OBJECTIVE To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder c...OBJECTIVE To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder carcinoma. METHODS Fifty-eight stage T4 bladder carcinoma patients were selected. The patients were grouped to the TAI group and the TAE group. The main symptom of hemorrhage was gross hematuria. None of the patients in our study could receive trunk embolization. The infusion plan was oxaliplatin （100 mg/m2） and epirubicin （EPI 50mg/m2）. Embolization was done with coils or strips of gelatin sponge. The duration of gross hematuria was observed. Routine urinalysis and routine blood examination were performed. EORTC QLQ-C30 was used to evaluate the quality of life before and after treatment. RESULTS Gross hematuria and hematuria by light microscope in all patients were reviewed. Resolution time of gross hematuria in the TAI group was 6.7 ± 1.8 days and that in the TAE group was 3.5 ± 0.7 days. The changes in routine urianlysis, routine blood examination and EORTC QLQ-C30 are shown in Figs.l-3. Gross hematuria disappeared in both groups within 7 days after treatment, but the time for the gross hematuria to resolve in the TAE group was much less than that in TAI group （t = 2.51, P 〈 0.01）, and there were no significant differences in the 7th and 21st day between the 2 groups. On the 90th day, the number of erythrocytes in the urine was near 30, close to gross hematuria. The EORTC QLQ-C30 scores decreased after interventional therapy in both groups, which means that quality of life was increased, but there were no significant differences between the 2 groups. CONCLUSION Selective internal iliac artery infusion and selective internal iliac artery embolization are safe, and, in our study, therapeutic efficacy was satisfactory in treating unremitting gross hematuria of stage T4 bladder carcinoma in patients who could not receive trunk embolization. TAE can stop gross hematuria in the short term, but it can be used just once and the long-term therapeutic effect is not satisfactory. TAI had a therapeutic effect similar to TAE, but for a shorter duration, and TAI can be performed multiple times. TAI is one of the facultative treatments for treating gross hematuria of stage T4 bladder carcinoma.展开更多
AIM To ascertain the prognostic role of the T4 and N2 category in stage Ⅲ pancreatic cancer according to the 8 th edition of the American Joint Committee on Cancer(AJCC) classification.METHODS Patients were collected...AIM To ascertain the prognostic role of the T4 and N2 category in stage Ⅲ pancreatic cancer according to the 8 th edition of the American Joint Committee on Cancer(AJCC) classification.METHODS Patients were collected from the Surveillance Epidemiology and End Results(SEER) database(2004-2013) and were divided into three groups: T(1-3)N2, T4 N(0-1), and T4 N2. Overall survival(OS) and disease-specific survival(DSS) of patients were evaluated by the Kaplan-Meier method. RESULTS For the first time, we found a significant difference in OS and DSS between T(1-3)N2/T4 N(0-1) and T4 N2 butnot between T(1-3)N2 and T4 N(0-1). A higher grading correlated with a worse prognosis in the T(1-3)N2 and T4 N2 groups.CONCLUSION Patients with stage T4 N2 had a worse prognosis than those with stage T(1-3)N2/T4 N(0-1) in the 8 th edition AJCC staging system for pancreatic cancer. We recommend that stage Ⅲ should be subclassified into stage ⅢA [T(1-3)N2/T4 N(0-1)] and stage ⅢB(T4 N2).展开更多
Objective: There is controversy about the best therapeutic surgical approach for treatment of patients with T4 gastric cancer. We evaluated the survival benefit of resection in this group of patients. Methods: We retr...Objective: There is controversy about the best therapeutic surgical approach for treatment of patients with T4 gastric cancer. We evaluated the survival benefit of resection in this group of patients. Methods: We retrospectively reviewed the hospital records of 288 patients with T4 gastric carcinoma to compare the clinicopathological results in patients with curative resection (n = 49) with patients with non-curative resection (n = 113) from 1980 to 2000. Results: Curative resection was performed in 49 (30.2%) patients, with the pancreas being the most frequently resected organ. The 5-year survival rate was 9.3% and the median survival time was 12 months for all 162 registered patients. The 5-year survival rates in patients after curative and non-curative resection were 14.3% vs 7.1% respectively. These values differed considerably between the two groups (P = 0.033). Operative type and curability were independent statistically significant prognostic parameters. Conclusion: Curability was an independent prognostic factor among all registered patients. Patients with T4 gastric carcinoma might be benefited from curative resection.展开更多
