Development and validation of a gene expression-based Breast Cancer Purity Score.

The prevalence of malignant cells in clinical specimens, or tumour purity, is affected by both intrinsic biological factors and extrinsic sampling bias. Molecular characterization of large clinical cohorts is typically performed on bulk samples; data analysis and interpretation can be biased by tumour purity variability. Transcription-based strategies to estimate tumour purity have been proposed, but no breast cancer specific method is available yet.

Breast cancers with high proliferation and low ER-related signalling have poor prognosis and unique molecular features with implications for therapy.

Background: Luminal breast cancers with high proliferation (MKS) and low ER-related signalling (ERS) have a poor prognosis. We investigated treatment responses and molecular features of MKS/ERS tumours to inform potential therapies.

Methods: Gene expression data from patients who received neoadjuvant chemotherapy (NAC) without (MDACC, N = 199) or with pembrolizumab (I-SPY2, N = 40), or endocrine therapy (NET) without (POETIC, N = 172) or with palbociclib (NeoPalAna, N = 32) were analyzed to assess treatment response by MKS/ERS-subgroups.

Pan-cancer analysis of antibody-drug conjugate targets and putative predictors of treatment response.

Background: Antibody-drug conjugates (ADCs) are a rapidly expanding class of compounds in oncology. Our goal was to assess the expression of ADC targets and potential downstream determining factors of activity across pan-cancer and normal tissues.

Materials And Methods: ADCs in clinical trials (n = 121) were identified through ClinicalTrials.

Concomitant ventral hernia repair and bariatric surgery: a retrospective analysis from a UK-based bariatric center.

Background: Ventral hernias (VH) are frequently encountered in patients with morbid obesity. Concomitant ventral hernia repair (VHR) and bariatric surgery (BS) is practiced but still controversial. Wound-related complications (seroma, hematoma, wound infection) and hernia recurrence rates are possible inhibitor factors.

Incidental oesophageal leiomyoma during laparoscopic Roux-en-Y gastric bypass: finding the unexpected does not affect outcomes.

Most bariatric procedures are now performed laparoscopically. Here, we describe a case of incidental oesophageal leiomyoma found during laparoscopic Roux-en-Y gastric bypass (LRYGB). To our knowledge, this is the first such case reported.

Is there a role for enhanced recovery after laparoscopic bariatric surgery? Preliminary results from a specialist obesity treatment center.

Background: There has been a relative lack of research on the effect of enhanced recovery in the context of morbid obesity surgery.

Objectives: To determine if the application of enhanced recovery after surgery (ERAS) principles can contribute to reduce postoperative hospital length of stay after bariatric surgery, controlling for other factors that may influence safe discharge on the first postoperative day.

Setting: University teaching hospital, United Kingdom.

Combined endoscopic-laparoscopic T-tube insertion for the treatment of staple-line leak after sleeve gastrectomy: a simple and effective therapeutic option.

Background: Management of staple-line leak after laparoscopic sleeve gastrectomy (LSG) remains controversial and matter of debate. Transforming a leak into a controlled fistula by insertion of a T-tube is a viable option. To minimize surgical dissection, and to facilitate identification of the leak site and insertion of the T-tube, we have developed a combined endoscopic-laparoscopic T-tube (ELT-t) insertion technique.

Parathyroid carcinoma: the importance of high clinical suspicion for a correct management.

Background. Parathyroid carcinoma is an infrequent clinical entity whose diagnosis is very challenge. Indeed a pre-operative or intraoperative diagnosis of parathyroid carcinoma is reported in less than half cases described in the literature.

Radionuclide evaluation of the lower gastrointestinal tract.

This review outlines the technical aspects and diagnostic performance parameters of nuclear medicine procedures used on patients with disorders of the lower gastrointestinal tract, with the exclusion of techniques using tumor-seeking radiopharmaceuticals. Chronic disorders of the lower gastrointestinal tract often reduce the quality of life because of discomfort from constipation or diarrhea. Five classes of radionuclide procedures are used to characterize these disorders: transit scintigraphy, searches for ectopic gastric mucosa in Meckel's diverticulum, scintigraphy of active inflammatory bowel disease, scintigraphic defecography, and scintigraphy to detect sites of gastrointestinal bleeding.

Efficacy of Nissen fundoplication versus medical therapy in the regression of low-grade dysplasia in patients with Barrett esophagus: a prospective study.

Objective: The aim of this study is to compare the effect of medical and surgical treatment on the history of patients with Barrett esophagus (BE) and histologic evidence of low-grade dysplasia (LGD).

Summary Background Data: BE is a complication of severe gastroesophageal reflux. It is considered a major risk factor for esophageal adenocarcinoma, which may develop through stages from nondysplastic metaplasia to dysplasia (LGD and high-grade dysplasia).

The Blue DRAGON--a system for monitoring the kinematics and the dynamics of endoscopic tools in minimally invasive surgery for objective laparoscopic skill assessment.

Minimally invasive surgeiy (MIS) involves a multi-dimensional series of tasks requiring a synthesis between visual information and the kinematics and dynamics of the surgical tools. Analysis of these sources of information is a key step in mastering MIS surgery but may also be used to define objective criteria for characterizing surgical performance. The BIueDRAGON is a new system for acquiring the kinematics and the dynamics of two endoscopic tools along with the visual view of the surgical scene.

Radionuclide gastroesophageal motor studies.

Disorders of the upper digestive tract have a high impact on modern society, in terms of both direct and indirect health care costs and of social burden. The most common presenting symptom is either dysphagia or dyspepsia. Discriminating specific diagnoses within this wide group of diseases requires sound clinical judgment and application of procedures to distinguish organic from nonorganic disease and to further characterize the functional or motility disturbance of nonorganic diseases.

Does stapled functional end-to-end anastomosis affect recurrence of Crohn's disease after ileocolonic resection?

Background/aims: Crohn's disease is characterized by a high incidence of perianastomotic recurrence after ileocolonic resection. The influence of anastomotic configuration on the incidence of reoperation was evaluated in patients undergoing resection for Crohn's disease.

Methodology: 106 patients affected by ileocolonic Crohn's disease were divided in two groups: group I with a hand-sewn end-to-side or side-to-side isoperistaltic anastomosis (30 patients) and group II with functional end-to-end anastomosis made with linear staplers (76 patients).

The use of small intestine submucosa in the repair of paraesophageal hernias: initial observations of a new technique.

Background: Recent reports suggest that when laparoscopy is used to repair paraesophageal hernias recurrence rates reach 20% to 40%. Tension-free hernia closure with synthetic mesh reduces recurrence but occasionally results in esophageal injury. We hypothesized that reinforcement of the hiatal closure with small intestine submucosa (SIS) mesh, in some unusually large hernias, might reduce recurrence rates without causing injury to the esophagus.

Expectations and outcomes when moving from open to laparoscopic adrenalectomy: multivariate analysis.

Various authors have suggested that laparoscopic adrenalectomy (LA) leads to better surgical outcomes than open surgery. The debate is still open, however, and indications and limitations of minimally invasive surgery have not been completely established. The objective of our study was to compare surgical outcomes of LA and open adrenalectomy (OA), using multivariate analysis to adjust for potential confounding factors (e.

Outcomes of laparoscopic Nissen fundoplication in patients with the "hypercontractile esophagus".

Hypothesis: To determine if a hypercontractile esophagus, manifested by high-amplitude peristaltic contractions (HAPCs) or hypertensive lower esophageal sphincter (HLES), affects the outcome of antireflux surgery.

Design: Case series. Prospectively maintained database.