Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36,480 cases.

BACKGROUND: The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus ACT in TNBC. METHODS: A systematic search was performed on the PubMed and Embase databases to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC. RESULTS: A total of nine studies involving 36,480 patients met the selection criteria. Among them, 10,728 (29.41%) received NACT, and 25,752 (70.59%) received ACT. The pathological complete response (pCR) rate was 35% (95% CI = 0.23-0.48). Compared with ACT, the overall survival (OS) of NACT was poor (HR = 1.59; 95% CI = 1.25-2.02; P = 0.0001), and there was no significant difference in disease-free survival (DFS) between the two treatments (HR = 0.85; 95% CI = 0.54-1.34; P = 0.49). NACT with pCR significantly improved the OS (HR = 0.53; 95% CI = 0.29-0.98; P = 0.04) and DFS (HR = 0.52; 95% CI = 0.29-0.94; P = 0.03), while the OS (HR = 1.18; 95% CI = 1.09-1.28; P < 0.0001) and DFS (HR = 2.36; 95% CI = 1.42-3.89; P = 0.0008) of patients with residual disease (RD) following NACT were worse compared to those receiving ACT. CONCLUSION: These findings suggest that, for TNBC, NACT with pCR is superior to ACT in improving OS and DFS, and it turns to be opposite when patients are receiving NACT with RD.

Correlation between macroscopic characteristics and tissue-specific chemical profiling of the root of Salvia miltiorrhiza.

BACKGROUND: Macroscopic identification has been widely used as a convenient method for herbal authentication and quality assessment. However, sensory evaluation heavily relied on personal experience and lacked enough evidence-based validations. PURPOSE: We aim to reveal the correlation between macroscopic characteristics and tissue-specific chemical composition of the root of Salvia miltiorrhiza (SMR), and then develop a rapid method for quality assessment. METHODS: Thirty-two batches of SMR were collected and evaluated. The outer-surface color and diameter as the representative tissue features of SMR were selected as the macroscopic indexes. SMR were then divided into three parts along transverse section as outer bark, middle part and central part, to explore the spatial distribution of chemicals. Outer-surface color information was converted into RGB values, while the diameter data were expressed by mean distance, respectively. Thirteen major components including eight salvianolic acids and five tanshinones in each part were determined by liquid chromatography tandem mass spectrometry. Finally, several mathematical models were established and optimized to evaluate the correlation between outer-surface color, size and chemical distribution. RESULT: All five tanshinones mainly distributed in the outer bark while salvianolic acids were averagely existed among three parts. Correlational studies revealed that the surface color depth was significantly and positively correlated with tanshinone contents in the outer bark, while the size showed poor correlation in any chemicals. A color-oriented model was thus developed for the prediction of tanshinone contents in SMR, and a 9 × 9 standard color chart was created for easily use. CONCLUSION: This study contributes an alternative method for macroscopic features-based quality evaluation of herbs, and also complements some scientific data for traditional knowledge.

Prediction of ovarian function in premenopausal breast cancer patients with amenorrhoea after chemotherapy: a simple clinical score.

We evaluated a non-invasive method for predicting the ovarian function of premenopausal breast cancer patients with amenorrhoea after chemotherapy. A total of 34 patients had ovarian function, whereas 56 had no ovarian function. Logistic regression analysis indicated that age (P = 0.034; hazards ratio [HR], 0.29; confidence interval [CI], 0.091-0.910), follicle-stimulating hormone (P = 0.032; HR 0.97; CI 0.944-0.997) and oestradiol (P = 0.047; HR 1.01; CI 1.000-1.015) were independent influencing factors that determine ovarian function. The ovarian function score (OFS) (P < 0.001; HR 48.00; CI 10.174-226.452) was obtained through a comprehensive analysis of these three variables, and it could more effectively predict ovarian function. According to receiver operating characteristic curve analysis, the OFS had the highest values compared with the other three variables (sensitivity, 94.6 %; specificity, 79.3 %). The OFS is simple and easy to use; thus, it is expected to become a new method for determining drug-induced amenorrhoea in women with breast cancer. Ovarian function likely still exists if the OFS is ≤1.

[Giant prostatic calculus with neurogenic bladder disease and prostate diverticulum: a case report and review of the literature].

OBJECTIVE: To study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum. METHODS: We retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 -20/HPF, RBC 12 - 15/HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus. RESULTS: The patient underwent TURP and transurethral lithotripsy with holmium-YAG laser. The prostatic calculus was carbonate apatite in composition. Urinary dynamic images at 2 weeks after surgery exhibited significant improvement in the highest urine flow rate and residual urine volume. Seventeen months of postoperative follow-up showed dramatically improved urinary incontinence and thicker urine stream. CONCLUSION: Prostate diverticulum with prostatic giant calculus is very rare, and neurogenic bladder may play a role in its etiology. Cystoscopy is an accurate screening method for its diagnosis. For the young patients and those who wish to retain sexual function, TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.