Investigation on peripheral retinal degeneration in civil aviation pilots recruitment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the prevalence on peripheral retinal degeneration and to provide theoretical support for the medical examination of civil aviation pilots recruitment. <p>METHODS: Two thousand four hundred and fifty prospective flight students(Four thousand nine hundred eyes)who received medical examination in Civil Aviation General Hospital from February 2018 to May 2019 were divided into three groups according to diopter after fully mydriatic with tropicamide phenylephrine eye drops(Group A: +3.00 to <-0.50D, Group B: -0.50 to <-3.00D, Group C: -3.00 to -4.50D). The prevalence of peripheral retinal degeneration in each eye was examined, and the results were statistically analyzed. <p>RESULTS:There were five hundred and seventy five students with different types of peripheral retinal degeneration in 2 450 checked students, the prevalence was 23.5%. There was statistical difference in the prevalence of peripheral retinal degeneration in different diopter groups(χ2=65.386, <i>P</i><0.01). There was statistical difference in the prevalence of different types of peripheral retinal degeneration(χ2=351.276, <i>P</i><0.01). There was statistical difference in the prevalence of peripheral retinal degeneration in different parts(χ2=563.712, <i>P</i><0.01). <p>CONCLUSION: Peripheral retinal degeneration is not rare in civil aviation recruitment. The prevalence increases with the progression of myopia, and the lesions are mostly in bitamporal quadrant. It is suggested to identify according to different types.

lnvestigation on retinal arteriosclerosis in civil aviators / 国际眼科杂志(Guoji Yanke Zazhi)

?AIM:To investigate and analyze the prevalence and the influencing factors on retinal arteriosclerosis in civil aviators of different ages.?METHODS:Two thousand seven hundred and seventy-eight commissioned civil aviators who received medical examination in Civil Aviation General Hospital from July 2014 to July 2015 were randomly divided into three groups: group A ( 1 311 aviators aged 22-39 ) , group B (618 aviators age 40-49 ), group C(849 aviators age 50-59). Aviators over 40 years old, were divided into two groups: group with retinal atherosclerosis and group without retinal atherosclerosis according to the results of fundus examination. Medical examination data of the aviators were analyzed.?RESULTS: Of 2 778 aviators, 334 ( 12. 02%) were detected with retinal arteriosclerosis, among which 318 aviators were classified as gradeⅠ, and 16 aviators as grade Ⅱ. The retinal arteriosclerosis prevalence of group A, B, and C increased with age, and the difference was statistically significant ( P < 0. 05 ). Biochemical tests showed that the prevalence of hypertension, hyperlipidemia, high fasting blood glucose and overweight increased in group with retinal arteriosclerosis compared with that in group without retinal arteriosclerosis, and the difference was statistically significant(P<0. 05).?CONCLUSION:The prevalence of retinal arteriosclerosis in commissioned civil aviators was 12. 02%, and most of the retinal arteriosclerosis was classified as grade Ⅰ. In aviators over 40 years old, hypertension, hyperlipidemia, high fasting blood glucose and overweight were important factors in the development of retinal arteriosclerosis.

External validation of nomograms for predicting cancer-specific mortality in penile cancer patients treated with definitive surgery / 癌症

Using a population-based cancer registry, Thuret et al. developed 3 nomograms for estimating cancer-specific mortality in men with penile squamous cell carcinoma. In the initial cohort, only 23.0% of the patients were treated with inguinal lymphadenectomy and had pN stage. To generalize the prediction models in clinical practice, we evaluated the performance of the 3 nomograms in a series of penile cancer patients who were treated with definitive surgery. Clinicopathologic information was obtained from 160 M0 penile cancer patients who underwent primary tumor excision and regional lymphadenectomy between 1990 and 2008. The predicted probabilities of cancer-specific mortality were calculated from 3 nomograms that were based on different disease stage definitions and tumor grade. Discrimination, calibration, and clinical usefulness were assessed to compare model performance. The discrimination ability was similar in nomograms using the TNM classification or American Joint Committee on Cancer staging (Harrell's concordance index = 0.817 and 0.832, respectively), whereas it was inferior for the Surveillance, Epidemiology and End Results staging (Harrell's concordance index = 0.728). Better agreement with the observed cancer-specific mortality was shown for the model consisting of TNM classification and tumor grade, which also achieved favorable clinical net benefit, with a threshold probability in the range of 0 to 42%. The nomogram consisting of TNM classification and tumor grading was shown to have better performance for predicting cancer-specific mortality in penile cancer patients who underwent definitive surgery. Our data support the integration of this model in decision-making and trial design.

