Objective:Traditional Chinese medicine(TCM)has been extensively used as one of popular alternative therapies for several cancers.However,it remains unclear whether TCM treatment is associated with longer survival in l...Objective:Traditional Chinese medicine(TCM)has been extensively used as one of popular alternative therapies for several cancers.However,it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients.In this study,we explored the effect of long-term TCM treatment on patients with different stages of lung cancer.Methods:All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study.Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group(control group).All patients were regularly followed up by clinic appointment or phone,and all survival data were collected from databases after the last follow-up in October 2017.Results:A total of 575 patients were included in this study,with 299 patients in the TCM group and 276 in the control group.For all patients,5-year disease-free survival(DFS)was 62.2% in TCM group and 42.1% in the control group,and 6-year DFSs were 51.8% and 35.4%,respectively(HR=0.51,95% CI:0.40 to 0.66,log-rank P≤0.001).For patients with stage I,5-year DFSs were 83.7%(TCM group)and 57.5%(control group)and 6-year DFSs were 73.7% and 51.9%,respectively(HR=0.30,95% CI:0.18 to 0.50,log-rank P≤0.001).For patients with stage II in the TCM group and the control group,5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%,respectively(HR=0.31,95% CI:0.19 to 0.52,log-rank P≤0.001),and for patients with stage III,5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group(HR=1.06,95% CI:0.72 to 1.56,log-rank P=0.76).Conclusions:This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients,especially in patients with stage I and II disease.However,these observational findings need being validated by large sample randomized controlled trials.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of liver cancer and has a high risk of invasion and metastasis along with a poor prognosis.AIM To investigate the independent predictive markers for dise...BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of liver cancer and has a high risk of invasion and metastasis along with a poor prognosis.AIM To investigate the independent predictive markers for disease-free survival(DFS)in patients with HCC and establish a trustworthy nomogram.METHODS In this study,445 patients who were hospitalized in The First Affiliated Hospital of Anhui Medical College between December 2009 and December 2014 were retrospectively examined.The survival curve was plotted using the Kaplan–Meier method and survival was determined using the log-rank test.To identify the prognostic variables,multivariate Cox regression analyses were carried out.To predict the DFS in patients with HCC,a nomogram was created.C-indices and receiver operator characteristic curves were used to evaluate the nomogram’s performance.Decision curve analysis(DCA)was used to evaluate the clinical application value of the nomogram.RESULTS Longer DFS was observed in patients with the following characteristics:elderly,I–II stage,and no history of hepatitis B.The calibration curve showed that this nomogram was reliable and had a higher area under the curve value than the tumor node metastasis(TNM)stage.Moreover,the DCA curve revealed that the nomogram had good clinical applicability in predicting 3-and 5-year DFS in HCC patients after surgery.CONCLUSION Age,TNM stage,and history of hepatitis B infection were independent factors for DFS in HCC patients,and a novel nomogram for DFS of HCC patients was created and validated.展开更多
[ Objective] In order to construct the specific equine disease-free zone of of the Guangzhou Asian Games, to ensure that the equestrian events of Guangzhou Asian Games be smoothly held. [Methods] The species, quantiti...[ Objective] In order to construct the specific equine disease-free zone of of the Guangzhou Asian Games, to ensure that the equestrian events of Guangzhou Asian Games be smoothly held. [Methods] The species, quantities, distribution and seasonal variations of insects and wild animals in related zones were investigated from 2008 to 2010, and the collected samples of the insects and wild animals were tested in laboratory for related equine diseases. [Results] The investigations indicated that there were some mosquitoes, flies, horseflies, punkies, ticks, bats, wild birds and wild bears in equastrianism venue and peripheral regions of disease-free zone of the Guangzhou Asian Games, the laboratory results of Japa- nese encephalitis, vesicular stomatitis, Nipah virus disease, West Nile fever, and Trypanosomiasis evansi, were all negative. According to the in- vestigations and test results, the risk assessments of insect and wild animal vectors in the prevalence of related equine diseases were made to con- firm that the risk was relatively low or very low, and comprehensive prevention and control measures with prevention as major measures and insecti- cides application and environment managements as supplementary means were made on the basis of the risk assessment conclusions. [ Conclu- sions] This research has laid a solid foundation for the successful building of the first specific equine disease-free zone in our country, ensured the smooth holding of the 16th equastdan competition in Guangzhou Asian Games.展开更多
