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Nomogram prediction of vessels encapsulating tumor clusters in small hepatocellular carcinoma≤3 cm based on enhanced magnetic resonance imaging

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1808-1820页

作者： Hui-Lin Chen Rui-Lin He Meng-Ting Gu Xing-Yu Zhao Kai-Rong Song Wen-Jie Zou Ning-Yang Jia Wan-Min Liu School of Health Science and Engineering University of Shanghai for Science and TechnologyShanghai 200093China Department of Radiology The Third Affiliated Hospital of Shanghai Naval Military Medical UniversityShanghai 200438China Department of Radiology Tongji University Affiliated Tongji HospitalShanghai 200065China

BACKGROUND Vessels encapsulating tumor clusters(VETC)represent a recently discovered vascular pattern associated with novel metastasis mechanisms in hepatocellular carcinoma(HCC).However,it seems that no one have focused on predicting VETC status in small HCC(sHCC).This study aimed to develop a new nomogram for predicting VETC positivity using preoperative clinical data and image features in sHCC(≤3 cm)patients.AIM To construct a nomogram that combines preoperative clinical parameters and image features to predict patterns of VETC and evaluate the prognosis of sHCC patients.METHODS A total of 309 patients with sHCC,who underwent segmental resection and had their VETC status confirmed,were included in the study.These patients were recruited from three different hospitals:Hospital 1 contributed 177 patients for the training set,Hospital 2 provided 78 patients for the test set,and Hospital 3 provided 54 patients for the validation set.Independent predictors of VETC were identified through univariate and multivariate logistic analyses.These independent predictors were then used to construct a VETC prediction model for sHCC.The model’s performance was evaluated using the area under the curve(AUC),calibration curve,and clinical decision curve.Additionally,Kaplan-Meier survival analysis was performed to confirm whether the predicted VETC status by the model is associated with early recurrence,just as it is with the actual VETC status and early recurrence.RESULTS Alpha-fetoprotein_lg10,carbohydrate antigen 199,irregular shape,non-smooth margin,and arterial peritumoral enhancement were identified as independent predictors of VETC.The model incorporating these predictors demonstrated strong predictive performance.The AUC was 0.811 for the training set,0.800 for the test set,and 0.791 for the validation set.The calibration curve indicated that the predicted probability was consistent with the actual VETC status in all three sets.Furthermore,the decision curve analysis demonstrated the clinical benefits of our model for pati

关键词： Small hepatocellular carcinoma Vessels encapsulating tumor clusters Nomogram Magnetic resonance imaging multicenter

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multicenter study of the clinicopathological features and recurrence risk prediction model of early-stage breast cancer with low-positive human epidermal growth factor receptor 2 expression in China (Chinese Society of Breast Surgery 021)

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Chinese Medical Journal 2022年第6期135卷 697-706页

作者： Ling Xin Qian Wu Chongming Zhan Hongyan Qin Hongyu Xiang Ling Xu Jingming Ye Xuening Duan Yinhua Liu Chinese Society of Breast Surgery(CSBrS) Chinese Society of Surgery of Chinese Medical Association Breast Disease Center Peking University First HospitalBeijing 100034China Jun Yi Tai He Medical Technology Co.Ltd Beijing 100024China 不详

Background:Breast cancer with low-positive human epidermal growth factor receptor 2(HER2)expression has triggered further refinement of evaluation criteria for HER2 expression.We studied the clinicopathological features of early-stage breast cancer with low-positive HER2 expression in China and analyzed prognostic factors.Methods:Clinical and pathological data and prognostic information of patients with early-stage breast cancer with low-positive HER2 expression treated by the member units of the Chinese Society of Breast Surgery and Chinese Society of Surgery of Chinese Medical Association,from January 2015 to December 2016 were collected.The prognostic factors of these patients were analyzed.Results:Twenty-nine hospitals provided valid cases.From 2015 to 2016,a total of 25,096 cases of early-stage breast cancer were treated,7642(30.5%)of which had low-positive HER2 expression and were included in the study.After ineligible cases were excluded,6486 patients were included in the study.The median follow-up time was 57 months(4-76 months).The disease-free survival rate was 92.1%at 5 years,and the overall survival rate was 97.4%at 5 years.At the follow-up,506(7.8%)cases of metastasis and 167(2.6%)deaths were noted.Multivariate Cox regression analysis showed that tumor stage,lymphvascular invasion,and the Ki67 index were related to recurrence and metastasis(P<0.05).The recurrence risk prediction model was established using a machine learning model and showed that the area under the receiving operator characteristic curve was 0.815(95%confidence interval:0.750-0.880).Conclusions:Early-stage breast cancer patients with low-positive HER2 expression account for 30.5%of all patients.Tumor stage,lymphvascular invasion,and the Ki67 index are factors affecting prognosis.The recurrence prediction model for breast cancer with low-positive HER2 expression based on a machine learning model had a good clinical reference value for predicting the recurrence risk at 5 years.Trial registration:ChiCTR.org.cn,ChiCTR2100046766.

