Surgical resection offers the best opportunity for survival in patients with colorectal cancer metastatic to the liver, with five-year survival rates up to 58% in selected cases. However, only a minority are resectable at the time of diagnosis. Continuous research in this field aims at increasing the percentage of patients eligible for resection, refining the indications and contraindications for surgery, and improving overall survival. The use of surgical innovations, such as staged resection, portal vein embolization, and repeat resection has allowed higher resection rates in patients with bilobar disease. The use of neoadjuvant chemotherapy allows up to 38% of patients previously considered unresectable to be significantly downstaged and eligible for hepatic resection. Ablative techniques have gained wide acceptance as an adjunct to surgical resection and in the management of patients who are not surgical candidates. Current management of colorectal liver metastases requires a multidisciplinary approach, which should be individualized in each case.
Eight children with congenital adrenal hyperplasia and late initiation of corticosteroid treatment are included in the present study. Four of them received LHRHa treatment for the arrest of central precocious puberty, while the other four served as controls. The administration of LHRHa was effective in arresting the manifestations of puberty. The final height in the LHRHa-treated group was 158.2 +/- 7.3 cm (SDS -1.1 +/- 0.5) and did not differ from the target height of 158.9 +/- 6.5 cm (SDS -1.1 +/- 0.2), while the final height in the controls was 153 +/- 11 cm, a value significantly lower than their target height of 164.5 +/- 8.3 (SDS -0.6 +/- 0.7) with p < 0.05. The data showed that LHRHa is effective in arresting central precocious puberty and appears to improve final height, bringing it closer to that expected from the genetic potentials.
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