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Current treatment paradigm and survival outcomes among patients with newly diagnosed multiple myeloma in China:a retrospective multicenter study

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Cancer Biology & Medicine 2023年第1期20卷 77-87页

作者： Huishou Fan Weida Wang Ya Zhang Jianxiang Wang Tao Cheng Lugui Qiu Xin Wang Zhongjun Xia Gang An State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood DiseasesHaihe Laboratory of Cell EcosystemInstitute of Hematology&Blood Diseases HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeTianjin 300020China State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineSun Yat-Sen University Cancer CenterGuangzhou 510060China Department of Hematology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Objective:Evidence on the prognostic value of autologous stem cell transplantation(ASCT)and minimal residual disease(MRD)dynamics of patients with newly diagnosed multiple myeloma(NDMM)in China is limited.Our objective in the current study was to understand the current care paradigm and outcomes of these patients.Methods:This longitudinal cohort study used historical data from three top-tier hematologic disease care hospitals that contributed to the National Longitudinal Cohort of Hematological Diseases-Multiple Myeloma.Treatment regimens[proteasome inhibitor(PI)-,immunomodulatory drug(IMiD)-,PI+IMiD-based,and conventional],post-induction response,ASCT and MRD status,and survival outcomes[progression-free survival(PFS)and overall survival(OS)]were evaluated.Results:In total,454 patients with NDMM were included(median age,57 years;59.0%males)with a median follow-up of 58.7 months.The overall response rate was 91.0%,83.9%,90.6%,and 60.9%for PI-,IMiD-,PI+IMiD-based,and conventional regimens,respectively.Patients with ASCT during first-line therapy(26.2%)had a longer PFS and OS than patients who did not receive ASCT[median PFS,42.9 vs.21.2 months,P<0.001;median OS,not reached(NR)vs.65.8 months,P<0.001].The median OS was NR,71.5,and 56.6 months among patients with sustained MRD negativity,loss of MRD negativity,and persistent MRD,respectively(P<0.001).Multivariate analysis revealed that the lactic dehydrogenase level,International Staging System stage,extra-medullary disease,and upfront ASCT were independent factors in predicting OS among NDMM patients.Conclusions:Our study showed that novel agent-based regimens,first-line ASCT,and sustained MRD negativity were associated with a superior outcome for patients with NDMM in China(Identifier:NCT04645199).

关键词： Multiple myeloma autologous stem cell transplantation minimal residual disease survival outcomes multicenter study

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Determinants of survival outcomes among esophageal cancer patients at a national referral hospital in Kenya

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Chronic Diseases and Translational Medicine 2023年第1期9卷 20-28页

作者： Amsalu Degu Peter N.Karimi Sylvia A.Opanga David G.Nyamu Department of Pharmaceutics and Pharmacy Practice School of Pharmacy and Health SciencesUnited States International University–AfricaNairobiKenya Department of Pharmacy Faculty of Health SciencesUniversity of NairobiNairobiKenya

Introduction:The overall 5-year survival rate for esophageal cancer patients in low-and middle-income countries was reported to be low,despite the availability of advanced treatments.Thus,this study aimed to assess determinants of survival outcomes among esophageal cancer patients in Kenya.Methods:A retrospective cohort study was employed among 299 adult esophageal cancer patients.The data were collected using a data abstraction tool consisting of patients’clinical characteristics and survival outcome measuring parameters.Statistical Package for the Social Sciences(SPSS)statistical software(version 20.0,IBM.USA)was used to analyze the data.The Kaplan–Meier and Cox regression analyses were used to determine the survival outcome and determinants of mortality,respectively.Results:The mortality rate was 43.1%,and 11.1%of patients demonstrated distant metastases in the follow-up period.Despite treatment,20.1%had progressed disease,and 13.0%did not respond to treatment.Radiotherapy(AHR:3.3,95%CI:1.4−7.8,p=0.007),chemotherapy(AHR:3.9,95%CI:1.2−6.1,p=0.020),and chemoradiation(AHR:5.6,95%CI:1.6−10.2,p=0.006)were the significant determinants of survival in advanced stage(III and and IV)patients.Conclusions:There was a high mortality rate,disease progression,and nonresponse of esophageal cancer patients.Hence,it is essential to improve the survival of patients through early detection and timely initiation of the available treatment options.