关键词： Breast tumor Low-positive HER2 expression multicenter CSBrS research Recurrence risk prediction model

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Electroacupuncture in Treatment of Acute Gastrointestinal Injury in Patients with Severe Traumatic Brain Injury:A multicenter Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2023年第8期29卷 721-729页

作者： XING Xi JIANG Rong-lin LEI Shu ZHI Yi-hui ZHU Mei-fei HUANG Li-quan HU Ma-hong LU Jun FANG Kun WANG Qiu-yan Department of ICU the First Affiliated Hospital of Zhejiang University of Traditional Chinese MedicineHangzhou(310000)China Department of ICU Tongde Hospital of ZhejiangTongdeZhejiang Province(310000)China Department of ICU Xinhua Hospital of ZhejiangHangzhou(310000)China Department of ICU Zhejiang integrated Traditional Chineseand Western Medicine HospitalHangzhou(310000)China Department of ICU Hangzhou Hospital of Traditional Chinese MedicalHangzhou(310000)China

Objective: To evaluate whether electroacupuncture(EA) would improve gastrointestinal function and clinical prognosis in patients with severe traumatic brain injury(TBI) complicocted by acute gastrointestinal injury(AGI). Methods: This multicenter, single-blind trial included patients with TBI and AGI admitted to 5Chinese hospitals from September 2018 to December 2019. A total of 500 patients were randomized to the control or acupuncture groups using a random number table, 250 cases in each group. Patients in the control group received conventional treatment, including mannitol, nutritional support, epilepsy and infection prevention, and maintenance of water, electrolytes, and acid-base balance. While patients in the acupuncture group received EA intervention at bilateral Zusanli(ST 36), Shangjuxu(ST 37), Xiajuxu(ST 39), Tianshu(ST 25), and Zhongwan(RN 12) acupoints in addition to the conventional treatment, 30 min per time, twice daily,for 7 d. The primary endpoint was 28-d mortality. The secondary endpoints were serum levels of D-lactic acid(D-lac), diamine oxidase(DAO), lipopolysaccharide(LPS), motilin(MTL) and gastrin(GAS), intra-abdominal pressure(IAP), bowel sounds, abdominal circumference, AGI grade, scores of gastrointestinal failure(GIF),Glasgow Coma Scale(GCS), Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ), Sequential Organ Failure Assessment(SOFA), and Multiple Organ Dysfunction Syndrome(MODS), mechanical ventilation time,intense care unit(ICU) stay, and the incidence of hospital-acquired pneumonia. Results: The 28-d mortality in the acupuncture group was lower than that in the control group(22.80% vs. 33.20%, P<0.05). Compared with the control group, the acupuncture group at 7 d showed lower GIF, APACHE Ⅱ, SOFA, MODS scores, D-lac,DAO, LPS, IAP, and abdominal circumference and higher GCS score, MTL, GAS, and bowel sound frequency(all P<0.05). In addition, the above indices showed simillar changes at 7 d compared with days 1 and 3 in the EA group(all P<0.05). Conclusion: Early EA can improve

关键词： electroacupuncture traumatic brain injury acute gastrointestinal injury multicenter randomized controlled trial

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Vasectomy reversal in China during the recent decade:insights from a multicenter retrospective investigation

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Asian Journal of Andrology 2023年第3期25卷 416-420页

