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Objective:To investigate the safety and prognosis of partial nephrectomy (PN) in the treatment of highly malignant non-clear renal cell carcinoma (nccRCC).Methods:Clinical data of 47 patients with cT 1N 0M 0 high malignant nccRCC treated in Changhai Hospital from March 2016 to March 2022 were retrospectively analyzed. All patients received PN. There were 34(72.3%) males and 13(27.7%) females. The mean age was (53.5±15.0) years, and average BMI, was(23.7±3.4)kg/m 2.The maximum tumor diameter was (29.8±12.6) mm, and R. E.N.A.L. score was 7(5-9), with 37(78.7%) cases of T 1a and 10(21.3%) cases of T 1b. The mean estimated glomerular filtration rate (eGFR) before surgery was (96.3±25.5) ml/ (min·1.73m 2). All patients underwent PN, including 1 patient (2.1%) undergoing open surgery, 29 patients (61.7%) undergoing laparoscopic surgery, and 17 patients (36.2%) undergoing robotic surgery. There were a total of 22(46.8%) cases of papillary cell carcinoma(pRCC)type Ⅱ, 4(8.5%) cases of collecting duct carcinoma (cdRCC), 9(19.1%) cases of MiT family translocated renal cell carcinoma (tRCC), 5(10.6%) cases of mucoid tubular and spindle cell carcinoma (mtSCC)and 7(14.9%) cases of unclassified renal cell carcinoma (uRCC). The surgical conversion rate, positive margin rate, operative time, intraoperative blood loss, complications, and postoperative hospital stay were analyzed. Preoperative and postoperative eGFR were analyzed, and overall survival (OS) and cancer specific survival (CSS) were calculated. Results:All the operations were successfully completed. No radical operation or open operation was performed, with operation time of(100±60) min and intraoperative blood loss of(100±59) ml. There were no intraoperative complication and 1 case (2.1%) suffered from postoperative complication. Postoperative hospital stay were 5 (4-6) days. The mean eGFR after surgery was (86.5±27.1) ml/(min·1.73m 2), and the difference was statistically significant ( P=0.041). In this study, the mean follow-up time was (45.7±20.9)months, and no adjuvant therapy was used after surgery. During the follow-up period, 2 patients died, who all of them were kidney cancer-related death, and both OS and CSS were 95.7% (45/47). Conclusions:PN is safe, feasible and has a good prognosis in the treatment of high malignant T 1 nccRCC. For tumors with clear imaging boundaries and complete envelope, complete tumor resection is more likely, postoperative follow-up should be strict, and no remedial radical or systemic treatment was required.
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Objective:To study the efficacy of different surgical methods in treatment of hilar cholangiocarcinoma (HCCA), and to analyze the factors affecting long-term prognosis of HCCA patients after surgical treatment.Methods:The clinical data of 105 patients who underwent surgical treatment for HCCA at the First Affiliated Hospital of Soochow University from April 2010 to October 2021 were retrospectively analysed. There were 58 males and 47 females, with age (64.2±10.6) years old. Data analysed included surgical treatments, postoperative pathological data, perioperative complications and survival on follow-up. The Kaplan Meier survival curve was plotted, and the log-rank test and Cox proportional hazard model were performed to analyze the key factors affecting long-term prognosis.Results:Of 105 patients, 4 (3.8%) patients died during the perioperative period, and 58 patients (55.2%) developed complications with included 32 (30.5%) patients with pleural effusion and 12 (11.4%) patients with biliary leakage. The follow-up data was available in 85 patients with the overall median survival time of 19 months, and the 1-, 3-, 5-year cumulative survival rates of 58.1%, 27.0% and 24.8% respectively. The 1-, 3-, and 5-year cumulative survival rates for the R 0 resection patients ( n=59) were 69.4%, 36.2%, 27.4%, respectively, which were significantly better than 49.4%, 12.3%, 0% for the R 1/2 resection patients ( n=20), and 0% for the palliative drainage patients ( n=6) (all P<0.05). Univariate analysis and Cox multivariate analysis showed that age ≥70 years ( HR=2.158, 95% CI: 1.175-3.965), preoperative CA19-9 level ≥1 015 U/ml ( HR=1.981, 95% CI: 1.009-3.894), resection margin ( HR=2.587, 95% CI: 1.371-4.881), and lymph node metastasis ( HR=2.308, 95% CI: 1.167-4.567) were independent risk factors for long-term prognosis of HCCA patients (all P<0.05). Conclusions:R 0 resection was an effective way to prolong survival of patients with HCCA. Age, preoperative CA19-9 level, resection margin and lymph node metastasis were related to long-term survival of HCCA patients.