Influence of obesity on clinicopathological characteristics in patients with clinically localized prostate cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of anthropometric measures of obesity, including body mass index (BMI), abdominal subcutaneous adipose tissue and visceral adipose tissue, on pathological characteristics in patients with clinically localized prostate cancer.</p><p><b>METHODS</b>From January 2006 to March 2013, the 413 patients of prostate cancer who received radical prostatectomy (RP) and their clinical and pathological data had been collected. The median age for the entire cohort was 68 years, which ranged from 48 to 78 years. All patients were diagnosed with prostate cancer before surgery and the Gleason score ranged from 4 to 10 (median 7). Anthropometric measures of abdominal adiposity including anterior abdominal fat, posterior abdominal fat and anteroposterior diameter were measured from the T2 weighted sagittal localization images of MRI scans and subcutaneous adipose tissue and the percentage of visceral adipose tissue were calculated. The patients' clinical and pathologic characteristics across BMI groups were compared used Student's t test for continuous variables or chi-squared test for categorical variables. Moreover, univariable and multivariable logistic regression models were used to address the influence of anthropometric measures of obesity on pathological outcomes.</p><p><b>RESULTS</b>The BMI ranged from 14.2 to 34.0 kg/m(2) and the median value was 23.8 kg/m(2). The abdominal subcutaneous adipose tissue ranged from 12.6 to 60.3 mm and the median value was 31.4 mm. The percentage of visceral adipose tissue ranged from 71.1% to 92.1% and the median value was 83.8%. In RP specimens, Gleason score ≥ 8 was observed in 141 patients (34.1%), pathological tumor stage was T3a in 69 patients (16.7%) and pathological tumor stage was T3b in 78 patients (18.9%). Positive surgical margin and lymph node involvement were observed in 71(17.2%) and 38(9.2%) patients, respectively. Although univariate analysis showed that BMI ≥ 25 kg/m(2) was associated with pathological Gleason score ≥ 8 (OR = 1.413, P = 0.035), this positive correlation disappeared in multivariate analysis(P = 0.095). In multivariate analysis, the percentage of visceral adipose tissue was significantly associated with pathological Gleason score (OR = 9.618, P = 0.000), extracapsular extension (OR = 6.750, P = 0.002) and seminal vesicle invasion (OR = 4.419, P = 0.007) after adjusting for patient age, PSA level, clinical stage and biopsy Gleason score.</p><p><b>CONCLUSIONS</b>Anthropometric measures of abdominal adiposity was more sophisticated than simple BMI to evaluate the risk of obesity with regard to the aggressiveness of prostate cancer. The percentage of visceral adipose tissue was an independent factor for pathological Gleason score, extracapsular extension and seminal vesicle invasion in RP specimens.</p>

The value of diffusion-weighted MR imaging combined with transrectal ultrasound for transrectal prostate biopsy / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the clinical value of diffusion-weighted MR imaging in the detection of prostate cancer in suspected patients.</p><p><b>METHODS</b>Between January 2009 and December 2010, the 551 patients suspected as prostate cancer underwent prostate biopsy. Patients in group A were accepted to a transrectal ultrasound (TRUS) guided transrectal prostate biopsy (n = 410), while patients in group B were accepted to a diffusion weighted imaging (DWI) and TRUS jointly guided transrectal prostate biopsy (n = 141). The two groups were divided into 4 subgroups by prostate specific antigen (PSA) < 10 µg/L, 10 µg/L ≤ PSA < 20 µg/L, 20 µg/L ≤ PSA < 50 µg/L and PSA ≥ 50 µg/L. Then, the diagnostic rates of prostate biopsy guided by combination of DWI and TRUS with only TRUS were compared.</p><p><b>RESULTS</b>The diagnostic rate of patients with PSA < 10 µg/L, 10 µg/L ≤ PSA < 20 µg/L, 20 µg/L ≤ PSA < 50 µg/L and PSA ≥ 50 µg/L were 12.1%, 31.1%, 48.0%, 91.2% in group A, and 23.7%, 35.5%, 66.7%, 96.3% in group B, respectively. In the patients with PSA less than 10 µg/L, there were significant differences in diagnostic rate between the two biopsy techniques (χ(2) = 4.405, P < 0.05).</p><p><b>CONCLUSION</b>The combination of DWI and TRUS showed the potential to guide biopsy to cancer foci in patients suspected as prostate cancer. For patients with PSA < 10 µg/L, a DWI and TRUS jointly guided transrectal prostate biopsy was recommended.</p>