[Objective]The model of regionalization management of specific equine disease-free zone were analysed and discussed. [Methods]International animal epidemics regionalization management experience and specific equine di...[Objective]The model of regionalization management of specific equine disease-free zone were analysed and discussed. [Methods]International animal epidemics regionalization management experience and specific equine disease-free zone establishment were analysed and discussed based on the State and OIE principles. [Results]The regionalization management of specific equine disease-free zone with county administrative regions level of international recognition was established first in China,combined with the region's geographical barrier and animal health. [Conclusion]The aim is to to provide experience and reference for other areas to establish specific disease-free zone.展开更多
BACKGROUND In recent years,the incidence of colorectal cancer(CRC)has been increasing.With the popularization of endoscopic technology,a number of early CRC has been diagnosed.However,despite current treatment methods...BACKGROUND In recent years,the incidence of colorectal cancer(CRC)has been increasing.With the popularization of endoscopic technology,a number of early CRC has been diagnosed.However,despite current treatment methods,some patients with early CRC still experience postoperative recurrence and metastasis.AIM To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.METHODS A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study.Results of blood routine test,liver and kidney function tests and tumor markers were collected before surgery.Patients were followed up through disease-specific database and telephone interviews.Tumor recurrence,metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.RESULTS We comprehensively compared the predictive value of preoperative blood routine,blood biochemistry and tumor markers for disease-free survival(DFS)and overall survival(OS)of CRC.Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS[hazard ratio(HR)=0.995,95% confidence interval(CI):0.991-0.999,P=0.015],while serum carcinoembryonic antigen(CEA)level(HR=1.008,95%CI:1.001-1.016,P=0.027)and serum total cholesterol level(HR=1.538,95%CI:1.026-2.305,P=0.037)were independent risk factors for OS.The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL.Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level,the difference between the two groups was not statistically significant(P=0.075).CONCLUSION For patients with T2N0M0 or T3N0M0 CRC,preoperative platelet count was a protective factor for DFS,while serum CEA level was an independent risk factor for OS.Given that these measures are easier to detect and more acceptable to patients,they may have broader applications.展开更多
BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have ...BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have been reported to be equal or better.As IA requires opening the intestinal tract in the abdominal cavity under pneumoperitoneum,there are concerns about intraperitoneal bacterial infection and recurrence of peritoneal dissemination due to the spread of bacteria and tumor cells.However,intraperitoneal bacterial contamination and medium-term oncological outcomes have not been clarified.abdominal cavity in IA.METHODS Of 127 patients who underwent laparoscopic colon resection for colon cancer from April 2015 to December 2020,75 underwent EA(EA group),and 52 underwent IA(IA group).After propensity score matching,the primary endpoint was 3-year disease-free survival rates,and secondary endpoints were 3-year overall survival rates,type of recurrence,surgical site infection(SSI)incidence,number of days on antibiotics,and postoperative biological responses.RESULTS Three-year disease-free survival rates did not significantly differ between the IA and EA groups(87.2%and 82.7%,respectively,P=0.4473).The 3-year overall survival rates also did not significantly differ between the IA and EA groups(94.7%and 94.7%,respectively;P=0.9891).There was no difference in the type of recurrence between the two groups.In addition,there were no significant differences in SSI incidence or the number of days on antibiotics;however,postoperative biological responses,such as the white blood cell count(10200 vs 8650/mm^(3),P=0.0068),C-reactive protein(6.8 vs 4.5 mg/dL,P=0.0011),and body temperature(37.7 vs 37.5℃,P=0.0079),were significantly higher in the IA group.CONCLUSION IA is an anastomotic technique that should be widely performed because its risk of intraperitoneal bacterial contamination and medium-term oncological outcomes are comparable to those of EA.展开更多
