Background: Few researches have reported the relationship between surgical skill and outcome on gastric cancer surgery. To prevent complication after gastrectomy, we need to identify specific manipulation or techniques that can increase the risk. In the present report, we attempt to identify techniques that directly cause intra-abdominal infectious complications (IAICs).

Methods: This is a study protocol. We planned the multicenter case-control study, where the cases are patients who developed IAICs and the controls were those who did not develop IAICs after gastrectomy. All of one-hundred patients diagnosed as clinical ≤T4a and ≤N1, and underwent distal gastrectomy are extracted. Two raters blinded to the outcome evaluate each video after editing to remove personal information from the operating videos. We then identified items with significant difference between the two groups for consideration of whether or not they were risk factors for IAIC.

Tumors comprise two types of non-cancerous cells, first recruited cells such as stem cells and macrophages, and second, tissue-steady cells that are part of the tissue including adipose cells, fibroblasts, and steady macrophage-derived cells, all having a significant impact on tumor progression. This review addresses some effects of stem cells on cancer advancement as the predominant outcome of stem cell therapy on cancer cell lines revealed controversial results. In addition, this review will address some reasons of distinct cancer responses and hypotheses the notion of unfolded protein response as a key switch in cancer development.

Background/Aims: Pancreatic neuroendocrine tumors (p-NETs) are a group of functionally and biologically heterogeneous tumors which are clinically rare. Here we report the clinical features, treatment strategies and survival of p-NET patients treated at a single institution.

Methods: Patients pathologically diagnosed with p-NETs and treated at The American University of Beirut Medical Center between 2005 and 2015 were recruited. Tissue specimens from patients’ samples were collected during surgical resections and needle biopsies performed at our center to determine tumor characteristics. The 2010 WHO NET and ENETs classification systems were used in concordance for all cases to determine staging. The WHO divided the p-NET grades into: Grade 1 neuroendocrine tumors (G1), Grade 2 neuroendocrine tumors (G2), Grade 3 neuroendocrine carcinoma (G3) and mixed adeno and neuroendocrine carcinoma (MANEC). Survival analyses using Kaplan-Meier were plotted using SPSS 23.0 (IBM).

Results: We identified 27 p-NET patients with pathological reports. Median age of patients at diagnosis was 52 years. The majority were males (63%). The proportions of patients with pathologic TNM stages IA/B, IIA/B, III, and IV disease were 18%, 22%, 4%, and 56% of all patients. Seventeen patients (63%) underwent surgery and eighteen patients (67%) received chemotherapy and/or somatostatin analogues. Median survival of the whole cohort was more than 10.8 years while the median survival of patients diagnosed at stage IV was 6 years. The one and two-year survival rates for the entire cohort were 97% and 83%, respectively. The one and two-year survival rates of stage IV were 93% and 70%, respectively.

Conclusion: Because of their variable presentations and non-standardized treatment plans, p-NETs still represent a significant clinical challenge and their management requires a coordinated multidisciplinary approach.

Background and Aims: Breast cancer (BC) is the most common type of cancer that affects Jordanian women. Several studies highlighted the independent effect of various diet and lifestyle factors on the risk of BC. Therefore, the objective of this study was to evaluate the association between lifestyle factors and BC in a selected group of Jordanian woman.

Methods: A case control study was conducted from October 2016 to September 2017. A total of 400 Jordanian women 20–65 years of age were recruited. 200 of recently diagnosed BC patients were compared to 200 apparently healthy controls. BC patients were matched with controls in age, income and marital status. A package consisted of three structured questionnaires: Personal Information and Seven-Day Physical Activity Recall (PAR) questionnaires were administered to all participants in this study.

Results: Increasing in BMI was associated significantly and positively with BC risk (OR 1.80 (95%CI: 1.01–3.27), P-trend = 0.037). A significant inverse association has been found between BC and physical activity (OR 0.32 (95%CI: 0.13–0.80), P-trend = 0.021). A significant positive association was detected between BC and smoking (OR 4.38 (95%CI: 2.08–9.22), P-trend = 0.001), a significant negative effect of lactation in the risk of BC was found (OR 3.71(95%CI: 2.20–6.26), P-trend = 0.0001).

Conclusion: A significant increase in BC risk was detected with Increasing in BMI and smoking, on the other hand a significant negative effect of lactation and physical activity in the risk of BC was found.

The present case report describes a 21-year-old male patient with intussusception of the small intestine due to adenoma. The patient presented with acute onset of severe abdominal pain, with clinical symptoms and preoperative ultrasonography raising a differential diagnosis of intussusception. Laparotomy identified a mass lesion within the small intestine as the leading point of intussusception, highlighting the importance of preoperatively evaluating neoplastic lesions in adult intussusception.

Background: The protocatechuic acid (PCA) is a natural polyphenolic antioxidant commonly distributed in plants and is considered as one of the main ingredients of some traditional herbal medicine. PCA has many pharmacological effects that may be closely linked to its antioxidant activity. Herein, we newly conducted this animal experiment to evaluate the therapeutic potentials of PCA on the 7,12-Dimethylbenzanthracene (DMBA) -induced hepatocarcinogenesis in the mouse model. Additionally, the in vitro antioxidant activity of PCA was estimated.

