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Computed tomography-based radiomics for prediction of neoadjuvant chemotherapy outcomes in locally advanced gastric cancer: A pilot study

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Chinese Journal of Cancer Research 2018年第4期30卷 406-414页

作者： Zhenhui Li Dafu Zhang Youguo Dai Jian Dong Lin Wu Yajun Li Zixuan Cheng Yingying Ding Zaiyi Liu Department of Radiology the Third Affiliated Hospital of Kunming Medical University Yunnan Cancer Hospital Department of Abdominal Surgery the Third Affiliated Hospital of Kunming Medical University Yunnan Cancer Hospital Department of Pathology the Third Affiliated Hospital of Kunming Medical University Yunnan Cancer Hospital Department of Radiology Guangdong General Hospital Guangdong Academy of Medical Sciences School of Medicine South China University of Technology

Objective： The standard treatment for patients with locally advanced gastric cancer has relied on perioperativeradio-chemotherapy or chemotherapy and surgery. The aim of this study was to investigate the wealth of radiomicsfor pre-treatment computed tomography （CT） in the prediction of the pathological response of locally advancedgastric cancer with preoperative ***： Thirty consecutive patients with CT-staged Ⅱ/Ⅲ gastric cancer receiving neoadjuvant chemotherapywere enrolled in this study between December 2014 and March 2017. All patients underwent upper abdominal CTduring the unenhanced, late arterial phase （AP） and portal venous phase （PP） before the administration ofneoadjuvant chemotherapy. In total, 19,985 radiomics features were extracted in the AP and PP for each *** methods were adopted during feature selection and eight methods were used in the process of building theclassifier model. Thirty-two combinations of feature selection and classification methods were examined. Receiveroperating characteristic （ROC） curves were used to evaluate the capability of each combination of feature selectionand classification method to predict a non-good response （non-GR） based on tumor regression grade （TRG）.Results： The mean area under the curve （AUC） ranged from 0.194 to 0.621 in the AP, and from 0.455 to 0.722in the PP, according to different combinations of feature selection and the classification methods. There was onlyone cross-combination machine-learning method indicating a relatively higher AUC （〉0.600） in the AP, while 12cross-combination machine-learning methods presented relatively higher AUCs （all 〉0.600） in the PP. The featureselection method adopted by a filter based on linear discriminant analysis ＋ classifier of random forest achieved asignificantly prognostic performance in the PP （AUC, 0.722~0.108; accuracy, 0.793; sensitivity, 0.636; specificity,0.889; Z=2.039; P=0.041）.Conclusions： It is possible to predict non-GR after neoadi

关键词： Gastric cancer neoadjuvant chemotherapy radiomics tomography spiral computed

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Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 95-102页

作者： Minha Kim Stephanie Stroever Krist Aploks Alexander Ostapenko Xiang Da Dong Ramanathan Seshadri Department of General Surgery Danbury HospitalDanburyCT 06810United States Department of Research and Innovation Nuvance HealthDanburyCT 06810United States Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery Danbury HospitalDanburyCT 06810United States

BACKGROUND Gallbladder cancer is the most common malignancy of the biliary ***-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 ***,there is no consensus of guidelines for neoadjuvant therapy in gallbladder *** investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative *** hypothesized patients who underwent NACT were more likely to have higher post-operative *** To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had *** A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had *** calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was *** Of the 452 patients,52 patients received NACT prior to *** were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.

关键词： Gallbladder cancer neoadjuvant chemotherapy Radical cholecystectomy National Surgery Quality Improvement Program Postoperative outcome

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Could neoadjuvant chemotherapy increase postoperative complication risk of laparoscopic total gastrectomy? A monoinstitutional propensity score-matched study in China

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World Journal of Gastrointestinal Surgery 2021年第5期13卷 429-442页

作者： Hao Cui Jian-Xin Cui Yu-Ning Wang Bo Cao Huan Deng Ke-Cheng Zhang Tian-Yu Xie Wen-Quan Liang Yi Liu Lin Chen Bo Wei School of Medicine Nankai UniversityTianjin 300071China Department of General Surgery Institute of General SurgeryChinese PLA General HospitalBeijing 100853China First Medical Center Chinese PLA General HospitalBeijing 100853China