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Objective To study factors affecting prognosis of patients with intrahepatic cholangiocarcinoma (ICC),focusing on the correlation between extent of lymph node dissection and prognosis of patients with ICC.Methods The clinical data of ICC patients who underwent radical resection at the Hepatobiliary and Pancreatic Surgery of Affiliated Cancer Hospital of Zhengzhou University from October 2013 to October 2017 were retrospectively analyzed.According to the extent of lymph node dissection,the patients were divided into the non-dissected lymph node group,the routine dissection lymph node group and the extended lymph node dissection group.The prognoses of the three groups were compared.The Cox stepwise regression model was used to analyze the independent risk factors for prognosis of patients with ICC.Results The 178 patients included 109 males and 69 females.Their ages ranged from 30 to 81 years (average 59 years).There were 80 patients in the non-dissected group,34 patients in the routine lymph node dissection group,and 64 patients in the extended lymph node dissection group.The overall survival rates of the 178 patients at 3 years after liver resection was 29.2％ (52/178),overall median survival 25.8 months.The 3-year survival rates of the non-dissected group,routine dissection group,and extended dissection group were 10.0％ (8/80),52.9％ (18/34),40.6％ (26/64),respectively.The differences among the three groups were significant (P ＜ 0.05).Comparison among the three groups showed that there was no significant difference in survival rates between the routine dissection group and the extended dissection group (P ＞ 0.05).There was a significant difference in survival rates between the non-dissected group and the extended lymph node dissection group (P ＜0.05).Univariate analysis showed that CA19-9,tumor diameter,portal tumor thrombus,and lymph node dissection were related to prognosis of patients with ICC (P ＜ 0.05).Multivariate analysis showed CA19-9,tumor diameter,and extent of lymph nodes clearance were related to patient survival (P ＜ 0.05).Conclusions CA19-9,tumor diameter,and extent of lymph node dissection were independent risk factors of survival in patients with ICC.For patients with ICC who undergo surgical resection,conventional laparoscopic lymph node dissection can achieve good results,and there is no need to extend lymph node dissection.
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@# Objective: To screen differentially expressed lncRNA, miRNA and mRNA in colorectal cancer (CRC) in TCGA database, and to explore their relationship with CRC prognosis and related biological functions. Methods: RNA sequencing (RNA-Seq) data and miRNA-Seq data of CRC samples were downloaded from the TCGAdatabase and analyzed, and differentially expressed lncRNA, miRNA and mRNA were screened by R program. The lncRNA-miRNA-mRNA ceRNA network in CRC was constructed by analyzing and integrating the relationships between differentially expressed RNAs through miRcode, TargetScan and miRTarbase databases.KaplanMeier method was used to analyze the relationship between the expression of lncRNA, miRNA, mRNA in ceRNA network and the survival prognosis of patients.Finally, the signal pathways involved in the occurrence and development of CRC were analyzed by GSEA functional enrichment analysis software. Results: A total of 614 differentially expressed lncRNAs, 244 differentially expressed miRNAs, and 12 672 differentially expressed mRNAs in CRC were identified; a ceRNA network consisting of 139 lncRNAs, 37 miRNAs and 228 mRNAs was constructed;It was found that 58 lncRNAs, 23 miRNAs, and 150 mRNAs were associated with the prognosis of CRC.The results of GSEA enrichment analysis showed that mRNA was mainly involved in signaling pathways such as Notch, Hedgehog and TGF-β. Conclusion: CRC-related ceRNA network was successfully constructed and lncRNAs, miRNAs and mRNAs associated with CRC prognosis were screened. It provides a valuable preliminary basis for further in-depth clinical research and basic experimental research on CRC.