Material and methods: To induce the hepatocarcinogenesis, DMBA (35 mg/kg, once per week) was orally administered for 4 weeks in the tumor test groups. After six weeks, the administration of PCA (100 mg/kg/day) was started for 4 weeks. Mice were sacrificed after ten weeks for measuring and comparing the serum hepatic enzymes level, antioxidant markers and telomerase reverse transcriptase (TERT) gene expression between the mice in DMBA with PCA (PCA group) and DMBA without PCA (non-PCA group). Also, the antioxidant activity of PCA was measured in vitro using two different antioxidant assays.

Results: The elevation of all liver enzymes and other hepatic biomarkers observed in DMBA group were significantly suppressed in PCA-treated group. In addition, the TERT gene expression in liver tissue was significantly decreased in PCA-treated group. Our results also showed that the PCA exhibited a high antioxidant ability in vitro comparable to the positive control ascorbic acid.

Conclusion: The protocatechuic acid decreased TERT expression and oxidative stress in DMBA-induced liver carcinogenesis mice model.

The present case report describes a 59-year-old man with colon adenocarcinoma with neuroendocrine differentiation. The initial presentation was defect in the visual field and an elevated lesion in the retina. Positron emission tomography, contrast-enhanced computed tomography, and colonoscopy led to the diagnosis of descending colon cancer with metastasis to the bones, adrenal glands, choroid, and regional and distant lymph nodes. Despite administering CapeOX (capecitabine plus oxaliplatin) treatment after performing palliative surgery for colonic obstruction, ileus occurred due to the rapid growth of the dissemination and remnant metastatic lymph nodes. Thus, further treatment was not possible.

Although adenocarcinoma with neuroendocrine differentiation in the colon is a rare disease, its aggressive nature and poor prognosis highlight the need for further research and development of standard therapy.

Background: Most of previous studies have used Immunoradiometric assay (IRMA) for quantitative determination of Alpha- fetoprotein (AFP) in the sera of gastric cancer patients, but no works were recorded the analysis of AFP in gastric cancer tissues by IRMA.

The purposes of the present study were to measure AFP concentrations in cytosolic and nuclear fractions of gastric adenocarcinoma and gastric lymphoma tissues by binding to an ¹²⁵I-anti AFP antibody and to find out the optimum conditions for forming the ¹²⁵I-anti AFP antibody/AFP complex.

Methods: Tumor tissue samples were taken from 14 patients with gastric adenocarcinoma and 13 patients with gastric lymphoma. Preliminary tests of AFP binding to an ¹²⁵I-anti AFP antibody were performed. The optimum conditions, including the AFP concentration, ¹²⁵I-anti AFP antibody concentration, pH, temperature and time of binding the ¹²⁵I-anti AFP antibody with AFP in cytosolic and nuclear fractions of gastric cancer tissue homogenates were investigated. The stability of the ¹²⁵I-anti AFP antibody/AFP complex and the AFP recovery were also examined.

Results: Comparison of biochemical studies for AFP in cytosolic and nuclear fractions of gastric adenocarcinoma and gastric lymphoma tissue homogenates showed that there were differences in AFP concentrations and the optimum conditions of binding with an ¹²⁵I-anti AFP antibody.

Conclusion: The results revealed that the determination of AFP concentrations in gastric cancer tissues could be carried out by biochemical binding with an ¹²⁵I-anti AFP antibody. The binding percent values of the ¹²⁵I-anti AFP antibody/AFP complexes were increased at the optimum conditions.

Introduction: The combination regimen of fluorouracil, folinate, oxaliplatin, and irinotecan (FOLFOXIRI) plus bevacizumab (Bmab) is recommended as the first-line treatment for patients with mutant RAS/BRAF or patients with wild RAS/BRAF right-side located, according to the 2019 colorectal cancer guidelines of the Japanese Society of Cancer for Colon and Rectum. However, little is known the practical results for Japanese patients.

Patients: Five cases with FOLFOXIRI + Bmab therapy as first-line for locally advanced colorectal cancer (CRC) with or without metastasis in our department from August 2018 were analyzed.

Results: A median age was 71 years old including 4 male and 1 female. The location of cancer was as right-side colon in 1 case, left-side colon in 3 cases, and rectum in 1 case. Three cases had KRAS mutation. One case of BRAF mutation was found. Bypass or colostomy was performed in all patients prior to chemotherapy. A median number of 10 (3–16) chemotherapy courses were administered, and the best response was partial response (PR) in four cases and stable disease (SD) in one case. Considering primary tumor, four cases achieved primary site resection and one case was radically resected as Cur B resection. Three patients experienced grade 3 toxicity and then the treatment dose was reduced.

Conclusion: Our experienced 5 cases of locally advanced CRC treated with modified FOLFOXIRI + Bmab as fist-line therapy demonstrated that quite good tumor shrinkage was obtained in a quite short period of therapy even with quite high incidence of severe toxicities.