AIM To analyze the survival trends in colorectal cancer(CRC) based on the different classifications recommended by the seventh and eighth editions of the American Joint Committee on Cancer staging system(AJCC-7^(th) a...AIM To analyze the survival trends in colorectal cancer(CRC) based on the different classifications recommended by the seventh and eighth editions of the American Joint Committee on Cancer staging system(AJCC-7^(th) and AJCC-8^(th)).METHODS The database from our institution was queried to identify patients with pathologically confirmed stage 0-Ⅳ CRC diagnosed between 2006 and 2012. Data from 2080 cases were collected and 1090 cases were evaluated through standardized inclusion and exclusion criteria. CRC was staged by AJCC-7^(th) and then restaged by AJCC-8^(th). Five-year disease-free survival(DFS) and overall survival(OS) were compared. SPSS 21.0 software was used for all data. DFS and OS were compared and analyzed by Kaplan-Meier and Log-rank test.RESULTS Linear regression and automatic linear regression showed lymph node positive functional equations by tumornode-metastasis staging from AJCC-7^(th) and tumornode-metastasis staging from AJCC-8^(th). Neurological invasion, venous infiltration, lymphatic infiltration, and tumor deposition put forward stricter requirements for pathological examination in AJCC-8^(th) compared to AJCC-7^(th). After re-analyzing our cohort with AJCC-8^(th),the percentage of stage ⅣB cases decreased from 2.8% to 0.8%. As a result 2% of the cases were classified under the new ⅣC staging. DFS and OS was significantly shorter(P = 0.012) in stage ⅣC patients compared to stage ⅣB patients.CONCLUSION The addition of stage ⅣC in AJCC-8^(th) has shown that peritoneal metastasis has a worse prognosis than distant organ metastasis in our institution's CRC cohort. Additional datasets should be analyzed to confirm these findings.展开更多
AIM: To compare disease-free survival(DFS) between extramural vascular invasion(EMVI)-positive and-negative colon cancer patients evaluated by computed tomography(CT).METHODS: Colon cancer patients(n = 194) undergoing...AIM: To compare disease-free survival(DFS) between extramural vascular invasion(EMVI)-positive and-negative colon cancer patients evaluated by computed tomography(CT).METHODS: Colon cancer patients(n = 194) undergoing curative surgery between January 2009 and December 2013 were included. Each patient's demographics, cancer characteristics, EMVI status, pathological status and survival outcomes were recorded. All included patients had been routinely monitored until December 2015. EMVI was defined as tumor tissue within adjacent vessels beyond the colon wall as seen on enhanced CT. Disease recurrence was defined as metachronous metastases, local recurrence, or death due to colon cancer. Kaplan-Meier analyses were used to compare DFS between the EMVI-positive and-negative groups. Cox's proportional hazards models were used to measure the impact of confounding variables on survival rates.RESULTS: EMVI was observed on CT(ct EMVI) in 60 patients(30.9%, 60/194). One year after surgery, there was no statistically significant difference regarding the rates of progressive events between EMVI-positive and-negative patients [11.7%(7/60) and 6.7%(9/134), respectively; P = 0.266]. At the study endpoint, the EMVI-positive patients had significantly more progressive events than the EMVI-negative patients [43.3%(26/60) and 14.9%(20/134), respectively; oddsratio = 4.4, P < 0.001]. Based on the Kaplan-Meier method, the cumulative 1-year DFS rates were 86.7%(95%CI: 82.3-91.1) and 92.4%(95%CI: 90.1-94.7) for EMVI-positive and EMVI-negative patients, respectively. The cumulative 3-year DFS rates were 49.5%(95%CI: 42.1-56.9) and 85.8%(95%CI: 82.6-89.0), respectively. Cox proportional hazards regression analysis revealed that ctE MVI was an independent predictor of DFS with a hazard ratio of 2.15(95%CI: 1.12-4.14, P = 0.023). CONCLUSION: ctE MVI may be helpful when evaluating disease progression in colon cancer patients.展开更多
