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American Journal of Cancer Prevention

ISSN (Print): 2328-7314

ISSN (Online): 2328-7322

Editor-in-Chief: Nabil Abdel-Hamid




Surgical Treatment of Huge Primary Retroperitoneal Tumor: A Report of 14 Cases

1Department of General Surgery, The Second People's Hospital of Jiulongpo District, Chong Qing, China

2Department of Hepatobiliary, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

3Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

American Journal of Cancer Prevention. 2016, 4(4), 64-69
doi: 10.12691/ajcp-4-4-4
Copyright © 2017 Science and Education Publishing

Cite this paper:
Zheng-jun Cheng, Qian Cheng, Jian-ping Gong, Chan Qiu, Da-xing Li. Surgical Treatment of Huge Primary Retroperitoneal Tumor: A Report of 14 Cases. American Journal of Cancer Prevention. 2016; 4(4):64-69. doi: 10.12691/ajcp-4-4-4.

Correspondence to: Da-xing  Li, Department of General Surgery, The Second People's Hospital of Jiulongpo District, Chong Qing, China. Email:


Objective: To summarize the surgical therapy for huge retroperitoneal tumor. Methods: Retrospective analysis was carried out to study the surgical therapy on 14 patients with huge retroperitoneal tumor. Results: Complete resection in eight cases, partial resection in two cases, combined evisceration in three cases, one biopsy and six cases recurred after surgery. Conclusion: Operative skills and the management during perioperative period are important for the treatment of huge retroperitoneal tumor.



[1]  Virseda Rodríguez JA, Donate Moreno MJ, Pastor Navarro H, et al. Primary retroperitoneal tumors: review of our 10-year case series. Arch Esp Urol 2010; 63: 13-22.
[2]  Ballo MT, Zagars GK, Pollock RE, et al. Retroperitoneal soft tissue sarcoma: An analysis of radiation and surgical treatment. Int J Radiat Oncol Biol Phys 2007; 67: 158-163.
[3]  Tseng WW, Madewell JE, Wei W, et al. Locoregional Disease Patterns in Well-Differentiated and Dedifferentiated Retroperitoneal Liposarcoma: Implications for the Extent of Resection? Ann Surg Oncol 2014; 21: 2136-2143.
[4]  Krikelis D, Judson I. Role of chemotherapy in the management of soft tissue sarcomas. Expert Rev Anticancer Ther 2010; 10: 249-260.
[5]  An JY, Heo JS, Noh JH, et al. Primary malignant retroperitoneal tumors: analysis of a single institutional experience. Eur J Surg Oncol 2007; 33: 376-382.
Show More References
[6]  Pisters PWT, O’Sullivan B. Retroperitoneal sarcomas: combined modality treatment approaches. Curr Opin Oncol 2002; 14: 400-405.
[7]  Youssef E, Fontanesi J, Mott M, et al. Long-term outcome of combined modality therapy in retroperitoneal and deep-trunk soft-tissue sarcoma: analysis of prognostic factors. Int J Radiat Oncol Biol Phys 2002; 54: 514-519.
[8]  Pirayesh A, Chee Y, Helliwell TR, et al. The management of retroperitoneal soft tissue sarcoma: a single institution experience with a review of the literature. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 2001; 27: 491-497.
[9]  Gronchi A, Casali PG, Fiore M, et al. Retroperitoneal soft tissue sarcomas: patterns of recurrence in 167 patients treated at a single institution. Cancer 2004; 100: 2448-2455.
[10]  Erzen D, Sencar M, Novak J. Retroperitoneal sarcoma: 25 years of experience with aggressive surgical treatment at the Institute of Oncology, Ljubljana. J Surg Oncol 2005; 91: 1-9.
[11]  Linehan DC, Lewis JJ, Leung D, Brennan MF. Influence of biologic factors and anatomic site in completely resected liposarcoma. J Clin Oncol Off J Am Soc Clin Oncol 2000; 18: 1637-1643.
[12]  Ferrario T, Karakousis CP. Retroperitoneal sarcomas: grade and survival. Arch Surg Chic Ill 1960 2003; 138: 248-251.
Show Less References


Experience for Management of Surgical Treatment in Patients with Carcinomas of the Pancreatic Head or Periampullary Region

1Department of General Surgery Hospital of traditional Chinese medicine of Yubei, Chongqing, 401120, China

2Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China

American Journal of Cancer Prevention. 2017, 5(1), 1-9
doi: 10.12691/ajcp-5-1-1
Copyright © 2017 Science and Education Publishing

Cite this paper:
LUO Tao, LI Xing, GONG Jianping, LI Qujin. Experience for Management of Surgical Treatment in Patients with Carcinomas of the Pancreatic Head or Periampullary Region. American Journal of Cancer Prevention. 2017; 5(1):1-9. doi: 10.12691/ajcp-5-1-1.