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OBJECTIVE: To investigate the prognostic factors of esophageal cancer with brain metastasis. METHODS: SEER Stat 8.3.5 was used to collect 39 cases of esophageal cancer with brain metastasis from 2010 to 2015 in the Surveillance, Epidemiology and End RESULTS:(SEER) database. X-tile software was used to determine the best cut-off value of the age. Prognostic factors were analyzed with log-rank and Cox proportional hazard model by SPSS(v25.0). RESULTS: The median survival time of patients with esophageal cancer with brain metastasis was 7.0 months, the 6-month survival rate was 53.3%, and the 1-year survival rate was 16.3%. Only age(χ~2=4.045, P=0.044)was the prognostic factor, while there was insufficient evidence to show whether gender, marriage, race, primary site, histological grade,surgery, pathological type, T stage or N stage was associated with the prognosis of the patients. CONCLUSION: Brain metastasis is a rare metastatic type of esophageal cancer. Age is associated with worse prognosis, while the influences of other risk factors are not clear.Active treatment can lead to better prognosis.
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OBJECTIVE: To analyze the prognostic factors related to liver metastasis of esophageal cancer and establish an effective prediction model. METHODS: The data of 464 cases of esophageal cancer with liver metastasis from 2010 to 2015 was collected from the National Cancer Institute SEER database by SEER stat 8.3.5 software. SPSS(v25.0) was used to analyze the prognostic factors of esophageal cancer liver metastasis and Kaplan-Meier curve was used for survival analysis. We introduced the meaningful variables of single factor analysis in Cox proportional hazard model and multivariate analysis and obtained the independent influencing factors of prognosis.Independent factors were then included in the accelerated failure time model to construct the nomogram. RESULTS: The mean survival time of patients in this study was 11.6 months(95%CI: 10.075-13.209), and their 1-, 3-, and 5-year survival rates were 29.4%, 5.5%, and 0,respectively. Age(HR=1.452, 95% CI: 1.175-1.795), marriage(HR=0.753, 95%CI: 0.611-0.927) and surgery(HR=0.428, 95% CI: 0.227-0.807) were independent prognostic factors for patients. We constructed the nomogram with risk factors of prognosis, and the C-index value was 0.614. CONCLUSION: The prognosis of esophageal cancer liver metastasis is poor. being young, Being married, and surgery are associated with better survival, and the nomogram we have constructed is proved to have good predictive ability.
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OBJECTIVE: To establish a prediction model for the prognosis of patients with esophageal cancer lung metastasis.METHODS: Data from 194 patients with esophageal cancer lung metastasis from 2010 to 2015 was collected from the National Cancer Institute Surveillance, Epidemiology and End RESULTS:(SEER) database. The best cutoff value for age was determined by X-tile software.Prognostic factors were analyzed by SPSS(v25.0) with the log-rank method and the Cox proportional hazard model. Risk factors from univariate analysis were used to construct prediction nomogram with R studio software(version 3.5.1). RESULTS: The median survival time of 194 patients with esophageal cancer lung metastasis was 7.0 months, the 3-month survival rate was 69.9%, and the 1-year survival rate was 27.7%. Age(HR=1.51, 95% CI: 1.066-2.140) and pathological type(HR=0.736, 95% CI: 0.543-0.998) were independent prognostic factors for patients with esophageal cancer lung metastasis. The value of C-index was 0.634(95% CI=0.585-0.683). CONCLUSION: For patients with esophageal cancer lung metastasis, being young and adenocarcinoma are associated with a better prognosis. The prediction of the nomogram is good.