Penile rehabilitation with vacuum erection device for erectile dysfunction after radical prostatectomy / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of vacuum erection device (VED) for erectile dysfunction (ED) after radical prostatectomy (RP).</p><p><b>METHODS</b>Six cases of ED after open RP were reviewed. Three of the patients started a daily rehabilitation protocol using VED 10 min/d within 3 months after RP (group A, early intervention), while the other 3 initiated the same protocol after 12 months (group B, late intervention). We compared the IIEF-5 scores as well as stretched penile lengths and mid-shaft circumferences before and after 3 and 6 months of VED rehabilitation. We also assessed the safety of the device and sexual satisfaction of the patients and their partners.</p><p><b>RESULTS</b>The mean IIEF-5 score of the six cases was remarkably increased at 3 and 6 months of VED rehabilitation (P < 0.05), significantly higher in group A than in B at 3 months (8.7 +/- 0.6 vs 6.7 +/- 0.6, P < 0.05) and 6 months (13.0 +/- 1.0 vs 8.3 +/- 1.5, P < 0.05). After 6 months of VED rehabilitation, there were no significant changes in stretched penile length or mid-shaft circumference in group A, both significantly decreased in group B (P < 0.05), and sexual satisfaction of the patients and their partners were 83.3% and 50%, respectively. No serious adverse events were observed except mild complaint of pe- nile skin darkening in 1 case and numb feeling during the intercourse in 2.</p><p><b>CONCLUSION</b>Early use of VED after RP improves erectile function and helps to preserve the length and mid-shaft circumference of the penis.</p>

ADAM9 decreases in castration resistant prostate cancer and is a prognostic factor for overall survival / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A disintegrin and metalloprotease 9 (ADAM9) is a membrane-anchored enzyme which is considered to be involved in some diseases including tumor. However, the role of ADAM9 in castration resistant prostate cancer (CRPC) is not clear. This study aimed to explore the different expressions on protein and messenger RNA (mRNA) level of ADAM9 between hormonal sensitive prostate cancer (HSPC) and CRPC tissue, and find the correlation with prognosis.</p><p><b>METHODS</b>Clinicopathologic characteristics of 106 HSPC and 76 CRPC cases were collected. The ADAM9 expressions were analyzed using immunohistochemistry. ADAM9 mRNA of 32 additional cases (16 HSPC and 16 CRPC patients) were analyzed via quantitative real-time polymerase chain reaction (RT-PCR). The prediction values of variables for overall survival (OS) of CRPC patients were analyzed using Cox regression.</p><p><b>RESULTS</b>ADAM9 protein expression was significantly downregulated in CRPC compared with HSPC tissue (31.6% vs. 81.1%, P < 0.001). The relativity transcription level of ADAM9 mRNA was 0.45 for CRPC tissue and 1.0 for HSPC tissue (P = 0.002). In the CRPC group, patients with low ADAM9 protein expression were significantly associated with shorter OS than patients with high expression (38.6 months vs. 57.8 months, hazard rate (HR) = 2.638, P = 0.023).</p><p><b>CONCLUSION</b>ADAM9 expression was low in CRPC, correlated with poor prognosis and might be involved in the succession from HSPC to CRPC by various functions.</p>

