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Shorter recurrence-free survival time, higher risk of multiple recurrences： a retrospective study of non-muscle invasive bladder cancer after transurethral resection

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Chinese Medical Journal 2012年第20期125卷 3681-3686页

作者： DENG Nan CHEN Jun-xing CHEN Ling-wu QIU Shao-peng LI Xiao-fei WANG Dao-hu Department of Urology First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510080China

Background Multiple recurrences are common in non-muscle invasive bladder cancer, but the-risk of multiple recurrences has not been fully described. Identifying patients at high risk of multiple recurrences will help to select an optimal therapeutic strategy and to improve prognosis. This study was conducted to identify the risk factors for multiple recurrences of non-muscle invasive bladder cancer. Methods We reviewed the clinical data of all patients with non-muscle invasive bladder cancer in our hospital between January 2003 and February 2010. Patients with at least one recurrence were included. Multivariate analysis was performed for theorized risk factors （age, gender, tumor stage, grade, size, location, number of lesions, adjuvant intra-vesical chemotherapy after transurethral resection, and recurrence-free survival after each resection） to clarify risk factors for multiple recurrences of non-muscle invasive bladder cancer. Results Of the 278 patients with non-muscle invasive bladder cancer, 84 were with at least one recurrence and a total of 222 recurrences among them were followed up for 6-70 months （mean, 36.1 months）. recurrence-free survival after initial resection predicted the overall frequency of bladder cancer recurrence （risk ratio （RR） = 37.83, 95% confidence interval （C/）=3.45-396.13, P=0.001） and second recurrence （RR=6.15, 95% C/=1.28-29.57, P=0.023）. Similarly, recurrence-free survival after a second resection was the only significant risk factor for third recurrence （RR=31.08, 95% C1=2.53-381.47, P=0.007）. Moreover, recurrence-free survival after initial resection was the only significant factor to predict later progression to muscle invasive bladder cancer （RR=8.62, 95% C1=1.47-58.34, P=0.001）. Conclusions recurrence-free survival after resection is an independent predictor of multiple recurrences of non-muscle invasive bladder cancer. The shorter the period between resection and recurrence is, the higher the risk of multiple recurrences.

关键词： bladder cancer," recurrence," risk factors recurrence-free survival

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Chylous ascites has a higher incidence after robotic surgery and is associated with poor recurrence-free survival after rectal cancer surgery

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Chinese Medical Journal 2022年第2期135卷 164-171页

作者： Xiaojie Wang Zhifang Zheng Min Chen Shenghui Huang Xingrong Lu Ying Huang Pan Chi Department of Colorectal Surgery Union HospitalFujian Medical UniversityFuzhouFujian 350001China Department of Obstetrics Fujian Provincial Maternity and Children's HospitalAffiliated Hospital of Fujian Medical UniversityFuzhouFujian 350001China

Background:Postoperative chylous ascites is an infrequent condition after colorectal surgery and is easily ***,its effect on the long-term oncological prognosis is not well *** study aimed to investigate the short-term and long-term impact of chylous ascites treated with neoadjuvant therapy followed by rectal cancer surgery and to evaluate the incidence of chylous ascites after different surgical ***:A total of 898 locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy followed by surgery between January 2010 and December 2018 were *** clinicopathological data and outcomes of the patients with chylous ascites were compared with those of the patients without chylous *** primary endpoint was recurrence-free survival(RFS).To balance baseline confounders between groups,propensity score matching(PSM)was performed for each patient with a logistic regression ***:Chylous ascites was detected in 3.8%(34/898)of the *** incidence of chylous ascites was highest after robotic surgery(6.9%,6/86),followed by laparoscopic surgery(4.2%,26/618)and open surgery(1.0%,2/192,P=0.021).The patients with chylous ascites had a significantly higher number of lymph nodes harvested(15.6 vs.12.8,P=0.009)and a 3-day longer postoperative hospital stay(P=0.017).The 5-year RFS rate was 64.5%in the chylous ascites group,which was significantly lower than the rate in the no chylous ascites group(79.9%;P=0.007).The results remained unchanged after PSM was *** chylous ascites group showed a nonsignificant trend towards a higher peritoneal metastasis risk(5.9%vs.1.6%,P=0.120).Univariate analysis and multivariate analysis confirmed chylous ascites(hazard ratio=3.038,P<0.001)as an independent negative prognostic factor for ***:Considering the higher incidence of chylous ascites after laparoscopic and robotic surgery and its adverse prognosis,we recommend sufficient coagulation of

