Primary tumor resection improves prognosis of unresectable carcinomas of the transverse colon including flexures with pulmonary metastasis: a cohort study.

PURPOSE: Studies of unresectable colorectal cancer pulmonary metastasis (CRPM) have rarely analyzed patient prognosis from the perspective of colonic subsites. This study aimed to evaluate the effects of primary tumor resection (PTR) on the prognosis of patients with unresectable pulmonary metastases of transverse colon cancer pulmonary metastasis (UTCPM), hepatic flexure cancer pulmonary metastasis (UHFPM), and splenic flexure cancer pulmonary metastasis (USFPM). METHODS: Patients were identified from the Surveillance, Epidemiology, and End Results database between 2000 and 2018. The Cox proportional hazards regression models were used to identify prognostic factors of overall survival (OS) and cause-specific survival (CSS). The Kaplan-Meier analyses and log-rank tests were conducted to assess the effectiveness of PTR on survival. RESULTS: This study included 1294 patients: 419 with UHFPM, 636 with UTCPM, and 239 with USFPM. Survival analysis for OS and CSS in the PTR groups, showed that there were no statistical differences in the the UHFPM, UTCPM, and USFPM patients. There were statistical differences in the UHFPM, UTCPM, and USFPM patients for OS and CSS. Three non-PTR subgroups showed significant statistical differences for OS and CSS. CONCLUSION: We confirmed the different survival rates of patients with UTCPM, UHFPM, and USFPM and proved for the first time that PTR could provide survival benefits for patients with unresectable CRPM from the perspective of the colonic subsites of the transverse colon, hepatic flexure, and splenic flexure.

Robot-assisted versus fluoroscopy-guided pedicle screw fixation of thoracolumbar compression fractures.

The aim of this study is to compare the clinical outcomes and accuracy of robot-assisted (RA) versus fluoroscopy-guided (FG) pedicle screw fixation of thoracolumbar compression fractures. We retrospectively enrolled 85 patients with surgically treated thoracolumbar compression fractures in our study (RA group, 45 patients; FG group, 40 patients). We analyzed the accuracy of pedicle screw placement by using the Gertzbein-Robbins classification, and calculated the one-time success rate (i.e., the rate of screws successfully inserted in the first attempt). We also evaluated volume of blood loss, operative time, visual analogue scale scores for pain, Cobb angle, and postoperative complications. The rates of grade A screw placement (96% vs 68.5%; P < .005), clinically acceptable screw placement (98.2% vs 86%; P < .005), and the one-time success rate (97.3% vs 82.5%; P < .005) were all significantly higher in the RA group than in the FG group. No differences were observed in sex, age, body mass index, volume of blood loss, operative time, visual analogue scale scores, Cobb angle, and postoperative complications between the 2 groups. Compared to FG surgery, RA surgery yielded greater accuracy and one-time success rates of pedicle screw fixation of thoracolumbar compression fractures, with comparable clinical outcomes.

Expression of metabotropic glutamate receptor 4 in osteosarcoma.

Metabotropic glutamate receptor 4 (mGluR4) has been associated with the pathogenesis of osteosarcoma. The aim of this study was to investigate mGluR4 expression and its clinical significance in osteosarcoma patients. mGluR4 expression was investigated using immunohistochemistry (IHC) in 58 osteosarcomas and 32 giant-cell tumors of bone. The correlations between mGluR4 expression and clinicopathological characteristics were analyzed with the Chi-squared test and survival curves were generated using the Kaplan-Meier method. The IHC results demonstrated that 20.69% (12/58) of the osteosarcomas and 43.75% (14/32) of the giant-cell tumors were mGluR4-positive. The statistical analysis revealed that mGluR4 expression was correlated with gender, age, Enneking stage and tumor volume in osteosarcomas (P<0.05). In the multivariate stepwise Cox regression analysis, Enneking stage was found to be statistically significantly associated with survival (P<0.05) and the survival analysis demonstrated that the survival probability was significantly higher in patients with higher mGluR4 expression compared with those with lower expression (P<0.05). Therefore, mGluR4 expression may be used to estimate the prognosis of osteosarcoma patients.