Evaluation of perioperative complications in the elderly with radical prostatectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the incidence and severity of perioperative complications in elderly patients with radical prostatectomy (RP).</p><p><b>METHODS</b>A total of 242 patents underwent RP for prostate cancer were retrospectively assessed, whose clinicopathologic factors and perioperative complications were retrieved from the medical records. The mean age in the elderly group (n = 163) and control group (n = 79) were (73.2 ± 2.4) and (63.2 ± 4.8) years, respectively. The clinicopathologic factors including Charlson comorbidity index and preoperative prostate specific antigen were statistically significant different. The difference of clinicopathologic factors and perioperative complications between the elderly group (≥ 70 years old) and control group were statistically analyzed using the SPSS 17.0.</p><p><b>RESULTS</b>The incidence of perioperative complications was 23.5% in the elderly group and 22.7% in the control group. Except for gross hematuria (there were 12 cases in elderly group and 1 case in control group, respectively, χ(2) = 3.89, P < 0.05) and perioperative transfusion (there were 36 cases in elderly group and 7 cases in control group, respectively, χ(2) = 6.37, P < 0.05), there was no significant difference in each kind or total of perioperative complications.</p><p><b>CONCLUSION</b>The elderly patients underwent RP in experienced center are not associated with higher or more serious perioperative complications.</p>

The building and validation of a model to predict the bone metastases of patients with newly diagnosed prostate cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To develop and validate a nomogram used to predict the bone metastasis risks according to the clinicopathological factors of patients with newly diagnosed prostate cancer.</p><p><b>METHODS</b>The 501 cases were randomly assigned into development sample (300 cases) and validation sample (201 cases). In the development sample, Logistic regression analysis was used to explore the predictors of bone metastases, and then a nomogram was built based on regression coefficients and validated in the validation sample.</p><p><b>RESULTS</b>Prostate specific antigen, cT3, cT4 and Gleason score ≥ 8 were the independent prognostic factors (P < 0.05), and the OR values were 5.65, 2.89, 9.07 and 2.87 respectively. The concordance index was 0.830 in the model sample and 0.799 in the validation sample.</p><p><b>CONCLUSION</b>A nomogram, built based on the clinicopathological factors, could be used to predict the risk of bone metastases and then could be helpful for the rational use of bone scan.</p>

Docetaxel plus prednisone versus mitoxantrone plus prednisone as first-line chemotherapy for metastatic hormone-refractory prostate cancer: long-term effects and safety / 中华外科杂志

<p><b>OBJECTIVE</b>To compare docetaxel plus prednisone with mitoxantrone plus prednisone as first-line chemotherapy for metastatic hormone-refractory prostate cancer (mHRPC).</p><p><b>METHODS</b>From January 2007 through August 2010, 62 patients with mHRPC received 5 mg of prednisone twice daily were randomly assigned to receive mitoxantrone 12 mg/m² every three weeks (group A) or 75 mg/m² every three weeks (group B). The cycles of each regimen were less than 10 times. The primary end point was overall survival. The secondary end points were the prostate-specific antigen (PSA) response rate, the duration of PSA response and the objective tumor response rate (ORR). All the t test, χ² test and Fisher's exact test were performed between 2 groups.</p><p><b>RESULTS</b>Thirty-one patients enrolled in group A received a median 4 cycles of regimen (range 1 - 10), whereas 30 patients enrolled in group B received a median of 7 cycles of regimen (range 2 - 10). There were 45.2% patients in group A and 70.0% in group B had PSA response (χ² = 3.85, P < 0.05). The duration time of PSA response was 121 days (range 20-323 days) in group A and 168 days (range 42 - 447 days) in group B, respectively. The ORR was 15.0(3/20) in group A and 10.3% (3/29) in group B, respectively. The median survival was 511 days (95%CI: 357 - 665 days) in group A and 833 days (95%CI: 634 - 1032 days) in group B, respectively (χ² = 4.20, P = 0.040). The incidence of thrombocytopenia in group A was higher than group B (χ² = 5.60, P = 0.018); the incidences of nausea and vomiting (χ² = 4.32, P = 0.038), diarrhea (P = 0.024), fatigue (χ² = 5.90, P = 0.015), and alopecia (χ² = 5.42, P = 0.020) in group B were higher than group A.</p><p><b>CONCLUSION</b>Docetaxel plus prednisone can lead to superior overall survival and PSA response rate in patients with mHRPC.</p>