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OBJECTIVE: To investigate the prognostic factors of esophageal cancer with multiple organ metastases and establish a prognostic prediction model. METHODS: Patients data were extracted from the SEER database. The clinical data of 388 patients with esophageal cancer with multiple organ metastases were retrospectively analyzed. Risk factors were analyzed by log-rank method and survival curves were drawn by K-M method. Multivariate analysis was performed by Cox proportional hazard model to obtain independent prognostic factors for multi-organ metastasis of esophageal cancer. A prediction nomogram was further established.RESULTS: The mean survival time of patients in this study was 7.3 months, and the survival rates for 1-, 3-, and 5-year were 15.5%,1.2%, and 0, respectively. Age was an independent prognostic factor. The value of C-index was 0.618. CONCLUSION: The prognosis of esophageal cancer with multiple organ metastases is poor. Age at the diagnosis and patterns of multiple organ metastases are related to the survival time of patients. The prediction nomogram provided a good prognosis prediction.
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Objective To analyze the prognostic factors in the surgical treatment of hilar cholangiocarcinoma.Methods The retrospective case-control study was conducted.The clinicopathological data of 93 patients [61 males and 32 females,age (64±8)years with the range of 43-84 years] with hilar cholangiocarcinoma who underwent surgical treatments in the General Hospital of the Northern Theater from January 2010 to December 2017 were collected.According to preoperative different staging and intraoperative exploration of hilar cholangiocarcinoma,corresponding operations were performed.Observation indicators:(1) surgical treatment situations;(2) tumor typing,staging and degree of differentiation:① tumor typing and staging,② degree of tumor differentiation;(3) follow-up situations;(4) analysis of prognostic factors:① univariate analysis,② multivariate analysis;(5) subgroup analysis.Follow-up using outpatient examination and telephone interview was performed to detect survival time and survival rate of patients up to December 31,2017.Kaplan-Meier method was used to calculate survival time and survival rate and to draw survival curves.Survival situations were analyzed byLog-rank test.The univariate analysis and multivariate analysis were performed using the Log-rank test and COX proportional hazard model respectively.Results (1) Surgical treatment situations:93 patients underwent surgical treatments,including 51 undergoing radical resection,23 undergoing palliative resection,16 undergoing internal biliary drainage or external drainage,3 undergoing abdominal laparotomy and intraoperative biopsy.(2) Tumor typing,staging and degree of differentiation.① Tumor typing and staging:of the 93 patients with hilar cholangiocarcinoma,Bismuth-Corlette type Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳ were detected in 26,22,9,18 and 18 patients.TNM stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were detected in 7,34,22 and 30 patients,Mayo Clinic stage 1,2,3,4 were detected in 20,19,51 and 3 patients.② Degree of tumor differentiation:results of pathological examination showed 16 of 93 patients with highly differentiated adenocarcinoma,35 with moderately differentiated adenocarcinoma,37 with poorly differentiated adenocarcinoma,4 with mucinous adenocarcinoma and 1 with papillary adenocarcinoma.(3) Follow-up situations:93 patients were followed up for 6-36 months,with a median time of 24 months.The survival time of 93 patients was (21.4±2.1)months and the 1-,2-,3-year overall survival rates were 62.2％,34.9％ and 17.1％,respectively.(4) Analysis of prognostic factors:① results of univariate analysis showed that preoperative level of TBil,preoperative level of CA19-9,preoperative level of CA24-2,surgical methods,lymph node metastasis,vascular invasion,TNM staging,Mayo Clinic staging,degree of tumor differentiation were related factors affecting prognosis of patients with hilar cholangiocarcinoma (x2 =6.321,7.357,6.590,22.088,11.173,22.914,23.326,25.966,39.512,P＜0.05).② Results of multivariate analysis showed that preoperative level of TBil,preoperative level of CA 19-9,surgical methods,vascular invasion and degree of tumor differentiation were independent factors affecting prognosis of patients with hilar cholangiocarcinoma (odds ratio=1.002,1.001,2.690,2.626,0.420,95％ confidence interval:1.000-1.004,1.000-1.002,1.474-4.910,1.333-5.134,0.206-0.854,P＜0.05).