Correspondence to: LI  Qujin, Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China. Email:


Objective: Pancreaticoduodenectomy was considered as the standard choice of surgery treatment to carcinomas in the pancreatic head or periampullary region. This study will focus on the experience summary to manage the patients with carcinomas in the pancreatic head or periampullary region who underwent surgery treatment in west area of China to investigate the different surgical methods, prognosis and long term survival. Method: We consecutively reviewed 73 patients underwent surgery treatment in our hospital between January 2007 and December 2011. Surgery treatment described as radical operation of PD treatment and palliative operation of choledochojejunostomy plus drainage. We assessed different variables to summarize the management of patients and to evaluate the long term survival. Result: 32 patients received PD treatment and 41 patients received palliative surgery treatment. Histologic diagnosis indicated that all patients had malignant disease. PD procedures spent more time to complete the operation. 3 patients in PD group developed pancreatic fistula and 1 of them died on the seventh days postoperative. 2 patients developed wound infection and 1 patient developed malnutrition which finally reversed by medical intervention. The postoperative mortality in PD group was observed in 2 of 32 patients. The postoperative mortality in PD group was 6.25% (n=2). Long term survival of PD and palliative surgery group was described as 15.4 months and 5.6 months respectively. Conclusion:The treatment of patients with carcinomas in the pancreatic head or periampullary region continues to be associated with high incidence of postoperative complicatons. Early diagnosis and pancreaticoduodenectomy represents the only possibility of cure.