关键词： Locally advanced rectal cancer Chylous ascites Neoadjuvant chemoradiotherapy recurrence-free survival

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Sirolimus improves the prognosis of liver recipients with hepatocellular carcinoma:A single-center experience

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Hepatobiliary & Pancreatic Diseases International 2023年第1期22卷 34-40页

作者： Peng Liu Xin Wang Huan Liu Shu-Xian Wang Qing-Guo Xu Lin Wang Xiao Xu Jin-Zhen Cai Organ Transplantation Center The Affiliated Hospital of Qingdao UniversityQingdao 266100China Institute of Organ Donation and Transplantation Department of MedicineQingdao UniversityQingdao 266100China Department of Hepatobiliary and Pancreatic Surgery The Center for Integrated Oncology and Precision MedicineAffiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310003China National Health Commission(NHC)Key Laboratory of Combined Multi-Organ Transplantation Hangzhou 310003China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310003China

Background:Tumor recurrence after liver transplantation(LT)for selective patients diagnosed with hepatocellular carcinoma(HCC)in the setting of cirrhosis is the greatest challenge effecting the prognosis of these *** aim of this study was to evaluate the efficacy of sirolimus on the prognosis for these ***:The data from 193 consecutive HCC patients who had undergone LT from January 2015 to December 2019 were retrospectively *** patients were divided into the sirolimus group[patients took sirolimus combined with calcineurin inhibitors(CNIs)(n=125)]and non-sirolimus group[patients took CNI-based therapy without sirolimus(n=68)].recurrence-free survival(RFS)and overall survival(OS)were compared between the two *** prognostic factors and independent risk factors for RFS and OS were further ***:Non-sirolimus was an independent risk factor for RFS(HR=2.990;95%CI:1.050-8.470;P=0.040)and OS(HR=3.100;95%CI:1.190-8.000;P=0.020).A higher proportion of patients beyond Hangzhou criteria was divided into the sirolimus group(69.6%vs.80.9%,P=0.030).Compared with the non-sirolimus group,the sirolimus group had significantly better RFS(Precurrence and prolonged RFS and OS in LT patients with different stage of HCC.

关键词： Hepatocellular carcinoma Liver transplantation Sirolimus Tumor recurrence recurrence-free survival Overall survival

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Surgical resection versus liver transplantation for hepatocellular carcinoma within the Hangzhou criteria: a preoperative nomogram-guided treatment strategy

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Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 480-486页

作者： Yang Li Dan-Yun Ruan Chang-Chang Jia Hui Zhao Guo-Ying Wang Yang Yang Nan Jiang Department of Hepatic Surgery and Liver Transplantation Center of the Third Affiliated Hospital Organ Transplantation Institute of Sun Yat-Sen University Organ Transplantation Research Center of Guangdong Province Guangzhou 510630 China Department of Medical Oncology the Third Affiliated Hospital of Sun Yat-Sen University Guangzhou 510630 China Department of Biotherapy the Third Affiliated Hospital of Sun Yat-Sen University Guangzhou 510630 China

BACKGROUND: With the expansion of surgical criteria, the comparative efficacy between surgical resection (SR) and liver transplantation (LT) for hepatocellular carcinoma is inconclusive. This study aimed to develop a prognostic nomogram for predicting recurrence-free survival of hepatocellular carcinoma patients after resection and explored the possibility of using nomogram as treatment algorithm reference. METHODS: From 2003 to 2012, 310 hepatocellular carcinoma patients within Hangzhou criteria undergoing resection or liver transplantation were included. Total tumor volume, albumin level, HBV DNA copies and portal hypertension were included for constructing the nomogram. The resection patients were stratified into low- and high-risk groups by the median nomogram score of 116. Independent risk factors were identified and a visually orientated nomogram was constructed using a Cox proportional hazards model to predict the recurrence risk for SR patients. RESULTS: The low-risk SR group had better outcomes compared with the high-risk SR group (3-year recurrence-free survival rate, 71.1% vs 35.9%; 3-year overall survival rate, 89.8% vs 78.9%, both Precurrence-free survival rate but similar overall survival rate compared with the transplantation group (3-year recurrence-free survival rate, 35.9% vs 74.1%, Psurvival rate, 78.9% vs 79.6%, P>0.05). CONCLUSIONS: This nomogram offers individualized recurrence risk evaluation for hepatocellular carcinoma patients within Hangzhou criteria receiving resection. Transplantation should be considered the first-line treatment for high risk patients.

关键词： hepatocellular carcinoma surgical resection liver transplantation nomogram recurrence-free survival

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High mucin 5AC expression predicts adverse postoperative recurrence and survival of patients with clear-cell renal cell carcinoma

High mucin 5AC expression predicts adverse postoperative rec...

