ABSTRACT
Objective:To investigate the characteristics and risk factors of local recurrence in resected pancreatic cancer.Methods:The clinicopathological data of 190 patients in whom recurrent sites can be identified after radical resection of pancreatic cancer from Sep 2013 to Aug 2020 at the Cangzhou Central Hospital were retrospectively analyzed. The survival time and clinicopathological characteristics of local recurrence were compared with those of other recurrence types. Cox risk regression model was used to analyze the risk factors of local recurrence.Results:The recurrence sites were local (49 cases, 25.8%), liver (53 cases, 27.9%), lung (35 cases, 18.4%), peritoneal (25 cases, 13.2%) and multiple sites (28 cases, 14.7%). Patients mRFS and mOS were 17.8 months and 30.9 months respectively. The clinicopathological features of patients with local recurrence were compared with those of other recurrence types [tumor diameter ( P=0.023), preoperative CA199 level ( P=0.021), peripancreatic nerve plexus invasion ( P=0.031), lymphovascular invasion ( P=0.004), surgical margin state ( P<0.001) and postoperative adjuvant chemotherapy ( P=0.038)]. Tumor diameter ( P=0.018), peripancreatic nerve plexus invasion ( P=0.002) and postoperative adjuvant chemotherapy ( P=0.004) were independent factors for local recurrence in resected pancreatic cancer, and only peripancreatic nerve plexus invasion was not associated with other recurrence types. Conclusions:Local recurrence in resected pancreatic cancer has important impact on the prognosis of patients. Peripancreatic nerve plexus invasion is an independent factor affecting local recurrence.
ABSTRACT
Objective To evaluate the effectiveness and safety of rivaroxaban or enoxaparin in preventing deep vein thrombosis(DVT) and pulmonary embolism (PE) after major orthopedic surgery. Methods A total of 278 patients underwent major orthopedic surgery, from September 2009 to May 2012, were included in this study. One hundred and forty patients (the average age was 72.7 years, 42.8% were male) were treated with oral rivaroxaban, 10 mg/d. One hundred and thirty-eight patients (the average age was 69.9 years, 39.1%were male) were treated with subcutaneous enoxaparin,40 mg/d. Data were compared between two groups. The ending events included venous thrombosis VTE(DVT and PE), wound complica-tions, re-admission,need for blood transfusion,big and minor bleeding events and death. Results There were no signifi-cant differences in the incidence of VTE, blood transfusions and re- admission rates between two groups. The incidence rates of minor bleeding were 2.1%and 5.8%in two groups. There were no pulmonary embolism, severe bleeding or death in two groups of patients.Conclusion There were no significant differences in the incidence rates of VTE or major bleeding areas in patients with oral treatment of rivaroxaban and enoxaparin.Rivaroxaban was safer with a slightly decrease in minor bleeding and wound complications.
ABSTRACT
Objective Systemic chemotherapy for metastatic pancreatic cancer is still a difficult problem in clinical practice. The standard chemotherapy of pancreatic cancer has been gemcitabine, but the response rate is low. Therefore, it is in urgent need to explore an effective clinical therapy for this cancer. This paper, a case report, is aimed at discussing the effectiveness of vinorelbine and cisplatin combined with endostatin as the first-line therapy for metastatic pancreatic cancer. Methods A 52-year-old female patient was diagnosed with pancreas cancer with liver metastasis at the time of the first visit to our hospital. Systemic chemotherapy with vinorelbine and cisplatin combined with endostatin was conducted. Results Liver metastases almost disappeared after the first cycle of chemotherapy. The primary tumor decreased by one third in size after four cycles and disappeared after the sixth cycle according to the CT scan evaluation. Conclusion Vinorelbine and cisplatin combined with endostatin can be a promising regimen for metastatic pancreatic cancer.