The potential survival benefit of neoadjuvant chemotherapy(NC)in patients with advanced gastric cancer has been widely *** the development of minimally invasive surgery,which is represented by laparoscopy,the effect of NC on the safety of laparoscopic gastrectomy remains to be further *** To compare the short-term outcomes of laparoscopic total gastrectomy(LTG)after NC(NC-LTG)with LTG *** A total of 92 patients who underwent NC-LTG and 381 patients who received LTG alone at the Chinese PLA General Hospital between September 2015 and September 2020 were retrospectively included in our *** used propensityscore matching(PSM)to balance baseline *** 1:1 PSM,73 patients were included in each group with no statistically significant difference in baseline *** The NC-LTG group exhibited a longer operation time(244.10±48.13 min vs 225.74±45.33 min,P=0.019)and increased intraoperative blood loss[150(100-300)mL vs 100(100-200)mL,P=0.011]compared to the LTG *** 30-d postoperative morbidity of the NC-LTG group was 20.5%(15/73),and that of the LTG group was 13.7%(10/73).There were no significant differences in 30-d severe complication rates or anastomotic leakage *** analysis showed that the patients with pTNM(pathological tumor-node-metastasis classification)T0N0-II in the NC-LTG group underwent a longer operation than the LTG group,while no significant difference was found in any perioperative index for the pTNM III patients.A multivariate analysis showed that an operation time longer than 240 min was an independent risk factor(odds ratio=3.021,95%confidence interval:1.160-7.868,P=0.024),while NC was not an independent risk factor for postoperative complications in *** Despite a longer operation time and more blood loss after NC-LTG,which indicate surgical difficulty,NC-LTG exhibits acceptable short-term outcomes compared to LTG,suggesting the safety and feasibility of NC-LTG.

关键词： neoadjuvant chemotherapy Gastric cancer Laparoscope Total gastrectomy Morbidity

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Development of a clinical nomogram for prediction of response to neoadjuvant chemotherapy in patients with advanced gastric cancer

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 396-408页

作者： Bing Liu Yu-Jie Xu Feng-Ran Chu Guang Sun Guo-Dong Zhao Sheng-Zhong Wang Department of Gastrointestinal Surgery Central South University Xiangya School of Medicine Affiliated Haikou HospitalHaikou 570208Hainan ProvinceChina Clinical College Hainan Medical UniversityHaikou 571199Hainan ProvinceChina

BACKGROUND The efficacy of neoadjuvant chemotherapy(NAC)in advanced gastric cancer(GC)is still a controversial *** To find factors associated with chemosensitivity to NAC treatment and to provide the optimal therapeutic strategies for GC patients receiving *** The clinical information was collected from 230 GC patients who received NAC treatment at the Central South University Xiangya School of Medicine Affiliated Haikou Hospital from January 2016 to December *** absolute shrinkage and selection operator logistic regression analysis was used to find the possible predictors.A nomogram model was employed to predict the response to *** In total 230 patients were finally included in this study,including 154 males(67.0%)and 76 females(33.0%).The mean age was(59.37±10.60)years,ranging from 24 years to 80 *** to the tumor regression grade standard,there were 95 cases in the obvious response group(grade 0 or grade 1)and 135 cases in the poor response group(grade 2 or grade 3).The obvious response rate was 41.3%.Least absolute shrinkage and selection operator analysis showed that four risk factors significantly related to the efficacy of NAC were tumor location(P<0.001),histological differentiation(P=0.001),clinical T stage(P=0.008),and carbohydrate antigen 724(P=0.008).The C-index for the prediction nomogram was *** calibration curve revealed that the predicted value exhibited good agreement with the actual *** curve analysis showed that the nomogram had a good value in clinical *** A nomogram combining tumor location,histological differentiation,clinical T stage,and carbohydrate antigen 724 showed satisfactory predictive power to the response of NAC and can be used by gastrointestinal surgeons to determine the optimal treatment strategies for advanced GC patients.