文摘OBJECTIVE To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder carcinoma. METHODS Fifty-eight stage T4 bladder carcinoma patients were selected. The patients were grouped to the TAI group and the TAE group. The main symptom of hemorrhage was gross hematuria. None of the patients in our study could receive trunk embolization. The infusion plan was oxaliplatin （100 mg/m2） and epirubicin （EPI 50mg/m2）. Embolization was done with coils or strips of gelatin sponge. The duration of gross hematuria was observed. Routine urinalysis and routine blood examination were performed. EORTC QLQ-C30 was used to evaluate the quality of life before and after treatment. RESULTS Gross hematuria and hematuria by light microscope in all patients were reviewed. Resolution time of gross hematuria in the TAI group was 6.7 ± 1.8 days and that in the TAE group was 3.5 ± 0.7 days. The changes in routine urianlysis, routine blood examination and EORTC QLQ-C30 are shown in Figs.l-3. Gross hematuria disappeared in both groups within 7 days after treatment, but the time for the gross hematuria to resolve in the TAE group was much less than that in TAI group （t = 2.51, P 〈 0.01）, and there were no significant differences in the 7th and 21st day between the 2 groups. On the 90th day, the number of erythrocytes in the urine was near 30, close to gross hematuria. The EORTC QLQ-C30 scores decreased after interventional therapy in both groups, which means that quality of life was increased, but there were no significant differences between the 2 groups. CONCLUSION Selective internal iliac artery infusion and selective internal iliac artery embolization are safe, and, in our study, therapeutic efficacy was satisfactory in treating unremitting gross hematuria of stage T4 bladder carcinoma in patients who could not receive trunk embolization. TAE can stop gross hematuria in the short term, but it can be used just once and the long-term therapeutic effect is not satisfactory. TAI had a therapeutic effect similar to TAE, but for a shorter duration, and TAI can be performed multiple times. TAI is one of the facultative treatments for treating gross hematuria of stage T4 bladder carcinoma.
文摘AIM To ascertain the prognostic role of the T4 and N2 category in stage Ⅲ pancreatic cancer according to the 8 th edition of the American Joint Committee on Cancer(AJCC) classification.METHODS Patients were collected from the Surveillance Epidemiology and End Results(SEER) database(2004-2013) and were divided into three groups: T(1-3)N2, T4 N(0-1), and T4 N2. Overall survival(OS) and disease-specific survival(DSS) of patients were evaluated by the Kaplan-Meier method. RESULTS For the first time, we found a significant difference in OS and DSS between T(1-3)N2/T4 N(0-1) and T4 N2 butnot between T(1-3)N2 and T4 N(0-1). A higher grading correlated with a worse prognosis in the T(1-3)N2 and T4 N2 groups.CONCLUSION Patients with stage T4 N2 had a worse prognosis than those with stage T(1-3)N2/T4 N(0-1) in the 8 th edition AJCC staging system for pancreatic cancer. We recommend that stage Ⅲ should be subclassified into stage ⅢA [T(1-3)N2/T4 N(0-1)] and stage ⅢB(T4 N2).
文摘Objective: There is controversy about the best therapeutic surgical approach for treatment of patients with T4 gastric cancer. We evaluated the survival benefit of resection in this group of patients. Methods: We retrospectively reviewed the hospital records of 288 patients with T4 gastric carcinoma to compare the clinicopathological results in patients with curative resection (n = 49) with patients with non-curative resection (n = 113) from 1980 to 2000. Results: Curative resection was performed in 49 (30.2%) patients, with the pancreas being the most frequently resected organ. The 5-year survival rate was 9.3% and the median survival time was 12 months for all 162 registered patients. The 5-year survival rates in patients after curative and non-curative resection were 14.3% vs 7.1% respectively. These values differed considerably between the two groups (P = 0.033). Operative type and curability were independent statistically significant prognostic parameters. Conclusion: Curability was an independent prognostic factor among all registered patients. Patients with T4 gastric carcinoma might be benefited from curative resection.