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2017年中国肿瘤标志物学术大会暨第十一届肿瘤标志物青年科学家论坛

作者： Haijian Zhang Dengfu Yao Jiejie Xu Jianxin Gu Research Center of Clinical Medicine Affiliated Hospital of Nantong University Department of Biochemistry and Molecular Biology School of Basic Medical SciencesFudan University Department of Urology Fudan University Shanghai Cancer Center

Background: Mucin 5 AC(MUC5 AC), as a member of secreted/gel-forming mucin family, was frequently found to be abnormally expressed in inflammation or malignant diseases. However, the clinic pathologic features and prognostic values of MUC5 AC in clear cell renal cell carcinoma(ccRCC) have not been reported up to now. Methods: MUC5 AC expression was analyzed by immunohistochemistry on tissue microarrays. KaplanMeier survival curves, Univariate and Multivariate Cox analysis and newly-established nomogram model were performed to evaluate the prognostic value. Results: MUC5 AC expression was firstly found to be up-regulated in patients with ccRCC, positively associated with tumor size, pN stage, lymphovascular invasion, Fuhrman grade, rahbdoid differentiation, sarcomatoid features, tumor necrosis, ECOG-PS and recurrence. Furthermore, MUC5 AC expression might be contributed to risk stratification of ccRCC patients with TNM stage Ⅲ+Ⅳ or Fuhrman grade 3 or 4 for overall survival(OS) and recurrence-free survival(RFS) analysis, and it was demonstrated to be negatively correlated with OS and RFS of ccRCC patients. What’s more, MUC5 AC was identified as a potential independent adverse prognostic factor;prediction accuracy of MUC5 AC-based new nomogram model was drastically improved for OS and RFS of ccRCC patients. Conclusion: MUC5 AC is a promising independent adverse prognostic factor for ccRCC patients, it maybe conducive to postoperative risk stratification and guide treatment in the future.

关键词： mucin 5AC clear cell renal cell carcinoma overall survival recurrence-free survival prognostic biomarker

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Diagnosis and treatment of biliary mucinous cystic neoplasms: A single-center experience

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 495-501页

作者： Jun-Jun Jia Ya-Fen Cheng Mei-Bao Feng Li Liu Ming-Qi Shuai Xiao-Dong Shen Xiao-Feng Tang Shu-Sen Zheng Division of Hepatobiliary and Pancreatic Surgery Department of Surgerythe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of International Healthcare Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Pathology the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Library the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background: Biliary mucinous cystic neoplasms(BMCNs) are rare hepatobiliary cystic tumors, which can be divided into noninvasive and invasive types. This study aimed to investigate the diagnosis, treatment, and prognosis of BMCNs in a large single center. Methods: We analyzed 49 patients with BMCNs confirmed by postoperative pathology at the First Afflliated Hospital, Zhejiang University School of Medicine between January 2007 and December 2021. Results: Among the 49 patients, 37 were female(75.5%), and the average age was 57.04 years. Common symptoms included abdominal discomfort, jaundice and fever, while 22 patients(44.9%) had no symptoms. Serum carbohydrate antigen(CA) 19-9 and CA125 concentrations were elevated in 34.8% and 19.6% of patients, respectively. Forty-eight patients had tumors in the intrahepatic bile ducts and only one had a tumor in the extrahepatic bile duct. Forty-eight patients with noninvasive intrahepatic BMCNs were further analyzed in terms of pathological features: 34(70.8%) had low-grade intraepithelial neoplasms(LGINs), and 14(29.2%) had high-grade intraepithelial neoplasms(HGINs). The potential immunohistochemical markers of BMCNs were cytokeratin(CK) 19, CK7, estrogen receptor and progesterone receptor. Follow-up data for 37 patients with intrahepatic BMCNs were obtained. The median overall survival(OS) of BMCNs was not reached. The longest survival time was 137 *** 5-and 10-year OS rates were 100% and 85.4%, respectively. The 5-and 10-year recurrence-free survival(RFS) rates were 93.9% and 80.2%, respectively. Conclusions: BMCNs are rare cystic neoplasms that commonly occur in middle-aged females. BMCNs can only be diagnosed and classified by postoperative pathology, as there are no specific clinical presentations, serological indicators or imaging modalities for preoperative diagnosis. Complete surgical resection is necessary for BMCNs, and the postoperative prognosis is favorable.