关键词： Advanced gastric cancer Predictor neoadjuvant chemotherapy Nomogram Tumor regression grade

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Comparison between upfront surgery and neoadjuvant chemotherapy in patients with locally advanced gastric cancer:A systematic review

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World Journal of Gastrointestinal Surgery 2023年第8期15卷 1808-1818页

作者： Stylianos Fiflis Menelaos Papakonstantinou Alexandros Giakoustidis Gregory Christodoulidis Eleni Louri Vasileios N Papadopoulos Dimitrios Giakoustidis A’Department of Surgery General Hospital PapageorgiouThessaloniki 56429Greece Department of General Surgery University Hospital of LarissaLarissa 41110Greece

BACKGROUND Gastric cancer(GC)is a major health concern *** resection and chemotherapy is the mainstay treatment for gastric carcinoma,however,the optimal approach remains unclear and should be different in each *** can be administered both pre-and postoperatively,but a multidisciplinary approach is preferred when *** is particularly relevant for locally advanced GC(LAGC),as neoadjuvant chemotherapy(NAT)could potentially lead to tumor downsizing thus allowing for a complete resection with curative *** though the recent progress has been impressive,European and International guidelines are still controversial,thus attenuating the need for a more standardized approach in the management of locally advanced *** To investigate the effects of NAT on the overall survival(OS),the disease-free survival(DFS),the morbidity and the mortality of patients with LAGC in comparison to upfront surgery(US).METHODS For this systematic review,a literature search was conducted between November and February 2023 in PubMed,Cochrane Library and *** for studies including patients with *** independent reviewers conducted the research and extracted the data according to predetermined inclusion and exclusion *** Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to form the search strategy and the study protocol has been registered in the International Prospective Register of Systematic *** Eighteen studies with 4839 patients with LAGC in total were included in our systematic *** were separated into two groups;one receiving NAT before the gastrectomy(NAT group)and the other undergoing upfront surgery(US group).The OS ranged from 41.6%to 74.2%in the NAT group and from 30.9%to 74%in the US *** DFS was also longer in the NAT group and reached up to 80%in certain *** complications related to the chemotherapy or the surgery ranged from 6.4%to 38.1%in

关键词： Gastric cancer Locally advanced gastric cancer neoadjuvant chemotherapy Surgery Survival

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EFFECTS OF neoadjuvant chemotherapy ON MDR1 AND MRP GENE EXPRESSION IN PRIMARY BREAST CANCER

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Chinese Journal of Cancer Research 2004年第1期16卷 51-54页

作者：刘杏娥孙晓东吴金民 Center of Oncology Sir Run Run Shaw Hospital Sir Run Run Shaw Institute of Clinical Research Zhejiang University

Objective: To investigate the effects of neoadjuvant chemotherapy on the expression of drug resistance genes, multidrug resistance-1 (MDR1) and multidrug resistance-associated protein (MRP), in patients with primary breast cancer. Methods: MDR1 and MRP expression were detected by semi-quantitative RT-PCR in 20 patients with primary breast cancer, before and after chemotherapy. Results: Before chemotherapy, MDR1 and MRP expression can be detected in 15 cases (75%) and 18 cases (90%) respectively. After chemotherapy, expression of MDR1 is not significantly different from that before chemotherapy, but expression of MRP is significantly different from that before chemotherapy. Conclusion: Expression of drug resistance gene MRP, but not MDR1, is enhanced in patients with primary breast cancer submitted to neoadjuvant chemotherapy.

