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treatment patterns and survival outcomes in patients with nonmetastatic early-onset pancreatic cancer

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World Journal of Gastroenterology 2024年第12期30卷 1739-1750页

作者： Le-Tian Zhang Ying Zhang Bi-Yang Cao Chen-Chen Wu Jing Wang Graduate School Chinese PLA Medical SchoolBeijing 100853China Department of Radiation Oncology First Medical Center of Chinese PLA General HospitalBeijing 100853China Department of Internal Medicine Hospital of University of Science and Technology BeijingBeijing 100083China Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and *** role of combination therapy including surgery,radiotherapy,and chemotherapy in non-metastatic EOPC is not *** To investigate the treatment patterns and survival outcomes in patients with non-metastatic *** A total of 277 patients with non-metastatic EOPC who were treated at our institution between 2017 and 2021 were investigated *** survival(OS),disease-free survival,and progression-free survival were estimated using the Kaplan-Meier *** and multivariate analyses with the Cox proportional hazards model were used to identify prognostic *** With a median follow-up time of 34.6 months,the 1-year,2-year,and 3-year OS rates for the entire cohort were 84.3%,51.5%,and 27.6%,*** median OS of patients with localized disease who received surgery alone and adjuvant therapy(AT)were 21.2 months and 28.8 months,respectively(P=0.007).The median OS of patients with locally advanced disease who received radiotherapy-based combination therapy(RCT),surgery after neoadjuvant therapy(NAT),and chemotherapy were 28.5 months,25.6 months,and 14.0 months,respectively(P=0.002).The median OS after regional recurrence were 16.0 months,13.4 months,and 8.9 months in the RCT,chemotherapy,and supportive therapy groups,respectively(P=0.035).Multivariate analysis demonstrated that carbohydrate antigen 19-9 level,pathological grade,T-stage,N-stage,and resection were independent prognostic factors for non-metastatic *** AT improves postoperative survival in localized *** after NAT and RCT are the preferred therapeutic options for patients with locally advanced EOPC.

关键词： Pancreatic cancer Early-onset Non-metastatic multimodal treatment Radiotherapy Overall survival

Cancer: An unknown territory;rethinking before going ahead

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Genes & Diseases 2021年第5期8卷 655-661页

作者： Arun Upadhyay Department of Biochemistry Central University of RajasthanRajasthan305817India

Cancer is a disease of altered signaling and metabolism,causing uncontrolled divi-sion and survival of transformed cells.A host of molecules,factors,and conditions have been designated as underlying causes for the inception and progression of the *** enormous amount of data is available,system-wide interaction networks of the genes and proteins are generated over the years and have now reached up to a level of saturation,where we need to shift our focus to the more advanced and comprehensive methods and approaches of data analysis and *** with the availability of enormous literature on this one of the most pressing pathological conditions,a successful cure of the disease seems to be *** treatment plans,like immunotherapy and precision medicine,are being employed for different ***,their actual benefits to the patients would be known only after the evaluation of clinical data over the next few ***,we need to look at few fundamental challenges that should be addressed in more depth before we could devise bet-ter,rigorous,and comprehensive treatment plans and may successfully reach a possible cure of the *** article aims at bringing attention towards some fundamental gaps in our approach towards the disease that leads to failure in devising successful therapeutics.

关键词： Bottom-up approach Evolution of cancer Genetic diversity Immunotherapy multimodal treatment

Current status of esophageal cancer treatment

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Chinese Journal of Cancer Research 2020年第3期32卷 271-286页

作者： Tania Triantafyllou Bas P L Wijnhoven Department of Surgery Hippocration General Hospital of AthensNational and Kapodistrian University of AthensAthens 11527Greece Department of Surgery Erasmus University Medical CenterRotterdam 3000the Netherlands

Esophageal cancer(EC) remains one of the most common and aggressive diseases *** review discusses some debates in the modern management of the *** procedures for early cancer(T1a-b) are now embedded in routine care and the challenge will be to more accurately select patients for endoscopic resection with or without adjuvant *** multimodal therapies are associated with improved survival compared to surgery alone for locally advanced esophageal ***, there is no global consensus on the optimal ***, histological subtype(adenocarcinoma *** cell cancer) plays a role in the choice for *** studies are underway to resolve some *** extent of the lymphadenectomy during esophagectomy remains controversial especially after neoadjuvant *** ideal operation balances between limiting surgical trauma and optimizing *** invasive esophagectomy and enhanced recovery pathways are associated with decreased morbidity and faster recovery albeit there is no consensus yet what approach should be ***, immune checkpoint inhibitors present promising preliminary results in the novel treatment of advanced or metastatic EC but their widespread application in clinical practice is still awaited.