The study of electrical acupuncture stimulation therapy combined with pelvic floor muscle therapy for postprostatectomy incontinence / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the effectiveness and significance of whether electrical acupuncture stimulation combining with pelvic floor muscle therapy (PFMT) can improve the recovery of urinary continence.</p><p><b>METHODS</b>A total of 109 patients took part in the study of novel combination treatment for urinary continence from September 2008 to September 2009. Patients were divided into study group (n = 40) and control group (n = 69). The patients in study group received electrical acupuncture stimulation therapy combined with PFMT one week after removal the catheter. The patients in control group performed PFMT as the only treatment for post prostatectomy incontinence. The patients were followed up closely, with their clinical characteristics recorded, questionnaires of ICI-Q-SF filled up, and all the data for statistical analysis collected.</p><p><b>RESULTS</b>There was a significant difference between the study group and the control group in the urinary control curve (P = 0.029). The difference of continence probability between these two groups became greater from 4 weeks after surgery, and the difference reached the peak at 6 weeks (P = 0.023). Then the difference became smaller, and there was no difference at 16 weeks after surgery. ICI-Q-SF questionnaires showed the same results.</p><p><b>CONCLUSION</b>Electrical acupuncture stimulation therapy combining with PFMT can improve the recovery of patients' urinary continence after radical prostatectomy.</p>

External validation of the Partin tables 2007 in Chinese prostate cancer patients / 中华外科杂志

<p><b>OBJECTIVE</b>To validate the 2007 Partin tables externally, which are based on the population of United States, using a cohort of Chinese prostate cancer patients.</p><p><b>METHODS</b>All of the patients enrolled and underwent radical prostatectomy between January 2006 and February 2010 were reviewed. The cases without preoperative hormone therapy and pelvic lymph node involvement according to radiologic tests were used for the external validation of the 2007 Partin tables. A comparative analysis of the clinical and pathological parameters of this Chinese cohort and Partin tables cohort was performed. Values of areas under the receiver operating characteristic (ROC) curve were used to assess predictive accuracy for the Chinese cohort.</p><p><b>RESULTS</b>The mean age of the whole cohort was 67 years. The serum prostate specific antigen level, Gleason score and clinical stage of this cohort were higher than the Partin tables cohort. The pathological outcomes analysis revealed that the rates of organ confined disease, capsular penetration, seminal vesicle involvement and lymph node involvement were 62.3%, 16.7%, 12.3% and 8.8%, respectively. The area under the ROC curve (AUC) for organ confined disease, capsular penetration, seminal vesicle involvement and lymph node involvement were 0.735, 0.653, 0.601 and 0.845.</p><p><b>CONCLUSIONS</b>The Partin tables discriminate well for Chinese patients at risk for positive lymph node. The discrimination of organ confined disease is also acceptable and the discrimination of capsular penetration and seminal vesicle involvement is more limited.</p>

The survival analysis of metastatic prostate cancer / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the clinical and pathological informations of metastatic prostate cancer patients to find the predictive factors of the survival.</p><p><b>METHODS</b>To filter 364 cases of metastatic prostate cancer in the 940 cases of prostate cancer that were treated in Cancer Hospital Fudan University in Shanghai from March 1998 to June 2009, the cases had hormonal therapy and full clinical and pathological records. All the 364 cases were followed up and the clinical and pathological informations were analyzed, to find the predictive factors that related to the prognosis. Statistic software SPSS 15.0 was used for analysis. Cumulative survival was analyzed by the method of Kaplan-Meier. Cox regression was used for univariate and multivariate analysis. Log-rank method was used for the significance test.</p><p><b>RESULTS</b>The last follow-up date was 30th June 2009 and the median follow-up time was 24 months. At the final follow-up, 240 cases were alive, 109 cases were dead and 15 cases were lost to follow up. The median survival time of metastatic prostate cancer was 64 months, and the one-year, two-year, three-year, four-year, five-year survival rate was 92%, 78%, 66%, 60%, 54%. The univariate analysis indicated that Gleason score (P = 0.033), clinical stage (P < 0.001), the effectiveness of hormonal therapy (P < 0.001), the prostate specific antigen (PSA) nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P = 0.002) were predictive factors for the survival time of metastatic prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P < 0.001) were independent factors that predict the survival time of metastatic prostate cancer.</p><p><b>CONCLUSION</b>The PSA nadir during hormonal therapy and the time from the start of hormonal therapy to the PSA nadir are independent factors that predict the survival time of metastatic prostate cancer.</p>

