Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis: Prognosis and treatment of recurrences in a cohort study
EJSO
Authors: Cashin, P. H.; Graf, W.; Nygren, P.; Mahteme, H.
Abstract
Background: Cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) treatment of colorectal peritoneal carcincimatosis (PC) is gaining acceptance, but controversy remains. The primary aims were to analyse the outcome and prognostic variables of colorectal PC patients treated with CRS and IPC, and to report on the outcome of additional surgical treatments of subsequent recurrences. Methods: Patients referred for treatment of colorectal PC between 1996 and 2010 were included in a cohort. The following data was collected: clinicopathological parameters, survival, recurrences, perioperative chemotherapy and type of IPC (hyperthermic intraperitoneal chemotherapy, HIPEC; or sequential postoperative intraperitoneal chemotherapy, SPIC). Multivariable analyses were conducted on potential prognostic factors for overall survival (OS). Results: In the 151-patient cohort, the median OS was 34 months (range: 2-77) for CRS and HIPEC with five-year survival predicted at 40% (five-year disease-free survival 32%). For CRS and SPIC, the OS was 25 months (range: 2-188) with five-year survival at 18%. Open-and-close patients survived 6 months (range: 0-14) with no five-year survival (HIPEC vs. SPIC p = 0.047, SPIC vs. open-and-close p < 0.001). Adjuvant systemic chemotherapy was a noteworthy independent prognostic factor in the multivariable analysis. OS for patients undergoing additional surgical treatment of recurrences was 25 months vs. 10 months with best supportive care or palliative chemotherapy (p = 0.01). Conclusion: Substantial long-term survival is possible in patients with colorectal PC. HIPEC was associated with better OS than SPIC and adjuvant systemic chemotherapy may improve the outcome in patients. Good OS is achievable in selected patients undergoing additional surgical treatment of isolated liver or peritoneal recurrences after prior complete CRS. (C) 2012 Elsevier Ltd. All rights reserved.
A novel double RESURF LDMOS and a versatile JFET device used as internal power supply and current detector for SPIC
MICROELECTRONICS JOURNAL
Authors: Chen, Wanjun; Zhang, Bo; Li, Zhaoji
Abstract
In this paper, a novel double RESURF LDMOS with multiple rings in non-uniform drift region is proposed and successfully fabricated. The proposed device maximizes the benefits of the double RESURF technique by optimizes key process and device geometrical parameters in order to achieve the lowest on-resistance with the desired breakdown voltage. In addition, a versatile JFET device is firstly developed. The JFET device cannot only be used as the current detector, but also be used as the internal power supply for SPIC. Besides, it is compatible with Bipolar-CMOS technology, without any additional processes required. (C) 2005 Elsevier Ltd. All rights reserved.