关键词： Biliary mucinous cystic neoplasms Low-grade intraepithelial neoplasms High-grade intraepithelial neoplasms Overall survival recurrence-free survival

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How far along are we in revealing the connection between metformin and colorectal cancer?

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World Journal of Gastroenterology 2021年第14期27卷 1362-1368页

作者： Maja Cigrovski Berkovic Danko Mikulic Ines Bilic-Curcic Anna Mrzljak Department of Kinesiological Anthropology and Methodology Faculty of KinesiologyUniversity of ZagrebZagreb 10000Croatia Clinical Hospital Dubrava Zagreb 10000Croatia Department of Surgery Merkur University HospitalZagreb 10000Croatia Department of Pharmacology Faculty of MedicineUniversity of J.J.Strossmayer OsijekOsijek 31000Croatia Clinical Hospital Center Osijek Osijek 31000Croatia Department of Medicine Merkur University HospitalSchool of MedicineZagreb 10000Croatia

Colorectal cancer(CRC)is among the most prevalent cancers worldwide,and its prevention and reduction of incidence is *** presence of diabetes has been associated with a 30%increased risk of CRC,likely through the mechanism of hyperinsulinemia,which promotes tumorigenesis via the insulin receptor in the epithelium or by insulin-like growth factor pathways,inflammation,or adipokines,inducing cancer cell proliferation and cancer ***,the first-line agent in treating type 2 diabetes,has a chemopreventive role in CRC ***,preclinical studies suggest synergistic effects of metformin with oxaliplatin in inhibiting in vitro models of colon *** preclinical studies on the post diagnostic use of metformin were promising and suggested its synergistic effects with chemotherapy,the data on the possible effects of metformin after surgery and other CRC treatment in the clinical setting are less conclusive,and randomized controlled trials are still lacking.

关键词： Metformin Type 2 diabetes mellitus Colorectal cancer Chemoprevention recurrence-free survival Surgery

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Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival

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World Journal of Gastrointestinal Oncology 2022年第1期14卷 295-318页

作者： Ramón Cantero-Cid Karla Marina Montalbán-Hernández Jenny Guevara Alejandro Pascual-Iglesias Elisa Pulido JoséCarlos Casalvilla Cristóbal Marcano Cristina Barragán Serrano Jaime Valentín Gloria Cristina Bonel-Pérez JoséAvendaño-Ortiz Verónica Terrón Roberto Lozano-Rodríguez Alejandro Martín-Quirós Elvira Marín Eva Pena Laura Guerra-Pastrián Eduardo López-Collazo Luis Augusto Aguirre Tumor Immunology Laboratory The Innate Immune Response GroupHospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Digestive Surgery Service La Paz University HospitalMadrid 28046Spain Emergency Department and Emergent Pathology Research Group Hospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Pathologic Anatomy Service Hospital La PazMadrid 28046Spain

BACKGROUND Colorectal cancer(CRC)accounts for 9.4%of overall cancer deaths,ranking second after lung *** the large number of factors tested to predict their outcome,most patients with similar variables show big differences in ***,right-sided CRC(RCRC)and left-sided CRC(LCRC)patients exhibit large differences in outcome after surgical intervention as assessed by preoperative blood leukocyte *** hypothesised that stronger indexes than circulating(blood)leukocyte ratios to predict RCRC and LCRC patient outcomes will result from combining both circulating and infiltrated(tumour/peritumour fixed tissues)concentrations of *** To seek variables involving leukocyte balances in peripheral blood and tumour tissues and to predict the outcome of CRC *** Sixty-five patients diagnosed with colon adenocarcinoma by the Digestive Surgery Service of the La Paz University Hospital(Madrid,Spain)were enrolled in this study:43 with RCRC and 22 with *** were followed-up from January 2017 to March 2021 to record overall survival(OS)and recurrence-free survival(RFS)after surgical *** concentrations in peripheral blood were determined by routine laboratory ***-fixed samples of tumour and peritumoural tissues were assessed for leukocyte concentrations by immunohistochemical detection of CD4,CD8,and CD14 marker *** of leukocyte concentration in blood and tissues were calculated and evaluated for their predictor values for OS and RFS with Spearman correlations and Cox univariate and multivariate proportional hazards regression,followed by the calculation of the receiver-operating characteristic and area under the curve(AUC)and the determination of Youden’s optimal cutoff values for those variables that significantly correlated with either RCRC or LCRC patient *** patients from the cohort were randomly assigned to modelling and validation sets,and clinician-friendly nomogra

关键词： Left colorectal cancer Leukocyte ratios Prognostic variables recurrence-free survival Right colorectal cancer Overall survival