关键词： Breast cancer neoadjuvant chemotherapy Drug resistance (MDR1) Multidrug resistance-associated protein (MRP)

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Short and long-term outcomes between laparoscopic and open total gastrectomy for advanced gastric cancer after neoadjuvant chemotherapy

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World Journal of Gastrointestinal Surgery 2022年第5期14卷 452-469页

作者： Hao Cui Ke-Cheng Zhang Bo Cao Huan Deng Gui-Bin Liu Li-Qiang Song Rui-Yang Zhao Yi Liu Lin Chen Bo Wei School of Medicine Nankai UniversityTianjin 300071China Department of General Surgery and Institute of General Surgery the First Medical CenterChinese PLA General HospitalBeijing 100853China Medical School Chinese PLA General HospitalBeijing 100853China

BACKGROUND neoadjuvant chemotherapy(NACT)combined with surgery is regarded as an effective treatment for advanced gastric cancer(AGC).Laparoscopic surgery represents the mainstream of minimally invasive ***,surgeons focus more on surgical safety and oncological outcomes of laparoscopic gastrectomy after ***,we sought to evaluate short-and long-term outcomes between laparoscopic total gastrectomy(LTG)and open total gastrectomy(OTG)after *** To compare the short and long-term outcomes between LTG and OTG for AGC after *** We retrospectively collected the clinicopathological data of 136 patients who accepted gastrectomy after NACT from June 2012 to June 2019,including 61 patients who underwent LTG and 75 who underwent *** characteristics between the LTG and OTG groups showed no significant *** 26.0,R software,and GraphPad PRISM 8.0 were used to perform statistical *** Of the 136 patients included,eight acquired pathological complete response,and the objective response rate was 47.8%(65/136).The LTG group had longer operation time(P=0.015),less blood loss(P=0.003),shorter days to first flatus(P<0.001),and shorter postoperative hospitalization days(P<0.001).LTG spent more surgical cost than OTG(P<0.001),while total hospitalized cost of LTG was less than OTG(P<0.001).21(28.0%)patients in the OTG group and 14(23.0%)in the LTG group had 30-d postoperative complications,but there was no significant difference between the two groups(P=0.503).The 3-year overall survival(OS)rate was 60.6%and 64.6%in the LTG and OTG groups,respectively[hazard ratio(HR)=0.859,95%confidence interval(CI):0.522-1.412,P=0.546],while the 3-year disease-free survival(DFS)rate was 54.5%and 51.8%in the LTG and OTG group,respectively(HR=0.947,95%CI:0.582-1.539,P=0.823).Multivariate cox analysis showed that body mass index and pTNM stage were independent risk factors for OS while vascular invasion and pTNM stage were independent

关键词： neoadjuvant chemotherapy Gastric cancer Laparoscope Total gastrectomy Morbidity Survival

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Irinotecan-vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients:A retrospective study

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World Journal of Gastrointestinal Surgery 2022年第9期14卷 904-917页

作者： Wei Liu Feng-Lin Chen Kun Wang Quan Bao Hong-Wei Wang Ke-Min Jin Bao-Cai Xing Department of Hepatopancreatobiliary Surgery Peking University School of OncologyBeijing Cancer HospitalBeijing 100142China Department of Hepatopancreatobiliary Surgery Key Laboratory of Carcinogenesis and Translational ResearchMinistry of EducationPeking University School of OncologyBeijing Cancer Hospital and InstituteBeijing 100142China

BACKGROUND neoadjuvant chemotherapy(NC)improves the survival outcomes of selected patients with colorectal liver metastasis(CRLM).The benefits of irinotecan-based regimens in these patients are still under *** To compare the benefits of irinotecan-and oxaliplatin-based regimens in patients with resectable *** From September 2003 to August 2020,554 patients received NC and underwent hepatectomy for *** on a 1:1 propensity score matching(PSM)model,175 patients who received irinotecan were matched to 175 patients who received oxaliplatin to obtain two balanced groups regarding demographic,therapeutic,and prognostic *** chemotherapy was based on oxaliplatin in 353(63.7%)patients and irinotecan in 201(36.3%).After PSM,the 5-year progression-free survival(PFS)and overall survival(OS)rates with irinotecan were 18.0%and 49.7%,respectively,while the 5-year PFS and OS rates with oxaliplatin were 26.0%and 46.8%,*** blood loss,operating time,and postoperative complications differed significantly between the two *** the multivariable analysis,carbohydrate antigen 19-9,RAS mutation,response to NC,tumor size>5 cm,and tumor number>1 were inde-pendently associated with *** In NC in patients with CRLM,irinotecan is similar to oxaliplatin in survival outcomes,but irinotecan is superior regarding operating time,intraoperative blood loss,and postoperative complications.

