BACKGROUND The prognosis of gastric cancer in an advanced stage remains poor. The exact efficacy of the use of intraoperative sustained-release chemotherapy with 5-fluorouracil(5-FU) in advanced-stage gastric cancer i...BACKGROUND The prognosis of gastric cancer in an advanced stage remains poor. The exact efficacy of the use of intraoperative sustained-release chemotherapy with 5-fluorouracil(5-FU) in advanced-stage gastric cancer is still unelucidated.AIM To explore the long-term survival benefit of using sustained-release 5-FU implants in stage Ⅱ and stage Ⅲ gastric cancer patients.METHODS Patients with gastric cancer in a locally advanced stage and who underwent an R0 radical resection between Jan 2014, to Dec 2016, in this single institution were included. Patients with pathological diagnoses other than adenocarcinoma were excluded. All included patients were grouped according to whether intraoperative sustained-release(SR) chemotherapy with 5-FU was used or not(NSR). The primary end-point was 5-year overall survival. Kaplan–Meier method with logrank test was used to analyze the overall survival of patients and Cox analysis was used to analyze prognosis factors of these patients.RESULTS In total, there were 563 patients with gastric cancer with locally advanced stage, who underwent an R0 radical resection. 309 patients were included in the final analysis. 219(70.9%) were men, with an average age of 58.25 years. Furthermore, 56(18.1%) received neoadjuvant chemotherapy, and 191(61.8%) were in TNM stage Ⅲ. In addition, 158 patients received intraoperative sustainedrelease chemotherapy with 5-FU and were included in the SR group, while the other 161 patients were included in the NSR group. The overall complication rate was 12.94% in the whole group and 10.81%, 16.46% in SR and NSR groups, respectively. There were no significant differences between the two groups in overall survival and complication rate(P > 0.05). The multivariate cox analysis indicated that only N Stage and neoadjuvant therapy were independent influencing factors of survival.CONCLUSION Intraoperative sustained-release chemotherapy usage with 5-FU, did not improve the survival of patients who underwent an R0 radical resection in locally advanced stage of gastric cancer.展开更多
Objective:The postoperative survival rates of patients with gastric cancer at different stages treated at the National Cancer Center(NCC)of China have not been reported.Therefore,we evaluated the survival of patients ...Objective:The postoperative survival rates of patients with gastric cancer at different stages treated at the National Cancer Center(NCC)of China have not been reported.Therefore,we evaluated the survival of patients with gastric cancer who underwent surgery at the NCC from 2011 to 2018 to provide baseline information for further studies.Methods:We identified 7,301 patients with primary gastric carcinoma who underwent surgery at the NCC be-tween January 2011 and May 2018;among these,5,008 patients were enrolled in this study.Follow up was completed on April 30,2020.We analyzed the 5-year survival according to the stage,sex,age,and other clini-copathological features.Results:Five-year survival rates of patients with pTNM stages ⅠA,ⅠB,ⅡA,ⅡB,ⅢA,ⅢB,ⅢC,and Ⅳ treated at the NCC were 94.9%,91.8%,86.5%,76.1%,61.1%,44.2%,29.7%,and 8.1%,respectively,which were similar to those reported in Japan during the same period.Five-year survival rates of patients with ypTNM stages I,II,III,and IV were 93.1%,63.2%,27.2%,and 0.0%,respectively.In multivariable analysis,age,signet ring cell carcinoma,adjuvant chemotherapy,and degree of differentiation were revealed as important prognostic factors.Conclusion:The survival rates of patients with gastric cancer treated at the NCC have been significantly improved,reaching the levels of Japan in the same period.展开更多
In this study, we aimed to investigate the influencing factors of postoperative 5-year survival rate in non small-cell lung cancer（NSCLC） patients with stage I–III. We enrolled 220 patients who underwent surgical o...In this study, we aimed to investigate the influencing factors of postoperative 5-year survival rate in non small-cell lung cancer（NSCLC） patients with stage I–III. We enrolled 220 patients who underwent surgical operation and survived longer than 3 months, with histologically confirmed adenocarcinoma or squamous cell carcinoma from Jan. 2009 to Dec. 2009. Multiple variables, like age, gender, smoking, alcohol, obesity, family history of cancer, diabetes, hypertension, antidiabetic drugs, tumor staging, pathology, treatments, surgical side as well as lipid levels, were selected. We found that tumor staging was associated with 5-year survival rate of stage I–III NSCLC patients by univariate analysis. Furthermore, diabetes mellitus, hypertension and surgical side were associated with the overall survival of NSCLC patients with stage I, stageⅡand stage III, respectively. In conclusion, the status of chronic disease had potential effect on the postoperative 5-year survival rate of lung cancer patients.展开更多