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Clinicopathological characteristics and surgical outcomes of sarcomatoid hepatocellular carcinoma

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World Journal of Gastroenterology 2020年第29期26卷 4327-4342页

作者： Jian-Ping Wang Zhi-Gang Yao Ya-Wen Sun Xi-Han Liu Feng-Kai Sun Cun-Hu Lin Fu-Xin Ren Bei-Bei Lv Shuai-Jun Zhang Yang Wang Fan-Ying Meng Shun-Zhen Zheng Wei Gong Jun Liu Department of Liver Transplantation and Hepatobiliary Surgery Shandong Provincial HospitalCheeloo College of MedicineShandong UniversityJinan 250021Shandong ProvinceChina Department of Liver Transplantation and Hepatobiliary Surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Department of Pathology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Cancer Prevention and Control Research Office of Shandong Province Shandong Cancer Hospital and InstituteShandong First Medical University and Shandong Academy of Medical SciencesJinan 250117Shandong ProvinceChina Cheeloo College of Medicine Shandong UniversityJinan 250012Shandong ProvinceChina Department of Gastroenterology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Shandong Medical Imaging Research Institute Shandong UniversityJinan 250021Shandong ProvinceChina Department of Radiology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina

BACKGROUND Hepatocellular carcinoma(HCC)is the sixth most common type of cancer and the fourth leading cause of cancer-related death *** HCC,which contains poorly differentiated carcinomatous and sarcomatous components,is a rare histological subtype of HCC that differs from conventional *** is highly aggressive and has a poor *** clinicopathological characteristics,surgical outcomes and underlying mechanisms of its highly aggressive nature have not been fully *** To examine the clinicopathological characteristics and surgical outcomes of sarcomatoid HCC and explore the histogenesis of sarcomatoid *** In total,196 patients[41 sarcomatoid HCC and 155 high-grade(Edmondson-Steiner grade III or IV)HCC]who underwent surgical resection between 2007 and 2017 were retrospectively *** characteristics and surgical outcomes of sarcomatoid HCC were compared with those of patients with high-grade *** histological composition of invasive and metastatic sarcomatoid HCCs was *** Sarcomatoid HCC was more frequently diagnosed at an advanced stage with a larger tumor and higher rates of nonspecific symptom,adjacent organ invasion and lymph node metastasis than high-grade HCC(all P20 ng/mL;36.6%vs 78.7%,Precurrence-free survival(5.6 mo vs 16.4 mo,log-rank Psurvival(10.5 mo vs 48.1 mo,log-rank P<0.0001)than the high-grade *** controlling for confounding factors,the sarcomatoid subtype was identified as an independent predictor of poor *** analyses indicated that invasive and metastatic lesions were mainly composed of carcinomatous *** Sarcomatoid HCC was associated with a more advanced s

关键词： Sarcomatoid hepatocellular carcinoma Histological composition Liver resection Overall survival recurrence-free survival

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Derivation and validation of a preoperative prognostic model for resectable pancreatic ductal adenocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2023年第2期22卷 160-168页

作者： Shuai Xu Xiu-Ping Zhang Guo-Dong Zhao Wen-Bo Zou Zhi-Ming Zhao Qu Liu Ming-Gen Hu Rong Liu Faculty of Hepato-Biliary-Pancreatic Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of Liver Transplantation and Hepatobiliary Surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Background: The prognosis of patients with pancreatic ductal adenocarcinoma(PDAC) remains poor even after radical pancreaticoduodenectomy(PD). The study aimed to develop and validate a novel preoperative prognostic model to accurately predict the long-term survival of patients with ***: Patients with PDAC of pancreatic head from Chinese PLA General Hospital were included. The preoperative PDAC model with contour plots was developed using a non-linear model in the training cohort and then tested in the validation ***: Of 421 patients who met the inclusion criteria, 280 were in the training cohort and 141 in the validation cohort. Contour plots for preoperative PDAC model were established to visually predict the survival probabilities of these patients, based on preoperative carbohydrate antigen 19-9, preoperative fibrinogen to albumin ratio and pain symptoms. This model stratified patients into low-and high-risk groups with distinctly different long-term survival in the training cohort [median overall survival(OS)32.1 vs. 17.5 months;median recurrence-free survival(RFS) 19.3 vs. 10.0 months, both P survival of patients with resectable PDAC of pancreatic head. Besides, the model can screen high-risk patients with poor prognosis, which may provide references for personal treatment strategies in the future.

关键词： Pancreatic ductal adenocarcinoma Pancreaticoduodenectomy Contour plot Overall survival recurrence-free survival

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