Currently, 6 months of perioperative or adjuvant chemotherapy (ACT) is a standard treatment option after radical surgical removal of metachronous metastases in patients with metastatic colorectal cancer (CRC). Data show that ACT improves relapse-free survival in such patients, although no difference in overall survival rate was observed. We perform a systematic review to evaluate the efficacy of adjuvant chemotherapy after radical resection of metachronous metastases in CRC.

Despite pancreatoduodenectomy is one of the most difficult surgical interventions in abdominal surgery learning curve will differ from one surgeon to another.

No abstract

Solid pseudopapillary neoplasm (SPN) of the pancreas is an extremely rare tumor, associated with favorable prognosis and long-term survival in patients with advanced disease. However, limited data exist on systemic therapy for such patients. Herein, we present a case of a young woman with a history of SPN, who progressed after multiple surgical resections and chemotherapy regimens. The immunohistochemistry (IHC) showed overexpression of estrogen receptors (ER) and progesterone receptors (PR) in tumor tissue. The patient started to receive tamoxifen and showed a durable response to endocrine therapy.

Rationale. The search for a more effective therapy for vasospastic angina pectoris, taking into account clinical and economic indicators.Objective. To compare the clinical and economic efficiency of therapy with metoprolol tartrate and metoprolol succinate in patients with vasospastic angina.Materials and methods. A randomized study involving 77 patients with a follow-up period of 12 months was conducted. The results were compared in terms of antianginal efficacy parameters between a group of patients (n = 41) with vasospastic angina pectoris who received metoprolol tartrate (Еgilok at a dose of 25 mg 2 times a day) for standard therapy with a calcium antagonist (Norvasc), with a similar group of patients (n = 36) who received metoprolol succinate (Betaloc ZOK 50 mg). The primary endpoints were cardiovascular death, development of AMI, stroke, secondary endpoints — the number of clinically significant angina attacks, patients were followed up for 12 months (over 15 minutes, cases requiring hospitalization or calling an ambulance team).Results. During the observation period, a significant difference was obtained in the incidence of clinically significant angina attacks (p = 0.043) with an advantage in the group of patients receiving metoprolol succinate. According to the primary endpoints, there was no significant difference in the groups of metoprolol tartrate and succinate: in the number of cardiovascular mortality (p = 0.94), development of AMI (p = 0.89), stroke (p = 0.53).Conclusion. There are no significant differences in the incidence of adverse cardiovascular events, such as AMI, stroke, including those leading to death in the groups of patients with vasospastic angina taking metoprolol tartrate or succinate. However, there is a significant difference in the incidence of clinically significant anginal attacks with the advantage of succinate salt. Metoprolol tartrate has great pharmacoeconomic advantages.