Prevalence of incidental prostate cancer in patients undergoing radical cystoprostatectomy: data from China and other Asian countries / 亚洲男科学杂志(英文版)

The purpose of this study is to investigate the frequency of prostate cancer (Pca) discovered incidentally in radical cystoprostatectomy specimens in Asia and to determine the feasibility of prostate-sparing cystectomy (PSC) for Asian patients. Ninety-two male bladder cancer patients who underwent radical cystoprostatectomy at our center between January 2003 and January 2008 were included in this study. The mean age of patients was 67.1 years (range: 32-75 years). Prostate-specific antigen (PSA) levels and digital rectal examination (DRE) results before surgery were obtained retrospectively. Prostates of all patients were embedded and sectioned at 5-mm intervals. The same pathologist examined the prostatic tissues from radical cystoprostatectomy specimens. Finally, a structured literature review was performed using MEDLINE and PUBMED to estimate the occurrence of incidental Pca in Asia. Of the 92 patients, 3 (3.3%) were found to have Pca; in one out of three (33.3%) patients the disease was clinically significant due to a Gleason grade 4 carcinoma. Eight articles were included in our review. The overall incidence of Pca discovered incidentally in radical cystoprostatectomy specimens in Asia was 9.9% (64/642). When age was restricted to < 60 years, only 7 out of 222 (3.2%) patients were found to have synchronous Pca, and none of the cases was clinically significant. The occurrence of Pca in radical cystoprostatectomy specimens in Asia is much lower than that in Western countries. PSC might be feasible for Asian patients under a strict preoperative selection.

Repeat transurethral resection for non-muscle invasive bladder cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of repeat transurethral resection of tumor in patients with non-muscle invasive bladder cancer.</p><p><b>METHODS</b>From March 2004 to August 2008, 462 patients (350 males, 112 females, aged from 35 to 83 years old) with non-muscle invasive bladder cancer, were evaluated according to tumor stage, grade and muscle or no muscle tissue in initial transurethral resected sample. One hundred and twenty-five patients underwent repeat transurethral resection of bladder tumor within 4 to 6 weeks after initial resection. Of these 125 patients 49 were Ta, 76 were T1, 58 were low grade carcinoma, 67 were high grade carcinoma and 30 were not found presence of muscle tissue in initial resected sample in patients with T1 stage.</p><p><b>RESULTS</b>Of the 125 cases, 34.4% (43/125) had residual tumor and 65.6% (82/125) had no tumor on repeat transurethral resection. Of 43 cases with residual tumor 35 had non-muscle invasive tumor including 15 in Ta and 20 in T1. The patients with high grade carcinoma had more residual tumor than those with low grade carcinoma (P < 0.05). The patients with muscle tissue in initial transurethral resected sample had fewer residual tumor than those without (P < 0.05). Twelve cases (9.6%) were understated at initial resection. Six cases (4.8%) had bladder perforation and 7 (5.6%) had bleeding during repeat transurethral resection. All cases were followed up for 3 to 56 months (median 26 months), 37.2% (16/43) patients with residual tumor in repeat transurethral resection had recurrence while only 12.2% (10/82) without residual tumor in repeat transurethral resection did (P < 0.05).</p><p><b>CONCLUSIONS</b>Routine repeat transurethral resection is advised to non-muscle invasive bladder cancer patients with T1 tumor or high grade carcinoma or no muscle tissue in initial transurethral resected sample within 4 to 6 weeks after initial resection. Repeat transurethral resection could increases the stage accuracy.</p>

