الملخص
@#The National Comprehensive Cancer Network (NCCN) has updated and released the NCCN esophageal and esophagogastric junction cancers clinical practice guidelines in oncology (version 3. 2022). Compared with the version 4 of the guidelines in 2021, the 3 versions in 2022 have some updates and revisions, mainly focusing on molecular marker detection, perioperative treatment, advanced immunotherapy, radiotherapy and other aspects. This article will interpret the main content of the new edition of the guidelines, in order to enhance the understanding of the guidelines and guide the clinical practice of diagnosis and treatment.
الملخص
This study aimed to assess the role of the National Comprehensive Cancer Network (NCCN) risk classification in predicting biochemical recurrence (BCR) after radical prostatectomy (RP) in Chinese prostate cancer patients. We included a consecutive cohort of 385 patients with prostate cancer who underwent RP at Fudan University Shanghai Cancer Center (Shanghai, China) from March 2011 to December 2014. Gleason grade groups were applied at analysis according to the 2014 International Society of Urological Pathology Consensus. Risk groups were stratified according to the NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer version 1, 2017. All 385 patients were divided into BCR and non-BCR groups. The clinicopathological characteristics were compared using an independent sample t-test, Chi-squared test, and Fisher's exact test. BCR-free survival was compared using the log-rank test and multivariable Cox proportional hazard analysis. During median follow-up of 48 months (range: 1-78 months), 31 (8.05%) patients experienced BCR. The BCR group had higher prostate-specific antigen level at diagnosis (46.54 ± 39.58 ng ml-1 vs 21.02 ± 21.06 ng ml-1, P= 0.001), more advanced pT stage (P = 0.002), and higher pN1 rate (P < 0.001). NCCN risk classification was a significant predictor of BCR (P = 0.0006) and BCR-free survival (P = 0.003) after RP. As NCCN risk level increased, there was a significant decreasing trend in BCR-free survival rate (Ptrend = 0.0002). This study confirmed and validated that NCCN risk classification was a significant predictor of BCR and BCR-free survival after RP.
الموضوعات
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , China/epidemiology , Cohort Studies , Disease-Free Survival , Follow-Up Studies , Guidelines as Topic , Neoplasm Grading , Neoplasm Recurrence, Local/epidemiology , Prostate-Specific Antigen/analysis , Prostatectomy , Prostatic Neoplasms/surgery , Retrospective Studies , Risk Assessment , Survival Analysisالملخص
This study aimed to assess the role of the National Comprehensive Cancer Network (NCCN) risk classification in predicting biochemical recurrence (BCR) after radical prostatectomy (RP) in Chinese prostate cancer patients. We included a consecutive cohort of 385 patients with prostate cancer who underwent RP at Fudan University Shanghai Cancer Center (Shanghai, China) from March 2011 to December 2014. Gleason grade groups were applied at analysis according to the 2014 International Society of Urological Pathology Consensus. Risk groups were stratified according to the NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer version 1, 2017. All 385 patients were divided into BCR and non-BCR groups. The clinicopathological characteristics were compared using an independent sample t-test, Chi-squared test, and Fisher's exact tes.t BCR-free survival was compared using the log-rank test and multivariable Cox proportional hazard analysis. During median follow-up of 48 months (range: 1-78 months), 31 (8.05%) patients experienced BCR. The BCR group had higher prostate-specific antigen level at diagnosis (46.54 ± 39.58 ng ml-1 vs 21.02 ± 21.06 ng ml-1, P= 0.001), more advanced pT stage (P = 0.002), and higher pN1 rate (P < 0.001). NCCN risk classification was a significant predictor of BCR (P = 0.0006) and BCR-free survival (P = 0.003) after RP. As NCCN risk level increased, there was a significant decreasing trend in BCR-free survival rate (Ptrend = 0.0002). This study confirmed and validated that NCCN risk classification was a significant predictor of BCR and BCR-free survival after RP.
الملخص
Thyroid carcinoma is the most common cancer that affects the endocrine system.With the development of research meth-ods and techniques of various disciplines,the clinical diagnosis,treatment,and understanding of thyroid carcinoma are constantly pro-gressing.In the latest edition of the National Comprehensive Cancer Network(NCCN)guidelines,the preoperative evaluation of thy-roid nodules,the mode and range of the operation,and the treatment involving postoperative thyroid stimulating hormone(TSH)sup-pression have changed,all of which can provide a reference for the diagnosis and treatment of thyroid nodules.