[1]  Schmidt C Max, Powell Emilie S, Yiannoutsos Constantin T, et al. Pancreaticoduodenectomy a 20-year experience in 516 patients. Arch Surg, 2004; 139: 718-725.
[2]  Lai EC. H, Lau SH. Y, Lau WY. Measures to prevent pancreatic fistula after Pancreatoduodenectomy. Arch Surg. 2009, 144: 1074-1080.
[3]  Kong Justin, Gananadha Sivakumar, Hugh TJ, et al. pancreaticoduodenectomy: role of drain fluid analysis in the management of pancreatic fistula. Anz J. Surg, 2008; 78: 240-244.
[4]  Fuks David, Piessen Guillaume, Huet Emmanuel, et al. Life-threatening postoperativepancreatic fistula (grade C) after pancreaticoduodenectomy: incidence, prognosis, and risk factors. Am J Surg, 2009; 197: 702-709.
[5]  PatrikPessaux, Alain Sauvanet, Christophe Mariette, et al. External pancreatic duct stent decreases pancreatic fistula rate after pancreaticoduodenectomy: prospective multicenter randomized trial. Ann Surg, 2011; 253: 879-855.
Show More References
[6]  Weitz J, Rahbari N, Koch M, et al. The “artery first” approach for resection of pancreatic head cancer. J Am Coll Surg. 2010; 210:e1-4.
[7]  Gaedcke J, Gunawan B, Grade M, et al. The meso-pancreas is the primary site for R1 resection in pancreatic head cancer: relevance for clinical trials. Langenbecks Arch Surg. 2010, 395: 451-8.
[8]  Petrou A1, Soonawalla Z, Silva MA, at al. Prognostic indicators following curative pancreatoduodenectomy for pancreatic carcinoma: A retrospective multivariate analysis of a single centre experience. J BUON. 2016 Jul-Aug; 21(4):874-882.
[9]  Xu HX, Liu L, Xiang JF, et al. Postoperative serum CEA and CA125 levels are supplementary to perioperative CA19-9 levels in predicting operative outcomes of pancreatic ductal adenocarcinoma. Surgery. 2016 Nov 9. [Epub ahead of print].
[10]  Van der Gaag, Rauws Erik A.J, Van Eijck Casper H, et al. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med 2010; 362: 129-137.
[11]  Eshuis Wietse J, Van Der Gaag N A, Rauws Erik A, et al. Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage. Annals of Surg 2010; 252: 840-849.
[12]  Pannala Rahul, Leirness Jeffery, Bamlet William R, et al. Prevalence and clinical profile of pancreatic cancer-associated diabetes mellitus. Gastroenterology 2008; 134: 981-987.
[13]  Olivié Damien, Lepanto Luigi, Billiard Jean Sébastien, et al. Predicting resectability of pancreatic head cancer with multi-detector CT. Surgical and pathologic correlation. JOP 2007; 8: 753-758.
[14]  Hidalgo Manuel. Pancreatic cancer. N Eng J Med 2010; 362: 1605-1617.
[15]  De Jong Mechteld C, Farnell Michael B, Sclabas Guido, et al. Liver-directed therapy for hepatic metastases in patients undergoing pancreaticoduodenectomy. Ann Surg 2010; 252: 142-148.
[16]  Haga Yoshio, Wada Yasuo, Takeuchi Hitoshi, et al. Prediction of anastomotic leak and its prognosis in digestive surgery. World J Surg 2011; 35: 716-722.
[17]  Kawai Manabu, Yamaue Hiroki. Analysis of clinical trials evaluating complications after pancreaticoduodenectomy: a new era of pancreatic surgery. Surg Today, 2010; 40: 1011-1017.
[18]  Wu W, Wang X, Wu X, et al. Total mesopancreas excision for pancreatic head cancer: analysis of 120 cases. Chin J Cancer Res. 2016 Aug; 28(4):423-8.
[19]  Chu Carrie K, Farnell Michael B, Nguyen Justin H, et al. Prosthetic graft reconstruction after portal vein resection in pancreaticoduodenectomy: a multicenter analysis. J Am CollSurg 2010; 211: 316-324.
[20]  Chua Terence C, Saxena Akshat. Extended pancreaticoduodenectomy with vascular resection for pancreatic cancer: a systematic review. J Gastrointest Surg, 2010; 14: 1442-1452.
[21]  Xu Yufei, Liu Zuojin, Gong Jianping. Pancreaticoduodenectomy with early superior mesenteric artery dissection. Hepatobiliary Pancreat Dis Int. 2010, 9: 579-583.
[22]  Lin Q, Tan L, Zhou Y, et al. Radical nerve dissection for the carcinoma of head of pancreas: report of 30 cases. Chin J Cancer Res. 2016 Aug; 28(4):429-34.
[23]  Fujioka S, Misawa T, Yanaga K. Isolating tape method is useful for an early judgment of curability during pancreaticoduodenectomy forpancreatic cancer. J Hepatobiliary Pancreat Sci. 2016 Oct; 23(10): 20-24.
[24]  Yan L, Siddiqui AA, Laique S, et al. A large multicenter study of recurrence after surgical resection of branch-duct intraductal papillary mucinous neoplasm of the pancreas. Minerva Gastroenterol Dietol. 2016 Nov 8. [Epub ahead of print]
[25]  Werner Hartwig, Thilo Hackert, Ulf Hinz, et al. Pancreatic cancer surgery in the new millennium better prediction of outcome. Ann Surg 2011; 254: 311-319.
[26]  Katz Matthew H G, Merchant Nipun B, Brower Steven, et al. Standardization of surgical and pathologic variables is needed in multicenter trials of adjuvant therapy for pancreatic cancer: results from the ACOSOG Z5031 trial. Ann Surg Oncol, 2011; 18: 337-344.
Show Less References


Knowledge and Awareness about Cervical Cancer Screening and HPV Vaccine among Females Aged 15-49 Years in Rukum District of Nepal

1EPI, District Health Office, Rukum, Nepal

2Department of Health Sciences, National Open College, Pokhara University, Sanepa, Lalitpur, Nepal

3Department of Public Health, Asian College for Advance Studies, Lalitpur, Nepal

4Department of Biostatistics, KS Hegde Medical Academy, Nitte University, Mangalore, India

5Department of Research & Development, National Open College, Pokhara University, Sanepa, Lalitpur, Nepal

6Integrated management of Acute Malnutrition, IRHDTC, Maharajgunj, Nepal

7Nepal Cancer Care Foundation, Lalitpur, Nepal

American Journal of Cancer Prevention. 2017, 5(1), 10-16
doi: 10.12691/ajcp-5-1-2
Copyright © 2017 Science and Education Publishing

Cite this paper:
Krishna Khadka, Sanjeev Kumar Shah, Sanal TS, Jennifer Mathias, Abinash Upadhayay, Raju Ghimire, Sarita Ghimire. Knowledge and Awareness about Cervical Cancer Screening and HPV Vaccine among Females Aged 15-49 Years in Rukum District of Nepal. American Journal of Cancer Prevention. 2017; 5(1):10-16. doi: 10.12691/ajcp-5-1-2.

