves and log rank tests. Neither the univariate nor the multivariate analysis showed a significant difference. The K-ras mutation status showed a slightly higher metastasis rate in the case of right-sided tumors. Conclusion With our study results, the prognostic significance of K-ras mutation status for the distribution of metastasis can be refuted. Only for the subgroup of right-sided carcinomas with a K-ras point mutation on codon thirteen, there seems to be a slightly higher probability of metastasis. Immunological impact of Axl/TGF-beta signaling in hepatocellular carcinoma 1Center for Cancer Research, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; 2Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic, Rochester, MN, USA; 3Department of Surgery, HPB Center, Viennese Health Network, Clinic Favoriten and Sigmund Freud Private University, Vienna, Austria; 4Max Perutz Labs, Department of Chromosome Biology, Center for Integrative Bioinformatics Vienna, University of Vienna, Vienna, Austria Einleitung/Background Methoden/Methods Ergebnisse/Results Zusammenfassung/Conclusion Minimally Invasive Esophagectomy - Clinical Implementation of a new Technique Universitätsklinik für Visceral-, Transplantations- und Thoraxchirurgie, Medizinische Universität Innsbruck Background: Methods: Results: Conclusions: A rare case of rectum wall metastasis in pancreatic cancer - a case report LK Korneuburg, Österreich Einleitung/Background Up to 40% of patients at the initial diagnosis of pancreatic cancer are without secondary blastomas. These occur more often in the liver and peritoneum, rarely in the adrenal glands and bones. There are only 10 case reports in the English literature describing metastasis to the colo-rectum. Methoden/Methods An 82-year-old patient presented to the emergency room with abdominal pain, nausea, vomiting and stool retention. The CT scan showed the picture of a mechanical colon ileus. The patient had been treated oncologically for UICC stage IV pancreatic adenocarcinoma of the pancreatic tail. Metastases in the liver segment VII and in the rectum had been radiologically and histologically confirmed, whereas a metastasis in the stomach had been described only radiologically. Since the initial diganosis the patient had received palliative chemotherapy which stabilized the disease for 19 months. A laparotomy with deep anterior rectum resection and creation of a stoma of the descending colon was performed. Histological workup confirmed the metastasis. The postoperative course was uneventful, palliative chemotherapy was continued and the patient lived another 8 months. Ergebnisse/Results Colo-rectal metastasis from pancreatic carcinoma has rarely been described. The most commopn location of secondary blastomas were the sigmoid colon and the transverse colon. The mean survival rate was 7 months after the initial diagnosis, our patient survived for 27 months. Zusammenfassung/Conclusion This is the 11th case of colon metastasis from pancreatic cancer in the English literature. It is important to consider metastasis if a colonic mass occurs in the presence of pancreatic cancer. |