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Tumour response following preoperative chemotherapy is affected by body mass index in patients with colorectal liver metastases

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 331-342页

作者： Hua-Chuan Song Hang-Cheng Zhou Ping Gu Bing Bao Quan Sun Tian-Ming Mei Wei Cui Kang Yao Huan-Zhang Yao Shen-Yu Zhang Yong-Shuai Wang Rui-Peng Song Ji-Zhou Wang Department of General Surgery Provincial Hospital Affiliated to Anhui Medical UniversityHefei 230001Anhui ProvinceChina Department of Hepatobiliary Surgery The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Department of Pathology The First Affiliated Hospital of University of Science and Technology of ChinaDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Department of Gastrointestinal Surgery Tongcheng People’s HospitalTongcheng 231400Anhui ProvinceChina Department of Gastrointestinal Surgery Suzhou Hospital Affiliated to Anhui Medical UniversitySuzhou 234000Anhui ProvinceChina Department of General Surgery Xuancheng People’s HospitalXuancheng 242000Anhui ProvinceChina

BACKGROUND Colorectal cancer is the third most prevalent malignancy globally and ranks second in cancer-related mortality,with the liver being the primary organ of metastasis.preoperative chemotherapy is widely recommended for initially or potentially resectable colorectal liver metastases(CRLMs).Tumour pathological response serves as the most important and intuitive indicator for assessing the efficacy of chemotherapy.However,the postoperative pathological results reveal that a considerable number of patients exhibit a poor response to preoperative chemotherapy.Body mass index(BMI)is one of the factors affecting the tumori-genesis and progression of colorectal cancer as well as prognosis after various antitumour therapies.Several studies have indicated that overweight and obese patients with metastatic colorectal cancer experience worse prognoses than those with normal weight,particularly when receiving first-line chemotherapy regimens in combination with bevacizumab.AIM To explore the predictive value of BMI regarding the pathologic response following preoperative chemotherapy for CRLMs.METHODS A retrospective analysis was performed in 126 consecutive patients with CRLM who underwent hepatectomy following preoperative chemotherapy at four different hospitals from October 2019 to July 2023.Univariate and multivariate logistic regression models were applied to analyse potential predictors of tumour pathological response.The Kaplan-Meier method with log rank test was used to compare progression-free survival(PFS)between patients with high and low BMI.BMI<24.0 kg/m^(2) was defined as low BMI,and tumour regression grade 1-2 was defined as complete tumour response.RESULTS Low BMI was observed in 74(58.7%)patients and complete tumour response was found in 27(21.4%)patients.The rate of complete tumour response was significantly higher in patients with low BMI(29.7%vs 9.6%,P=0.007).Multivariate analysis revealed that low BMI[odds ratio(OR)=4.56,95%confidence interval(CI):1.42-14.63,P=0.011],targeted therapy with bevaciz

关键词： Colorectal liver metastases Body mass index Tumour regression grade preoperative chemotherapy Hepatectomy

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Predictive value of serum alpha-fetoprotein for tumor regression after preoperative chemotherapy for rectal cancer

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World Journal of Gastrointestinal Oncology 2022年第2期14卷 525-532页

作者： Da-Kui Zhang Jun Qiao Shao-Xuan Chen Zhi-Yong Hou Jian-Zheng Jie Department of General Surgery China-Japan Friendship HospitalBeijing 100029China Department of General Surgery Inner Mongolia International Mongolian HospitalHohhot 010020Inner Mongolia Autonomous RegionChina

BACKGROUND preoperative therapy is widely used in locally advanced rectal cancer.It can improve local control of rectal cancer.However,there are few indicators that can predict the effect of preoperative chemotherapy accurately.AIM To investigate whether the increase in serumα-fetoprotein(AFP)can predict better efficacy of preoperative chemotherapy.METHODS This was a retrospective study.We analyzed 125 patients admitted between 2017 and 2019 with locally advanced rectal cancer.All patients received six cycles of preoperative chemotherapy(mFOLFOX6 every 2 wk).Serum AFP of 26 patients rose slightly after three or four cycles of chemotherapy,and fell to normal again within 2 mo.The other 99 patients had a normal level of serum AFP during chemotherapy.Patients were divided into two groups(AFP risen and AFP normal).According to postoperative pathology,we compared tumor regression and complete response rate between the two groups.The primary outcome measure was the tumor regression grade(TRG)after chemotherapy.The difference in pathological complete response between the two groups was also investigated.RESULTS There were no tumor progression and distant metastasis in both groups during preoperative chemotherapy.Patients in the AFP risen group achieved better TRG 0/1 than those in the AFP normal group(61.5%vs 39.4%).The increase in AFP was a significant predictor for better tumor regression[χ2=4.144,odds ratio(OR)=2.666,P=0.04].In the AFP risen group,the complete response rate was 30.8%,which was higher than in the AFP normal group(30.8%vs 12.1%,χ2=4.542,OR=3.251,P=0.03).CONCLUSION Patients with a slight increase in serum AFP can achieve better tumor regression during preoperative chemotherapy,and are more likely to achieve pathological complete response.

