Hartmann's procedure (HP) is commonly used for the emergency treatment of complicated sigmoid diverticulitis (CSD). It is intended to restore intestinal continuity; however, in practice, reversal is not carried out in all patients. It is important to know the frequency of reversal and the impact of patient‐related factors on the decision for reversal.

The CXCL12-CXCR4 chemokine axis plays an important role in cell trafficking as well as in tumor progression. In colorectal cancer (CRC), the chemokine receptor CXCR4 has been shown to be an unfavorable prognostic factor in some studies, however, the role of its activated (phosphorylated) form, pCXCR4, has not yet been evaluated. Here, we aimed to investigate the prognostic value of CXCR4 and pCXCR4 in a large cohort of CRC patients.

AimThe standard of care for acute uncomplicated diverticulitis used to be an elective colon resection after the second or third episode. This practice was replaced by a more conservative and individualized approach. This study investigates current surgical practice in the treatment of acute uncomplicated diverticulitis in Switzerland.MethodRetrospective cross-sectional analysis of all hospital admissions due to uncomplicated diverticulitis in Switzerland using prospectively collected data from the Swiss Federal Statistical Office in two periods: 2004/2005 and 2010/2011. Treatment options were compared between the two periods with adjustment for baseline characteristics of patients and treating institutions.ResultsA total of 24497 patients (11835 in 2004/2005; 12662 in 2010/2011) were admitted to Swiss hospitals for uncomplicated diverticulitis. Between periods, the incidence increased from 81 to 85 admissions per 10(5) inhabitants per year. Elective admissions decreased from 46% (n=5490) to 34% (n=4294). The unadjusted resection rate decreased from 40% (n=4730) to 34% (n=4308). In the adjusted analysis, inpatients were more likely to have a resection in 2010/2011 than in 2004/2005 [odds ratio of 1.38 (95% confidence interval 1.25-1.54)]. In addition, private insurance, elective mode of admission and younger age increased the odds for resection while there was no evidence of an association between resection and either gender or comorbidities.ConclusionThe probability of colon resection for patients hospitalized with acute uncomplicated diverticulitis increased between periods while the overall number of colon resections declined. A change of practice expected given the paradigm shift towards conservative treatment could not be confirmed in this analysis.

Ischämie im Bereich der kolorektalen Anastomose ist ein Risikofaktor für Anastomoseinsuffizienzen (AI). Insbesondere die Perfusion im Kapillarbett (Mikroperfusion) des Kolons ist zur ungestörten Heilung der Anastomose wichtig. Die subjektive intraoperative Beurteilung der Mikroperfusion durch den Operteur ist jedoch nicht zuverlässig und objektive Messverfahren sind nicht im Alltag etabliert.