Objective: To investigate the associations between the different breast cancer subtypes and survival in Chinese women with operable primary breast cancer. Methods: A total of 1538 Chinese women with operable primary...Objective: To investigate the associations between the different breast cancer subtypes and survival in Chinese women with operable primary breast cancer. Methods: A total of 1538 Chinese women with operable primary breast cancer were analyzed in this study, the median follow-up was 77 months. Estrogen receptor (ER), progesterone receptor (PR), and HER2 status were available for these patients. Results: Luminal A (ER+ and/or PR+, HER2-) had a favorable disease-free survival (DFS) and overall survival (OS) compared with other subtypes in the entire cohort. Using the luminal A as a reference, among the patients with lymph node positive disease, HER2+ (ER-, PR-, HER2+) had the worst DFS (hazard ratio, HR=1.80, 95% CI 1.11 to 2.91, P=0.017) and luminal B (ER+ and/or PR+, HER2+) had the worst OS (HR=2.27, 95% CI 1.50 to 3.45, P0.001); among the patients with lymph node negative disease, triple-negative (ER-, PR-, HER2-) had the worst DFS (HR=2.21, 95% CI 1.43 to 3.41, P0.001), whereas no significant difference in DFS between HER2+ and luminal B or luminal A was observed. Conclusion: As compared with luminal A, luminal B and HER2+ have the worst survival in patients with lymph node positive disease, but this is not the case in patients with lymph node negative disease; triple-negative subtype has a worse survival in both lymph node positive and lymph node negative patients.展开更多
AIM:To assess the clinical significance and the prognostic value of preoperative serum carbohydrate antigen 19-9(CA 19-9)level in gastric cancer.METHODS:Between January 2005 and December2006,1960 patients underwent su...AIM:To assess the clinical significance and the prognostic value of preoperative serum carbohydrate antigen 19-9(CA 19-9)level in gastric cancer.METHODS:Between January 2005 and December2006,1960 patients underwent surgery for histologically confirmed gastric cancer.Of these,163 patients had elevated serum levels of CA 19-9 preoperatively,and1628 patients had normal serum levels of CA 19-9 preoperatively.For this study,325 patients were selected from the group of 1628 patients by age,sex,and cancer stage to serve as controls.Statistically significant differences in survival rates were calculated using the log-rank test.A P value less than 0.05 was considered statistically significant and was determined using SAS software.RESULTS:The baseline characteristics showed some differences between the two groups with regard to histology.Overall survival(OS)in the elevated and nonelevated group was 37.90 and 68.67 mo,respectively(P<0.001).N stage(P=0.001)was a significant predictor of disease-free survival by multivariate analysis.Also,N stage(P<0.001),and the presence of peritoneal metastasis(P<0.001)remained independent factors in predicting OS by multivariate analysis.Additionally,preoperative serum CA 19-9 levels were significantly associated with OS in univariate(P=0.009)and multivariate(P=0.021)analyses.CONCLUSION:Serum CA 19-9 can be considered an independent prognostic factor in predicting OS in patients anticipating surgery for gastric cancer.展开更多
基金the Nation Natural Science Foundation of China (No.814737627, No.81673947)the Science and Technology Commission of Shanghai Municipality (No.17401933500)the Shanghai Municipal Population and Family Planning Commission (No.201740059).
文摘Objective:Traditional Chinese medicine(TCM)has been extensively used as one of popular alternative therapies for several cancers.However,it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients.In this study,we explored the effect of long-term TCM treatment on patients with different stages of lung cancer.Methods:All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study.Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group(control group).All patients were regularly followed up by clinic appointment or phone,and all survival data were collected from databases after the last follow-up in October 2017.Results:A total of 575 patients were included in this study,with 299 patients in the TCM group and 276 in the control group.For all patients,5-year disease-free survival(DFS)was 62.2% in TCM group and 42.1% in the control group,and 6-year DFSs were 51.8% and 35.4%,respectively(HR=0.51,95% CI:0.40 to 0.66,log-rank P≤0.001).For patients with stage I,5-year DFSs were 83.7%(TCM group)and 57.5%(control group)and 6-year DFSs were 73.7% and 51.9%,respectively(HR=0.30,95% CI:0.18 to 0.50,log-rank P≤0.001).For patients with stage II in the TCM group and the control group,5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%,respectively(HR=0.31,95% CI:0.19 to 0.52,log-rank P≤0.001),and for patients with stage III,5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group(HR=1.06,95% CI:0.72 to 1.56,log-rank P=0.76).Conclusions:This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients,especially in patients with stage I and II disease.However,these observational findings need being validated by large sample randomized controlled trials.