(5) Subgroup analysis:of the 93 patients,the survival time of 51 undergoing radical resection was (28.0±2.3)months,and the 1-,2-,3-year survival rates were 75.3％,57.5％ and 25.7％,respectively;the survival time of 23 undergoing palliative resection was (14.0±2.4)months and the 1-,2-,3-year survival rates were 60.9％,13.0％,0,respectively;the survival time of 19 undergoing biliary drainage or open exploration was (8.0±2.9) months and the 1-,2-,3-year survival rates were 31.6％,7.9％,0,respectively.The survival of patients undergoing radical resection was significantly different from that of patients undergoing palliative resection,biliary drainage and open laparotomy respectively (x2 =10.939,18.343,P＜0.05).The survival of patients undergoing palliative resection was not statistically significant different from that of patients undergoing biliary drainage or exploration group (x2 =2.803,P＞0.05).Of the 35 patients with vascular invasion,the overall survival time was (7.0±2.0)months and 1-,2-,3-year survival rates were 14.5％,7.3％,0 respectively in 18 with portal vein invasion only,(10.0± 2.1)months and 37.5％,18.8％,and 18.8％ respectively in 8 with hepatic artery invasion,showing no statistically significant difference between the two groups (x2 =0.905,P＞0.05).Conclusions Preoperative level of TBil,preoperative level of CA19-9,surgical procedures,vascular invasion and degree of tumor differentiation are independent prognostic factors for patients with hilar cholangiocarcinoma.Radical resection can prolong the survival time of patients compared with other surgical treatments.
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Objective To investigate the clinical pathological characteristics and prognosis of primitive neuroectodermal tumor (PNET) of breast.Methods Patients with breast PNET were retrieved from CNKI,Pubmed,Europe PMC and other databases from Jan.1980 to Dec.2016.The clinical data of one patient with breast PNET in our hospital were analyzed retrospectively.Results 18 cases had painless,rapid growth mass as the main clinical features.The pathological morphology showed small round cell tumors,PAS staining positive.Immunohistochemistry CD99 and Fli-1 characteristic expression were the main indexes for the diagnosis of breast PNET.The positive expression of Vimentin,NSE,Syn and negative expression of CK,EMA,Desmin,CgA,LCA,S-100 also played an important role in the diagnosis of breast PNET.The positive expression of genetic marker EWSRI was the golden standard for diagnosis of breast PNET.The size of the tumor,surgical treatment,lymph node metastasis,distant metastasis and chemotherapy were the important factors that affect the prognosis of the PNET.The survival rates of 1 and 3 years were 71.4％ and 33.3％ respectively.Conclusions Breast PNET is a rare tumor with poor prognosis,and its diagnosis is highly dependent on pathology.Surgery can significantly improve the prognosis of the patients.Surgery should be the main treatment,combined with radiotherapy and chemotherapy.The current study does not show evidence of effectiveness in terms of endocrine or targeted drug therapy for breast PNET patients.
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Objective:To investigate the differences in the curative effects of neoadjuvant chemotherapy(NAC) for different subtypes of Luminal B breast cancer and its prognosis,and to discuss the clinical treatment characteristics of different subgroups.Methods:A total of 246 cases of Luminal B like breast cancer patients who completed the projected NAC courses and surgical treatment were selected.All the biopsy specimens before treatment were positive for estrogen receptot(ER).According to the expressions of progesterone receptor(PR), human epidermal growth factor-2(Her-2)and cell proliferation nuclear antigen Ki-67,246 cases of Luminal B breast cancer patients were divided into 3 subgroups.A subgroup(PR low expression group),Her-2 negative and PR< 20% or negative,Ki-67 any levels;B subgroup(PR high expression group),Her-2 negative,PR≥20% and Ki-67 ≥14%;C subgroup(Her-2 positive group),Her-2 positive,Ki-67 and PR any levels.The clinical pathological materials and follow-up recurrence events of the patients were collected.Results:Among the three subtypes of Luminal B breast cancer,there were no significant differences in the age,the size of primary tumor and the stage of TNM(P>0.05).There were significant differences in the lymph node metastasis rate among three subgroups(P=0.018),and the lymph node metastasis rate was the highest in A subgroup among three subgroups. There were no significant differences in the clinical response and pathological response among three subgroups(P=0.123,P=0.06).8.5%(21/246)patients achieved the pathological complete response(pCR);the rates of pCR in three subgroups had statistically significant difference(P=0.009);the rate of pCR in C subgroup was the highest, and the rate of pCR in B subgroup was the lowest.The Log-Rank test of the survival curves of three subgroups had not statistically significant difference(P=0.216),but the 3-year disease-free survival(DFS)and 5-year DFS of the patients in B subgroup were slightly higher than those in other two groups.The DFS of the patients in C subgroup was longer than that of the patients with Her-2 overexpression breast cancer at the same period,and the difference was statistically significant(P=0.047).Conclusion:Her-2 positive Luminal B breast cancer is more likely to achieve pCR in NAC and the prognosis is better than Her-2 overexpressing breast cancer.The patients with high expression of PR in Luminal B breast cancer patients have a tend of overall survival advantage compared with the patients with PR low expression and Her-2 positive expression.
