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Endoscopic retrograde cholangiopancreatography for bile duct stones in patients with a performance status score of 3 or 4

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World Journal of Gastrointestinal Endoscopy 2022年第4期14卷 215-225页

作者： Hirokazu Saito Yoshihiro Kadono Takashi Shono Kentaro Kamikawa Atsushi Urata Jiro Nasu Haruo Imamura Ikuo Matsushita Tatsuyuki Kakuma Shuji Tada Department of Gastroenterology Kumamoto City HospitalKumamoto City 862-8505Japan Department of Gastroenterology Tsuruta HospitalKumamoto City 862-0925Japan Department of Gastroenterology Kumamoto Chuo HospitalKumamoto City 862-0965Japan Department of Gastroenterology Saiseikai Kumamoto HospitalKumamoto City 861-4193Japan Department of Gastroenterological Surgery Kumamoto Chuo HospitalKumamoto City 862-0965Japan Department of Biostatics Kurume UniversityKurume City 8300011Japan

BACKGROUND As the aging population grows worldwide,the rates of endoscopic retrograde cholangiopancreatography(ERCP)for common bile duct stones(CBDS)in older patients with a poor performance status(PS)have been ***,the data on the safety and efficacy of ERCP for CBDS in patients with a PS score of 3 or 4 are lacking,with only a few studies having investigated this issue among patients with poor *** To examine the safety and efficacy of ERCP for CBDS in patients with a PS score of 3 or *** This study utilized a retrospective multi-centered design of three institutions in Japan for 8 years to identify a total of 1343 patients with CBDS having native papillae who underwent therapeutic *** a result,1113 patients with a PS 0-2 and 230 patients with a PS 3-4 were ***-to-one propensity-score matching was performed to compare the safety and efficacy of ERCP for CBDS between patients with a PS 0-2 and those with a PS *** The overall ERCP-related complication rates in all patients and propensity score-matched patients with a PS 0-2 and 3-4 were 9.0%(100/1113)and 7.0%(16/230;P=0.37),and 4.6%(9/196)and 6.6%(13/196;P=0.51),*** the propensity score-matched patients,complications were significantly more severe in the group with a PS 3-4 than in the group with a PS 0-2 group(P=0.042).Risk factors for complications were indications of ERCP and absence of antibiotics in the multivariate *** success rates,including complete CBDS removal and permanent biliary stent placement,in propensity score-matched patients with a PS 0-2 and 3-4 were 97.4%(191/196)and 97.4%(191/196),respectively(P=1.0).CONCLUSION ERCP for CBDS can be effectively performed in patients with a PS 3 or ***,the indication for ERCP in such patients should be carefully considered with prophylactic antibiotics.

关键词： Endoscopic retrograde Cholangiopancreatography Complication performance status Risk factor

Activity and bioavailability of tepotinib for leptomeningeal metastasis of NSCLC with MET exon 14 skipping mutation

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Cancer Communications 2021年第1期41卷 83-87页

作者： Hisashi Tanaka Kageaki Taima Tomonori Makiguchi Junichi Nakagawa Takenori Niioka Sadatomo Tasaka Department of Respiratory Medicine Hirosaki University Graduate School of MedicineAomori 036-8562Japan Department of Pharmacy Hirosaki University HospitalAomori 036-8562Japan

Tepotinib is a key drug for cancer patients with mesenchymal-epithelial transition receptor tyrosine kinase proto-oncogene(MET)exon 14 skipping ***,its bioavailability in the cerebrospinal fluid(CSF)in humans has not been fully ***,information about the efficacy of tepotinib in patients with leptomeningeal metastasis is ***,we present the case of a 56-year-old man who was diagnosed with lung adenocarcinoma with MET exon 14 skipping *** was urgently hospitalized due to leptomeningeal *** administered tepotinib 500 mg/day as the second-line therapy and observed improvement in leptomeningeal metastasis and performance *** tepotinib concentrations reached 1,648 ng/mL in the plasma and 30.6 ng/mL in the CSF,with a penetration rate(CSF/plasma)of 1.83%.These demonstrate tepotinib could achieve a high rate of central nervous system transition and could be effective against leptomeningeal metastasis.

