Prognostic significance of tumor-associated macrophage infiltration in gastric cancer: a meta-analysis.

Tumor-associated macrophages (TAMs), which play a crucial role in the tumor microenvironment, can be divided into M1 and M2 phenotypes, these phenotypes may exert opposite effects on the prognoses of patients with gastric cancer (GC). The association between TAMs and GC is contentious. Thus, a meta-analysis of 12 studies (incorporating 1388 patients) retrieved from the Cochrane Library, PubMed, and Embase databases was conducted in order to evaluate the relationship between TAMs and GC prognosis. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to explore the effect of these cells on survival of GC patients. Our results implied that high total TAM infiltration levels correspond to worse overall survival (OS) in patients with GC (HR = 1.70, 95%CI = 1.39-2.09; P < 0.001), and a similar result was observed in relation to M2 macrophage infiltration (HR = 1.71, 95%CI = 1.19-2.45; P = 0.004). In contrast, elevated M1 macrophage density in GC patients was associated with better OS (HR = 0.46, 95%CI = 0.33-0.65; P < 0.001). This meta-analysis showed that the numbers of infiltrating M2 macrophages and total TAMs might be negative prognostic factors for patients with GC, while M1 macrophage infiltration may be associated with a favorable survival rate.

Hepatic arterial infusion plus systemic chemotherapy as third-line or later treatment in colorectal liver metastases.

BACKGROUNDS: The present study aimed to evaluate benefit of hepatic arterial infusion chemotherapy (HAI) combined with systemic chemotherapy (SCT) for patients with colorectal liver metastases (CLMs) in a palliative setting. METHODS: This was a retrospective single-center study including 43 consecutive patients with CLM after failure of standard SCT. Among them, 20 (47 %) patients underwent HAI combined with SCT (Group A) and 23 historical control patients who had received SCT with or without targeted agent treatment (Group B). RESULTS: The two groups had similar characteristics. Compared with SCT alone, HAI combined with SCT prolonged survival (median 19.8 vs. 9.0 months; P = 0.045). Median hepatic progression-free survival was significantly longer for HAI combined with SCT vs. SCT alone (median 8.1 vs. 4.7 months; P = 0.027), as were response rates (25 and 0 %; P = 0.038) and progression-free survival (median 5.7 vs. 3.0 months; P = 0.02). Three patients (15 %) achieved conversion to potentially curative surgery. Grade 3/4 toxicities for Group A and Group B were neutropenia (5 and 8.7 %, respectively), anemia (5 and 0 %, respectively), and hyperbilirubinemia (0 and 4.3 %, respectively). Other complications were mostly grade 1 or 2. CONCLUSIONS: HAI combined with SCT treatment can improve overall survival compared with SCT alone in highly advanced CLM refractory to intravenous chemotherapy.