关键词： determinants esophageal cancer mortality survival outcomes

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Neoadjuvant Chemoradiotherapy Improving survival outcomes for Esophageal Carcinoma： An Updated Meta-analysis

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Chinese Medical Journal 2016年第24期129卷 2974-2982页

作者： Dong-Bin Wang Zhong-Yi Sun Li-Min Deng De-Qing Zhu Hong-Gang Xia Peng-Zhi Zhu Department of Cardiothoracic Surgery Tianjin Hospital Tianjin 300211 China

Background： The effectiveness of neoadjuvant chemoradiotherapy （NCRT） treatment for patients with esophageal carcinoma （EC） remains controversial. The aim of this study was to compare the effect of NCRT followed by surgery （NCRTS） with surgery alone （SA） for EC. Methods： The PubMed, EMBASE, and the Cochrane Library databases were electronically searched up to August 2015 for all the published studies that investigated EC patients receiving either NCRTS or SA, and the reference lists were also manually examined for the eligible studies. The risk ratio （RR） with 95% confidence intervals （CI s） as effective size was determined to assess the 1-, 3-, 5-year survival rates （SRs）, postoperative morbidity, and postoperative mortality. Heterogeneity was determined using the Q-test. The Begg＇s test and Egger＇s test were used for assessing any potential publication bias. Results： Of 1120 identified studies, 16 eligible studies were included in this analysis （involving 2549 patients）. Overall, the pooled results suggested that NCRTS was associated with significantly improved 1-year （RR： 1.07, 95% CI： 1.02–1.13）, 3-year （RR： 1.26, 95% CI： 1.14–1.39）, and 5-year （RR： 1.36, 95% CI： 1.18–1.56） SRs. However, the results also indicated that NCRTS had no or little effect on postoperative morbidity （RR： 0.93, 95% CI： 0.82–1.05） and postoperative mortality （RR： 1.17, 95% CI： 0.56–2.44）. Conclusions： Compared with SA, NCRTS can increase 1-, 3-, and 5-year SRs in patients with EC.

关键词： Esophageal Carcinoma Meta-analysis Neoadjuvant Chemoradiotherapy survival outcomes

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survival outcomes of patients with cervical esophageal cancer who received definitive radiotherapy:a retrospective study conducted in a single institution

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Oncology and Translational Medicine 2020年第4期6卷 135-142页

作者： Jing Wang Fei Liu Yingying Wu Lei Zhou Guangyuan Hu Lin Yang Department of Oncology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Objective Cervical esophageal cancer(CEC)is a relatively rare condition,with limited treatment options.The current study aimed to assess the survival outcomes of patients with CEC who received definitive radiotherapy.Methods In total,63 consecutive patients with CEC who received definitive radiotherapy between 2010 and 2018 were included in this study.The survival outcomes were analyzed based on statistics.Results The median progression-free survival(PFS)and overall survival(OS)of the patients were 12 and 19 months,respectively.There were no significant differences in terms of survival outcomes between the groups who received radiation doses≥60 andsurvival(LRFFS)(P=0.005)improved significantly in patients who received a radiation dose≥60 Gy compared with those who received a radiation dosesurvival outcomes of patients with CEC should be improved.In proximal CEC,a radiation dose≥60 Gy is significantly correlated with better PFS,OS,and LRFFS.However,further research must be performed to validate this finding.

关键词： cervical esophageal cancer definitive radiotherapy survival outcomes

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Liver transplantation in patients with incidental hepatocellular carcinoma/cholangiocarcinoma and intrahepatic cholangiocarcinoma： a single-center experience

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Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 264-270页

作者： Mohammed Elshamy Naftali Presser Abdulrahman Y Hammad Daniel J Firl Christopher Coppa John Fung Federico N Aucejo Hepatobiliary and Transplant Surgery Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA Imaging Institute Cleveland Clinic Cleveland OH USA

BACKGROUND： Reports of fiver transplantation （LT） in patients with mixed hepatocellular carcinoma/cholangiocarcinoma （HCC/CC） and intrahepatic cholangiocarcinoma （ICC） are modest and have been mostly retrospective after pathological categorization in the setting of presumed HCC. Some studies suggest that patients undergoing LT with small and unifocal ICC or mixed HCC/CC can achieve about 40%-60% 5-year post-transplant survival. The study aimed to report our experience in patients undergoing LT with explant pathology revealing HCC/CC and ICC. METHODS： From a prospectively maintained database, we performed cohort analysis. We identified 13 patients who underwent LT with explant pathology revealing HCC/CC or ICC. RESULTS： The observed recurrence rate post-LT was 31% （4/13） and overall survival was 85%, 51%, and 51% at 1, 3 and 5 years, respectively. Disease-free survival was 68%, 51%, and 41% at 1, 3 and 5 years, respectively. In our cohort, four patients would have qualified for exception points based on updated HCC Organ Procurement and Transplantation Network imaging guidelines. CONCLUSIONS： Lesions which lack complete imaging characteristics of HCC may warrant pre-LT biopsy to fully elucidate their pathology. Identified patients with early HCC/CC or ICC may benefit from LT if unresectable. Additionally, incorporating adjunctive perioperative therapies such as in the case of patients undergoing LT with hilar cholangiocarcinoma may improve outcomes but this warrants further investigation.

关键词： mixed hepatocellular carcinoma/ cholangiocarcinoma liver transplantation survival outcomes

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