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Objective: To investigate the differences in the curative effects of neoadjuvant chemotherapy (NAC) for different subtypes of Luminal B breast cancer and its prognosis, and to discuss the clinical treatment characteristics of different subgroups. Methods: A total of 246 cases of Luminal B like breast cancer patients who completed the projected NAC courses and surgical treatment were selected. All the biopsy specimens before treatment were positive for estrogen receptot (ER). According to the expressions of progesterone receptor (PR), human epidermal growth factor-2 (Her-2) and cell proliferation nuclear antigen Ki-67, 246 cases of Luminal B breast cancer patients were divided into 3 subgroups. A subgroup (PR low expression group), Her-2 negative and PR0.05). There were significant differences in the lymph node metastasis rate among three subgroups (P=0.018), and the lymph node metastasis rate was the highest in A subgroup among three subgroups. There were no significant differences in the clinical response and pathological response among three subgroups (P= 0.123, P=0.06). 8.5% 21/246) patients achieved the pathological complete response (pCR); the rates of pCR in three subgroups had statistically significant difference (P=0.009); the rate of pCR in C subgroup was the highest, and the rate of pCR in B subgroup was the lowest. The Log-Rank test of the survival curves of three subgroups had not statistically significant difference (P=0.216), but the 3-year disease-free survival (DFS) and 5-year DFS of the patients in B subgroup were slightly higher than those in other two groups. The DFS of the patients in C subgroup was longer than that of the patients with Her-2 overexpression breast cancer at the same period, and the difference was statistically significant (P= 0.047). Conclusion: Her-2 positive Luminal B breast cancer is more likely to achieve pCR in NAC and the prognosis is better than Her-2 overexpressing breast cancer. The patients with high expression of PR in Luminal B breast cancer patients have a tend of overall survival advantage compared with the patients with PR low expression and Her-2 positive expression.
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Objective To study the effect and prognosis of multiple channels percutaneous renal ureteral calculi removal in the treatment of patients with complex renal calculi.Methods One hundred and forty-four cases patients with complex renal calculi accepted treatment in Dongda Hospital of Shanxian County from June 2012 to March 2015 for research.According to the random number table method,the patients were divided into the observation group and the control group,72 cases in each group.The single channel type was used in the control group,while multi-channel type operation was use in the observation group.Indicators related to the operation,stones clearance rate,changes in the degree of hydronephrosis,and the major complications after treatment of the two groups were compared.Results The operation time of the observation group was (104.82 ±8.54) min,significantly longer than that of the control group ((90.23 ±7.68) min),but the duration of hospital stay,fistulation tube indwelling time and the residual stone surface area were (6.84±1.25) d,(5.23±2.16) d and (223.16± 113.49) mm2 respectively,significantly less than that of the control group ((8.33±2.13) d,(6.74 ± 2.19) d and (429.54 ± 107.88) mm2 respectively),the differences were statistically significant(P =0.000).The stone removal rate of the observation group was 86.11％ (62/72),significantly higher than that of the control group(72.22％ (52/72)),the difference was statistically significant (P =0.040).There was no significant difference in terms of the total stone clearance rate and the degree of kidney water after treatment between the two groups (P＞0.05).The total complication rate of the observation group was 11.11％(8/72),of the control group was 9.72％ (7/72),and the difference was not statistically significant(P ＞0.05).Conclusion The efficacy of multi-channel operation for complex renal calculi is better,safe and feasible,but should reduce the number of channels as much as possible,so as to reduce the damage to patients effectively.
