AIM: To investigate the prognostic significance of perioperative leukopenia in patients with resected gastric cancer.METHODS: A total of 614 eligible gastric cancer patients who underwent curative D2 gastrectomy and a...AIM: To investigate the prognostic significance of perioperative leukopenia in patients with resected gastric cancer.METHODS: A total of 614 eligible gastric cancer patients who underwent curative D2 gastrectomy and adjuvant chemotherapy were enrolled in this study. The relationship between pre- and postoperative hematologic parameters and overall survival was assessed statistically, adjusted for known prognostic factors.RESULTS: The mean white blood cell count(WBC) significantly decreased after surgery, and 107/614(17.4%) patients developed p-leukopenia, which was defined as a preoperative WBC ≥ 4.0 × 109/L and postoperative WBC < 4.0 × 109/L, with an absolute decrease ≥ 0.5 × 109/L. The neutrophil count decreased significantly more than the lymphocyte count. P-leukopenia significantly correlated with poor tumor differentiation and preoperative WBC. A higher preoperative WBC and p-leukopenia were independent negative prognostic factors for survival [hazard ratio(HR) = 1.602, 95% confidence interval(CI): 1.185-2.165; P = 0.002, and HR = 1.478, 95%CI: 1.149-1.902; P = 0.002, respectively] after adjusting for histology, Borrmann type, p TNM stage, vascular or neural invasion, gastrectomy method, resection margins, chemotherapy regimens, and preoperative WBC count. The patients with both higher preoperative WBC and p- leukopenia had a worse prognosis compared to those with lower baseline WBC and no p-leukopenia(27.5 mo vs 57.3 mo, P < 0.001). CONCLUSION: Preoperative leukocytosis alone or in combination with postoperative leukopenia could be independent prognostic factors for survival in patients with resectable gastric cancer.展开更多
Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers durin...Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.展开更多
基金Supported by The National Natural Science Foundation of China,No.81301896the Natural Science Foundation of the Colleges and Universities in Jiangsu Province,China,No.13KJB320011+2 种基金the Program for Development of Innovative Research Teams,Jiangsu Province Clinical Science and Technology Projects(Clinical Research Center,BL 2012008)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)Provincial Initiative Program for Excellency Disciplines,Jiangsu Province,China
文摘AIM: To investigate the prognostic significance of perioperative leukopenia in patients with resected gastric cancer.METHODS: A total of 614 eligible gastric cancer patients who underwent curative D2 gastrectomy and adjuvant chemotherapy were enrolled in this study. The relationship between pre- and postoperative hematologic parameters and overall survival was assessed statistically, adjusted for known prognostic factors.RESULTS: The mean white blood cell count(WBC) significantly decreased after surgery, and 107/614(17.4%) patients developed p-leukopenia, which was defined as a preoperative WBC ≥ 4.0 × 109/L and postoperative WBC < 4.0 × 109/L, with an absolute decrease ≥ 0.5 × 109/L. The neutrophil count decreased significantly more than the lymphocyte count. P-leukopenia significantly correlated with poor tumor differentiation and preoperative WBC. A higher preoperative WBC and p-leukopenia were independent negative prognostic factors for survival [hazard ratio(HR) = 1.602, 95% confidence interval(CI): 1.185-2.165; P = 0.002, and HR = 1.478, 95%CI: 1.149-1.902; P = 0.002, respectively] after adjusting for histology, Borrmann type, p TNM stage, vascular or neural invasion, gastrectomy method, resection margins, chemotherapy regimens, and preoperative WBC count. The patients with both higher preoperative WBC and p- leukopenia had a worse prognosis compared to those with lower baseline WBC and no p-leukopenia(27.5 mo vs 57.3 mo, P < 0.001). CONCLUSION: Preoperative leukocytosis alone or in combination with postoperative leukopenia could be independent prognostic factors for survival in patients with resectable gastric cancer.
文摘Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.