关键词： Rectal cancer preoperative chemotherapy Alpha-fetoprotein Predictive value Tumor

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Comprehensive Analysis of Key mRNAs and lncRNAs in Osteosarcoma Response to preoperative chemotherapy with Prognostic Values

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Current Medical Science 2021年第5期41卷 916-929页

作者： Mi LI Wei-ting CHENG Hao LI Zhi ZHANG Xiao-li LU Si-si DENG Jian LI Cai-hong YANG Department of Orthopedics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Oncology Department Wuhan No.1 Hospital Wuhan 430030China Cancer Center Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Institute of Experimental Immunology University Clinic of Rheinische Friedrich-Wilhelms-UniversityBonn D-53127Germany

Objective:Osteosarcoma is one of the most common types of bone sarcoma with a poor prognosis.However,identifying the predictive factors that contribute to the response to neoadjuvant chemotherapy remains a significant challenge.Methods:A public data series(GSE87437)was downloaded to identify differentially expressed genes(DEGs)and differentially expressed lncRNAs(DElncRNAs)between osteosarcoma patients that do and do not respond to preoperative chemotherapy.Subsequently,functional analysis of the transcriptome expression profile,regulatory networks of DEGs and DElncRNAs,competing endogenous RNAs(ceRNA)and protein-protein interaction networks were performed.Furthermore,the function,pathway,and survival analysis of hub genes was performed and drug and disease relationship prediction of DElncRNA was carried out.Results:A total of 626 DEGs,26 DElncRNAs,and 18 hub genes were identified.However,only one gene and two lncRNAs were found to be suitable as candidate gene and lncRNAs respectively.Conclusion:The DEGs,hub genes,candidate gene,and candidate lncRNAs screened out in this context were considered as potential biomarkers for the response to neoadjuvant chemotherapy of osteosarcoma.

关键词： osteosarcoma preoperative chemotherapy competing endogenous RNAs differentially expressed genes survival analysis

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EFFECT OF preoperative chemotherapy ON METASTASIZED LYMPH NODES IN PATIENTS WITH ADVANCED ESOPHAGEAL CARCINOMA

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Academic Journal of Xi'an Jiaotong University 2001年第1期13卷 83-85页

作者：王健生段小艺任宏赵凤林陈武科石景森 Department of Oncologicosurgery First Hosp. of Xi'an Jiaotong Univ. Xi'an 710061 China

Objective To investigate the effect and clinical value of preoperative chemotherapy on the treatment of metastasized lymph nodes in patients with advanced esophageal carcinoma. Methods We studied the pathological results of primary lesions and lymph nodes of 97 patients with advanced esophageal cancer between 1996 and 1999,62 patients were treated by preoperative chemotherapy and 35 patients were treated by surgery only. Results The metas- tasized rate and degree of mediastinum in preoperative group were 16.1% and 4.7% ,whereas 65.7% and 34.2% in the surgery only group (Ppreoperative group were 25.8% and 6.6% ,whereas 48.6% and 12.0% in the surgery only group (Pchemotherapy is effective not only against the primary lesions but also the metastasized lymph nodes. The lower complete response rate of the metastasized lymph may account for the unsatisfied long-term results. Whole resection of primary lesions and lymph nodes are still very important for a better prognosis even for patients who have a good response for the preoperative chemotherapy.

