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Cardiophrenic Lymph Nodes E-PÔSTER XIV Congresso Brasileiro de Cirurgia Oncológica TEMÁRIO: CIRURGIA CITORREDUTORA / HIPEC disease, as well as the higher risk of postoperative CÓDIGO: 88345 complications. CARDIOPHRENIC LYMPH NODES: WHAT IS Contato: Mariana Sousa Arakaki THEIR VALUE IN PATIENTS WITH PERITONEAL [email protected] CARCINOMATOSIS? WHAT CHANGES IN THE MANAGEMENT AND PROGNOSIS OF THESE TEMÁRIO: CIRURGIA CITORREDUTORA / HIPEC PATIENTS? CÓDIGO: 87883 Autores: Eduardo Hiroshi Akaishi / Akaishi, E. H. / Hospital das Clínicas da FMUSP; Mariana Sousa Arakaki CYTOREDUCTIVE SURGERY WITH CHEMO- / Arakaki, M. S. / Hospital das Clínicas da FMUSP; Helber THERAPY INTRAPERITONEAL HYPERTEN- Vidal Gadelha Lima / Lima, H. V. G. / Hospital das Clínicas SION (HIPEC) WITH PARTIAL HEPATECTOMY da FMUSP; Ivan Vinicius Andrade Galindo / Galindo, I. BY METASTATIC RIGHT COLON ADENOCAR- V. A. / A.C.Camargo Cancer Center; Lucas Afonso Daia CINOMA / Daia, L. A. / Hospital das Clínicas da FMUSP; Tomas Mansur Duarte de Miranda Marques / Marques, T. M. Autores: Matheus Pingerno dos Santos / SANTOS, M. D. M. / A.C.Camargo Cancer Center; Edivaldo Massazo P. / Universidade do Sul de Santa Catarina - UNISUL; Utiyama / Utiyama, E. M. / Hospital das Clínicas da Ariane Elias Antunes / ANTUNES, A. E / Universidade do FMUSP. Sul de Santa Catarina - UNISUL; Lucas Camargo Gamba Martins Do Amaral / AMARAL, L. C. G. M. / Universidade Introduction: Most primary tumors that occur within do Sul de Santa Catarina - UNISUL; Murilo Jebai the abdominal cavity can spread via hematogenous, Monteiro / MONTEIRO, M. J. / Universidade do Sul de lymphatic and peritoneal implantation. In the past, Santa Catarina - UNISUL; Italo Mattos Rinaldi / RINALDI, peritoneal carcinomatosis was considered fatal, I. M. / Universidade do Sul de Santa Catarina - UNISUL; causing intestinal obstruction and death in months Beatriz de Oliveira Kock / KOCK, B. O. / Universidade or years. Currently, in some types of tumors, in do Sul de Santa Catarina - UNISUL; Thamy dos Santos patients with exclusive peritoneal metastasis, surgical / SANTOS, T. / Hospital Nossa Senhora da Conceição; cytoreduction (CRS) with addition of hyperthermic Rayssa Pra Buss / BUSS, R. P. / Hospital Nossa Senhora intraperitoneal chemotherapy (HIPEC) may increase da Conceição; Cassiano Coral Accordi / ACCORDI, C. C. survival and provide a better quality of life. Following / Hospital Nossa Senhora da Conceição; Luiz Henrique Sugarbaker‘s publication in 1995 describing the CRS Locks Correa / Correa, L. H. L. / Hospital Nossa Senhora technique, many centers have gained competence da Conceição. to perform this procedure and consequently those patients who would die early, began to improve The Colorectal cancer (CCR) the most common neoplasia survival and with control of peritoneal disease, of the digestive tract and it has been observed in the dissemination to other sites (rarely seen previously), last few years that its incidence has been increasing; in such as cardiophrenic lymph nodes (CFLN), became Brazil is the fifth most commonly diagnosed malignancy important in several studies. CFLNs are considered and the fourth cause of death from cancer. Many factors as distant lymph nodes located in the space may be related, such as population aging, sedentary between the sternum, diaphragm and the heart. lifestyles and unhealthy eating habits. From 10 to 25% Objective: To discuss whether CFLN involvement has of patients with CCR develop distant metastasis to prognostic significance in patients with peritoneal the peritoneum. In this case report, we did object on carcinomatosis due to ovarian tumor. Show disease- this study describe the case of a patient underwent free survival (DFS) and postoperative complications in cytoreductive surgery and partial hepatectomy owing a series of patients. Method: We included patients to metastatic right colon adenocarcinoma for clinical with ovarian epithelial tumor who underwent CRS and presentations and clinical and surgical management. HIPEC, with histological confirmation of suspected Methods: This is an observational non-analytical CFLN, from 2002 to 2019. CFLNs were resected study. Results: ELM, 65 years-old, female, married. by transdiaphragmatic access during the surgical In mid-2018, the patient felt diffuse abdominal pain. procedure. Results: Four patients met the inclusion Abdominal US (08/2018) showed a massive right hepatic criteria: Case 1: 52 years, relapse disease, peritoneal lesion of 9.6 cm and a left annex heterogeneous image carcinomatosis index (PCI) 5, DFS 4 months, CFLN of 6.7 cm. Positive fecal occult blood testing (FOBT) and affected: 1. Case 2: 28 years, PCI 32, 2 reoperations, Ca 125 = 133. Abdominal CT (09/2018) showing 7.6 cm DFS 3 months, CFLN affected: 1. Case 3: 67 years, right hepatic lobe injury (S6, S7); expansive lesion in PCI 25, 1 reoperation, DFS 4 months, CFLN affected: the left annex with 8.5 cm involvement of the uterus. 