Research Developments on the Histopathology and Prognostic Predictors of Serous Borderline Tumor of Ovary

Serous borderline tumor of ovary (SBT)includes two subtypes of typical serous borderline tumor andmicropapillary variant, which have different histopathologyfeatures. Although SBTs behave in either way of the benigncounterparts or malignant serous carcinomas, microinvasion,peritoneal implants, and nodal involvement are all very commonin both subtypes of typical SBT and the micropapillary variant.The prognosis of the patients with serous borderline tumorof ovary and the mechanism of the microinvasion, peritonealimplantation and nodal involvement are still being debated, noris there universal agreement about the management of SBT. Toidentify the histopathologic features, prognostic predictors ofthe SBT, and its association with ovarian serous carcinomas, wereviewed the majority of the relevant papers published in recentliterature.

ALK gene copy number gain and its clinical significance in hepatocellular carcinoma

AIM: To examine the status and clinical significance of anaplastic lymphoma kinase (ALK) gene alterations in hepatocellular carcinoma (HCC) patients.

The relationship between treatment-induced hypertension and efficacy of anlotinib in recurrent or metastatic esophageal squamous cell carcinoma

Objective:In this post-hoc analysis,we evaluated anlotinib treatment-induced hypertension as a potential predictive factor of efficacy in esophageal squamous cell carcinoma(ESCC)patients.Methods:A total of 109 patients enrolled in the anlotinib group in a phase 2 trial were included.The tumor response was assessed by computed tomography at week 3,week 6,and then every 6 weeks until progressive disease was observed.The primary endpoint of the study was progression free survival(PFS).The secondary endpoints included overall survival(OS)and objective response rate(ORR).Results:In all patients,the median PFS was 3.02 months[95%confidence interval(CI):2.63–3.65 months]and the OS was 6.11 months(95%CI:4.40–7.79 months).The ORR was 7.34%(95%CI:3.22%–13.95%).A total of 59(54%)patients were diagnosed with treatment-induced hypertension(Group A),and the remaining patients(n=50,46%)were in Group B.Baseline prognostic factors were similar between the 2 groups.Patients in Group A had a longer PFS and OS and higher ORR.When stratifying patients using a previously known history of hypertension,treatment-induced hypertension was a predictor only for patients without previous hypertension,who had longer PFS[hazard ratio(HR):0.40,95%CI:0.24–0.68]and OS(HR:0.37,95%CI:0.21–0.67).Conclusions:We showed,for the first time,a correlation between treatment-induced hypertension and better prognoses in recurrent or metastatic ESCC patients treated with anlotinib,without a previously known history of hypertension.Treatment-induced hypertension may be a simple and low cost predictor for anlotinib antitumor efficacy in these patients,which may also reflect the intended target inhibition.

Progress on clinical prognosis assessment in liver failure

Liver failure is a group of clinical syndromes with a mortality rate of>50%.The accurate evaluation of severity in patients with liver failure has been a meaningful and hot topic in clinical research and an important guide for liver transplantation.Numerous prognosis studies have emerged in recent years with high accuracy and adequate validity.Nonetheless,different models utilize distinct parameters and have unequal efficiencies,leading to a specific value and unique application situations for each model.This review focused on the progress in recent prognostic studies including the model for end-stage liver disease,sequential organ failure assessment and its derivative models,the Chinese Group on the Study of Severe Hepatitis B Acute-on-Chronic Liver Failure,the Tongji prognostic predictor model,and other emerging prognostic models and predictors.This review aims to assist clinicians understand the framework of recent models and choose the appropriate model and treatment.

Gunshot injury to spine:An institutional experience of management and complications from a developing country

Purpose Gunshot wounds are the second leading cause of spinal cord injuries.Surgical intervention for gunshot injury to the spine carries a high rate of complications.There is a scarcity of data on civilian gunshot injuries to the spine in Pakistan.Approximately 60 cases over the last 10 years have been recoded,with unusual presentation and neurological recovery.Thus it is imperative to fill this gap in data,by reviewing cases of civilian gunshot injuries to spine presenting at a tertiary care hospital(Aga Khan University Hospital,Karachi).Methods This is a retrospective cohort study.Patients of all ages who presented to the emergency department of Aga Khan University Hospital,with gunshot injuries to spine between January 2005 and December 2016 were included in the study.Data were collected on neurological status(American Spinal Injury Association score was used for the initial and follow-up neurological assessment),extent of cord transection,motor and sensory deficits.The patients were further grouped into those with cord transection,and those with fractures of the bony spine but an intact spinal cord.These patients were then followed and the outcomes were recorded.Results A total of 40 patients were identified.The mean±SD of patients age was(30.9±9.5)years.Of the 40 patients with gunshot wounds,31 had the medical imaging performed at the facility,and hence they were included in this categorization.The remaining 9 patients were excluded from this additional grouping.Thirteen patients were managed surgically and 27 patients underwent the conservative management.The mean±SD of follow-up was(8.7±7.2)months.In our study,the thoracic spine was the most commonly injured region in gunshot injuries.Of the 31 patients with medical imaging performed at our institute,17(54.8%)had cord transection,of whom 8(47%)ultimately developed paraplegia.Conclusion The prognosis of gunshot injuries to the spine can be varied depending on whether the spinal cord is intact or transected.This will help healthcare providers to plan the further management of the patient and counsel them accordingly.