基金Supported by Research Fund Project of Anhui Institute of Translational Medicine,No.2021zhyx-C54Foundation of Anhui Medical University,No.2019xkj146National and Provincial Key Specialty Construction Plan,No.Z155080000004。
文摘BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of liver cancer and has a high risk of invasion and metastasis along with a poor prognosis.AIM To investigate the independent predictive markers for disease-free survival(DFS)in patients with HCC and establish a trustworthy nomogram.METHODS In this study,445 patients who were hospitalized in The First Affiliated Hospital of Anhui Medical College between December 2009 and December 2014 were retrospectively examined.The survival curve was plotted using the Kaplan–Meier method and survival was determined using the log-rank test.To identify the prognostic variables,multivariate Cox regression analyses were carried out.To predict the DFS in patients with HCC,a nomogram was created.C-indices and receiver operator characteristic curves were used to evaluate the nomogram’s performance.Decision curve analysis(DCA)was used to evaluate the clinical application value of the nomogram.RESULTS Longer DFS was observed in patients with the following characteristics:elderly,I–II stage,and no history of hepatitis B.The calibration curve showed that this nomogram was reliable and had a higher area under the curve value than the tumor node metastasis(TNM)stage.Moreover,the DCA curve revealed that the nomogram had good clinical applicability in predicting 3-and 5-year DFS in HCC patients after surgery.CONCLUSION Age,TNM stage,and history of hepatitis B infection were independent factors for DFS in HCC patients,and a novel nomogram for DFS of HCC patients was created and validated.
基金the help and strong support of Departments the Chinese Animal Health and Epidemic Center,Guangdong Rsearch Institute of Entomology,Harbin Veterinary Research Institute of Chinese Academy of Agricultural Sciences,the Agriculture,Fisheries and Conservation Department of Hong Kong and the Hong Kong Jockey Club etc.,during the entomophily and wild animals prevention and control in the disease-free zone of Guangzhou Asian Games
文摘[ Objective] In order to construct the specific equine disease-free zone of of the Guangzhou Asian Games, to ensure that the equestrian events of Guangzhou Asian Games be smoothly held. [Methods] The species, quantities, distribution and seasonal variations of insects and wild animals in related zones were investigated from 2008 to 2010, and the collected samples of the insects and wild animals were tested in laboratory for related equine diseases. [Results] The investigations indicated that there were some mosquitoes, flies, horseflies, punkies, ticks, bats, wild birds and wild bears in equastrianism venue and peripheral regions of disease-free zone of the Guangzhou Asian Games, the laboratory results of Japa- nese encephalitis, vesicular stomatitis, Nipah virus disease, West Nile fever, and Trypanosomiasis evansi, were all negative. According to the in- vestigations and test results, the risk assessments of insect and wild animal vectors in the prevalence of related equine diseases were made to con- firm that the risk was relatively low or very low, and comprehensive prevention and control measures with prevention as major measures and insecti- cides application and environment managements as supplementary means were made on the basis of the risk assessment conclusions. [ Conclu- sions] This research has laid a solid foundation for the successful building of the first specific equine disease-free zone in our country, ensured the smooth holding of the 16th equastdan competition in Guangzhou Asian Games.
文摘[Objective]The model of regionalization management of specific equine disease-free zone were analysed and discussed. [Methods]International animal epidemics regionalization management experience and specific equine disease-free zone establishment were analysed and discussed based on the State and OIE principles. [Results]The regionalization management of specific equine disease-free zone with county administrative regions level of international recognition was established first in China,combined with the region's geographical barrier and animal health. [Conclusion]The aim is to to provide experience and reference for other areas to establish specific disease-free zone.
文摘BACKGROUND In recent years,the incidence of colorectal cancer(CRC)has been increasing.With the popularization of endoscopic technology,a number of early CRC has been diagnosed.However,despite current treatment methods,some patients with early CRC still experience postoperative recurrence and metastasis.AIM To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.METHODS A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study.Results of blood routine test,liver and kidney function tests and tumor markers were collected before surgery.Patients were followed up through disease-specific database and telephone interviews.Tumor recurrence,metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.RESULTS We comprehensively compared the predictive value of preoperative blood routine,blood biochemistry and tumor markers for disease-free survival(DFS)and overall survival(OS)of CRC.Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS[hazard ratio(HR)=0.995,95% confidence interval(CI):0.991-0.999,P=0.015],while serum carcinoembryonic antigen(CEA)level(HR=1.008,95%CI:1.001-1.016,P=0.027)and serum total cholesterol level(HR=1.538,95%CI:1.026-2.305,P=0.037)were independent risk factors for OS.The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL.Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level,the difference between the two groups was not statistically significant(P=0.075).CONCLUSION For patients with T2N0M0 or T3N0M0 CRC,preoperative platelet count was a protective factor for DFS,while serum CEA level was an independent risk factor for OS.Given that these measures are easier to detect and more acceptable to patients,they may have broader applications.