关键词： Esophageal cancer endoscopic resection minimally invasive esophagectomy multimodal treatment fast-track protocols

palliative care and end-stage colorectal cancer management:The surgeon meets the oncologist

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World Journal of Gastroenterology 2014年第24期20卷 7602-7621页

作者： Renato Costi Francesco Leonardi Daniele Zanoni Vincenzo Violi Luigi Roncoroni Istituto di Clinica Chirurgica Generale e Terapia Chirurgica Dipartimento di Scienze ChirurgicheUniversità di ParmaAzienda Ospedaliero-Universitaria di Parma43126 ParmaItaly Dipartimento Polispecialistico 1 Unità Operativa di Oncologia MedicaAzienda Ospedaliero-Universitaria di Parma43126 ParmaItaly Dipartimento di Chirurgia Generale e Specialistica Ospedale di VaioAzienda Unità Sanitaria Locale di Parma43036 Fidenza (Parma)Italy

Colorectal cancer (CRC) is a common neoplasia in the Western countries, with considerable morbidity and mortality. Every fifth patient with CRC presents with metastatic disease, which is not curable with radical intent in roughly 80% of cases. Traditionally approached surgically, by resection of the primitive tumor or stoma, the management to incurable stage IV CRC patients has significantly changed over the last three decades and is nowadays multidisciplinary, with a pivotal role played by chemotherapy (CHT). This latter have allowed for a dramatic increase in survival, whereas the role of colonic and liver surgery is nowadays matter of debate. Although any generalization is difficult, two main situations are considered, asymptomatic (or minimally symptomatic) and severely symptomatic patients needing aggressive management, including emergency cases. In asymptomatic patients, new CHT regimens allow today long survival in selected patients, also exceeding two years. The role of colonic resection in this group has been challenged in recent years, as it is not clear whether the resection of primary CRC may imply a further increase in survival, thus justifying surgery-related morbidity/mortality in such a class of short-living patients. Secondary surgery of liver metastasis is gaining acceptance since, under new generation CHT regimens, an increasing amount of patients with distant metastasis initially considered non resectable become resectable, with a significant increase in long term survival. The management of CRC emergency patients still represents a major issue in Western countries, and is associated to high morbidity/mortality. Obstruction is traditionally approached surgically by colonic resection, stoma or internal by-pass, although nowadays CRC stenting is a feasible option. Nevertheless, CRC stent has peculiar contraindications and complications, and its long-term cost-effectiveness is questionable, especially in the light of recently increased survival. Per

关键词： Colorectal cancer Palliative care multimodal treatment Chemotherapy Surgery Stenting Radiotherapy

Primary large cell neuroendocrine carcinoma in the common bile duct:First Asian case report

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World Journal of Gastroenterology 2014年第47期20卷 18048-18052页

作者： Sung Bae Park Suk Bae Moon Young Joon Ryu Jeana Hong Yang Hee Kim Gi Bong Chae Seong Kweon Hong Department of Surgery Kangwon National University HospitalKangwon National University School of MedicineChuncheon 200-947South Korea Department of Pathology Kangwon National University HospitalKangwon National University School of MedicineChuncheon 200-947South Korea Department of Pediatrics Kangwon National University HospitalKangwon National University School of MedicineChuncheon 200-947South Korea

Large cell neuroendocrine carcinoma (LCNEC) in the biliary system is a poorly differentiated, high-grade neuroendocrine tumor. These tumors exhibit aggressive behavior and an increased tendency for early nodal and distant metastases. Herein, we report an unusual case of a pure primary LCNEC of the common bile duct (CBD). A 75-year-old female presented with nausea and jaundice. The patient underwent a CBD excision with lymph node dissection. Upon histological and immunohistochemical examination, the tumor exhibited pure large cell-type neuroendocrine features. Metastases were noted in two of the eight lymph nodes. The patient was administered adjuvant chemotherapy. The patient’s cancer recurred 7 mo after surgery, and the patient died from liver failure 5 mo after recurrence. The prognosis of LCNEC of CBD remains poor despite curative resection and adjuvant chemotherapy. The role of additional therapies, such as multimodal treatment including radiation therapy, must be further studied to improve the prognoses of patients.

关键词： Neuro endocrine tumor Large cell neuroendocrine carcinoma Metastases multimodal treatment Common bile duct