作者： Li-Juan Ren Rui-Zhi Xue Zi-Qiang Wu Er-Lei Zhi Wei Li Liang Huang Xu-Yu Xiang Dao-Yuan Li Xue-Ming Lin Department of Urology First Hospital of Shanxi Medical UniversityTaiyuan 030000China Department of Urology Xiangya Hospital of Central South UniversityChangsha 410000China Department of Urology Shanghai General HospitalShanghai 200000China Department of Urology Second Hospital of Tianjin Medical UniversityTianjin 300000China Department of Urology Zhujiang Hospital of Southern Medical UniversityGuangzhou 510000China Department of Urology First Affiliated Hospital of Nanchang UniversityNanchang 330000China Department of Urology Hainan General HospitalHaikou 570100China

To date,there is little information about the demography of vasectomy reversal(VR)patients or the factors currently influencing VR effectiveness in China,especially after the universal two-child policy was released in 2015.In this research,demographic data and perioperative medical records of VR patients were extracted from seven major hospitals in different provinces or municipalities of China.Meanwhile,a telephone survey of the patients was conducted to collect follow-up information.Eventually,448 VR cases from the past 13 years were included.The results were analyzed by stratified comparison to investigate factors that can influence postoperative vas deferens patency and pregnancy rate.Appropriately statistical methods were used,and all of the protocols were approved by the Ethics Committees of the institutes in this research.The results showed that the annual operation volume of VR quadrupled after the two-child policy was implemented.Nonmicrosurgery and a long duration of vasectomy were significantly associated with a lower patency rate.A follow-up survey showed that the general postoperative pregnancy rate was 27.2%.For female partners over the age of 35 years,the postoperative pregnancy rate showed a more severe decline,but only 35.5%of them had been given a fertility examination before their husbands’VR surgery.Our work revealed that more patients in China have been demanding VR in recent years.High-quality microsurgery and a short duration of vasectomy are crucial for restoring patency by VR.Clinical andrologists should perform a preoperative fertility evaluation of the patients’female partners.

关键词： demography microsurgery multicenter vasectomy reversal

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Paclitaxel liposome for injection (Lipusu) plus cisplatin versus gemcitabine plus cisplatin in the first-line treatment of locally advanced or metastatic lung squamous cell carcinoma: A multicenter, randomized, open-label, parallel controlled clinical study

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Cancer Communications 2022年第1期42卷 3-16页

作者： Jie Zhang Yueyin Pan Qin Shi Guojun Zhang Liyan Jiang Xiaorong Dong Kangsheng Gu Huijuan Wang Xiaochun Zhang Nong Yang Yuping Li Jianping Xiong Tienan Yi Min Peng Yong Song Yun Fan Jiuwei Cui Gongyan Chen Wei Tan Aimin Zang Qisen Guo Guangqiang Zhao Ziping Wang Jianxing He Wenxiu Yao Xiaohong Wu Kai Chen Xiaohua Hu Chunhong Hu Lu Yue Da Jiang Guangfa Wang Junfeng Liu Guohua Yu Junling Li Jianling Bai Wenmin Xie Weihong Zhao Lihong Wu Caicun Zhou Department of Medical Oncology Shanghai Pulmonary Hospital&Thoracic Cancer InstituteTongji University School of MedicineShanghai 200433P.R.China Department of Chemotherapy Anhui Provincial HospitalHefeiAnhui 230001P.R.China Department of Oncology Fuzhou Pulmonary Hospital of FujianFuzhouFujian 350008P.R.China Department of Respiratory Medicine the First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052P.R.China Department of Respiration Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghai 200030P.R.China Cancer Center Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022P.R.China Department of Medical Oncology the First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui 230032P.R.China Department of Respiration Henan Cancer HospitalZhengzhouHenan 450008P.R.China Department of Medical Oncology the Affiliated Hospital of Qingdao UniversityQingdaoShandong 266000P.R.China Department of Medical Oncology Hunan Cancer HospitalChangshaHunan 410013P.R.China Department of Pulmonary and Critical Care Medicine the First Affiliated Hospital of Wenzhou Medical CollegeShangcai villageWenzhouZhejiang 325000P.R.China Department of Medical Oncology the First Affiliated Hospital of Nanchang UniversityNanchangJiangxi 330006P.R.China Department of Medical Oncology Xiang Yang Central HospitalXiangyangHubei 441021P.R.China Department of Medical Oncology Renmin Hospital of Wuhan UniversityWuhanHubei 430060P.R.China Department of Respiration General Hospital of Eastern Theater Command of Chinese People’s Liberation ArmyNanjingJiangsu 210002P.R.China Department of Medical Oncology Zhejiang Cancer HospitalHangzhouZhejiang 310022P.R.China Cancer Center the First Bethune Hospital of Jilin UniversityChangchunJilin 130021P.R.China Department of Medical Oncology Harbin Medical University Cancer HospitalHarbinHeilongjiang 150081P.R.China Department of Respiratory Medicine Weifang People’s HospitalWeifangShandong