Correspondence to: Sanjeev  Kumar Shah, Department of Health Sciences, National Open College, Pokhara University, Sanepa, Lalitpur, Nepal. Email:;


Introduction: Cervical cancer is the first most common cancer and the leading cause of mortality among women in Nepal. The annual age standardized incidence rate of cervical cancer is 19.0 and the mortality rate is 12.0 per 100,000 women. Awareness and knowledge about cervical cancer among females is essential in the prevention of cancer. The objective of this study was to assess the level of knowledge and awareness about cervical cancer and to identify the screening practices among the women in Rukum district of Nepal. Methodology: This cross sectional study was conducted in Jan to Feb 2016 in Rukum, Nepal. Multistage sampling technique was used and 600 Female aged between 15-49 years were recruited. A semi structured interview questionnaire was used to collect the information. The inferential statistics, chi square test was used to summarize the data. For bivariate analysis, odds ratio and its 95% CI were obtained and binary logistic regression technique was used as a multivariate analysis. Results: Among the 600 women, 77.5% had heard about cervical cancer. Of these only 16% (72) were aware about cervical cancer screening and 7% were aware about the Pap smear test. Among these only 13.6 % (8/72) had ever undergone for cervical cancer screening. Only 5% had heard about HPV, among of them 30% knew that it can cause cervical cancer. Only 47% had adequate knowledge about cervical cancer, HPV and its screening. Education, occupation and monthly household income of the participants were significantly associated with knowledge of cervical cancer. Conclusion: This study identified that, there have been a low level of knowledge about cervical cancer among women. It indicates that there is a need to implement some strategies to enhance the knowledge of cervical cancer for these women.