الملخص
Objective@#To analyze the effect of NCCN (2015) risk stratification on prognosis of patients with acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#Retrospective analysis of 258 patients with AML in CR (186 cases in CR1, 72 cases in CR2) who underwent allogeneic HSCT in our hospital between April 2012 and March 2015 according to NCCN (2015) risk stratification. Of them, 63 cases were classified as low risk, 112 cases intermediate risk and 83 cases high risk.@*Results@#①With the median follow up of 18 (5-41) months, two-year disease free surviva (DFS) in 258 patients was 78.0% (95% CI 60.4%-96.6%) . Two-year DFS in AML after transplantation was 78.6% (95% CI 61.0%-96.2%) in low risk, 76.0% (95% CI 84.0%-93.6%) in intermediate risk and 80.3% (95% CI 62.7%-97.9%) (P=0.886) in high risk groups respectively. ②Univariate analysis showed that DFS has no significant difference in patient age, the median disease course before HSCT, the WBC number at the beginning of the disease, blood routine and chromosomes examination before transplantation, extramedullary disease before transplantation, disease status before transplantation, conditioning regimen, donor type, donor and recipient sex, recipient blood type, transfused MNC number, transfused CD34+ cell number and transfused CD3+ cell number. DFS was significant lower in primary AML than that in secondary AML (P=0.006) and also lower in MRD positive than that in MRD negative (P=0.003) . The accumulative relapse was significant higher in CR2 compared to that in CR1 (P=0.046) . Accumulative non-relapse mortality (NRM) was significanlyt higher in secondary AML compared to that in primary AML (P=0.004) and also higher in MRD positive compared to that in MRD negative (P=0.010) . ③Multivariate analysis showed that MRD positive was the only significant factor in DFS and NRM.@*Conclusion@#Allo-HSCT treatment of AML CR patients could achieve a high efficacy, which is similar between CR1 and CR2 patients. There is no significant correlation between NCCN (2015) risk stratification and the prognosis of AML patients with allo-HSCT treatment. Pre-conditioning MRD status monitored by multiparameter flow cytometry was the only impact factor on DFS and NRM in allo-HSCT for CR-AML patients.
الملخص
Objective@#To validate the prognostic value of NCCN-International Prognostic Index (NCCN-IPI) for patients with peripheral T-cell lymphoma (PTCL) treated with CHOP-based chemotherapy.@*Methods@#A retrospective analysis in 162 PTCL patients who were initially diagnosed and treated in Rui Jin Hospital from January 2003 to May 2013 was conducted. Baseline characteristics were collected, and survival analysis was performed according to the IPI and NCCN-IPI model.@*Results@#The estimated 5-year overall survival (OS) rate and progression free survival (PFS) rate were 33% and 20%, with median OS and PFS of 17.0 months and 9.2 months, respectively. Multivariate analysis indicated ECOG score (PFS: HR=2.418, 95%CI 1.535-3.809, P<0.001; OS: HR=2.347, 95%CI 1.435-3.839, P= 0.001) , specific extra-nodal sites (PFS: HR=1.800, 95%CI 1.216-2.665, P=0.003; OS: HR=1.608, 95% CI 1.054-2.454, P=0.027) and pathology type (PFS: HR=0.424, 95% CI 0.184-0.975, P=0.043; OS: HR=0.276, 95% CI 0.087-0.877, P=0.029) were independent prognostic factors of OS and PFS for the patients with PTCL. The survival rates of low risk patients based on NCCI-IPI were remarkably higher than the counterparts based on IPI (5-year OS 74% vs 54%, χ2=5.041, P=0.025, 5-year PFS 50% vs 38%, χ2= 5.295, P=0.021) . NCCN-IPI was outstanding to identify the subgroup of low risk patients with PTCL, who may benefit from conventional chemotherapy such as CHOP or CHOP-like regimen.@*Conclusion@#NCCN-IPI is more powerful for low risk PTCL patients and a strong supplement for IPI.
الملخص
The therapy of acute promyelocytic leukemia (APL) with all-trans retinoic acid and arsenic trioxide was first discovered in China, which made a great contribution worldwide to APL treatment. However, foreign guidelines did not include the Chinese chemotherapy regimens, and our regimens were inconsistent with foreign guidelines. Therefore, it is necessary to interpret the home and international guidelines and to explore standard treatment of APL by analyzing APL guidelines of the China, Europe and the United States. Owing to several discrepancies between domestic and foreign APL guidelines, unifying the APL's diagnosis and treatment standard is desperately needed at present according to the evidence-based medicine. It is hoped that Chinese chemotherapy regimens will be more acceptable to other countries of the world, and would benefit the diagnosis and treatment of human APL.
الملخص
Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia,which is rare in children.The treatment of APL mainly includes anthracycline-based chemotherapy,all-trans retinoic acid,and arsenic trioxide,which allow for complete remission,improve the long time survival rate and reduce related toxicity as well.About the optimized treatment,quick breakthroughs have already reached,not only at home in the 80's at the end of the 90's,but also abroad,like National Comprehensive Cancer Network of the United States in 2006-2013.This review summarizes the progress in diagnosis and treatment of children with APL.
الملخص
Non-H Lymphoma(NHL)is a heterogenous group of lymphoma which originates from B lymphocytes,T lymphocytes and Natural Killer cells.Every year,many very famous specialists of Hematology in the world come together to update the guideline of NHL for National comprehensive Cancer Network(NCCN).The guideline updated by NCCN is obtained good evaluation by clinical doctors in the world.This article makes a brief comment for the category,diagnosis and treatment of all subtypes NHL in V.I.2009 compared with V.I.2008.
الملخص
The National Comprehensive Cancer Network(NCCN)is an alliance of 21 world leading cancer centers in the U.S.A,working together to develop treatment guidelines for most cancers.The primary goal of all NCCN initiatives is to improve the quality,effectiveness,and efficiency of oncology practice so that patients can live better.The NCCN guidelines have become the most widely used in oncology practice.These guidelines are updated continually and are based upon evaluation of scientific data.The NCCN Esophageal Cancer Guidelines have no Chinese version at present and were not yet used in our clinical practice.We are in an attempt to interpret the NCCN Esophageal Cancer Guidelines in conjunction with our clinical practice in the management of esophageal cancer.