Clinical outcome and prognostic factors of T4N0M0 colon cancer after R0 resection:A retrospective study

BACKGROUND Paradoxically,patients with T4N0M0(stage II,no lymph node metastasis)colon cancer have a worse prognosis than those with T2N1-2M0(stage III).However,no previous report has addressed this issue.AIM To screen prognostic risk factors for T4N0M0 colon cancer and construct a prognostic nomogram model for these patients.METHODS Two hundred patients with T4N0M0 colon cancer were treated at Tianjin Medical University General Hospital between January 2017 and December 2021,of which 112 patients were assigned to the training cohort,and the remaining 88 patients were assigned to the validation cohort.Differences between the training and validation groups were analyzed.The training cohort was subjected to multi-variate analysis to select prognostic risk factors for T4N0M0 colon cancer,followed by the construction of a nomogram model.RESULTS The 3-year overall survival(OS)rates were 86.2%and 74.4%for the training and validation cohorts,respectively.Enterostomy(P=0.000),T stage(P=0.001),right hemicolon(P=0.025),irregular review(P=0.040),and carbohydrate antigen 199(CA199)(P=0.011)were independent risk factors of OS in patients with T4N0M0 colon cancer.A nomogram model with good concordance and accuracy was constructed.CONCLUSION Enterostomy,T stage,right hemicolon,irregular review,and CA199 were independent risk factors for OS in patients with T4N0M0 colon cancer.The nomogram model exhibited good agreement and accuracy.

PREPARATION AND MAGNETIC PROPERTIES OF POLYMERIC COMPLEXES CONTAINING 1,10-PHENANTHROLINE

A series of polymeric complexes were prepared from Fe^2＋, Co^2＋ or Ni^2＋ and poly（Schiff base） （DAPcIPA）, which was obtained by polycondensation of 5,6-diamino-1,10-phenanthroline （DAP） with isophthalaldehyde （IPA）. The structures of the polymer and the polymeric complexes were characterized by IR, 1^H-NMR and elemental analysis. The magnetic behavior of these complexes was measured as a function of magnetic field strength （0-3.98 ~ 106 A/m） at 5 K and as a function of temperature （5-300 K） at a magnetic field strength of 2.39 × 10^6 A/re. Experimental results show that DAPcIPA-Ni^2＋, DAPcIPA-Co^2＋ are soft ferromagnets while DAPcIPA-Fe^2＋ exhibits features of an antiferromagnet.

Clinical significance of skip lymph-node metastasis in pN1 gastric-cancer patients after curative surgery

Background:In addition to the stepwise manner of lymph-node metastasis from the primary tumour,the skip lymph-node metastasis(SLNM)was identified as a low-incidence metastasis of gastric cancer(GC).So far,both the mechanism and outcome of SLNM have not been elucidated completely.The purpose of this study was to analyse the clinical significance and the potential mechanism of SLNM in GC patients who had lymph-node metastasis.Methods:Clinicopathological data and follow-up information of 505 GC patients who had lymph-node metastasis were analysed to demonstrate the significance of SLNM in evaluating the prognostic outcome.According to the pathological results,all GC patients who had lymph-node metastasis were categorized into three groups:patients with the perigastric lymphnode metastasis,patients with the perigastric and extragastric lymph-node metastasis and patients with SLNM.Results:Among the 505 GC patients who had lymph-node metastasis,24(4.8%)had pathologically identified SLNM.The location of lymph-node metastasis was not significantly associated with 5-year survival rate and overall survival(OS)(P=0.194).The stratified survival analysis results showed that the status of SLNM was significantly associated with the OS in patients with pN1 GC(P=0.001).The median OS was significantly shorter in 19 pN1 GC patients with SLNM than in 100 patients with perigastric lymph-node metastasis(P<0.001).The case–control matched logistic regression analysis results showed that tumour size(P=0.002)was the only clinicopathological factor that may predict SLNM in pN1 GC patients undergoing curative surgery.Among the 19 pN1 GC patients with SLNM,17(89.5%)had metastatic lymph nodes along the common hepatic artery,around the celiac artery or in the hepatoduodenal ligament.Conclusions:SLNM may be considered a potentially practicable indicator for prognosis among various subgroups of pN1 GC patients.