基金This study was reviewed and approved by the Ethics Review Committee of the Research Ethics Committee,Tokai University School of Medicine(23RC011).
文摘BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have been reported to be equal or better.As IA requires opening the intestinal tract in the abdominal cavity under pneumoperitoneum,there are concerns about intraperitoneal bacterial infection and recurrence of peritoneal dissemination due to the spread of bacteria and tumor cells.However,intraperitoneal bacterial contamination and medium-term oncological outcomes have not been clarified.abdominal cavity in IA.METHODS Of 127 patients who underwent laparoscopic colon resection for colon cancer from April 2015 to December 2020,75 underwent EA(EA group),and 52 underwent IA(IA group).After propensity score matching,the primary endpoint was 3-year disease-free survival rates,and secondary endpoints were 3-year overall survival rates,type of recurrence,surgical site infection(SSI)incidence,number of days on antibiotics,and postoperative biological responses.RESULTS Three-year disease-free survival rates did not significantly differ between the IA and EA groups(87.2%and 82.7%,respectively,P=0.4473).The 3-year overall survival rates also did not significantly differ between the IA and EA groups(94.7%and 94.7%,respectively;P=0.9891).There was no difference in the type of recurrence between the two groups.In addition,there were no significant differences in SSI incidence or the number of days on antibiotics;however,postoperative biological responses,such as the white blood cell count(10200 vs 8650/mm^(3),P=0.0068),C-reactive protein(6.8 vs 4.5 mg/dL,P=0.0011),and body temperature(37.7 vs 37.5℃,P=0.0079),were significantly higher in the IA group.CONCLUSION IA is an anastomotic technique that should be widely performed because its risk of intraperitoneal bacterial contamination and medium-term oncological outcomes are comparable to those of EA.
文摘AIM To analyze the survival trends in colorectal cancer(CRC) based on the different classifications recommended by the seventh and eighth editions of the American Joint Committee on Cancer staging system(AJCC-7^(th) and AJCC-8^(th)).METHODS The database from our institution was queried to identify patients with pathologically confirmed stage 0-Ⅳ CRC diagnosed between 2006 and 2012. Data from 2080 cases were collected and 1090 cases were evaluated through standardized inclusion and exclusion criteria. CRC was staged by AJCC-7^(th) and then restaged by AJCC-8^(th). Five-year disease-free survival(DFS) and overall survival(OS) were compared. SPSS 21.0 software was used for all data. DFS and OS were compared and analyzed by Kaplan-Meier and Log-rank test.RESULTS Linear regression and automatic linear regression showed lymph node positive functional equations by tumornode-metastasis staging from AJCC-7^(th) and tumornode-metastasis staging from AJCC-8^(th). Neurological invasion, venous infiltration, lymphatic infiltration, and tumor deposition put forward stricter requirements for pathological examination in AJCC-8^(th) compared to AJCC-7^(th). After re-analyzing our cohort with AJCC-8^(th),the percentage of stage ⅣB cases decreased from 2.8% to 0.8%. As a result 2% of the cases were classified under the new ⅣC staging. DFS and OS was significantly shorter(P = 0.012) in stage ⅣC patients compared to stage ⅣB patients.CONCLUSION The addition of stage ⅣC in AJCC-8^(th) has shown that peritoneal metastasis has a worse prognosis than distant organ metastasis in our institution's CRC cohort. Additional datasets should be analyzed to confirm these findings.