Abstract Background: The prognostic role of the immunological microenvironment in colorectal cancer (CRC) is well known. Among immune cell types, CD8 positive T lymphocyte infiltration is an established prognostic marker clearly associated with a favorable clinical course of the disease. In contrast, there is limited information about the prognostic role of OX40 positive immune cell infiltration in CRC. However, increasing evidence suggests that OX40 positive immune cell infiltration, as a single biomarker, has a positive prognostic effect in CRC patients. To the best of our knowledge, the impact of the combination of OX40 positive immune cells and CD8 positive T lymphocytes is unknown. Methods: A tissue microarray composed of 441 biopsies was evaluated for OX40 positive immune cells and CD8 positive T lymphocyte infiltration by immunohistochemistry. The intratumoral number of tumor infiltrating cells positive for OX40 and CD8 antigens was evaluated by 2 independent investigators achieving an optimal concordance rate of 90%. According to the frequency and staining intensity, we identified four subgroups of cell population: OX40low/CD8low, OX40high/CD8low, OX40low/CD8high and OX40high/CD8high. They were correlated with clinicopathological data, and a combined survival analysis was performed. Results: The mean age of the patients cohort was 69.9 ±10.7 years. A total of 230 (52%) biopsies were from female and 211 (48%) from male CRC patients. Both, OX40 and CD8 positive cell infiltration had a significant, prognostic impact on the clinical outcome of the disease as individual markers (p<0.0001 and p=0.007, respectively). Remarkably, the combination of OX40 and CD8 positive cell infiltration (OX40high/CD8high), significantly enhanced the overall survival of these patients (p<0.0001). These results were maintained after a multivariate Cox regression analysis including T and N stages, grade, vascular invasion, tumor border configuration, microsatellite stability and CD8 and OX40 positive cell infiltration suggesting that this combination is an independent prognostic factor in CRC patients. Conclusion: The combination OX40 and CD8 positive cell infiltration significantly enhances the overall survival compared to OX40 and CD8 positive cell infiltration alone. OX40high/CD8high positive cell infiltration is an independent, favorable, prognostic marker in CRC. Citation Format: Benjamin Weixler, Raoul A. Droeser, Roberto Sorge, Tarik Delko, Christian A. Nebiker, Giandomenica Iezzi, Giulio C. Spagnoli, Christoph Kettelhack, Urs W. von Holzen, Daniel Oertli, Luigi Terracciano, Luigi Tornillo, Giuseppe Sconocchia. OX40 expression improves the prognostic value of CD8 positive lymphocyte density in colorectal carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4715. doi:10.1158/1538-7445.AM2014-4715

Isolated limb perfusion (ILP) with tumor necrosis factor (TNF) and melphalan was carried out in 21 patients with regionally metastatic malignant melanoma of the limbs. The observed response rate was 65% complete and 15% partial remission. These results warrant further investigation of ILP with TNF and melphalan vs ILP with melphalan alone in a prospective randomised multicenter trial.

Michael Montemurroa,1, Stephan Dirnhoferb,2, Markus Bornerc, Roger Burkhardd, Nicolas Demartinesa, Markus Furrere, Louis Guilloua, Christoph Kettelhackb,2, Claudio Knüslif, Igor Langera, Urs Metzgerd, Claudio Redaellig, Luigi Tornillob,2, Markus von Flüef, Roger von Moose,3, Serge Leyvraza,1 a Centre Hospitalier Universitaire Vaudois, Lausanne, b Universitätsspital, Basel, c Inselspital, Bern, und Spitalszentrum, Biel, d Stadtspital Triemli, Zürich, e Kantonsspital Graubünden, Chur, f St. Claraspital, Basel, g Klinik Hirslanden, Zürich RECOMMANDAT IONS Forum Med Suisse 2008;8(30–31):544–549 544

EinleitungInzidenz und Prävalenz gastrointestinaler Stromatumore (GIST) wurden lange Zeit unterschätzt, bis grosse epidemiologische Studien jährliche Inzidenz raten von 10 bis 20 pro Million Einwohner zeigten [1].Während die chirurgische Entfernung kleiner GIST in der Regel kurativ ist, gab es in der Vergangenheit keine effektive chirurgische oder zyto toxische Behandlung fortgeschrittener oder metastasierter GIST [2].Die Entdeckung, dass GIST und deren Vorläuferzellen das Oberflächenantigen KIT (CD117) exprimieren [3], und die Identifikation eines dauerhaft aktiven Rezeptors in den meisten GIST

Zielstellung: Methoden: Ergebnisse: Schlussfolgerungen: Aim: Methods: Results: Conclusion:

Aim: Hepatic metastases from melanoma are associated with poor prognosis. Systemic chemotherapy and biological treatments remain unsatisfactory. This study investigated the impact of hepatic arterial chemotherapy in patients with ocular and cutaneous melanoma.Methods: In a retrospectively analysed observational study, 36 consecutive patients with hepatic metastases from ocular or cutaneous melanoma were assigned for surgical hepatic port-catheter implantation. Fotemustine was delivered weekly for a 4-week period, followed by a 5-week rest and a maintenance period every 3 weeks until progression. Overall survival, response and toxicity were analysed and compared.Results: After port-catheter implantation 30/36 patients were finally treated (18 with ocular and 12 with cutaneous melanoma). A median of 8 infusions per patient were delivered (range 3-24). 30% thrombocytopenia grade >= 3,7% neutropenia grade >= 3 but no nausea or vomiting grade >= 3 were encountered. Nine out of 30 patients achieved partial remission, 10/30 stable disease; 11/30 patients were progressive. Median survival for all treated patients was 14 months. Partial remission and stable disease were associated with a survival advantage compared to progressive disease (19 vs. 5 months). No significant difference in survival was observed for ocular versus cutaneous melanoma. Serum LDH was a significant predictor of both response and survival.Conclusions: Hepatic arterial Fotemustine chemotherapy was well tolerated. Meaningful response and survival rates were achieved in ocular as well as cutaneous melanoma. Careful patient selection in consideration of extra-hepatic involvement is crucial for the effectiveness of this treatment. Independent from the primary melanoma site, it is debatable if patients with highly elevated serum-LDH may benefit from this approach. (C) 2006 Elsevier Ltd. All rights reserved.

British Journal of DermatologyVolume 155, Issue 2 p. 488-491 Complete remission of multiple satellite and in-transit melanoma metastases after sequential treatment with isolated limb perfusion and topical imiquimod J. Utikal, J. Utikal Departments of Dermatology, Venereology and Allergology and Pathology, University Medical Center Mannheim, Ruprecht-Karl-University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68135 Mannheim, GermanySearch for more papers by this authorA. Zimpfer, A. Zimpfer Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorA. Thoelke, A. Thoelke Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorR. Figl, R. Figl Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorR. Hildenbrand, R. Hildenbrand Departments of Dermatology, Venereology and Allergology and Pathology, University Medical Center Mannheim, Ruprecht-Karl-University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68135 Mannheim, GermanySearch for more papers by this authorC. Kettelhack, C. Kettelhack Division of Surgery and Surgical Oncology, Robert-Roessle Hospital, Charité Campus Buch, Humboldt-University Berlin, Germany E-mail: jochen.utikal@haut.ma.uni-heidelberg.deSearch for more papers by this authorS. Goerdt, S. Goerdt Departments of Dermatology, Venereology and Allergology and Pathology, University Medical Center Mannheim, Ruprecht-Karl-University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68135 Mannheim, GermanySearch for more papers by this authorD. Schadendorf, D. Schadendorf Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorS. Ugurel, S. Ugurel Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this author J. Utikal, J. Utikal Departments of Dermatology, Venereology and Allergology and Pathology, University Medical Center Mannheim, Ruprecht-Karl-University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68135 Mannheim, GermanySearch for more papers by this authorA. Zimpfer, A. Zimpfer Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorA. Thoelke, A. Thoelke Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorR. Figl, R. Figl Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorR. Hildenbrand, R. Hildenbrand Departments of Dermatology, Venereology and Allergology and Pathology, University Medical Center Mannheim, Ruprecht-Karl-University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68135 Mannheim, GermanySearch for more papers by this authorC. Kettelhack, C. Kettelhack Division of Surgery and Surgical Oncology, Robert-Roessle Hospital, Charité Campus Buch, Humboldt-University Berlin, Germany E-mail: jochen.utikal@haut.ma.uni-heidelberg.deSearch for more papers by this authorS. Goerdt, S. Goerdt Departments of Dermatology, Venereology and Allergology and Pathology, University Medical Center Mannheim, Ruprecht-Karl-University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68135 Mannheim, GermanySearch for more papers by this authorD. Schadendorf, D. Schadendorf Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this authorS. Ugurel, S. Ugurel Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Medical Center Mannheim, Mannheim, GermanySearch for more papers by this author First published: 12 May 2006 https://doi.org/10.1111/j.1365-2133.2006.07333.xCitations: 14 Conflicts of interest: none declared. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume155, Issue2August 2006Pages 488-491 RelatedInformation