Background:Lipusu is the first commercialized liposomal formulation of pacli-taxel and has demonstrated promising efficacy against locally advanced lung squamous cell carcinoma(LSCC)in a small-scale study.Here,we conducted a multicenter,randomized,phase 3 study to compare the efficacy and safety of cis-platin plus Lipusu(LP)versus cisplatin plus gemcitabine(GP)as first-line treat-ment in locally advanced or metastatic LSCC.Methods:Patients enrolled were aged between 18 to 75 years,had locally advanced(clinical stage IIIB,ineligible for concurrent chemoradiation or surgery)or metastatic(Stage IV)LSCC,had no previous systemic chemother-apy and at least one measurable lesion as per the Response Evaluation Criteria in Solid Tumors(version 1.1)before administration of the trial drug.The primary endpoint was progression-free survival(PFS).The secondary endpoints included objective response rate(ORR),disease control rate(DCR),overall survival(OS),and safety profiles.To explore the possible predictive value of plasma cytokines for LP treatment,plasma samples were collected from the LP group at baseline and first efficacy evaluation time and were then subjected to analysis by 45-Plex ProcartaPlex Panel 1 to detect the presence of 45 cytokines using the Luminex xMAP technology.The correlation between treatment outcomes and dynamic changes in the levels of cytokines were evaluated in preliminary analyses.Results:The median duration of follow-up was 15.4 months.237 patients in the LP group and 253 patients in the GP group were included in the per protocol set(PPS).In the PPS,the median PFS was 5.2 months versus 5.5 months in the LP and GP group(hazard rtio[HR]:1.03,P=0.742)respectively.The median OS was 14.6 months versus 12.5 months in the LP and GP group(HR:0.83,P=0.215).The ORR(41.8%versus 45.9%,P=0.412)and DCR(90.3%versus 88.1%,P=0.443)were also similar between the LP and GP group.A significantly lower proportion of patients in the LP group experienced adverse events(AEs)leading to treatment interruptions(10.9%versus 26.

关键词： chemotherapy cisplatin clinical trial gemcitabine liposomal paclitaxel(Lipusu) locally advanced lung squamous cell carcinoma metastatic multicenter plasma cytokines

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A multicenter Metal–Organic Framework for Quantitative Detection of Multicomponent Organic Mixtures

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CCS Chemistry 2022年第10期4卷 3238-3245页

作者： Zongsu Han Kunyu Wang Yinlin Chen Jiangnan Li Simon JTeat Sihai Yang Wei Shi Peng Cheng Department of Chemistry Key Laboratory of Advanced Energy Materials Chemistry(MOE)and Renewable Energy Conversion and Storage Center(RECAST)College of ChemistryNankai UniversityTianjin 300071 Department of Chemistry The University of ManchesterManchester M139PL Advanced Light Source Lawrence Berkeley National LaboratoryBerkeleyCA 94720

Instant recognition and quantification of multicomponent organicmixtures,especially the oneswith similar characteristics,remains a key challenge in the chemical industry.Although luminescence sensing is considered a rapid and facile method for the detection of various chemical substances,the simultaneous and quantitative detection of three or more components has not yet been achieved.Herein,we report a rationally designed white-light-emitting metal–organic framework(MOF)EuTb@NKU-102,and demonstrate its application in the simultaneous discrimination of multicomponent organic mixtures.