The survival analysis of the advanced metastatic castration-resistant prostate cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze predictive factors of advanced metastatic castration-resistant prostate cancer.</p><p><b>METHODS</b>From December 1996 to March 2008, 250 cases of advanced metastatic prostate cancer progressed into the stage of hormonal independent prostate cancer. The last follow-up date was 31 March 2008 and the median follow-up time was 24 months. During the follow-up, 131 cases were alive, 105 cases were dead and 14 cases were lost to follow-up. Clinical and pathological information of the cases was analyzed to find the predictive factors that related to the prognosis.</p><p><b>RESULTS</b>The median survival time of advanced metastatic castration-resistant prostate cancer was 30 months, and the one-year, two-year, three-year survival rate was 79%, 59%, and 41%. The univariate analysis indicated that prostate specific antigen (PSA) at diagnosis, clinical stage, the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, the time of response duration during hormonal therapy, PSA velocity (PSAV) and PSA doubling time (PSADT) at the emergency of castration-resistant prostate cancer, age and PSA at the diagnosis of castration-resistant prostate cancer were factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-resistant prostate cancer, the time of response duration during hormonal therapy were independent factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer.</p><p><b>CONCLUSION</b>The PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-resistant prostate cancer and the time of response duration during hormonal therapy are independent factors that predict the survival time of advanced metastatic castration-resistant prostate cancer.</p>

MR imaging features of different renal cell carcinoma subtypes / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare and analyze the MRI features of different renal cell carcinoma (RCC) subtypes.</p><p><b>METHODS</b>The MR images of 81 surgically and pathologically confirmed renal cell carcinomas from 79 patients were reviewed retrospectively. The MR imaging features of lesions in plain scan, the degree and patterns of lesion enhancement (homogeneous, heterogeneous, peripheral), and tumor spreading patterns were analyzed. In order to evaluate the diagnostic validity of differentiating RCC subtypes using signal enhancement, receiver operating characteristic curves (ROC) were generated. The cutoff value of post-contrast signal intensity to noise ratios (SNR) of the tumor parenchyma were also generated in order to differentiate clear cell RCC from other subtypes.</p><p><b>RESULTS</b>Of the 81 lesions, 58 were clear cell carcinomas, 10 chromophobe cell carcinomas, 8 papillary cell carcinomas, and 5 unclassified RCC. All the chromophobe cell subtype tumors showed a homogeneous density (P < 0.05). The clear cell subtype tumors were likely heterogenous, and also showed heterogenous enhancement with mixed signal than other subtypes (P < 0.05). The cutoff value of SNR, which was used to differentiate clear cell subtype from the other subtypes, were 616 (corticomedullary phase), 579 (nephrographic phase) and 278 (excretory phase), retrospectively. The nephrographic phase is the most appropriate for differentiation, with a sensitivity of 62.1%, specificity of 91.3%, positive predictive value of 94.7%, negative predictive value of 48.8% and an accuracy value of 70.3%. No significant difference was found in tumor spreading patterns among all subtypes of RCC.</p><p><b>CONCLUSION</b>MR imaging features, particularly tumor heterogeneity and degree of enhancement are useful in differentiation of the renal cell carcinoma subtypes, and in choosing an individualized therapy.</p>

Epidemiology of prostate cancer from three centers and analysis of the first-line hormonal therapy for the advanced disease / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the epidemiology information of prostate cancer from three centers of Beijing, Shanghai, Guangzhou, and to reflect the current situation of prostate cancer in China, and to analyze the information of 272 patients with advanced prostate cancer who received hormonal therapy to find the prognostic factors of hormone therapy.</p><p><b>METHODS</b>Collect the information of 525 patients with prostate cancer from three centers. Two hundred and seventy-two cases of advanced prostate cancer with full information were selected from the 525 cases to analyze the prognostic factors of hormone therapy.</p><p><b>RESULTS</b>Three hundred and fifty-seven cases (68.0%) had advanced disease at diagnosis and 80.2% patients received hormone therapy as the main therapy. Prognostic analysis indicated that Gleason score, bone metastasis and prostate specific antigen nadir were independent prognostic factors of progression-free survival time.</p><p><b>CONCLUSIONS</b>In this report, most patients are advanced prostate cancer at diagnose, and hormonal therapy is the main therapy. Gleason score, bone metastasis, prostate specific antigen nadir are independent prognostic factors of advanced prostate cancer after hormone therapy.</p>