[1]  Feraly J, Soerijomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0,Cancer Incidence and Mortality worldwide: IARC Cancer Base No 11.Lyon,France:International Agency for Research on Cancer;2013. [Accessed on 2nd Sep 2015]. Available from:
[2]  Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012: Global Cancer Statistics, 2012. CA Cancer J Clin. 2015 Mar;65(2):87-108.
[3]  World Health Organization. Comprehensive cervical cancer prevention and control: a healthier future for girls and women. Geneva, Switzerland: World Health Organization Press. 2013. Available from:
[4]  Burd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev. 2003 Jan; 16(1):1-17.
[5]  Castellsagué X, Muñoz N. Chapter 3: Cofactors in human papillomavirus carcinogenesis--role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr. 2003; (31): 20-8.
Show More References
[6]  Ribeiro AA, Costa MC, Alves RRF, Villa LL, Saddi VA, Carneiro MADS, et al. HPV infection and cervical neoplasia: associated risk factors. Infect Agent Cancer. 2015; 10: 16.
[7]  Bruni L, Barrionuevo-Rosas L, Albero G, et al. ICO information Centre on HPV and Cancer (HPV Information Centre).Human Papillomavirus and Related Diseases in Nepal. Summary Report 2015. [Accessed on 2nd Sep 2015]. Available from:
[8]  World Health Organization, World Health Organization, Reproductive Health and Research. Comprehensive cervical cancer control: a guide to essential practice. [Internet]. 2014 [cited 2015 Nov 1]. Available from:
[9]  Control of cancer of the cervix uteri. A WHO meeting. Bull World Health Organ. 1986; 64(4): 607-18.
[10]  Gakidou E, Nordhagen S, Obermeyer Z. Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS Med. 2008 Jun 17; 5(6): e132.
[11]  Johnson DC, Bhatta MP, Gurung S, Aryal S, Lhaki P, Shrestha S. Knowledge and awareness of human papillomavirus (HPV), cervical cancer and HPV vaccine among women in two distinct Nepali communities. Asian Pac J Cancer Prev APJCP. 2014; 15(19): 8287-93.
[12]  Liu FW, Vwalika B, Hacker MR, Allen S, Awtrey CS. Cervical cancer and HPV vaccination: Knowledge and attitudes of adult women in Lusaka, Zambia. J Vaccines Vaccin. 2012 Jun 12; 3(138).
[13]  Ugwu E, Obi S, Ezechukwu P, Okafor I, Ugwu A. Acceptability of human papilloma virus vaccine and cervical cancer screening among female health-care workers in Enugu, Southeast Nigeria. Niger J Clin Pract. 2013; 16(2):249.
[14]  Ortashi O, Raheel H, Shalal M, Osman N. Awareness and knowledge about human papillomavirus infection and vaccination among women in UAE. Asian Pac J Cancer Prev APJCP. 2013; 14(10): 6077-80.
[15]  Sabeena S, Bhat PV, Kamath V, Aswathyraj S, Arunkumar G. Knowledge, Attitude and Practice Concerning Human Papilloma Virus Infection and its Health Effects among Rural Women, Karnataka, South India. Asian Pac J Cancer Prev APJCP. 2015; 16(12): 5053-8.
[16]  Bansal AB, Pakhare AP, Kapoor N, Mehrotra R, Kokane AM. Knowledge, attitude, and practices related to cervical cancer among adult women: A hospital-based cross-sectional study. J Nat Sci Biol Med. 2015 Dec; 6(2): 324-8.
[17]  Joy T, Sathian B, Bhattarai C, Chacko J. Awareness of cervix cancer risk factors in educated youth: a cross-sectional, questionnaire based survey in India, Nepal, and Sri Lanka. Asian Pac J Cancer Prev APJCP. 2011; 12(7): 1707-12.
[18]  Saha A, Chaudhury AN, Bhowmik P, Chatterjee R. Awareness of cervical cancer among female students of premier colleges in Kolkata, India. Asian Pac J Cancer Prev APJCP. 2010; 11(4): 1085-90.
[19]  Assoumou SZ, Mabika BM, Mbiguino AN, Mouallif M, Khattabi A, Ennaji MM. Awareness and knowledge regarding of cervical cancer, Pap smear screening and human papillomavirus infection in Gabonese women. BMC Womens Health. 2015; 15: 37.
[20]  Ozyer S, Uzunlar O, Ozler S, Kaymak O, Baser E, Gungor T, et al. Awareness of Turkish female adolescents and young women about HPV and their attitudes towards HPV vaccination. Asian Pac J Cancer Prev APJCP. 2013; 14(8): 4877-81.
[21]  Cunningham MS, Skrastins E, Fitzpatrick R, Jindal P, Oneko O, Yeates K, et al. Cervical cancer screening and HPV vaccine acceptability among rural and urban women in Kilimanjaro Region, Tanzania. BMJ Open. 2015; 5(3): e005828.
[22]  Shrestha J, Saha R, Tripathi N. Knowledge, Attitude and Practice regarding Cervical Cancer Screening Amongst Women visiting Tertiary Centre in Kathmandu, Nepal. Nepal J Med Sci. 2013 Oct 14; 2(2): 85-90.
[23]  Ranabhat S, Tiwari M, Dhungana G, Shrestha R. Association of knowledge, attitude and demographic variables with cervical Pap smear practice in Nepal. Asian Pac J Cancer Prev APJCP. 2014; 15(20): 8905-10.
[24]  Shekhar S, Sharma C, Thakur S, Raina N. Cervical Cancer Screening: Knowledge, Attitude and Practices among Nursing Staff in a Tertiary Level Teaching Institution of Rural India. Asian Pac J Cancer Prev. 2013 Jun 30;14(6):3641-5.
[25]  Hoque ME, Ghuman S, Hal GV. Human Papillomavirus vaccination acceptability among female university students in South Africa. Asian Pac J Cancer Prev APJCP. 2013; 14(8): 4865-9.
[26]  Ebu NI, Mupepi SC, Siakwa MP, Sampselle CM. Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana. Int J Womens Health. 2015; 7: 31-9.
[27]  Kim Y, Jun JK, Choi KS, Lee H-Y, Park E-C. Overview of the National Cancer screening programme and the cancer screening status in Korea. Asian Pac J Cancer Prev APJCP. 2011; 12(3): 725-30.
[28]  Sirovich BE, Welch HG. The Frequency of Pap Smear Screening in the United States. J Gen Intern Med. 2004 Mar 1; 19(3): 243-50.
Show Less References