The only factor determining long term survival is the stage of the malignancy. As seen in our series, the TW 37 majority of our patients had very advanced disease on diagnosis and fared badly subsequently with almost all the patients developing disease recurrences. Though several of our patients developed peritoneal disease

subsequently, it could be related to the advanced staging and progression of the primary malignancy rather than contributed by the perforation. Unfortunately, large series is not available in the literature to shed more light into this. The role of surgery in gastric lymphoma has been addressed by numerous reports and should only be performed as a primary radical Inhibitors,research,lifescience,medical treatment, palliative procedure or when emergency complications such as massive bleeding or perforation are encountered (25)-(28). The implications of the gastric perforation in Inhibitors,research,lifescience,medical the long term survival of these patients appear minimal with no reports of associated recurrence reported. The most important factor determining the long term survival is again the stage of the lymphoma. None of our patients had any systemic or peritoneal recurrence and both are currently well upon completion of their chemotherapy. Conclusions Surgery in perforated gastric malignancy is fraught with numerous

challenges. Short-term outcome is dismal and is dependent on the various Inhibitors,research,lifescience,medical patient and disease factors. Long-term survival in these patients is dependent on the underlying Inhibitors,research,lifescience,medical stage of the malignancy.

Footnotes No potential conflict of interest.
Anal cancer is a highly curable disease. Chemoradiotherapy has superseded surgery since it results in an equivalent survival with the benefit of a better functional outcome, as there is no need for colostomy. However, the long-term complications of definitive chemoradiotherapy for anal cancer have not been systematically described. In this report, we present the case of a woman who presented with therapy-induced myelodysplasia within a year after treatment for anal cancer. A 58-year-old woman with no significant past medical history was diagnosed Inhibitors,research,lifescience,medical with squamous-cell carcinoma of the anal canal, during a work-up for hematochezia. She regularly drank moderate amounts of vodka in the evening, and was a heavy smoker. The anal DNA ligase cancer was treated in standard fashion with chemoradiation, the chemotherapy consisting of 5-fluorouracil and mitomycin C. Follow-up physical examination and imaging studies revealed a complete response, as well as a normal complete blood count (CBC) during the following months. One year after the end of treatment, a CBC performed 2 days prior to a scheduled visit revealed a platelet count of 15 x 109/L. The patient was immediately called to the clinic for an evaluation. She denied any complaint. One to two weeks before the visit, she had been scratched by a pet cat. This was followed by fever, and swelling of the right hand.