BACKGROUND Plasmacytoma is a rare neoplastic disorder that arises from B-lymphocytes.Solitary bladder plasmacytoma,a type of solitary extramedullary plasmacytoma,is even rarer.Treatments for solitary extramedullary pl...BACKGROUND Plasmacytoma is a rare neoplastic disorder that arises from B-lymphocytes.Solitary bladder plasmacytoma,a type of solitary extramedullary plasmacytoma,is even rarer.Treatments for solitary extramedullary plasmacytoma include surgery,chemotherapy,and radiation.However,there are no clinical trials or guidelines specifying which treatment might represent the gold standard.CASE SUMMARY We herein report a case of a 51-year-old woman with solitary bladder plasmacytoma(SBP).There remains no consensus regarding the optimal treatment for SBP.However,we successfully treated her with transurethral resection of bladder tumor followed by postoperative radiotherapy(50 Gy/25 F).The patient remained free of tumor recurrence at a 7-mo follow-up.CONCLUSION Radiation is the potential main treatment for SBP.However,surgery is also necessary.展开更多
Background: The impact of breast appearance after breast cancer surgical treatment on patients’ quality of life led to the development of the oncoplastic approach. However, studies reporting oncologic results associa...Background: The impact of breast appearance after breast cancer surgical treatment on patients’ quality of life led to the development of the oncoplastic approach. However, studies reporting oncologic results associated with this treatment strategy are scarce. This cross-sectional study was designed to assess oncologic outcomes among patients who underwent oncoplastic surgery. Methods: A total of 190 breast cancer patients who underwent breast-conserving surgery were enrolled. Fifty of them underwent oncoplastic surgery and 140 had none breast reconstruction procedure (control group). All surgeries were performed by the same surgical team. Results: Groups were similar with regard to staging, histological type, grade of the tumor, presence of intraductal component, hormone receptors and nodal commitment. Patients in oncoplastic surgery group had larger tumors (ρ = 0.001) and more lymphovascular invasion (ρ = 0.047). Further, a higher proportion of them underwent chemotherapy (ρ = 0.030). Follow-up time of control group was longer (ρ = 0.05), and these patients also had a longer relapse-free survival time (ρ = 0.001). Local recurrence rate was 5.8% (11/190) and it was significantly greater in the oncoplastic surgery group (8/11, ρ = 0.001). Time to local recurrence after surgery was longer in oncoplastic surgery group (ρ = 0.002). Overall, patients in oncoplastic surgery group were younger (ρ = 0.001), but at the time of local recurrence, patients in oncoplastic surgery group were older than those in control group (ρ = 0.0002). Conclusions: Among the studied patients, local recurrence rate was greater in those who underwent oncoplastic surgery.展开更多
Objectives:To investigate the impact of serumα-fetoprotein(AFP)levels on survival and early recurrence after R0 resection in primary hepatocellular carcinoma(HCC).Methods:We retrospectively analyzed clinical data of ...Objectives:To investigate the impact of serumα-fetoprotein(AFP)levels on survival and early recurrence after R0 resection in primary hepatocellular carcinoma(HCC).Methods:We retrospectively analyzed clinical data of 582 patients with primary HCC(male:488,female:94;mean age:51 years[age range,31-73 years])who underwent R0 resection between January 1997 and December 2009.The 1-,3-,and 5-year overall survival(OS)rates and the clinico-pathological factors between the AFP-negative and AFP-positive groups were compared.Risk fac-tors of early recurrence in the AFP-positive group were further analyzed.Results:Age and histological differentiation were significantly lower in the AFP-positive group than in AFP-negative group(χ^(2)=11.004,32.293;P=0.000).In the AFP-positive group,serumγ-glutamyl transferase levels,tumor diameters,TNM stage,and early recurrence rate were higher(χ^(2)=9.814 to 14.009,P<0.05),whereas the proportion of solitary HCC was lower(χ^(2)=8.509,P=0.004).The 1-,3-,and 5-year OS rates in the AFP-positive group were 80.5%,66.9%,and 40.2%,respectively,and those in the AFP-negative group were 89.2%,79.9%,and 50.3%,respec-tively(χ^(2)=11.884,P=0.001).The 1-,3-,and 5-year disease-free survival rates were 65.6%,48.5%,29.6%in the AFP-positive group and 81.7%,63.9%,42.1%in the AFP-negative group respectively(χ^(2)=15.574,P=0.000).The median OS times of early recurrence and non-early recurrence were 10 and 62 months,respectively(χ^(2)=45.013,P=0.000),and their median survival times from recurrence to death were 6 and 14 months,respectively(χ^(2)=40.581,P=0.000).Multiple-factor analysis suggested non-solitary HCC and low histological differentiation are independent risk factors influencing early recurrence of HCC.Conclusion:Elevated preoperative serum AFP levels were indicative of early HCC recurrence.展开更多
