AIM: Preoperative intra-arterial infusion chemotherapy could increase the radical resection rate of advanced gastric cancer, but its effect on the long-term survival has not been assessed. This study was designed to e...AIM: Preoperative intra-arterial infusion chemotherapy could increase the radical resection rate of advanced gastric cancer, but its effect on the long-term survival has not been assessed. This study was designed to evaluate the clinical significance of preoperative intra-arterial infusion chemotherapy for advanced gastric cancer. METHODS: Clinicopathological data of 91 patients who underwent curative resection for advanced gastric cancer were collected. Among them, 37 patients undertaken preoperative intra-arterial infusion chemotherapy were used as the interventional chemotherapy group, and the remaining 54 patients as the control group. Eleven factors including clinicopathological variables, treatment procedures and molecular biological makers that might contribute to the long-term survival rate were analyzed using Cox multivariate regression analysis.RESULTS: The 5-year survival rate was 52.5% and 39.8%,respectively, for the interventional group and the control group (P<0.05). Cox multivariate regression analysis revealed that the TNM stage (P<0.001), preoperative intraarterial infusion chemotherapy (P=0.029) and growth pattern (P=0.042) were the independent factors for the long-term survival of patients with advanced gastric cancer. CONCLUSION: Preoperative intra-arterial infusion chemotherapy plays an important role in improving the prognosis of advanced gastric cancer.展开更多
AIM:To study clinical characteristics and management of patients with early severe acute pancreatitis (ESAP).METHODS: Data of 297 patients with severe acute pancreatitis (SAP) admitted to our hospital within 72h after...AIM:To study clinical characteristics and management of patients with early severe acute pancreatitis (ESAP).METHODS: Data of 297 patients with severe acute pancreatitis (SAP) admitted to our hospital within 72h after onset of symptoms from January 1991 to June 2003 were reviewed for the occurrence and development of early severe acute pancreatitis (ESAP).ESAP was defined as presence of organ dysfunction within 72 h after onset of symptoms.Sixtynine patients had ESAP, 228 patients without organ dysfunction within 72 h after onset of symptoms had SAR The clinical characteristics,incidence of organ dysfunction during hospitalization and prognosis between ESAP and SAP were compared.RESULTS.Impairment degree of pancreas (Balthazar CT class) in ESAP was more serious than that in SAP (5.31±0.68vs 3.68±0.29, P<0.01). ESAP had a higher mortality than SAP (43.4% vs 2.6%, P<0.01), and a higher incidence ofhypoxemia (85.5% vs 25%, P<0.01), pancreas infection (15.9% vs 7.5%, P<0.05),abdominal compartment syndrome (ACS) (78.3% vs 23.2%,P<0.01) and multiple organ dysfunction syndrome (MODS)(78.3% vs 10.1%,P<0.01).In multiple logistic regression analysis,the main predisposing factors to ESAP were higher APACHE II score, Balthazar CT class,MODS and hypoxemia.CONCLUSION:ESAP is characterised by MODS, severe pathological changes of pancreas,early hypoxemia and abdominal compartment syndrome. Given the poor prognosis of ESAP,these patients should be treated in specialized intensive care units with special measures such as close supervision, fluid resuscitation, improvement of hypoxemia,reduction of pancreatic secretion, elimination of inflammatory mediators,prevention and treatment of pancreatic infections.展开更多
文摘AIM: Preoperative intra-arterial infusion chemotherapy could increase the radical resection rate of advanced gastric cancer, but its effect on the long-term survival has not been assessed. This study was designed to evaluate the clinical significance of preoperative intra-arterial infusion chemotherapy for advanced gastric cancer. METHODS: Clinicopathological data of 91 patients who underwent curative resection for advanced gastric cancer were collected. Among them, 37 patients undertaken preoperative intra-arterial infusion chemotherapy were used as the interventional chemotherapy group, and the remaining 54 patients as the control group. Eleven factors including clinicopathological variables, treatment procedures and molecular biological makers that might contribute to the long-term survival rate were analyzed using Cox multivariate regression analysis.RESULTS: The 5-year survival rate was 52.5% and 39.8%,respectively, for the interventional group and the control group (P<0.05). Cox multivariate regression analysis revealed that the TNM stage (P<0.001), preoperative intraarterial infusion chemotherapy (P=0.029) and growth pattern (P=0.042) were the independent factors for the long-term survival of patients with advanced gastric cancer. CONCLUSION: Preoperative intra-arterial infusion chemotherapy plays an important role in improving the prognosis of advanced gastric cancer.
文摘AIM:To study clinical characteristics and management of patients with early severe acute pancreatitis (ESAP).METHODS: Data of 297 patients with severe acute pancreatitis (SAP) admitted to our hospital within 72h after onset of symptoms from January 1991 to June 2003 were reviewed for the occurrence and development of early severe acute pancreatitis (ESAP).ESAP was defined as presence of organ dysfunction within 72 h after onset of symptoms.Sixtynine patients had ESAP, 228 patients without organ dysfunction within 72 h after onset of symptoms had SAR The clinical characteristics,incidence of organ dysfunction during hospitalization and prognosis between ESAP and SAP were compared.RESULTS.Impairment degree of pancreas (Balthazar CT class) in ESAP was more serious than that in SAP (5.31±0.68vs 3.68±0.29, P<0.01). ESAP had a higher mortality than SAP (43.4% vs 2.6%, P<0.01), and a higher incidence ofhypoxemia (85.5% vs 25%, P<0.01), pancreas infection (15.9% vs 7.5%, P<0.05),abdominal compartment syndrome (ACS) (78.3% vs 23.2%,P<0.01) and multiple organ dysfunction syndrome (MODS)(78.3% vs 10.1%,P<0.01).In multiple logistic regression analysis,the main predisposing factors to ESAP were higher APACHE II score, Balthazar CT class,MODS and hypoxemia.CONCLUSION:ESAP is characterised by MODS, severe pathological changes of pancreas,early hypoxemia and abdominal compartment syndrome. Given the poor prognosis of ESAP,these patients should be treated in specialized intensive care units with special measures such as close supervision, fluid resuscitation, improvement of hypoxemia,reduction of pancreatic secretion, elimination of inflammatory mediators,prevention and treatment of pancreatic infections.
