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Transanal total mesorectal excision combined with intersphincteric resection has similar long-term oncological outcomes to laparoscopic abdominoperineal resection in low rectal cancer:a propensity score-matched cohort study

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Gastroenterology Report 2022年第1期10卷 377-385页

作者： Zhi-Hang Liu Zi-Wei Zeng Hai-Qing Jie Liang Huang Shuang-Ling Luo Wen-Feng Liang Xing-Wei Zhang Liang Kang Department of Colorectal Surgery The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background Transanal total mesorectal excision(taTME)or intersphincteric resection(ISR)has recently proven to be a valid and safe surgical procedure for low rectal cancer.However,studies focusing on the combination of these two technologies are limited.This study aimed to evaluate perioperative results,long-termoncologic outcomes,and anorectal functions of patients with low rectal cancer undergoing taTME combined with ISR,by comparing with those of patients undergoing laparoscopic abdominoperineal resection(laAPR).Methods After 1:1 propensity score matching,200 patients with low rectal cancer who underwent laAPR(n=100)or taTME combined with ISR(n=100)between September 2013 and November 2019 were included.Patient demographics,clinicopathological characteristics,oncological outcomes,and anal functional results were analysed.Results Patients in the taTME-combined-with-ISR group had less intraoperative blood loss(79.6672.6 vs 107.3665.1 mL,P=0.005)and a lower rate of post-operative complications(22.0%vs 44.0%,Poncological outcomes for patients with low rectal cancer undergoing laAPR and those undergoing taTME combined with ISR.Patients receiving taTME combined with ISR had acceptable post-operative anorectal function.

关键词： rectal cancer transanal totalmesorectal excision laparoscopic abdominoperineal resection oncological outcomes

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Surgical route and pathological risk factors in early cervical cancer-Node Zero(SURPEC-N0)

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Journal of Cancer Metastasis and Treatment 2022年第1期8卷 42-53页

作者： T S Shylasree Stuti Gupta Akshay Patil Pooja Singh Amita Maheshwari Santosh Menon Supriya Chopra Lavanya Gurram Palak Popat Umesh Mahantshetty Rajendra Kerkar Department of Gynaecology Oncology Tata Memorial HospitalHomi Bhabha National InstituteMumbai 400012India Consultant Gynaecological Oncologist Department of Gynaecological OncologyAberdeen Royal InfirmaryForesterhill Aberdeen AB252ZNUK Department of Biostatistics Tata Memorial HospitalHomi Bhabha National InstituteMumbai 400012India Department of Pathology Gynaecology Oncology Disease Management GroupTata Memorial HospitalHomi Bhabha National InstituteMumbai 400012India Department of Radiation Oncology Gynaecology Oncology Disease Management GroupTata Memorial HospitalHomi Bhabha National InstituteMumbai 400012India Department of Radiology Gynaecology Oncology Disease Management GroupTata Memorial HospitalHomi Bhabha National InstituteMumbai 400012India

Aim:The aim of this study is to compare disease-free survival(DFS)and overall survival(OS)in patients with stage I cervical cancer(≤4cms,lymph node-negative)undergoing open radical hysterectomy(ORH)vs.minimally invasive radical hysterectomy(MIRH).Methods:All patients undergoing radical hysterectomy between January 2012-December 2018 from the largest tertiary referral cancer centre were included.A 1:1 propensity matching was done based on four independent prognostic factors to compare DFS and OS with the route of surgery.Results:One hundred and ninety-nine patients were included during the study period.The median age of the cohort was 50 years.The median follow-up of patients was 47 months.Following 1:1 propensity matching,a total of 174 patients were analysed for DFS and OS in ORH(n=87)and MIRH(n=87)groups.Protective measure was used in two-thirds of the patients during MIRH.Twenty-nine patients(16.7%)had recurrences.For the matched cohort(n=174),the DFS at 36 and 60 months was 84.8%(78.1%-89.6%)and 81%(73.4%-86.6%)respectively and the OS was 96.5%(91.7%-98.5%)and 95.6%(90.3%-98%)respectively.There was no statistically significant difference in DFS or OS between ORH and MIRH.Conclusion:The present study showed no difference in oncological outcomes in MIRH compared to ORH.Retrospective audits on patient characteristics such as screening/vaccination history along with surgical technique/load and matching for crucial risk factors should be factored in future studies to eliminate the possible methodological errors.

关键词： Cancer cervix radical hysterectomy route of surgery oncological outcomes

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Radiofrequency ablation versus partial nephrectomy for the treatment of clinical stage 1 renal masses： a systematic review and meta-analysis

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Chinese Medical Journal 2014年第13期127卷 2497-2503页

作者： Wang Shangqian Qin Chao Peng Zhihang Cao Qiang Li Pu Shao Pengfei Ju Xiaobing Meng Xiaoxin Lu Qiang Li Jie Wang Meilin Zhang Zhengdong Gu Min Zhang Wei Yin Changjun Department of Urology First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu 210029 China Department of Epidemiology and Biostatistics Department of Molecular and Genetic Toxicology School of Public Health Nanjing Medical UniversityNanjing Jiangsu 210029 China

Background Over the past two decades,the clinical presentation of renal masses has evolved,where the rising incidence of small renal masses （SRMs） and concomitant minimal invasive treatments have led to noteworthy changes in paradigm of kidney cancer.This study was to perform a proportional meta-analysis of observational studies on perioperative complications and oncological outcomes of partial nephrectomy （PN） and radiofrequency ablation （RFA）.Methods The US National Library of Medicine＇s life science database （Medline） and the Web of Science were exhaustly searched before August 1,2013.Clinical stage 1 SRMs that were treated with PN or RFA were included,and perioperative complications and oncological outcomes of a total of 9 565 patients were analyzed.Results Patients who underwent RFA were significantly older （P ＜0.001）.In the subanalysis of stage T1 tumors,the major complication rate of PN was greater than that of RFA （laparoscopic partial nephrectomy （LPN）/robotic partial nephrectomy （RPN）：7.2％,open partial nephrectomy （OPN）：7.9％,RFA：3.1％,both P ＜0.001）.Minor complications occurred more frequently after RFA （RFA：13.8％,LPN/RPN：7.5％,OPN：9.5％,both P ＜0.001）.By multivariate analysis,the relative risks for minor complications of RFA,compared with LPN and OPN,were 1.7-fold and 1.5-fold greater （both P ＜0.01）,respectively.Patients treated with RFA had a greater local progression rate than those treated by PN （RFA：4.6％,LPN/RPN：1.2％,OPN：1.9％,both P ＜0.001）.By multivariate analysis,the local tumor progression for RFA versus LPN/RPN and OPN were 4.5-fold and 3.1-fold greater,respectively （both P ＜0.001）.Conclusions The current data illustrate that both PN and RFA are viable strategies for the treatment of SRMs.Compared with PN,RFA showed a greater risk of local tumor progression but a lower major complication rate,which is considered better for poor candidates.PN is with no doubt the golden treatment for SRMs,and LPN has been widely accepted as the first option for nephron-sparing surgery by experienced urologists.RFA

关键词： meta-analysis partial nephrectomy radiofrequency ablation complication oncological outcomes

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