Background Nasopharyngeal carcinoma （NPC） is endemic in Southern Asia. Radiation therapy remains the mainstay of treatment strategies for NPC. Although approximately 19%-56% of patients develop a recurrent disease 5...Background Nasopharyngeal carcinoma （NPC） is endemic in Southern Asia. Radiation therapy remains the mainstay of treatment strategies for NPC. Although approximately 19%-56% of patients develop a recurrent disease 5 years after their primary treatment, recognition of post-radiation changes and early detection of relapse are important in improving the outcome of NPC. Our aim was to analyze the post-radiation changes and recurrent diseases related to NPC using computed tomography （CT） scans and to investigate their relationship. Methods CT scans of 510 pathologically proven NPC patients who have been followed up for more than 2 years after radiation were reviewed. The tumor＇s response to the radiation therapy and its relevance to recurrence were evaluated. Results For patients who were followed up for more than 2 years, their CT scans-obtained within 3 months, during the 4th to the 6th month, and beyond 7 months after radiation therapy, showed a normal nasopharyngeal cavity with a slight thickening in the wall in 93.5%, 95.0% and 84.8% of the patients respectively. The degree of tumor regression had no significant relevance to the risk of recurrence within the initial 3 months （P=0.094）. During this term, the relapse rates in the cases in which the nasopharyngeal walls were displayed as normal, slightly or moderately thickening, or with obvious residual masses on CT scans were 7.1%, 11.7%, 23.5% and 23.1% respectively. The degree of tumor regression beyond 3 months after radiation therapy had a considerable reverse relevance to the risk of recurrence （P=-0.000）. The relapse rates were 13.2%, 14.1%, 10.2% and 2.1%, respectively, in the cases with a normal and a slightly thickening nasopharyngeal wall during the 4th to the 6th month, the 7th to the 12th month, the 13th to the 24th month, and beyond 25 months after radiation. In contrast, the percents in cases with moderate or more aggressive thickening walls in the corresponding periods were 62.5%, 88.9%, 100% and 100%. Within 6 months after radiation therapy, shown by CT scans the metastatic lymph nodes disappeared, markedly decreased, slightly decreased, or enlarged in 37.4%, 51.8%, 4.7%, and 0.4%, respectively, of the patients. During 6 to 12 months after radiation therapy, the proportions were 78.5%, 19.2%, 0.6% and 1.7% correspondingly. Beyond 12 months, the proportions were 83.7%, 7.9%, 0%, and 8.4%. The regression degree of the malignant nodes after radiation therapy showed a remarkable reverse relevance to the risk of recurrence in lymph nodes （P=0.000）. In the cases with disappearing, markedly decreased, slightly decreased, or enlarged malignant nodes within six months after radiation, the relapse rates were 2.9%, 4.5%, 12.5% and 100%, respectively. Conclusions If the nasopharyngeal walls are shown to remain moderately thick on a CT scan beyond 6 months after radiotherapy, the risk of relapse will increase. The baseline images taken within 3 months after radiotherapy and regular follow-uo studies are the kev to pick up the tumor recurrences in an earlier stage.展开更多
文摘BACKGROUND Plasmacytoma is a rare neoplastic disorder that arises from B-lymphocytes.Solitary bladder plasmacytoma,a type of solitary extramedullary plasmacytoma,is even rarer.Treatments for solitary extramedullary plasmacytoma include surgery,chemotherapy,and radiation.However,there are no clinical trials or guidelines specifying which treatment might represent the gold standard.CASE SUMMARY We herein report a case of a 51-year-old woman with solitary bladder plasmacytoma(SBP).There remains no consensus regarding the optimal treatment for SBP.However,we successfully treated her with transurethral resection of bladder tumor followed by postoperative radiotherapy(50 Gy/25 F).The patient remained free of tumor recurrence at a 7-mo follow-up.CONCLUSION Radiation is the potential main treatment for SBP.However,surgery is also necessary.
文摘Background: The impact of breast appearance after breast cancer surgical treatment on patients’ quality of life led to the development of the oncoplastic approach. However, studies reporting oncologic results associated with this treatment strategy are scarce. This cross-sectional study was designed to assess oncologic outcomes among patients who underwent oncoplastic surgery. Methods: A total of 190 breast cancer patients who underwent breast-conserving surgery were enrolled. Fifty of them underwent oncoplastic surgery and 140 had none breast reconstruction procedure (control group). All surgeries were performed by the same surgical team. Results: Groups were similar with regard to staging, histological type, grade of the tumor, presence of intraductal component, hormone receptors and nodal commitment. Patients in oncoplastic surgery group had larger tumors (ρ = 0.001) and more lymphovascular invasion (ρ = 0.047). Further, a higher proportion of them underwent chemotherapy (ρ = 0.030). Follow-up time of control group was longer (ρ = 0.05), and these patients also had a longer relapse-free survival time (ρ = 0.001). Local recurrence rate was 5.8% (11/190) and it was significantly greater in the oncoplastic surgery group (8/11, ρ = 0.001). Time to local recurrence after surgery was longer in oncoplastic surgery group (ρ = 0.002). Overall, patients in oncoplastic surgery group were younger (ρ = 0.001), but at the time of local recurrence, patients in oncoplastic surgery group were older than those in control group (ρ = 0.0002). Conclusions: Among the studied patients, local recurrence rate was greater in those who underwent oncoplastic surgery.