Objective: To investigate the factors affecting progno- sis of patients with primary hepatocellular carcinoma (PHC) after resection. Methods: From 1976 to 1992, 213 patients with PHC treated with hepatectomy were foll...Objective: To investigate the factors affecting progno- sis of patients with primary hepatocellular carcinoma (PHC) after resection. Methods: From 1976 to 1992, 213 patients with PHC treated with hepatectomy were followed up for more than 5 years. Thirty-one of the patients who had sur- vived for more than 5 years were compared with 56 patients who had survived for less than 5 years. Results: Early detection of tumor, radical resection, number of tumors, capsule formation, operation safe distance, presence of portal tumor embolus, pre- sence of cirrhosis and tumor size were important fac- tors affecting the prognosis of patients with PHC. The proportion of small liver cancer in the patients who had survived for more than 5 years was greatly larger than that in the control group. Conclusions: Early detection of tumor and radical re- section are of value in raising the 5-year survival rate. Much remains to be investigated about the rela- tionship between safe margin distance and prognosis of patients with PHC.展开更多
Aim:Long-term survival after hepatocellular cancer(HCC)is difficult to achieve likely related to recurrence.This study aimed to identify factors that were predictive of 10-year survival after the diagnosis of HCC.Meth...Aim:Long-term survival after hepatocellular cancer(HCC)is difficult to achieve likely related to recurrence.This study aimed to identify factors that were predictive of 10-year survival after the diagnosis of HCC.Methods:In a prospectively collected database of 1374 HCC cases(1993-2019),we identified 70 patients who survived over 10 years regardless of treatment.We then identified 164 patients in the entire cohort who either had liver resection or transplant,and died before 10 years.Demographics,tumor characteristics,treatment,recurrence and treatment of recurrence were compared.Results:Of the 10-year survivors,36 underwent transplant,27 had liver resection and 7 patients had only locoregional therapy.Compared to the non-survivors,the 10-year survivors were younger and had fewer comorbidities or recurrence,smaller tumor size,lower AST,ALT,AFP,platelets,neutrophil-to-lymphocyte ratio.Multivariate analysis showed only age and diabetes to be negative predictors.Recurrence occurred in 24 survivors(34.3%)with mean time to recurrence with standard deviation 57.1±42.6 months compared to 80 non-survivors(48.7%)with mean time to recurrence of 15.3±14.8 months.For hepatic resection,10-year survivors had longer time to recurrence compared to non-survivors(median:31.3 months).Conclusion:Long-term survivors mostly occur after resection or transplant,but 10%of our cohort survived 10 years with only locoregional therapy.Underlying health status maybe an important predictor of 10-year survival for ;patients receiving liver resections.Recurrence of HCC occurs in both 10-year survivors and non-survivors,but later recurrence with aggressive treatment of the recurrence may allow for 10-year survival.展开更多
基金the CAMS Initiative for Innovative Medicine,No.2016-I2M-1-007。
文摘BACKGROUND The prognosis of gastric cancer in an advanced stage remains poor. The exact efficacy of the use of intraoperative sustained-release chemotherapy with 5-fluorouracil(5-FU) in advanced-stage gastric cancer is still unelucidated.AIM To explore the long-term survival benefit of using sustained-release 5-FU implants in stage Ⅱ and stage Ⅲ gastric cancer patients.METHODS Patients with gastric cancer in a locally advanced stage and who underwent an R0 radical resection between Jan 2014, to Dec 2016, in this single institution were included. Patients with pathological diagnoses other than adenocarcinoma were excluded. All included patients were grouped according to whether intraoperative sustained-release(SR) chemotherapy with 5-FU was used or not(NSR). The primary end-point was 5-year overall survival. Kaplan–Meier method with logrank test was used to analyze the overall survival of patients and Cox analysis was used to analyze prognosis factors of these patients.RESULTS In total, there were 563 patients with gastric cancer with locally advanced stage, who underwent an R0 radical resection. 309 patients were included in the final analysis. 219(70.9%) were men, with an average age of 58.25 years. Furthermore, 56(18.1%) received neoadjuvant chemotherapy, and 191(61.8%) were in TNM stage Ⅲ. In addition, 158 patients received intraoperative sustainedrelease chemotherapy with 5-FU and were included in the SR group, while the other 161 patients were included in the NSR group. The overall complication rate was 12.94% in the whole group and 10.81%, 16.46% in SR and NSR groups, respectively. There were no significant differences between the two groups in overall survival and complication rate(P > 0.05). The multivariate cox analysis indicated that only N Stage and neoadjuvant therapy were independent influencing factors of survival.CONCLUSION Intraoperative sustained-release chemotherapy usage with 5-FU, did not improve the survival of patients who underwent an R0 radical resection in locally advanced stage of gastric cancer.
基金the National Central Cancer Registry for matching patient survival outcomessupported by National Natural Science Foundation of China(grant number 82072734).