关键词： esophageal carcinoma preoperative chemotherapy metastasized lymph nodes

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Visceral debranching followed by chemotherapy and resection for locally advanced pancreatic cancer with arterial invasion: case report

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胰腺病学杂志(英文) 2022年第3期05卷 134-136页

作者： Ronellenfitsch Ulrich Rebelo Artur Kleeff Jorg Department of Visceral Vascular and Endocrine Surgery 3. University Hospital Halle (Saale) 4. Martin-Luther-University Halle-Wittenberg 5. Halle (Saale) 6. Germany

The oncological outcome of patients with locally advanced pancreatic cancer continues to be dismal. Abutment or invasion of visceral arteries, which constitutes irresectability according to the consensus of the International Association of Pancreatology and can be found in a considerable proportion of patients upon initial diagnosis, usually precludes complete resection in curative intent. Simultaneous tumor resection and arterial reconstruction are associated with relevant morbidity and mortality. Here, we present a case in which a therapeutic split was done so that isolated arterial reconstruction (visceral debranching with an iliacohepatic bypass graft) preceded neoadjuvant FOLFIRINOX chemotherapy and subsequent multivisceral tumor resection. Despite several perioperative vascular complications, which were addressed by surgical and endovascular techniques, the patient had a favorable outcome of the operations and is tumor-free after 8 months of follow-up. The feasibility and safety of this novel therapeutic strategy of a therapeutic split with isolated visceral debranching as the first treatment step is currently evaluated in a clinical trial (PREVADER, NCT04136769).

关键词： Arterial reconstruction Pancreatic cancer preoperative chemotherapy Therapeutic split

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Retrospective analysis of 56 patients with advanced gastric cancer treated with combination of intravenous and intra-arterial intensified neoadjuvant chemotherapy

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Chinese Medical Journal 2012年第5期125卷 780-785页

作者： LI Guo-li LIU Kun BAOYang CAO Jian-ming XU Jian WANG Xu-ling WU Bo LI Jie-shou Research Institute of General SurgeryJinling Hospital NanjingUniversity School of Medicine Nanjing Jiangsu 210-002 China Department of Medical ImagingJinli-ng-Hospital NanjingUniversity School of Medicine Nanjing Jiangsu 210-002 China Department of-Pathology Jinli-ng-Hospital NanjingUniversity School of Medicine Nanjing Jiangsu 210002 China

Background Pre-operative chemotherapy has gained widespread interest while treating advanced gastric cancer in eastern countries. However, there is currently no established standard regimen for gastric cancer. The aim of this research was to explore the value of preoperative chemotherapy with a combination of intravenous and intra-arterial intensified chemotherapy in advanced .qastric cancer.

关键词： advanced gastric cancer preoperative chemotherapy intra-arterial chemotherapy intravenous chemotherapy ways of drug administration

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A contemporary evidence basis for neoadjuvant chemotherapy in upfront resectable pancreatic adenocarcinoma:a systematic review of the literature

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Journal of Pancreatology 2020年第1期3卷 12-20页

作者： Stonko David P. He Jin Zheng Lei Blair Alex B. The Pancreatic Cancer Precision Medicine Center of Excellence Program Johns Hopkins University School of MedicineBaltimoreMDUSA Section of Hepatobiliary and Pancreatic Surgery Division of Surgical OncologyJohns Hopkins HospitalBaltimoreMDUSA Division of Oncology Johns Hopkins University School of MedicineBaltimoreMDUSA

Pancreatic ductal adenocarcinoma(PDAC)is an aggressive cancer with poor survival.Local control through surgical resection paired with radiotherapy and chemotherapy comprise the primary tenets of treatment.Debate exists regarding the timing of treatment and ordering of systemic therapy and resection in the management of early stage disease.The goal of this study was to review the literature and describe the contemporary evidence basis for the role of neoadjuvant therapy(NAT)in the setting of upfront resectable(UP-R)PDAC.Five databases were searched in parallel to identify relevant original articles investigating neoadjuvant therapy where at least 1 study arm contained UP-R PDAC;studies with only borderline resectable or locally advanced disease were excluded.Due to the diversity in NAT regimens and study design between trials,qualitative analyses were performed to investigate patient selection,impact on perioperative and survival outcomes,safety,and cost effectiveness.Thirty-five studies met inclusion criteria,of which 24 unique trials are discussed here in detail.These studies included those trials using single agents as well as more recent trials comparing modern multiagent therapies,and several large database analyses.Overall the data suggest that NAT is safe,may confer survival benefit for appropriately selected patients,is cost effective,and is an appropriate approach for UP-R PDAC.Nevertheless,the risk for disease progression during upfront medical therapy,requires appropriate patient identification and close monitoring,and emphasizes the need for further discovery of more effective chemotherapeutics,useful biomarkers or molecular profiles,and additional prospective comparative studies.

关键词： Neoadjuvant therapy Pancreatic ductal adenocarcinoma Pancreatic neoplasms preoperative chemotherapy Resectable pancreatic cancer Upfront resectable

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