Purpose: To clarify whether the risk factors for high-risk stage II colorectal cancer (CRC) indicated in the treatment guidelines can be applied to elderly CRC patients.

Methods: We analyzed 228 stage II CRC patients aged 75 years or older from a prospectively collected database from January 2001 to December 2015 to identify risk factors for recurrences.

Results: The recurrence-free survival rates at 1-, 3-, and 5 years after surgery were 94.0%, 84.6%, and 81.5%, respectively. A univariate analysis revealed that the gender, tumor location, and T status were related to outcomes. In a multivariate Cox proportional-hazards regression analysis, the T status was a significant risk factor for recurrence. Risk factors for the T3 group were examined in a sub-group analysis. A univariate analysis revealed that the gender was related to outcomes. In a multivariate Cox proportional-hazards regression analysis, the gender was a significant risk factor for recurrence. Risk factors for the T4 group were examined in a sub-group analysis. A univariate analysis revealed that the tumor location was related to outcomes. In a multivariate Cox proportional-hazards regression analysis, the tumor location was a significant risk factor for recurrence.

Conclusion: This study revealed that only T4 lesion was a risk factor for recurrence of stage II CRC in elderly patients. It is possible that not all risk factors listed in the guidelines apply to elderly patients. Adjuvant chemotherapy should be considered for elderly stage II CRC patients with T4 factor.

Introduction: fractal geometry has been implemented to study natures’ irregular objects with diverse applications in medicine, from characterizations of human structures such as the division of bronchial or arterial trees to the diagnosis of abnormal cells, as it has been evidenced in the study of neoplasms. In this investigation, a characterization of the degree of irregularity of histologic samples of normal and thyroid gland neoplasms was developed in the context of fractal and Euclidean geometry.

Methods: photographs of normal and neoplastic thyroid histologic samples obtained as surgical pieces were processed by a software that allows to delimit the borders of cellular structures. Then, grids of 5 and 10 pixels were superimposed over the images in order to measure their surfaces and occupation spaces through the Box-Counting method.

Results: For nucleus measures values between 14 to 34 in the 5 pixels grid and values between 7 to 16 in the 10 pixels grid suggest normality.

Conclusions: The surface of the nucleus and the cytoplasm measured by grids of 5 and 10 pixels, allow to carry out a more objective characterizations of both normal and abnormal thyroid cells.

Introduction: Some patients are more susceptible to multiple primary malignancies (MPMs). However, understanding of the effects of this susceptibility on the benefits and detriments to patient survival are poorly understood.

Methods: Participants (n = 3,263) underwent human leukocyte antigen (HLA) testing, surgery, and histological confirmation, and were confirmed with the date of surgery or diagnosis of metachronous MPMs. Risk factors for MPM included sex, age, interval period between first primary malignancy and metachronous malignancy, treatment, family history, germ layer of tumor origin, and MPM-relevant HLA-restricted human endogenous retrovirus (HERV) gene-derived peptides, which were examined for their association with the incidence of MPMs and overall survival.

Results: Patients susceptible to MPMs included those aged 60 years and over, those who underwent surgery only, those with non-endoderm-origin tumors, those with a family history of malignancies, and those in the survival-disadvantage peptide groups. Except for patients with esophageal MPM (+), patients with MPM (+) had poorer overall survival than those with MPM (-). Patients with esophageal MPM (+) had more survival-favorable peptides and fewer survival-unfavorable peptides. HLAs more susceptible to MPM included HLA-A2, -B7, -B13, -B39, -B55, -B62, -Cw6, and -Cw10, and those that were less susceptible to MPM included HLA-B56 and -Cw8. Patients who were MPM (+) with survival-favorable peptide groups B and H, and HLA-A2, -B61, -DQ4, or -DR15, had significantly better survival than patients without these peptides.

Conclusion: MPM-relevant HLA-restricted human endogenous retrovirus gene-derived peptides associated with the incidence of MPMs and patients had differential effects on patient survival.

A 64-year-old man with a history of asbestos exposure was diagnosed with stage IIIB epithelioid malignant pleural mesothelioma. After chemotherapy was introduced, the size of the tumors decreased initially but subsequently increased. A total of 13 sessions of palliative radiotherapy were conducted for multiple ectopic pleural masses and celiac lymph node metastases over five years and 11 months. The patient received 8 courses of nivolumab, which became available after he completed radiotherapy. Nevertheless, he had progressive disease and died seven years and 11 months after the initial examination. We report this instructive case of long-term survival achieved by repeated palliative radiotherapy.

Objectives: To evaluate the quality of patients with gastric cancer after laparoscopic total gastrectomy using the PGSAS-45 questionnaire developed by the Japanese Postgastrectomy Syndrome Working Party (JPGSWP).

Methods: A descriptive cohort study was conducted in patients with gastric adenocarcinoma who underwent laparoscopic total gastrectomy with D2 lymph node dissection. The data were retrospectively (7 patients) and prospectively (29 patients) collected in the Hue Central Hospital and Hue Medicine and Medicine University Hospital from January 2019 to December 2020.

Results: Of 36 patients, the total symptom score at one month, six months, and 12 months were respectively 1.53 ± 0.36, 1.34 ± 0.27, and 1.22 ± 0.20. At one month, the total symptom score in patients <60 years old and patients ≥60 was respectively 1.39 ± 0.25 and 1.66 ± 0.40 (p = 0.003). The physical and mental components summary in males and females were 73.36 ± 11.13 and 60.96 ± 13.84, respectively-(p = 0.016). At 6 months, the total symptom score and the physical component summary and mental component summary in females were 1.42 ± 0.30 and 67.46 ± 14.42; and 1.26 ± 0.23, and 78.78 ± 9.69 in males (p = 0.038 and 0.004, respectively). At 12 months, the total symptom score was significantly lower in males and patients with comorbidities than in females and those without comorbidities (p = 0.018 and 0.025, respectively). Other relationships showed no statistical differences.

Conclusions: Quality of life in patients with gastric cancer after laparoscopic total gastrectomy showed a time-dependent recovery. Age, gender, and comorbidities were factors that significantly affected the quality of life of patients.