Salvage surgery for neck residue or recurrence of nasopharyngeal carcinoma after primary radiotherapy: options of surgical methods and regions.

BACKGROUND: Salvage surgery has been recommended as the approach of choice for neck residue or recurrence of nasopharyngeal carcinoma (NPC) after primary radiotherapy (RT). This study aimed to assess the outcome and prognostic factors, options for different surgical methods, and the extent of neck dissection (ND) for patients. METHODS: NPC patients who had undergone RT and received salvage surgery for neck residue or recurrence from January 2001 to December 2011 were retrospectively analyzed. The overall survival (OS) rate was calculated by Kaplan-Meier method, and prognostic factors were determined by log-rank test and Cox regression analysis. RESULTS: In 153 cases, 96 cases have level I dissections. The metastasis rate was 20/153 (13.07%) for level I metastasis and 7/153 (4.58%) for parotid gland cases. The 3- and 5-year OS rate was 57.2 and 40.6%, respectively, and median survival time was 49 months. By univariate analysis, the age, rN staging, size of lymph nodes (LN), extra-capsular spread (ECS), and surgical procedure were significant prognostic factors. By multivariable analysis, the age, rN staging, and size of LN were significant prognostic factors. CONCLUSIONS: Salvage surgery is effective for neck failure of NPC after primary treatment, but patients with age >50 years, stage rN3, or LN >6 cm have poor prognosis.

The 2002 AJCC TNM classification is a better predictor of primary small cell esophageal carcinoma outcome than the VALSG staging system.

Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive malignant tumor with a poor prognosis. The optimal disease staging system and treatment approaches have not yet been defined. This study aimed to evaluate the prediction of different staging systems for prognosis and treatment options of SCCE. We retrospectively accessed the clinicopathologic characteristics, treatment strategy, and prognosis of 76 patients diagnosed with primary SCCE between 2001 and 2011. The 1-, 2-, 3-, and 5-year overall survival rates were 58%, 31%, 19%, and 13%, respectively. Univariate analysis showed that the 2002 American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification (P = 0.002), Veterans Administration Lung Study Group (VALSG) stage (P = 0.001), predisposing factors (P < 0.001), T category (P = 0.023), and M category (P < 0.001) were prognostic factors for overall survival. Multivariate analysis showed that the 2002 AJCC TNM stage (P < 0.001) was the only independent prognostic factor for survival. The value of the area under the receiver operator characteristic (ROC) curve (AUC) of the 2002 AJCC TNM staging system was larger than that of VALSG staging system with regard to predicting overall survival (0.774 vs. 0.620). None of the single treatment regimens showed any benefit for survival by Cox regression analysis. Thus, the 2002 AJCC TMN staging system improved the prediction of SCCE prognosis; however, the optimal treatment regimen for SCCE remains unclear.

Up-regulation of BRAF activated non-coding RNA is associated with radiation therapy for lung cancer.

Radiation therapy has become more effective in treating primary tumors, such as lung cancer. Recent evidence suggested that BRAF activated non-coding RNAs (BANCR) play a critical role in cellular processes and are found to be dysregulated in a variety of cancers. The clinical significance of BANCR in radiation therapy, and its molecular mechanisms controlling tumor growth are unclear. In the present study, C57BL/6 mice were inoculated Lewis lung cancer cells and exposed to radiation therapy, then BANCR expression was analyzed using qPCR. Chromatin immunoprecipitation and western blot were performed to calculate the enrichment of histone acetylation and HDAC3 protein levels in Lewis lung cancer cells, respectively. MTT assay was used to evaluate the effects of BANCR on Lewis lung cancer cell viability. Finally, we found that BANCR expression was significantly increased in C57BL/6 mice receiving radiation therapy (P<0.05) compared with control group. Additionally, knockdown of BANCR expression was associated with larger tumor size in C57BL/6 mice inoculated Lewis lung cancer cells. Histone deacetylation was observed to involve in the regulation of BANCR in Lewis lung cancer cells. Moreover, over expression HDAC3 reversed the effect of rays on BANCR expression. MTT assay showed that knockdown of BANCR expression promoted cell viability surviving from radiation. In conclusion, these findings indicated that radiation therapy was an effective treatment for lung cancer, and it may exert function through up-regulation BANCR expression.

Regeneration of magnetic biochar derived from eucalyptus leaf residue for lead(II) removal.