文摘AIM: To compare disease-free survival(DFS) between extramural vascular invasion(EMVI)-positive and-negative colon cancer patients evaluated by computed tomography(CT).METHODS: Colon cancer patients(n = 194) undergoing curative surgery between January 2009 and December 2013 were included. Each patient's demographics, cancer characteristics, EMVI status, pathological status and survival outcomes were recorded. All included patients had been routinely monitored until December 2015. EMVI was defined as tumor tissue within adjacent vessels beyond the colon wall as seen on enhanced CT. Disease recurrence was defined as metachronous metastases, local recurrence, or death due to colon cancer. Kaplan-Meier analyses were used to compare DFS between the EMVI-positive and-negative groups. Cox's proportional hazards models were used to measure the impact of confounding variables on survival rates.RESULTS: EMVI was observed on CT(ct EMVI) in 60 patients(30.9%, 60/194). One year after surgery, there was no statistically significant difference regarding the rates of progressive events between EMVI-positive and-negative patients [11.7%(7/60) and 6.7%(9/134), respectively; P = 0.266]. At the study endpoint, the EMVI-positive patients had significantly more progressive events than the EMVI-negative patients [43.3%(26/60) and 14.9%(20/134), respectively; oddsratio = 4.4, P < 0.001]. Based on the Kaplan-Meier method, the cumulative 1-year DFS rates were 86.7%(95%CI: 82.3-91.1) and 92.4%(95%CI: 90.1-94.7) for EMVI-positive and EMVI-negative patients, respectively. The cumulative 3-year DFS rates were 49.5%(95%CI: 42.1-56.9) and 85.8%(95%CI: 82.6-89.0), respectively. Cox proportional hazards regression analysis revealed that ctE MVI was an independent predictor of DFS with a hazard ratio of 2.15(95%CI: 1.12-4.14, P = 0.023). CONCLUSION: ctE MVI may be helpful when evaluating disease progression in colon cancer patients.
基金supported by grants from the Program fro Breast Cancer Tissue Bank of Beijingthe National Natural Science Foundation of China (No.30973436)
文摘Objective: To investigate the associations between the different breast cancer subtypes and survival in Chinese women with operable primary breast cancer. Methods: A total of 1538 Chinese women with operable primary breast cancer were analyzed in this study, the median follow-up was 77 months. Estrogen receptor (ER), progesterone receptor (PR), and HER2 status were available for these patients. Results: Luminal A (ER+ and/or PR+, HER2-) had a favorable disease-free survival (DFS) and overall survival (OS) compared with other subtypes in the entire cohort. Using the luminal A as a reference, among the patients with lymph node positive disease, HER2+ (ER-, PR-, HER2+) had the worst DFS (hazard ratio, HR=1.80, 95% CI 1.11 to 2.91, P=0.017) and luminal B (ER+ and/or PR+, HER2+) had the worst OS (HR=2.27, 95% CI 1.50 to 3.45, P0.001); among the patients with lymph node negative disease, triple-negative (ER-, PR-, HER2-) had the worst DFS (HR=2.21, 95% CI 1.43 to 3.41, P0.001), whereas no significant difference in DFS between HER2+ and luminal B or luminal A was observed. Conclusion: As compared with luminal A, luminal B and HER2+ have the worst survival in patients with lymph node positive disease, but this is not the case in patients with lymph node negative disease; triple-negative subtype has a worse survival in both lymph node positive and lymph node negative patients.
文摘AIM:To assess the clinical significance and the prognostic value of preoperative serum carbohydrate antigen 19-9(CA 19-9)level in gastric cancer.METHODS:Between January 2005 and December2006,1960 patients underwent surgery for histologically confirmed gastric cancer.Of these,163 patients had elevated serum levels of CA 19-9 preoperatively,and1628 patients had normal serum levels of CA 19-9 preoperatively.For this study,325 patients were selected from the group of 1628 patients by age,sex,and cancer stage to serve as controls.Statistically significant differences in survival rates were calculated using the log-rank test.A P value less than 0.05 was considered statistically significant and was determined using SAS software.RESULTS:The baseline characteristics showed some differences between the two groups with regard to histology.Overall survival(OS)in the elevated and nonelevated group was 37.90 and 68.67 mo,respectively(P<0.001).N stage(P=0.001)was a significant predictor of disease-free survival by multivariate analysis.Also,N stage(P<0.001),and the presence of peritoneal metastasis(P<0.001)remained independent factors in predicting OS by multivariate analysis.Additionally,preoperative serum CA 19-9 levels were significantly associated with OS in univariate(P=0.009)and multivariate(P=0.021)analyses.CONCLUSION:Serum CA 19-9 can be considered an independent prognostic factor in predicting OS in patients anticipating surgery for gastric cancer.