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Objective:To investigate the changes of circulating tumor cells in locally advanced esophageal squamous cell carcinoma pa-tients treated with concurrent chemoradiotherapy. The effect of these alterations on the patients’prognosis was also analyzed. Meth-ods:Circulating tumor cells were detected by immunomagnetic enrichment and fluorescence in 48 cases of locally advanced esopha-geal carcinoma patients treated with concurrent chemoradiotherapy. The dynamic changes of circulating tumor cells were compared between pre-and post-chemoradiotherapy. Moreover, the association of these changes with the clinical characteristics and two-year survival rate were analyzed. Results:The positive rate of circulating tumor cells was closely associated with the T stage, lymph node metastasis, and clinical stage (P<0.05), and the positive rates in pre-and post-chemoradiotherapy were 52.1%(25/48) and 20.8%(10/48), respectively. The difference was statistically significant (P<0.05). Kaplan-Meier analysis showed that the positive rate of circulating tumor cells predicted an adverse two-year survival rate in both pre-and post-chemoradiotherapy (P<0.05). Cox regression analysis showed that the clinical stage and circulating tumor cells after concurrent chemoradiotherapy were independent prognostic factors in the patients with esophageal carcinoma. Conclusion:Circulating tumor cells can reflect the disease progression in patients with locally advanced esophageal cancer. These cells can also predict the prognosis of esophageal cancer patients treated with concurrent chemo-radiotherapy.
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Objective:This study aimed to analyze and compare the prognosis and the prognostic factors of combined small cell lung cancer (CSCLC) and pure small cell lung cancer (PSCLC) retrospectively. Methods:The clinicopathological characteristics of the 343 small cell lung cancer patients who were diagnosed in Tianjin Medical University Cancer Institute and Hospital between January 2006 and December 2012 were collected and reviewed. Survival analysis was performed and prognostic factors were assessed. Results:The median OS (overall survival) and PFS (progression free survival) of CSCLC were 31 and 21 months, respectively, and the median OS and PFS of PSCLC were 15 and 9 months, respectively. The Kaplan-Meier survival curves revealed that the prognosis of CSCLC was significantly better compared with that of PSCLC. COX analysis showed that disease stage, pathology, and therapy were indepen-dent prognostic factors of small cell lung cancer. Univariate analysis indicated that the small cell lung cancer group benefited from the surgery, particularly the CSCLC. NLR , therapy, and disease stage influenced the prognosis of PSCLC, and disease stage and therapy in-fluenced the prognosis of CSCLC. Multivariate analysis revealed that disease stage and therapy were independent risk factors of CSCLC in regard to OS. Conclusion:The prognosis of CSCLC was better compared with that of PSCLC. Limited-stage small cell lung cancer should undergo surgery, particularly the CSCLC.
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Objective To investigate the prognostic factors and the clinical outcome of locally recurrent rectal cancer after radical resection. Methods From April 2000 to April 2004, 105 patients with locally recurrent rectal cancer after radical resection were re-treated in Tianjin cancer hospital. Thirty-four patients were re-treated with surgery combined with adjuvant chemoradiotherapy (group 1), 35 with surgery alone (group 2), and 36 with chemoradiotherapy (group 3). The impact of 17 clinicopathological factors and treatment modalities on the survival was analyzed. Results The follow-up rate was 95. 2%. The median survival time was 23 months. The 1-, 3-and 5-year survival rates of patients with locally recurrent rectal cancer were 63% ,34% and 19%, respectively. The 1-, 3-and 5-year survival rates were 79%, 55% and 32% in group 1 ; 68%, 40% and 14% in group 2; and 64%, 36% and 11% in group 3; respectively (χ~2 =7. 96,P =0. 019). The univariate analysis showed that the degree of differentiation, depth of tumor invasion, number of metastatic lymph nodes, initial TNM stage, recurrent location, time to recurrence, and surgery combined with adjuvant therapy were significant prognostic factors, with the last 4 being the independent prognostic factors. Conclusions Surgery combined with chemoradiotherapy may improve the survival of patients with locally recurrent rectal cancer.