Regeneration of Pb-loaded magnetic biochar prepared with eucalypts leaf residue was studied by using EDTA-2Na as a regenerant. The desorption efficiency was found to be 84.1% in 120 min with iron leaching amount of 1.1 mg g(-1). Higher SBET and pore volume were observed in regenerated magnetic biochars and no significant band shifts occurred in FTIR spectra during 6 regeneration cycles. The decrease of Pb(II) adsorption capacity (from 52.4 to 41.5 mg g(-1)) was only found in the first regeneration cycle. Magnetic separation performance of adsorbents was not significantly affected by multiple regeneration cycles.

Combined performance of biochar sorption and magnetic separation processes for treatment of chromium-contained electroplating wastewater.

Magnetic biochar was prepared with eucalyptus leaf residue remained after essential oil being extracted. Batch experiments were conducted to examine the capacity of the magnetic biochar to remove Cr (VI) from electroplating wastewater and to be separated by an external magnetic field. The results show that the initial solution pH plays an important role on both sorption and separation. The removal rates of Cr (VI), total Cr, Cu (II), and Ni (II) were 97.11%, 97.63%, 100% and 100%, respectively. The turbidity of the sorption-treated solution was reduced to 21.8NTU from 4075NTU after 10min magnetic separation. The study also confirms that the magnetic biochar still retains the original magnetic separation performance after the sorption process.

[Squamous cell carcinoma of cervical lymph nodes from an unknown primary site: a retrospective analysis of treatment strategies and prognosis].

OBJECTIVE: To analyze the treatment strategies and prognosis of squamous cell carcinoma of cervical lymph nodes from an unknown primary site (SCCUP). METHODS: A total of 125 cases with SCCUP was retrospectively analyzed from January 2001 to December 2011. Ninety-seven of the cases were treated with neck dissection (ND), including 24 with classic radical ND, 62 with modified ND and 11 with extended radical ND. Of 125 cases with SCCUP, 72 cases were supplemented with radiotherapy and 52 cases with chemotherapy. Radiotherapy was applied with extensive field in 36 cases, bilateral neck in 15 cases, and ipsilateral neck in 21 cases. The patients were followed up and the Kaplan-Meier method was used to calculate survival curves. Cox's analysis and logistic regression were used to evaluate the prognosis factors for SCCUP. RESULTS: The 5-year overall survival rate and disease free survival rate of the cohort were 66.2% and 60.0%, respectively. The median survival time was 70 months. Cox's analysis showed N-stage, extracapsular spread, bilateral neck metastasis and ND were independent prognostic factors for SCCUP. Logistic regression suggested that N-stage was the main factor for nodal recurrence or uncontrolled. The primary tumor sites emerged in 27 patients (21.6%) within 3 - 96 months after treatment (median time was 15 months), but only 4 patients (11.1%) existed in 36 cases underwent radiotherapy with extensive field. CONCLUSIONS: N-stage and extracapsular spread are two major factors influencing the prognosis of SCCUP. ND may improve the locoregional control and long-term survival.

[Primary oncocytic carcinoma of the salivary glands: a clinical and pathologic study of 12 cases].

PURPOSE: To investigate the clinicopathological feature of oncocytic carcinoma of the salivary gland, and discuss diagnosis, treatment and prognosis. METHODS: From March 2001 to September 2010, the clinical data and pathological features of 12 cases of oncocytic carcinoma of the salivary gland in Zhejiang Cancer Hospital were reviewed and analyzed retrospectively. All cases are followed up. The Kaplan-Meier method was used to calculate survival curves by SPSS 16.0 software package. RESULTS: The tumors were found mainly as a painless, irregular-shaped mass or lymphadenectasis in the head and neck firstly. Pathologically, oncocytic carcinoma of salivary gland origin was an extremely rare proliferation of malignant oncocytes with adenocarcinomatous architectural phenotypes, including prominent nucleoli and infiltrative qualities. Surgery was the principal treatment, and postoperative radiotherapy was used as adjuvant treatment. Of the 12 cases with follow-up for 6 to 120 months, 7 cases survived without regional or distant metastases. 1 case survived with regional and distant metastases. 2 cases died of regional recurrences.1 case had lymphatic metastasis and died of distant metastasis finally.1 case had given up therapy and died of tumor progress ultimately. 3 cases had local recurrence within 2 years, and the recurrence rate was 25%; 3 cases died within 2 years, and the mortality rate was 25%. CONCLUSIONS: Oncocytic carcinoma of salivary gland origin is an extremely rare tumor in head and neck, with short course and rapid progress. Radical resection postoperative radiotherapy is the treatment of choice. The prognosis of oncocytic carcinoma may be associated with tumor stage, regional lymph node metastases and complete surgical excision.