关键词： cerebrospinal fluid IC50 leptomeningeal metastasis MET exon 14 skipping mutation non-small cell lung carcinoma performance status pharmacokinetics tepotinib

Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma

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World Journal of Hepatology 2017年第36期9卷 1322-1331页

作者： Francesca Romana Ponziani Irene Spinelli Emanuele Rinninella Lucia Cerrito Antonio Saviano Alfonso Wolfango Avolio Michele Basso Luca Miele Laura Riccardi Maria Assunta Zocco Brigida Eleonora Annicchiarico Matteo Garcovich Marco Biolato Giuseppe Marrone Anna Maria De Gaetano Roberto Iezzi Felice Giuliante Fabio Maria Vecchio Salvatore Agnes Giovanni Addolorato Massimo Siciliano Gian Lodovico Rapaccini Antonio Grieco Antonio Gasbarrini Maurizio Pompili Department of Internal Medicine Gastroenterology and Hepatology Agostino Gemelli Hospital Department of Liver Transplant Surgery Agostino Gemelli Hospital Department of Oncology Gastroenterology and Hepatology Agostino Gemelli Hospital Department of Bioimaging and Radiological Sciences Agostino Gemelli Hospital Department of Hepatobiliary Surgery Agostino Gemelli Hospital Department of Pathology Agostino Gemelli Hospital

AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METHODS The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo(95%CI: 10.6-17.0). Only alphafetoprotein(AFP) serum level > 200 ng/m L and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up(HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year(HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC(OR = 0.263, 95%CI: 0.111-0.622, P = 0.002).CONCLUSION The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients' survival confers them as useful predictive tools for treatment management and clinical decisions.

关键词： Hepatocellular carcinoma Cirrhosis Barcelona Clinic Liver Cancer stage C Alphafetoprotein Disease control performance status Survival

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Open Journal of Internal Medicine 2014年第3期4卷 47-58页

作者： Gunnar Svensson Sven-Borje Ewers Ola Ohlsson Hakan Olsson Department of Medicine Central HospitalKristianstadSweden Department of Cancer Epidemiology Clinical SciencesUniversity of LundLundSweden Department of Oncology University HospitalLundSweden

Introduction: Tumour stage is the most important prognostic factor in non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). The aim of this study was to evaluate if female gender was a prognostic factor in different tumour stages in relation to histology and given therapy. Methods: From 1989-2008, 1497 patients in eastern Scania, in southern Sweden with 202,000 inhabitants, were referred and prospectively registered. Tumour stage, performance status, lung cancer type and primary therapy were registered. Results: In NSCLC, female patients in stages 1 and 2 who were treated with surgery had a better 5-year survival rate (79.4%), compared to males (60.6%;p = 0.0004). Female patients in stage 3 with active therapy (surgery and/or radiotherapy and/or chemotherapy) had a better 5-year survival than males (20.6% vs. 10.5%, respectively, p = 0.0006). Female patients with adenocarcinoma were favourable in stages 1-3. In stage 4, there was no survival difference between females and males. In SCLC, females with limited disease (LD) and active therapy (chemotherapy ±?radiotherapy ± surgery) had a higher 5-year survival rate (28%) than males (5.6%);p = 0.001. Females with extensive disease (ED) and active therapy (chemotherapy ± radiotherapy) had a better 5-year survival (3.9%) compared to males (0.7%);p = 0.023. In multivariate analyses, patient performance status at diagnosis was also an independent prognostic factor in all tumour stages of lung cancer. Conclusions: This population-based study corroborates a female survival advantage in NSCLC stages 1-3, but not in metastatic stage 4, and this is also demonstrated for the adenocarcinoma subgroup. The study also confirms better prognosis in females with SCLC in both LD and ED. The study also demonstrates the importance of patient performance status as a prognostic factor in all stages of lung cancer.

关键词： Gender performance status Prognostic Factor NSCLC(Non-Small Cell Lung Cancer) SCLC(Small Cell Lung Cancer) Tumour Stage