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Objective To analyze the results and prognosis for patients with inoperable pancreatic carcinoma treated by interventional chemotherapy (IC) ,three-dimensional radiotherapy (RT), or IC + RT.Methods From 2003 to 2008,139 patients with locally advanced (82 patients, stage Ⅲ) or metastatic (57 patients, stage Ⅳ) pancreatic cancer were retrospectively analyzed, including 74 with pancreatic head carcinoma (53.2%).Three patients with ductal adenocarcinoma were diagnosed with fine-needle aspiration, all other patients were clinically diagnosed with imagings (CT, MRI and/or ultrasonosraphy),clinical symptoms and tumor markers, There were 71,34 and 34 patients receiving IC alone, 3DCRT alone and 3DCRT plus IC, respectively.Log-rank univariate and Cox model multivariate analyses were used to determine prognostic factors.Results The follow-up rate was 92.1%.115 and 98 patients were followedup longer than 1 and 2 years, respectively.The 1-and 2-year overall survival rates were 37.1% and 16.3%for all patients, 44% and 20% for patients with locally advanced disease.The corresponding rates were 18% and 5%, 61% and 29% ,48% and 25% (χ2= 14.65,P=0.001) for patients receiving IC alone, RT alone, and IC + RT, respectively.In univariate analysis, staging (χ2= 44.49, P = 0.035), radiotherapy (χ2= 15.32, P = 0.000) and tumor location (χ2= 10.741, P = 0.002) were prognostic factors.In multivariate analysis, tumor location (χ2= 5.00, P = 0.025) and radiotherapy (χ2= 7.93, P = 0.005) were prognostic factors.Conclusions Radiotherapy can improve overall survival among patients with inoperable pancreatic cancer.The effect of RT + IC should be further investigated.
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Objective To analyze the prognosis of T1-T2 stage breast cancer with 1 -3 positive axillary nodes after mastectomy, and to explore a subgroup of patients who could benefit from adjuvant radiotherapy. Methods In the retrospective study of 412 eligible patients, survival analysis was performed using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Log-rank method and Cox regression analysis, respectively. Results The follow-up rate was 98. 7%. 215 and 41patients were followed up for 5 and 10 years,respectively. The 5-and 10-year overall survival (OS) rate was 90. 0% and 81.3%, respectively. The 5-and 10-year locoregional recurrence (LRR) rate was 10. 7% and 18. 6%, respectively. In univariate analysis, T2 statging, more than one positive node, hormone receptornegative ( ER&PR-negative), ratio of positive lymph nodes (LNR) ＞ 25%, Her-2 positive, no hormonal therapy were associated with a significantly higher rate of LRR. T2 staging, more than one positive node,hormone receptor-negative were the risk factors for LRR with statistical significance in the multivariate analysis. Basing on these 3 risk factors, the high-risk group (with 2 -3 factors) had a 10-year LRR rate of 36. 9% compared with 3.9% in the low-risk group ( with 0 - 1 factors;x2 =20. 64,P =0. 000). The 5-year and 10-year distant metastasis (DM) rate was 12.9% and 24. 5%, respectively. LRR, and LNR ＞25%were statistically significant predictors of DM in the multivariate analysis. The 5-year DM rate for patients with LRR was 36. 6% compared with 9. 7% without LRR (x2 = 16. 34,P =0. 000). The 5-year OS rate for patients with LRR was 69. 9% compared with 92. 9% without LRR ( x2 = 20. 79, P = 0. 000). LRR was associated with a higher risk of distant metastasis and worse survival. Conclusions LRR after mastectomy has a significant impact on the outcome of patients with T1 -T2 breast cancer and 1 - 3 positive axillary nodes.Patients who have 2 -3 risk factors might benefit from radiotherapy.