关键词： Colorectal cancer Liver metastasis Liver resection neoadjuvant chemotherapy

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neoadjuvant chemotherapy Followed by Surgery versus Primary Surgery in Advanced Epithelial Ovarian Cancer: A Review of Outcomes at National Institute of Cancer Research Hospital in Bangladesh

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Journal of Cancer Therapy 2021年第11期12卷 621-633页

作者： Farhana Kalam Shahana Pervin K. M. Nazmul Islam Joy Johirul Islam Annekathryn Goodman Gynaecological Oncology Department National Institute of Cancer Research & Hospital (NICRH) Dhaka Bangladesh Neurology Department SShMC Dhaka Bangladesh Cancer Epidemiology NICRH Dhaka Bangladesh Harvard Medical School Division Gynecologic Oncology Massachusetts General Hospital Boston USA

Introduction: This study evaluated the difference in operative and clinical outcomes for patients with advanced ovarian cancer after primary debulking surgery (PDS) versus neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) in Bangladesh. Methods: Sixty patients with advanced epithelial ovarian cancer presenting to the department of Gynaecological Oncology at the National Institute of Cancer Research and Hospital were prospectively enrolled. Thirty patients underwent primary debulking surgery and thirty patients received NACT followed by IDS. Results: In the PDS and IDS groups respectively, 56.7% and 50% of patients presented with stage IIIC and 67.7% and 56.7% respectively had serious papillary type histopathology. Duration of surgery, amount of blood loss and total hospital stay were significantly lower (p in

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neoadjuvant chemotherapy for Transitional Cell Carcinoma of the Bladder： A Single Centre Experience

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Journal of Life Sciences 2016年第2期10卷 85-90页

作者： Gauhar Sultan Babar Malik Syed Najeeb Niamatullah Altaf Hashmi Asad Shehzad Mubarak M SyedAdeeb ul Hassan Rizvi Department of Medical Oncology Sindh Institute of Urology & Transplantation Karachi Pakistan Department of Pathology Sindh Institute of Urology & Transplantation KarachL Pakistan

Urothelial cancers usually recur distantly rather than loco-regionally. In patients with pT2 and pT3/pT4 tumors, local recurrence has been observed in 3-4% and 11-16%, respectively, whereas distant failure has occurred in 10-27% and 19-35%, respectively. Despite local therapy most patients with muscle invasive transitional cell carcinoma （TCC） of the bladder die of systemic relapse, indicating a need for effective adjunctive systemic treatment. We determined whether neoadjuvant chemotherapy improved overall survival. This study evaluated the role of neoadjuvant combination chemotherapy with gemcitabine/cisplatin （GC） in improving the outcome of this group of patients. A total of 44 patients （84% Male, 16% Female） with newly diagnosed bladder cancer （T3-4, N0-2, M0） were subjected to initial 3 cycles of GC, then managed according to response. Patients were assessed clinically after each cycle and by Interim CT scan after 3 cycles of chemotherapy and those who achieved complete or partial response underwent radical cystectomy. We enrolled 63 patients, 19 of whom were found to be ineligible; thus, 44 were assigned to receive neoadjuvant chemotherapy followed by surgery. Average size of the largest tumor was greater that 30mm in 77% patients. According to Computed Tomographic findings 70% patients belonged to Stage T4A. The overall response rate to GC was 50%, and incomplete response was achieved in 25% whereas 25% patients were lost to follow up. Twenty two patients who had complete response, underwent cystectomy and diversion. It was observed that those patients who underwent radical cystectomy with ureterosigmoidostomy had an increased serum creatinine in comparison to patients who had ileal conduit. The size of the effect is modest and combination chemotherapy can be administered safely without adverse outcomes resulting in delayed local therapy. Further efforts to identify the patients most likely to benefit from neoadjuvant therapy are necessary to optimize its us

关键词： Bladder cancer neoadjuvant chemotherapy cystectomy transitional cell carcinoma.

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