关键词： multicenter emission multicomponent mixture isomer sensing material metal–organic framework

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Rate of anticoagulant use, and factors associated with not prescribing anticoagulant in older Thai adults with non-valvular atrial fibrillation: A multicenter registry

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Journal of Geriatric Cardiology 2019年第3期16卷 242-250页

作者： Rungroj Krittayaphong Arintaya Phrommintikul Pornchai Ngamjanyaporn Khanchai Siriwattana Wiwat Kanjanarutjawiwat Thoranis Chantrarat Roj Rojjarekampai Pontawee Kaewcomdee Patthrapon Sonkhammee Division of Cardiology Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Faculty of Medicine Chiang Mai UniversityChiang MaiThailand Chonburi Hospital ChonburiThailand Nakornping Hospital Chiang MaiThailand Prapokklao Hospital ChanthaburiThailand Phramongkutklao College of Medicine Mahidol UniversityBangkokThailand Faculty of Medicine Thammasat UniversityPathum ThaniThailand

Objectives To investigate the rate of anticoagulant use,the reasons for not prescribing anticoagulant,and the factors associated with non-prescription of anticoagulant in older Thai adults with non-valvular atrial fibrillation.Methods A multicenter registry of patients with non-valvular atrial fibrillation was conducted during 2014 to 2017 in Thailand.Demographic,medical history,antithrombotic medication,non-antithrombotic medication,and laboratory data were collected and analyzed.Data were compared between the older adult (≥ 65 years) and younger adult (< 65 years) groups.The reasons why anticoagulant was not prescribed were collected,and predictive factors were identified.Results A total of 3218 patients (1873 males) with an average age of 67.3 ± 11.3 years were included.Almost two-thirds (61.0%) of patients were in the older adult group.Anticoagulant was prescribed in 2422 patients (75.3%): 81.4% in the older adult group and 65.7% in the younger adult group.The three main reasons for not prescribing anticoagulant were already taking antiplatelets,patient refusal,and bleeding risk.These reasons were more common in older adults as compared to younger adults.Multivariate analysis revealed current use of antiplatelets to be the most important factor that predict the non-prescription of anticoagulant in older population.Conclusions The prevalence of anticoagulant prescription among older Thai adults with atrial fibrillation is 81.4%.Taking antiplatelet drugs was found to be the strongest reason that predicts the non-prescription of anticoagulant in this patient population.A guideline should be developed to optimize the use of anticoagulant and antiplatelet in older adults.

关键词： Anticoagulant use multicenter registry Non-valvular atrial fibrillation Older Thai adults

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Burden of diabetic foot ulcer in Nigeria: Current evidence from the multicenter evaluation of diabetic foot ulcer in Nigeria

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World Journal of Diabetes 2019年第3期10卷 200-211页

作者： Ejiofor Ugwu Olufunmilayo Adeleye Ibrahim Gezawa Innocent Okpe Marcelina Enamino Ignatius Ezeani Department of Medicine Enugu State University of Science and Technology Enugu Enugu 400001 Nigeria Department of Medicine Lagos State University Lagos Lagos 100001 Nigeria Department of Medicine Bayero University Kano Kano 700001 Nigeria Department of Medicine Ahmadu Bello University Zaria Kaduna 800001 Nigeria Department of Medicine Federal Medical Center Keffi Nasarawa 961101 Nigeria Department of Medicine Federal Medical Center Umuahia Abia 440001 Nigeria

BACKGROUND Nigeria bears the greatest burden of diabetes prevalence in Sub-Saharan Africa. Diabetic foot ulcer (DFU) is a serious and potentially life-threatening complication of diabetes. Significant improvements in diabetic foot incidence and outcomes have been recorded in many Western countries in the past decade. However, the current burden of DFU in Nigeria is largely unknown. AIM To evaluate the patients’ profile, ulcer characteristics, associated co-morbidities and outcome of patients with DFU in Nigeria. METHODS multicenter evaluation of diabetic foot ulcer in Nigeria was a one year multicenter observational study of patients hospitalized for DFU in six tertiary health institutions in Nigeria from March 2016 to March 2017. Demographic and diabetes information, ulcer characteristics and associated co-morbidities were assessed. Relevant laboratory and imaging studies were performed. All patients received appropriate multi-disciplinary care and were followed up until discharge or death. Outcome variables of interest were ulcer healing, lower extremity amputation (LEA), duration of hospitalization and mortality. RESULTS A total of 336 patients (55.1% male) with mean age of 55.9 ± 12.5 years were enrolled into this study. Majority (96.1%) had type 2 diabetes. Only 25.9% of the subjects had prior foot care knowledge. Most of the subjects presented late to the hospital and median (IQR) duration of ulcer at presentation was 39 (28-54) d. Ulcers were already advanced (Wagner grades ≥ 3) in 79.2% of the subjects while 76.8% of the ulcers were infected at the time of admission. The commonest comorbidities were systemic hypertension, anemia and hyperglycemic emergencies. One hundred and nineteen subjects (35.4%) suffered LEA while 10.4% left against medical advice. The median (IQR) duration of hospitalization was 52.0 (29-66) d with case fatality rate of 20.5%. CONCLUSION The burden of DFU in Nigeria is very high. The major gaps include low level of foot care knowledge among diabetic patients, overdependence on self-

