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Advantage of oncological outcome of robotic-assisted pancreatoduodenectomy (RPD) in stage I pancreatic ductal adenocarcinomas (PDAC)

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胰腺病学杂志(英文) 2022年第3期05卷 125-131页

作者： Li Jingfeng Zhao Shulin Jin Jiabin Shi Yusheng Weng Yuanchi Chen Mengmin Chen Hao Xu Zhiwei Deng Xiaxing Shen Baiyong Peng Chenghong Department of General Surgery Pancreatic Disease Center 3. Ruijin Hospital 4. Shanghai Jiao Tong University School of Medicine 5. Shanghai 6. China

Background: Robotic-assisted pancreatoduodenectomy (RPD) has been widely performed in the treatment of pancreatic tumors. The oncologic outcome in the early stage of pancreatic ductal adenocarcinomas (PDAC) operated by RPD has not been ***: Clinical data of pathology confirmed stage I PDAC from January 2015 to December 2020 in Ruijin hospital, Shanghai Jiao Tong University School of Medicine was collected and retrospectively analyzed. Patients were divided into the open pancreaticoduodenectomy (OPD) group and the RPD group. Clinicopathological data and prognosis data were compared and ***: A total of 426 patients were enrolled in this study, including 342 patients in the OPD group and 84 patients in the RPD group. The baseline characteristics of both groups were equivalent. Incidence of R1 resection was significantly lower in RPD group (3 [3.6%] vs 40 [11.7%],P = .044). RPD group was associated with better disease-free survival (DFS) and overall survival (OS) (DFS: Haszard Ratio [HR]: 0.681, 95% confidence interval [CI]: 0.491-0.945,P = .022; OS: HR: 0.667, 95% CI: 0.478-0.932,P = .017). T2 stage was associated with poor DFS and OS (DFS: HR: 1.471, 95% CI: 1.092-1.981,P = .011; OS: HR: 1.616, 95% CI: 1.209-2.160,P = .035). R1 resection was associated with poor OS (HR: 1.483, 95% CI: 1.028-2.140,P = .035) while adjuvant therapy was associated with better OS (HR: 0.589, 95% CI: 0.452-0.766,P < .001). Kaplan-Meier estimate showed significantly longer DFS and OS in RPD group (DFS:P = .004; OS:P = .009).Conclusion: For stage I PDAC patients, RPD surgery achieved higher R0 resection rates and better DFS and OS. T1 stage was associated with better DFS. R0 resection and adjuvant therapy were the accesses to better OS.

关键词： DFS early stage PDAC oncological outcome OS RPD

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Multidisciplinary discussion and management of synchronous colorectal liver metastases: A single center study in China

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World Journal of Gastrointestinal Oncology 2023年第9期15卷 1616-1625页

作者： Hao Li Guo-Li Gu Song-Yan Li Yang Yan Shi-Dong Hu Ze Fu Xiao-Hui Du Graduate School Medical School of Chinese People’s Liberation ArmyBeijing 100039China Department of General Surgery Air Force Medical CenterAir Force Medical UniversityBeijing 100142China Department of General Surgery Chinese People’s Liberation Army General HospitalBeijing 100039China

BACKGROUND The multidisciplinary team(MDT)has been carried out in many large hospitals ***,given the costs of time and money and with little strong evidence of MDT effectiveness being reported,critiques of MDTs *** To evaluate the effects of MDTs on patients with synchronous colorectal liver metastases and share our opinion on management of synchronous colorectal liver *** In this study we collected clinical data of patients with synchronous colorectal liver metastases from February 2014 to February 2017 in the Chinese People’s Liberation Army General Hospital and subsequently divided them into an MDT+group and an *** total,93 patients in MDT+group and 169 patients in MDT-group were included *** Statistical increases in the rate of chest computed tomography examination(P=0.001),abdomen magnetic resonance imaging examination(P=0.000),and preoperative image staging(P=0.0000)were observed in patients in MDT+***,the proportion of patients receiving chemotherapy(P=0.019)and curative resection(P=0.042)was also higher in MDT+*** analysis showed that the population of patients assessed by MDT meetings had higher 1-year[hazard ratio(HR)=0.608,95%confidence interval(CI):0.398-0.931,P=0.022]and 5-year(HR=0.694,95%CI:0.515-0.937,P=0.017)overall *** These results proved that MDT management did bring patients with synchronous colorectal liver metastases more opportunities for comprehensive examination and treatment,resulting in better outcomes.

关键词： Synchronous colorectal liver metastases Multidisciplinary team Imaging examination Treatment strategy oncological outcome

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Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases

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World Journal of Gastrointestinal Oncology 2017年第5期9卷 218-227页

作者： Min Hoe Chew Yu-Ting Yeh Ee-Lin Toh Stephen Aditya Sumarli Ghee Kheng Chew Lui Shiong Lee Mann Hong Tan Tiffany Priyanthi Hennedige Shin Yi Ng Say Kiat Lee Tze Tec Chong Hairil Rizal Abdullah Terence Lin Hon Goh Mohamed Zulfikar Rasheed Kok Chai Tan Choong Leong Tang Department of Colorectal Surgery Singapore General Hospital Department of Obstetrics and Gynaecology Singapore General Hospital Department of Urology Singapore General Hospital Department of Orthopaedic Surgery Singapore General Hospital Division of oncological Imaging National Cancer Centre Singapore Department of Anaesthesiology Singapore General Hospital Vascular Surgery Singapore General Hospital Department of Plastic Reconstructive and Aesthetic SurgerySingapore General Hospital