文摘Objective:The postoperative survival rates of patients with gastric cancer at different stages treated at the National Cancer Center(NCC)of China have not been reported.Therefore,we evaluated the survival of patients with gastric cancer who underwent surgery at the NCC from 2011 to 2018 to provide baseline information for further studies.Methods:We identified 7,301 patients with primary gastric carcinoma who underwent surgery at the NCC be-tween January 2011 and May 2018;among these,5,008 patients were enrolled in this study.Follow up was completed on April 30,2020.We analyzed the 5-year survival according to the stage,sex,age,and other clini-copathological features.Results:Five-year survival rates of patients with pTNM stages ⅠA,ⅠB,ⅡA,ⅡB,ⅢA,ⅢB,ⅢC,and Ⅳ treated at the NCC were 94.9%,91.8%,86.5%,76.1%,61.1%,44.2%,29.7%,and 8.1%,respectively,which were similar to those reported in Japan during the same period.Five-year survival rates of patients with ypTNM stages I,II,III,and IV were 93.1%,63.2%,27.2%,and 0.0%,respectively.In multivariable analysis,age,signet ring cell carcinoma,adjuvant chemotherapy,and degree of differentiation were revealed as important prognostic factors.Conclusion:The survival rates of patients with gastric cancer treated at the NCC have been significantly improved,reaching the levels of Japan in the same period.
基金General Research Program of Medical Health in Zhejiang Province(Grant No.2014KYB039)Zhejiang Provincial Program for the Zhejiang Medical and Health Science and Technology Program(Grant No.2015KYB071)+2 种基金Scientific Research Fund Project of Integrated Chinese and Western Medicine Institute in Zhejiang Province(Grant No.2014LYK021)Science and Technology in Zhejiang Province Chinese Medicine Program(Grant No.2016ZA038)1022 Talent Training Program of Zhejiang Cancer Hospital
文摘In this study, we aimed to investigate the influencing factors of postoperative 5-year survival rate in non small-cell lung cancer（NSCLC） patients with stage I–III. We enrolled 220 patients who underwent surgical operation and survived longer than 3 months, with histologically confirmed adenocarcinoma or squamous cell carcinoma from Jan. 2009 to Dec. 2009. Multiple variables, like age, gender, smoking, alcohol, obesity, family history of cancer, diabetes, hypertension, antidiabetic drugs, tumor staging, pathology, treatments, surgical side as well as lipid levels, were selected. We found that tumor staging was associated with 5-year survival rate of stage I–III NSCLC patients by univariate analysis. Furthermore, diabetes mellitus, hypertension and surgical side were associated with the overall survival of NSCLC patients with stage I, stageⅡand stage III, respectively. In conclusion, the status of chronic disease had potential effect on the postoperative 5-year survival rate of lung cancer patients.
文摘Objective: To investigate the factors affecting progno- sis of patients with primary hepatocellular carcinoma (PHC) after resection. Methods: From 1976 to 1992, 213 patients with PHC treated with hepatectomy were followed up for more than 5 years. Thirty-one of the patients who had sur- vived for more than 5 years were compared with 56 patients who had survived for less than 5 years. Results: Early detection of tumor, radical resection, number of tumors, capsule formation, operation safe distance, presence of portal tumor embolus, pre- sence of cirrhosis and tumor size were important fac- tors affecting the prognosis of patients with PHC. The proportion of small liver cancer in the patients who had survived for more than 5 years was greatly larger than that in the control group. Conclusions: Early detection of tumor and radical re- section are of value in raising the 5-year survival rate. Much remains to be investigated about the rela- tionship between safe margin distance and prognosis of patients with PHC.
文摘Aim:Long-term survival after hepatocellular cancer(HCC)is difficult to achieve likely related to recurrence.This study aimed to identify factors that were predictive of 10-year survival after the diagnosis of HCC.Methods:In a prospectively collected database of 1374 HCC cases(1993-2019),we identified 70 patients who survived over 10 years regardless of treatment.We then identified 164 patients in the entire cohort who either had liver resection or transplant,and died before 10 years.Demographics,tumor characteristics,treatment,recurrence and treatment of recurrence were compared.Results:Of the 10-year survivors,36 underwent transplant,27 had liver resection and 7 patients had only locoregional therapy.Compared to the non-survivors,the 10-year survivors were younger and had fewer comorbidities or recurrence,smaller tumor size,lower AST,ALT,AFP,platelets,neutrophil-to-lymphocyte ratio.Multivariate analysis showed only age and diabetes to be negative predictors.Recurrence occurred in 24 survivors(34.3%)with mean time to recurrence with standard deviation 57.1±42.6 months compared to 80 non-survivors(48.7%)with mean time to recurrence of 15.3±14.8 months.For hepatic resection,10-year survivors had longer time to recurrence compared to non-survivors(median:31.3 months).Conclusion:Long-term survivors mostly occur after resection or transplant,but 10%of our cohort survived 10 years with only locoregional therapy.Underlying health status maybe an important predictor of 10-year survival for ;patients receiving liver resections.Recurrence of HCC occurs in both 10-year survivors and non-survivors,but later recurrence with aggressive treatment of the recurrence may allow for 10-year survival.