关键词： Burden Diabetes Epidemiology Foot ulcer Amputation Mortality multicenter evaluation of diabetic foot ulcer in Nigeria Nigeria Africa

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Irinotecan plus S-1 versus S-1 in patients with previously treated recurrent or metastatic esophageal cancer(ESWN 01):a prospective randomized,multicenter,open-labeled phase 3 trial

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Cancer Communications 2019年第1期39卷 151-160页

作者： Jing Huang Binghe Xu Ying Liu Junxing Huang Ping Lu Yi Ba Lin Wu Yuxian Bai Shu Zhang Jifeng Feng Ying Cheng Jie Li Lu Wen Xianglin Yuan Changwu Ma Chunhong Hu Qingxia Fan Xi Wang Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeNo 17 Panjiayuan NanliChaoyang DistrictBeijing 100021P.R.China Department of Medical Oncology Henan Cancer HospitalZhengzhou 450008HenanP.R.China Department of Medical Oncology Taizhou People’s HospitalTaizhou 225300JiangsuP.R.China Department of Medical Oncology First Affiliated Hospital of Xinxiang Medical UniversityXinxiang 453100HenanP.R.China Department of Medical Oncology Tianjin Cancer HospitalTianjin 300060P.R.China Department of Medical Oncology Hunan Cancer HospitalChangsha 410006HunanP.R.China Department of Medical Oncology Harbin Medical University Cancer HospitalHarbin 150040HeilongjiangP.R.China Department of Medical Oncology Shandong Cancer HospitalJinan 250117ShandongP.R.China Department of Medical Oncology Jiangsu Cancer HospitalNanjing 210009JiangsuP.R.China Department of Medical Oncology Jilin Cancer HospitalChangchun 130012JilinP.R.China Department of Radiotherapy Shanxi Cancer HospitalTaiyuan 030013ShanxiP.R.China Department of Medical Oncology Shanxi Cancer HospitalTaiyuan 030013ShanxiP.R.China Department of Medical Oncology Tongji HospitalWuhan 430030HubeiP.R.China Department of Medical Oncology Chifeng Municipal HospitalChifeng 024000Inner MongoliaP.R.China Department of Oncology The Second Xiangya Hospital of Central South UniversityChangsha 410011HunanP.R.China Department of Oncology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052HenanP.R.China