To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODSThis retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ2 test or Fisher’s exact test, as applicable. RESULTSAll 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were locally invasive rectal adenocarcinoma (n = 13), advanced colonic adenocarcinoma (n = 5), recurrent cervical carcinoma (n = 3) and malignant sacral chordoma (n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedura

关键词： Colorectal cancer Advanced pelvic tumour Sacrectomy oncological outcome Pelvic exenteration Chordoma

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Adjuvant therapy for orbital non-rhabdomyosarcoma soft tissue sarcoma:comparison of long-term outcome between radiotherapy and chemotherapy

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International Journal of Ophthalmology(English edition) 2023年第3期16卷 402-410页

作者： Xiao-Feng Li Rui-Qi Ma Xue Wu Lu Gan Zhi-Yu Peng Jiang Qian Department of Ophthalmology Eye and ENT Hospital of Fudan UniversityShanghai 200031China Laboratory of Myopia Chinese Academy of Medical SciencesShanghai 200031China NHC Key Laboratory of Myopia Fudan UniversityShanghai 200031China Department of Ophthalmology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

AIM:To illustrate clinicopathological features of orbital non-rhabdomyosarcoma soft tissue sarcoma(NRSTS),and to compare the treatment outcome between postoperative radiotherapy(RT) and chemotherapy in a retrospective analysis nearly ***:A retrospective cohort study of 56 patients with orbital NRSTS were reviewed,34 of whom received postoperative RT,and 22 received postoperative *** clinicopathological features,local recurrence,metastases,and survival data were *** analysis was performed using the Kaplan-Meier ***:During follow-up(111.8mo,ranged 8-233mo) for 56 patients,19 patients of them developed local recurrence,and 7 patients developed distant *** patients died during follow-up *** survival rates considering the whole study group was 78.57% at 5y,and 72.16% at 10y after the initial *** with chemotherapy,RT was associated with lower risk of local recurrence [hazard ratio for RT vs chemotherapy,0.263,95% confidence interval(CI),0.095-0.728,P=0.0015];with lower risk of distant metastasis(hazard ratio for RT vs chemotherapy,0.073,95%CI,0.015-0.364,P=0.0014);and with lower risk of death from disease(hazard ratio for RT vs chemotherapy,0.066,95%CI,0.022-0.200,P<0.0001).The 5-year survival rate in RT group was 97.06% compared to 50% in chemotherapy ***:In patients with orbital NRSTS,postoperative RT provides better control of local recurrence,distant metastasis,and death from disease than *** is the more preferrable adjuvant therapy compared to chemotherapy possibly.

关键词： orbital tumor non-rhabdomyosarcoma soft tissue sarcoma oncological outcome adjuvant radiotherapy adjuvant chemotherapy

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Short-and long-term outcomes of laparoscopic vs open surgery for T2 gallbladder cancer:A systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2022年第12期14卷 1387-1396页

作者： Wei Zhang De-Liang Ouyang Xu Che Department of Hepatobiliary and Pancreatic Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeShenzhen 518116Guangdong ProvinceChina Department of General Surgery The Third Affiliated HospitalHengyang Medical SchoolUniversity of South ChinaHengyang 421900Hunan ProvinceChina

BACKGROUND With the development of laparoscopic techniques,gallbladder cancer(GBC)is no longer a contraindication to laparoscopic surgery(LS).Although LS is recommended for stage T1 GBC,the value of LS for stage T2 GBC is still *** To evaluate the short-and long-term outcomes of LS in comparison to those of open surgery(OS)for stage T2 *** We searched the PubMed,Embase,Cochrane Library,Ovid,Google Scholar,and Web of Science databases for published studies comparing the efficacy of LS and OS in the treatment of stage T2 GBC,with a cutoff date of September *** Stata 15 statistical software was used for *** risk(RR)and weighted mean difference(WMD)were calculated to assess binary and continuous outcome indicators,***’s test and Egger’s test were used for detecting publication *** A total of five studies were included,with a total of 297 patients,153 in the LS group and 144 in the OS ***-analysis results showed that the LS group was better than the OS group in terms of operative time[WMD=-41.29,95%confidence interval(CI):-75.66 to-6.92,P=0.02],estimated blood loss(WMD=-261.96,95%CI:-472.60 to-51.31,P=0.01),and hospital stay(WMD=-5.67,95%CI:-8.53 to-2.81,P=0.0001),whereas there was no significant difference between the two groups in terms of blood transfusion(RR=0.60,95%CI:0.31-1.15,P=0.13),complications(RR=0.72,95%CI:0.39-1.33,P=0.29),number of lymph nodes retrieved(WMD=–1.71,95%CI:-4.27 to-0.84,P=0.19),recurrence(RR=0.41,95%CI:0.06-2.84,P=0.36),3-year and 5-year overall survival(RR=0.99,95%CI:0.82-1.18,P=0.89 and RR=1.02,95%CI:0.68-1.53,P=0.92;respectively),and 3-year and 5-year disease-free survival(RR=1.01,95%CI:0.84-1.21,P=0.93 and RR=1.15,95%CI:0.90-1.46,P=0.26;respectively).CONCLUSION The long-term outcomes of LS for T2 GBC are similar to those of OS,but LS is superior to OS in terms of operative time,intraoperative bleeding,and postoperative hospital ***,these findings should be

关键词： Gallbladder cancer T2 stage Laparoscopic cholecystectomy oncological outcome Metaanalysis

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