br Conclusion In contrast to

Conclusion In T-5224 manufacturer to other orthopedic fields, a disease encountered in musculoskeletal oncology could be life threatening. Most soft tissue tumors are not malignant, and STSs are often misdiagnosed clinically as benign lesions (e.g., lipoma, hematoma, and lymph nodes). The relatively higher incidence rates of local recurrence and amputation in the unplanned surgery group emphasizes the importance of referrals and preventing iatrogenic mistakes such as hasty biopsy and margin-positive primary resections. To avoid unplanned surgery of STSs, guidelines for clinicians to increase their awareness of the clinical features that suggest malignancy in any soft tissue lump are recommended (Table 2). The more clinical features are present, the greater is the risk of malignancy. On excision of any soft tissue tumor, surgeons should be aware of the potential risk of erroneous management of malignancy. Education and standardization of the treatment for STSs are essential for avoiding unplanned surgery.
Introduction Esophageal cancer is a highly fatal disease. Esophagectomy is commonly accepted as a local curative treatment for esophageal cancer and offers an opportunity for long-term survival. Because of the globally increasing life expectancy and size of the aged population, a growing number of elderly patients are becoming potential candidates for esophagectomy for esophageal cancer. However, esophagectomy, being a major operative surgery, has previously shown high mortality and poor long-term survival in elderly patients. Despite advanced surgical technologies and perioperative care techniques, the adequacy of esophagectomy in elderly patients with esophageal cancer remains controversial. Data on the effects of surgery and the survival outcome following esophagectomy in elderly patients remain scant. The short-term surgical risk and potential loss in quality of life must be analyzed against the long-term benefit of the surgery. No standard cutoff age for identifying patients as elderly in relation to esophagectomy has been defined. Along with a gradual decline in physiological function and functional reserve, aging slows the process of recovery from major stress conditions such as surgery. A study reported that an age >70 years was associated with a significantly increased risk from surgery for esophageal cancer. The stress-buffering properties of physiological support following esophagectomy were more evident in patients aged ≥70 years than in those aged <70 years. Thus, the age of 70 years was considered a critical cutoff point for identifying patients who received esophagectomy as elderly. In the current study, we retrospectively enrolled patients with esophageal cancer and compared their surgical and long-term survival outcomes by assigning them to two groups.
Methods Patients who received curative esophagectomy for esophageal cancer between January 2001 and December 2012 were enrolled and assigned to two groups according to their age at diagnosis: Group 1 comprised patients aged ≥70 years and Group 2 comprised patients aged <70 years. Esophagectomy and reconstruction of the esophagus were conducted using the Orringer transhiatal technique for lower esophageal tumors and the two-stage Ivor–Lewis or three-stage McKeown procedure for tumors of the mid and upper third of the esophagus. Clinical data of the patients were retrospectively collected and analyzed. The definitions of tumors, metastatic descriptors, and staging classification used in the current study were based on the definitions described in the seventh edition of the American Joint Committee on Cancer staging manual. Thus, the stages of patients who were treated before 2009 were revised according to the new staging system. Because a standard definition of celiac and cervical lymph nodes related to lower thoracic and upper thoracic esophageal cancer is not described in the manual, the stage of these cases in both groups was considered as the M1 stage.