RESUMO
BACKGROUND: The time interval between neoadjuvant immunotherapy and surgery is 6 weeks for esophageal squamous cell carcinoma (ESCC), but whether delayed surgery affects prognosis remains unclear. METHODS: Clinical data of locally advanced ESCC who underwent neoadjuvant immunotherapy followed by esophagectomy from November 2019 to December 2022 were collected. The surgery outcomes and prognosis were compared between short-interval (time to surgery ≤ 6 weeks) and long-interval groups (time to surgery > 6 weeks). RESULTS: 152 patients were enrolled totally, with a ratio of 91:61 between short-interval and long-interval groups. The rate of pathological complete response in the short-interval and long-interval groups were 34.1% and 24.6% (P = 0.257). Delayed surgery did not have a significantly impact on the number of lymph node dissections (P = 0.133), operative duration (P = 0.689), blood loss (P = 0.837), hospitalization duration (P = 0.293), chest drainage duration (P = 0.886) and postoperative complications (P > 0.050). The 3-year Overall survival (OS) rates were 85.10% in the short-interval group, and 82.07% in the long-interval group (P = 0.435). The 3-year disease-free survival (DFS) rates were 83.41% and 70.86% in the two groups (P = 0.037). Subgroup analysis revealed that patients with a favorable response to immunotherapy (tumor regression grade 0) exhibited inferior 3-year OS (long-interval vs. short-interval: 51.85% vs. 91.08%, P = 0.035) and DFS (long-interval vs. short-interval: 47.40% vs. 91.08%, P = 0.014) in the long-interval group. CONCLUSIONS: Delayed surgery after neoadjuvant immunotherapy does not further improve pathological response; instead, it resulted in a poorer DFS. Especially for patients with a favorable response to immunotherapy, delayed surgery increases the risk of mortality and recurrence.
Assuntos
Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Esofagectomia , Imunoterapia , Terapia Neoadjuvante , Humanos , Masculino , Feminino , Carcinoma de Células Escamosas do Esôfago/terapia , Carcinoma de Células Escamosas do Esôfago/mortalidade , Carcinoma de Células Escamosas do Esôfago/patologia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Terapia Neoadjuvante/métodos , Pessoa de Meia-Idade , Neoplasias Esofágicas/terapia , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Prognóstico , Imunoterapia/métodos , Esofagectomia/métodos , Idoso , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
The utilization of polymer conformations to construct a variety of superlattices is a common method within the field. However, this technique often results in only long-range ordering rather than the formation of distinct superlattices. In this study, a well-organized array of discrete pancake-shaped superlattices (DPSs) is successfully obtained through the utilization of air-liquid interface self-assembly, facilitated by the confined environment created by a block copolymer. It is crucial to note that both the self-assembly behavior and resulting morphologies of the DPSs can be precisely tuned by adjusting several experimental parameters, most notably the concentration and molecular architecture of the block copolymers. Furthermore, this work provides valuable insights into the formation processes and mechanisms underpinning the DPSs. The approach described here is both straightforward and efficacious, establishing a strong foundation for subsequent research and the development of non-close-packed superlattice structures.
Assuntos
Nanopartículas , Polímeros , Nanopartículas/química , Polímeros/química , Tamanho da Partícula , Propriedades de SuperfícieRESUMO
The optimization of flame retardancy and thermal conductivity in epoxy resin (EP), utilized in critical applications such as mechanical components and electronics packaging, is a significant challenge. This study introduces a novel, ultrasound-assisted self-assembly technique to create a dual-functional filler consisting of carbon nanotubes and ammonium polyphosphate (CNTs@APP). This method, leveraging dynamic ligand interactions and strategic solvent selection, allows for precise control over the assembly and distribution of CNTs on APP surfaces, distinguishing it from conventional blending approaches. The integration of 7.5 wt.% CNTs@APP10 into EP nanocomposites results in substantial improvements in flame retardancy, as evidenced by a limiting oxygen index (LOI) value of 31.8% and achievement of the UL-94 V-0 rating. Additionally, critical fire hazard indicators, including total heat release (THR), total smoke release (TSR), and the peak intensity of CO yield (PCOY), are significantly reduced by 45.9% to 77.5%. This method also leads to a remarkable 3.6-fold increase in char yield, demonstrating its game-changing potential over traditional blending techniques. Moreover, despite minimal CNTs addition, thermal conductivity is notably enhanced, showing a 53% increase. This study introduces a novel approach in the development of multifunctional EP nanocomposites, offering potential for wide range of applications.