Purpose: With the improvements in newer chemotherapeutic agents, there is currently no consensus regarding the validity of palliative resection of the primary tumor for colorectal cancer with incurable distant metasta...Purpose: With the improvements in newer chemotherapeutic agents, there is currently no consensus regarding the validity of palliative resection of the primary tumor for colorectal cancer with incurable distant metastasis. We retrospectively analyzed prognostic factor in patients with colorectal cancer accompanied by incurable synchronous liver metastasis. Methods: 82 patients with incurable synchronous liver metastases, who underwent primary tumor resection alone, were enrolled. Results: The multivariate analysis revealed that the presence of ascites (P = 0.001, Hazard ratio = 2.96) and differentiation (P = 0.003, Hazard ratio = 3.68) were found to be significant independent prognostic factors. The median survival time among the patients with ascites was 4.8 months and that among the patients with poorly-differentiated or mucinous adenocarcinoma, or signet ring cell carcinoma (high grade differentiation) was 1.4 months, respectively. Conclusion: The presence of ascites and differentiation were prognostic factors in the patients with incurable liver metastases. Therefore, because prognosis is generally poor after primary tumor resection in the patients with ascites or high grade differentiation, the introduction of systemic chemotherapy with alleviation of symptoms related to the primary tumor should be taken into account as one of the therapeutic strategies.展开更多
Background: We examined the possibility of predicting prognosis by the number of lymph node metastases. Methods: Two hundred and forty nine patients with lymph node metastases who underwent curative surgery for colon ...Background: We examined the possibility of predicting prognosis by the number of lymph node metastases. Methods: Two hundred and forty nine patients with lymph node metastases who underwent curative surgery for colon cancer were enrolled in this study. We calculated cancer-specific survival according to the number of lymph node metastases. Results: There was a tendency toward better rates of cancer-specific survivals among the patients with 1 LNM, compared with those with 2 LNM (p = 0.07). When comparing cancer-specific survival between the patients with 1, 2-3 and 4 or more lymph node metastases, cancer-specific survival was well stratified (p i.e., the patients with 1, 2 and 3 and 4 or more lymph node metastases. This study was in favor of the TNM classification in which N category is classified by the number of lymph node metastases.展开更多
Background: We retrospectively identified prognostic factors in patients with Stage III colon cancer and considered the effectiveness of postoperative adjuvant chemotherapy based on these prognostic factors. Methods: ...Background: We retrospectively identified prognostic factors in patients with Stage III colon cancer and considered the effectiveness of postoperative adjuvant chemotherapy based on these prognostic factors. Methods: Two hundred and thirty four patients with lymph node metastases who underwent curative surgery for colon cancer between 1999 and 2005 were enrolled in the present study. Firstly, clinicopathological factors and survival data, were analyzed to determine prognostic factors related to cancer-specific survival. Secondly, we examined the effectiveness of postoperative adjuvant chemotherapy based upon these prognostic factors. Results: The multivariate analysis revealed that differentiation (P = 0.03, Hazard ratio = 2.50), lymphatic invasion (P = 0.02, Hazard ratio = 3.23) and the TNM classification, 7th?edition (P = 0.04, Hazard ratio = 1.94) were found to be significant independent prognostic factors. Among the patients classified as TNM IIIA, the recurrence-free survival rates were extremely good. Among the patients classified as IIIB and IIIC, there was no significant difference between the patients with and without postoperative adjuvant chemotherapy. Conclusion: The present study suggests that the patients with Stage IIIA colon cancer may not require postoperative adjuvant chemotherapy. The addition of oxaliplatin to 5-FU should be considered for the patients with Stage IIIB and IIIC colon cancer, for whom the prognoses are far from satisfactory.展开更多
