ABSTRACT
Objective To evaluate the change of clinicopathological features and prognosis of papillary thyroid cancer over a 15-year period.Methods The clinicopathological features and outcomes of papillary thyroid cancer patients were analyzed in three groups according to the time of diagnosis:group Ⅰ (1997-2001),group Ⅱ (2002-2006),and group Ⅲ (2007-2011).Results As time advanced,the average age of papillary thyroid cancer patients increased,tumor stage,like size,extrathyroid invasion and lymph node metastasis decreased dramatically (P ＜ 0.01).The percentage of multifocality and bilaterality increased.The long-term follow up data (median follow up time was 6.6 years),indicated that the 15-year over all survival was 97.8％ and the 15-year disease-free survival was 90.2％.Tumor ≥3 cm,bilaterality,extrathyroid invasion,lymph node metastasis and AJCC stage were correlated with tumor recurrence.By multivariate COX-regression analysis only lymph node metastasis and bilaterality were independent risk factors.Conclusion The clinicopathological features of papillary thyroid cancer changed over 15 years,with the percentage of early-staged patients increased.Lymph node metastasis and bilaterality are two risk factors for tumor recurrence.
ABSTRACT
ObjectiveTo observe the clinical effects of locking proximal humerus plate(LPHP) in the treatment of complex proximal humeral fracture of aged patients and to analyze the influencing factors. Methods Among 39 cases with complex humeral fractures (aged 60-83 years),there were 29 cases with three-part fractures and 10 with four-part fractures according to the Neer classification.They were operated by LPHP via deltoid-pectoral approach. Neer numerical rating system was employed to evaluate postoperative function of shoulders.Results39 cases were followed up for average of 16 months.According to Neer numerical rating system,the excellence rates of three-part fractures and four-part fractures were 86.2％ (25 cases) and 50.0％ (5 cases),respectively,with total excellence rate of 76.9％(30 cases). Age (OR =1.314, P＜0.05) and fracture type ( OR =1.295, P＜0.05)ofpatientswereindependentriskfactorsforprognosis of proximal humeral fracture of aged patients by multiple logistic regression. Conclusions LPHP is an effective implant for treating complex proximal humeral fracture of aged patients,with age and fracture types as important risk factors of prognosis.=humeral fractures
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Objective To evaluate the prognostic value of China Classification System and TNM staging in patients with liver cancer undergoing resection. Methods From Jan 1986 to Dec 2000, 246 patients underwent resection of liver cancer. At least three years of follow-up was made in these 246 cases. Results The 1, 3, 5, 7, and 10-year disease-free survival rates were 55%, 30%, 25%, 20% and 18%, respectively. The 1,3,5,7,and 10-year disease-free survival rates predicted by China Classification System and TNM staging were statistically different and positively correlated with each other. Differences of survival rate between stageⅠa、Ⅰb、Ⅱa 、Ⅱb and Ⅲ by China Classification System were all statistically significant. Conclusions Based both on tumor extension and liver function, China Classification System was more accurate in than TNM stage predicting the prognosis of liver cancer patients undergoing resection.