Background:The benefit of systemic treatments in esophageal squamous cell carcinoma(ESCC)which has pro-gressed after chemotherapy is still uncertain and optimal regimens based on randomized trials have not yet been established.We aimed to compare the efficacy of irinotecan plus S-1 with S-1 monotherapy in recurrent or metastatic ESCC patients who had resistance to platinum-or taxane-based chemotherapy.Methods:We conducted a prospective randomized,multicenter,open-label,phase 3 trial in 15 centers across China.Eligible patients were adults with histologically confirmed recurrent or metastatic ESCC,and were randomly assigned(ratio,1:1)to receive either irinotecan plus S-1(intravenous infusion of irinotecan[160 mg/m2]on day 1 and oral S-1[80-120 mg]on days 1-10,repeated every 14 days)or oral S-1 monotherapy(80-120 mg/day on days 1-14,repeated every 21 days)using a central computerized minimization procedure.The primary endpoint was progression-free survival(PFS).Results:Between December 23,2014 and July 25,2016,we screened 148 patients and randomly assigned 123 patients to receive either irinotecan plus S-1 regimen(n=61)or S-1 monotherapy(n=62).After a median follow-up of 29.2 months(95%confidence interval[CI]17.5-40.9 months),the median PFS was significantly longer in the irinotecan plus S-1 group than in the S-1 monotherapy group(3.8 months[95%CI 2.9-4.3 months]vs.1.7 months[95%CI 1.4-2.7 months],hazard ratio=0.58,95%CI 0.38-0.86,P=0.006).The objective response rates were 24.6%in the irinotecan plus S-1 group and 9.7%in the S-1 monotherapy group(P=0.002).The patients in the irinotecan plus S-1 group presented with increased rates of grade 3-4 leukopenia(16.4%vs.0%),neutropenia(14.8%vs.1.6%),and nausea(4.9%vs.0%).No significant difference in grade 3-4 diarrhea and no treatment-related deaths were observed in both groups.Conclusions: The combination of irinotecan with S-1 was similarly tolerable but significantly prolonged PFS compared to S-1 monotherapy as a second- or third-line treatment in patients with recurren

关键词： Esophageal squamous cell carcinoma Recurrent Metastasis multicenter open-label randomized trial Irinotecan S-1 Overall survival Progression-free survival Objective response rate Disease control rate

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A nomogram for individualized estimation of survival among adult patients with adrenocortical carcinoma after surgery:a retrospective analysis and multicenter validation study

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Cancer Communications 2019年第1期39卷 683-695页

作者： Jianqiu Kong Junjiong Zheng Jinhua Cai Shaoxu Wu Xiayao Diao Weibin Xie Xiong Chen Chenyi Liao Hao Yu Xinxiang Fan Chaowen Huang Zhuowei Liu Wei Chen Qiang Lv Haide Qin Jian Huang Tianxin Lin Department of Urology Sun Yat-Sen Memorial HospitalSun Yat-Sen University107 Yan Jiang West RoadGuangzhou 510120GuangdongP.R.China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhou 510120GuangdongP.R.China Department of Neurology Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhou 510120GuangdongP.R.China Department of Obstetrics and Gynecology Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630GuangdongP.R.China Department of Urology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Urology First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080GuangdongP.R.China Department of Urology The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029JiangsuP.R.China State Key Laboratory of Oncology in South China Guangzhou 510120GuangdongP.R.China

Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is limited.The objective of this study was to develop and externally validate a nomogram for overall survival(OS)prediction in adult patients with ACC after surgery.Methods:Based on the data from the Surveillance Epidemiology,and End Results(SEER)database,adults patients diagnosed with ACC between January 1988 and December 2015 were identified and classified into a training set,comprised of 404 patients diagnosed between January 2007 and December 2015,and an internal validation set,com-prised of 318 patients diagnosed between January 1988 and December 2006.The endpoint of this study was OS.The nomogram was developed using a multivariate Cox proportional hazards regression algorithm in the training set and its performance was evaluated in terms of its discriminative ability,calibration,and clinical usefulness.The nomogram was then validated using the internal SEER validation,also externally validated using the Cancer Genome Atlas set(TCGA,82 patients diagnosed between 1998 and 2012)and a Chinese multicenter cohort dataset(82 patients diag-nosed between December 2002 and May 2018),respectively.Results:Age at diagnosis,T stage,N stage,and M stage were identified as independent predictors for OS.A nomo-gram incorporating these four predictors was constructed using the training set and demonstrated good calibration and discrimination(C-index 95%confidence interval[CI],0.715[0.679-0.751]),which was validated in the internal validation set(C-index[95%CI],0.672[0.637-0.707]),the TCGA set(C-index[95%CI],0.810[0.732-0.888])and the Chi-nese multicenter set(C-index[95%CI],0.726[0.633-0.819]),respectively.Encouragingly,the nomogram was able to successfully distinguished patients with a high-risk of mortality in all enrolled patients and in the subgroup analyses.Decision curve analysis indicated that the nomogram was clinically useful and applicable.Conclusions:T

关键词： Adrenocortical carcinoma Adult patients Overall survival Nomogram Validation Decision curve analysis Surveillance Epidemiology and End Results(SEER) The Cancer Genome Atlas(TCGA) multicenter

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