In our prior publication[1],we elucidated IL-33-dependent mechanisms that regulate drug-induced liver injury.In this commentary,we mechanistically connected IL-33-dependent drug-induced steatohepatitis with nonalcohol...In our prior publication[1],we elucidated IL-33-dependent mechanisms that regulate drug-induced liver injury.In this commentary,we mechanistically connected IL-33-dependent drug-induced steatohepatitis with nonalcoholic steatohepatitis.Drug-induced steatohepatitis(DISH)is a rare form of drug-induced liver injury caused by drugs that are capable of inducing metabolic injury,steatosis or steatohepatitis[2].展开更多
文摘Purpose: With the improvements in newer chemotherapeutic agents, there is currently no consensus regarding the validity of palliative resection of the primary tumor for colorectal cancer with incurable distant metastasis. We retrospectively analyzed prognostic factor in patients with colorectal cancer accompanied by incurable synchronous liver metastasis. Methods: 82 patients with incurable synchronous liver metastases, who underwent primary tumor resection alone, were enrolled. Results: The multivariate analysis revealed that the presence of ascites (P = 0.001, Hazard ratio = 2.96) and differentiation (P = 0.003, Hazard ratio = 3.68) were found to be significant independent prognostic factors. The median survival time among the patients with ascites was 4.8 months and that among the patients with poorly-differentiated or mucinous adenocarcinoma, or signet ring cell carcinoma (high grade differentiation) was 1.4 months, respectively. Conclusion: The presence of ascites and differentiation were prognostic factors in the patients with incurable liver metastases. Therefore, because prognosis is generally poor after primary tumor resection in the patients with ascites or high grade differentiation, the introduction of systemic chemotherapy with alleviation of symptoms related to the primary tumor should be taken into account as one of the therapeutic strategies.
文摘Background: We examined the possibility of predicting prognosis by the number of lymph node metastases. Methods: Two hundred and forty nine patients with lymph node metastases who underwent curative surgery for colon cancer were enrolled in this study. We calculated cancer-specific survival according to the number of lymph node metastases. Results: There was a tendency toward better rates of cancer-specific survivals among the patients with 1 LNM, compared with those with 2 LNM (p = 0.07). When comparing cancer-specific survival between the patients with 1, 2-3 and 4 or more lymph node metastases, cancer-specific survival was well stratified (p i.e., the patients with 1, 2 and 3 and 4 or more lymph node metastases. This study was in favor of the TNM classification in which N category is classified by the number of lymph node metastases.
文摘Background: We retrospectively identified prognostic factors in patients with Stage III colon cancer and considered the effectiveness of postoperative adjuvant chemotherapy based on these prognostic factors. Methods: Two hundred and thirty four patients with lymph node metastases who underwent curative surgery for colon cancer between 1999 and 2005 were enrolled in the present study. Firstly, clinicopathological factors and survival data, were analyzed to determine prognostic factors related to cancer-specific survival. Secondly, we examined the effectiveness of postoperative adjuvant chemotherapy based upon these prognostic factors. Results: The multivariate analysis revealed that differentiation (P = 0.03, Hazard ratio = 2.50), lymphatic invasion (P = 0.02, Hazard ratio = 3.23) and the TNM classification, 7th?edition (P = 0.04, Hazard ratio = 1.94) were found to be significant independent prognostic factors. Among the patients classified as TNM IIIA, the recurrence-free survival rates were extremely good. Among the patients classified as IIIB and IIIC, there was no significant difference between the patients with and without postoperative adjuvant chemotherapy. Conclusion: The present study suggests that the patients with Stage IIIA colon cancer may not require postoperative adjuvant chemotherapy. The addition of oxaliplatin to 5-FU should be considered for the patients with Stage IIIB and IIIC colon cancer, for whom the prognoses are far from satisfactory.
基金The work was supported in part by the Johns Hopkins School of Medicine Stimulating and Advancing ACCM Research(StAAR)award program.
文摘In our prior publication[1],we elucidated IL-33-dependent mechanisms that regulate drug-induced liver injury.In this commentary,we mechanistically connected IL-33-dependent drug-induced steatohepatitis with nonalcoholic steatohepatitis.Drug-induced steatohepatitis(DISH)is a rare form of drug-induced liver injury caused by drugs that are capable of inducing metabolic injury,steatosis or steatohepatitis[2].
