ABSTRACT
AIM: To assess the effects of preoperative treatment on the hepatic histology of non-tumoral liver and the postoperative outcome. METHODS: One hundred and six patients underwent hepatic resection for colorectal metastases between 1999 and 2009. The surgical specimens were reviewed with established criteria for diagnosis and grading of pathological hepatic injury. The impact of preoperative therapy on liver injury and postoperative outcome was analyzed. RESULTS: Fifty-three patients (50%) received surgery alone, whereas 42 patients (39.6%) received neoadjuvant chemotherapy and 11 (10.4%) patients received preoperative hepatic artery infusion (HAI). Chemotherapy included oxaliplatin-based regimens (31.1%) and irinotecan-based regimens (8.5%). On histopathological analysis, 16 patients (15.1%) had steatosis, 31 (29.2%) had sinusoidal dilation and 20 patients (18.9%) had steatohepatitis. Preoperative oxaliplatin was associated with sinusoidal dilation compared with surgery alone (42.4% vs 20.8%, P = 0.03); however, the perioperative complication rate was not significantly different between the oxaliplatin group and surgery group (27.3% vs 13.2%, P = 0.1). HAI was associated with more steatosis, sinusoidal dilation and steatohepatitis than the surgery group, with higher perioperative morbidity (36.4% vs 13.2%, P = 0.06) and mortality (9.1% vs 0% P = 0.02). CONCLUSION: Preoperative oxaliplatin was associated with sinusoidal dilation compared with surgery alone. However, the preoperative oxaliplatin had no significant impact on perioperative outcomes. HAI can cause pathological changes and tends to increase perioperative morbidity and mortality.
ABSTRACT
OBJECTIVE: To investigate whether the clinical characteristics, treatment modalities and prognosis of elderly (>/= 70 years) patients with advanced non-small cell lung cancer (NSCLC) differed from those of young (= 45 years) patients. METHODS: This retrospective study included 256 elderly patients and 143 young patients with chemotherapy-naive advanced NSCLC treated at Department of Thoracic Medical Oncology in Beijing Cancer Hospital from March 1995 to May 2007. All patients received first-line chemotherapy. Clinical data were analyzed using chi-square test, Log-lank test, Cox regression and Kaplan-Meier survival analysis. RESULTS: (1) Women, adenocarcinoma and stage IV disease were more common in young patients (46.2% vs 22.3%, P = 0.000, 71.3% vs 54.7%, P = 0.001 and 72.7% vs 61.7%, P = 0.026), when compared with elderly patients. The smoker rate in young women was also higher (95.5%). (2) The disease control rate (DCR) of first-line chemotherapy was similar between young and elderly patients (P = 0.257). Platinum-based combination chemotherapy was a benefit factor for the disease control rate of first-line chemotherapy, whatever in young patients (P = 0.047) or in elderly patients (P = 0.028). Hematologic toxicities were similar between these 2 groups. (3) There was no significant difference in terms of median progression free survival (PFS) or median overall survival (OS) between young and elderly patients (P = 0.399 and P = 0.869, respectively). (4) Easten Cooperative Oncology Group (ECOG) score, DCR for first-line chemotherapy and the regimen of second-line chemotherapy were all independent prognostic factors (P = 0.000, 0.021 and 0.000 in young patients, P = 0.007, 0.000 and 0.000 in elderly patients, respectively). CONCLUSION: Women, adenocarcinoma and stage IV disease were more common in young patients when compared with elderly patients. The increased incidence of NSCLC in young women may be associated with the high smoker rate. The OS and PFS were not significantly different between young and elderly patients.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Humans , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
AIM: To investigate the inhibitory effect of gefitinib combined with cytotoxic agent cisplatin (CDDP) on hepatocellular carcinoma (HCC). METHODS: Female Kunming mice and H22 hepatocarcinoma cells were used. Gefitinib at daily dose of 100 mg/kg body weight (BW) or lecithin liquid was given by gastrogavage once a day for 5 or 10 successive days. CDDP or normal saline (NS) was administered intraperitoneally (i.p.) once a day for 5 successive days. Mice were randomly divided into control group (lecithin, or NS, i.p.), CDDP group (daily dose, 1.2 mg/kg BW; d1-5, or d6-10), Gefitinib (d1-5, or d6-10, or d1-10), and Gefitinib combined with CDDP groups. The inhibitory rate (IR) of tumor, net BW, spleen index (SI), thymus index (TI) and the amount of peripheral blood cells of mice were detected on the 12th experiment day. RESULTS: The growth of HCC in mice was inhibited by Gefitinib alone (IR: 41% in d1-10 group and 30% in d1-5 group, respectively) or CDDP alone (IR: 32-54% in d1-5 group or d6-10 group). The highest inhibitory effect (IR: 56%) on HCC growth was observed in Gefitinib (d1-10) combined with CDDP (d1-5) group. Higher inhibition was also observed in CDDP (d1-5) followed by Gefitinib (d6-10) group than that in Gefitinib (d1-5) followed by CDDP (d6-10) group (IR: 61% vs 36%, P < 0.01) in the independent study. Net BW, SI, TI and the amount of blood cells of mice in Gefitinib alone group were not significantly different from those in control groups. CONCLUSION: Gefitinib can significantly inhibit the growth of murine H22 hepatocellular carcinoma. If Gefitinib is used after CDDP treatment in animal experiments, the inhibitory effect could be enhanced.