1. Case 4: 68 years, PCI 29, 2 reoperations, DFS 10 Colonoscopy (09/2018) showed a neoplastic lesion in months, CFLN affected: 2. Conclusion: CRS with the cecum and the biopsy revealed an adenocarcinoma. HIPEC in patients with CFLN is questionable. Based The search for microsatellite instability was negative on the presented cases, in patients with malignant and mutation of the KRAS gene detected in codon ovarian neoplasia with peritoneal disease presenting 12. The patient was submitted to chemotherapy with suspicious CFLN, we suggest that a biopsy be with FOLFIRINOX. The diagnostic impression was of performed to histologically confirm the involvement right colon Adenocarcinoma with liver metastasis, of CFLN since, probably, the surgical procedure will ppendages and peritoneum. The procedure was surgical not benefit disease-free survival and prognosis of the cytoreduction with right partial colectomy, enlarged Braz J Oncol. 2019; 15(Supl.2): 1-196 1 E-PÔSTER XIV Congresso Brasileiro de Cirurgia Oncológica total hysterectomy for pelvic peritoneum, partial peritoneal macroscopic implants. Of the 2 patients hepatectomy (S6 / S7), cholecystectomy, omentectomy, with PM (3.4%), none of the lavages were positive. right diaphragm peritonectomy and parietal colic gutter Conclusion: The incidence of positive peritoneal lavage + HIPEC (Oxaliplatin) and right closed pleural drainage. reported in most studies ranges from 1.6% to 21%. This On postoperative physical examination, the patient is study had a low incidence of positive peritoneal lavage flushed, hypoactive and wandering, working ileostomy. (1.7%). The main factor that seems to be directly related Flaccid abdomen, painless, depressible, good looking to this low incidence of positive peritoneal lavage is the operative wound. In this case, the approach chosen for used cytological study methodology, with Papanicolaus the case is efficient because cytoreductive surgery with staining. For a better evaluation of peritoneal cytology, intra peritoneal hypertension chemotherapy (HIPEC) the staining techniques and histopathological evaluation for patients with peritoneal metastases in patients should be expanded. Patients will be followed up to with RCC has been shown to significantly improve the assess whether the cytology findings of peritoneal prognosis and quality of life of the patient compared lavage confer any oncologic prognostic factor. with chemotherapy or palliative approaches. Contato: Luiza dos Santos Menezes Contato: Matheus Pingerno dos Santos [email protected] [email protected] TEMÁRIO: ONCOGINECOLOGIA TEMÁRIO: CIRURGIA CITORREDUTORA / HIPEC CÓDIGO: 87419 CÓDIGO: 88000 A CASE REPORT: PELVIC MASS AS ETIOLOGY INCIDENCE OF POSITIVE PERITONEAL OF NOT USUAL COMPLICATIONS CYTOLOGY IN COLORECTAL CANCER PATIENTS Autores: Ana Carolina Bathelt Fleig / Fleig, A. C. B. F. AT A REFERRAL HOSPITAL IN SALVADOR, / Hospital Santa Isabel; Guilherme Moreira Buchen / BRAZIL Buchen, G. M. / Hospital Santa Isabel; Mauricio Correa / Correa, M. / Hospital Santa Isabel; Yara Fernanda Autores: Cláudio de Almeida Quadros / Quadros, CA de Souza Neto / Neto, Y. F. S. / Hospital Santa Isabel; / Hospital Aristides Maltez; Emerson Prisco / Prisco, Raquel Bittencourt Catto / Catto, R. B. / Hospital Santa E. / Hospital Aristides Maltez; Mario Feitosa Falcão Isabel; Thayla Valderrama Bicheri / Bicheri, T. V. / / Falcão, M. F. / Hospital Aristides Maltez; Luiza dos Hospital Santa Isabel; Francielly Carine Marques Lauer / Santos Menezes / Menezes, L.S. / Hospital Aristides Lauer, F. C. M. / FURB; Bernardo Przysiezny / Przysiezny Maltez; Thiago Cardoso Matias / Matias, T.C. / Hospital / FURB; Willian Lorenzetti / Lorenzetti, W. / Hospital Aristides Maltez; Daniela Santos Mascarenhas Ribeiro / Santa Isabel; João Augusto dos Reis Guerra / Guerra, J. Mascarenhas, D.R. / Hospital Aristides Maltez; Antonina A. R. / Hospital Santa Isabel. Campos Silveira Machado / Machado, A.C. / Hospital Aristides Maltez. N.D, female, 68 anos, previously heatrlhy, has came to de ER with hipogastric abdominal pain associated Introduction: Peritoneal metastasis (PM) defines TNM wtih a previous trauma, a victim of running over with stage IV in patients with colorectal cancer (CRC). The low trauma cinematic two days ago. She evolved with treatment of this condition was restricted to palliative an abscess of abdominal muscle store in US, surgically chemotherapy. The survival of patients with undergoing drained and optimized with antibiotic therapy by 10 cytoreductive surgery with or without hyperthermic days. The paciente retorned to ER with fecaloid
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