文摘Objectives:To investigate the impact of serumα-fetoprotein(AFP)levels on survival and early recurrence after R0 resection in primary hepatocellular carcinoma(HCC).Methods:We retrospectively analyzed clinical data of 582 patients with primary HCC(male:488,female:94;mean age:51 years[age range,31-73 years])who underwent R0 resection between January 1997 and December 2009.The 1-,3-,and 5-year overall survival(OS)rates and the clinico-pathological factors between the AFP-negative and AFP-positive groups were compared.Risk fac-tors of early recurrence in the AFP-positive group were further analyzed.Results:Age and histological differentiation were significantly lower in the AFP-positive group than in AFP-negative group(χ^(2)=11.004,32.293;P=0.000).In the AFP-positive group,serumγ-glutamyl transferase levels,tumor diameters,TNM stage,and early recurrence rate were higher(χ^(2)=9.814 to 14.009,P<0.05),whereas the proportion of solitary HCC was lower(χ^(2)=8.509,P=0.004).The 1-,3-,and 5-year OS rates in the AFP-positive group were 80.5%,66.9%,and 40.2%,respectively,and those in the AFP-negative group were 89.2%,79.9%,and 50.3%,respec-tively(χ^(2)=11.884,P=0.001).The 1-,3-,and 5-year disease-free survival rates were 65.6%,48.5%,29.6%in the AFP-positive group and 81.7%,63.9%,42.1%in the AFP-negative group respectively(χ^(2)=15.574,P=0.000).The median OS times of early recurrence and non-early recurrence were 10 and 62 months,respectively(χ^(2)=45.013,P=0.000),and their median survival times from recurrence to death were 6 and 14 months,respectively(χ^(2)=40.581,P=0.000).Multiple-factor analysis suggested non-solitary HCC and low histological differentiation are independent risk factors influencing early recurrence of HCC.Conclusion:Elevated preoperative serum AFP levels were indicative of early HCC recurrence.
文摘Background Nasopharyngeal carcinoma （NPC） is endemic in Southern Asia. Radiation therapy remains the mainstay of treatment strategies for NPC. Although approximately 19%-56% of patients develop a recurrent disease 5 years after their primary treatment, recognition of post-radiation changes and early detection of relapse are important in improving the outcome of NPC. Our aim was to analyze the post-radiation changes and recurrent diseases related to NPC using computed tomography （CT） scans and to investigate their relationship. Methods CT scans of 510 pathologically proven NPC patients who have been followed up for more than 2 years after radiation were reviewed. The tumor＇s response to the radiation therapy and its relevance to recurrence were evaluated. Results For patients who were followed up for more than 2 years, their CT scans-obtained within 3 months, during the 4th to the 6th month, and beyond 7 months after radiation therapy, showed a normal nasopharyngeal cavity with a slight thickening in the wall in 93.5%, 95.0% and 84.8% of the patients respectively. The degree of tumor regression had no significant relevance to the risk of recurrence within the initial 3 months （P=0.094）. During this term, the relapse rates in the cases in which the nasopharyngeal walls were displayed as normal, slightly or moderately thickening, or with obvious residual masses on CT scans were 7.1%, 11.7%, 23.5% and 23.1% respectively. The degree of tumor regression beyond 3 months after radiation therapy had a considerable reverse relevance to the risk of recurrence （P=-0.000）. The relapse rates were 13.2%, 14.1%, 10.2% and 2.1%, respectively, in the cases with a normal and a slightly thickening nasopharyngeal wall during the 4th to the 6th month, the 7th to the 12th month, the 13th to the 24th month, and beyond 25 months after radiation. In contrast, the percents in cases with moderate or more aggressive thickening walls in the corresponding periods were 62.5%, 88.9%, 100% and 100%. Within 6 months after radiation therapy, shown by CT scans the metastatic lymph nodes disappeared, markedly decreased, slightly decreased, or enlarged in 37.4%, 51.8%, 4.7%, and 0.4%, respectively, of the patients. During 6 to 12 months after radiation therapy, the proportions were 78.5%, 19.2%, 0.6% and 1.7% correspondingly. Beyond 12 months, the proportions were 83.7%, 7.9%, 0%, and 8.4%. The regression degree of the malignant nodes after radiation therapy showed a remarkable reverse relevance to the risk of recurrence in lymph nodes （P=0.000）. In the cases with disappearing, markedly decreased, slightly decreased, or enlarged malignant nodes within six months after radiation, the relapse rates were 2.9%, 4.5%, 12.5% and 100%, respectively. Conclusions If the nasopharyngeal walls are shown to remain moderately thick on a CT scan beyond 6 months after radiotherapy, the risk of relapse will increase. The baseline images taken within 3 months after radiotherapy and regular follow-uo studies are the kev to pick up the tumor recurrences in an earlier stage.
