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Advanced gastric cancer without distant metastasis remains a potentially curable disease, but the prognosis is poor in this condition because of the high unresectability rate at presentation and the high recurrence rate after radical surgery. Administration of neoadjuvant chemotherapy has several potential benefits for advanced gastric cancer. This treatment can decrease tumor stage and improve R0 resection rate. Neoadjuvant chemotherapy has higher patient tolerability and a higher rate of chemotherapy completion than adjuvant chemotherapy. In vivo drug sensitivity tests can also be conducted to avoid unnecessary surgeries. Although high-intensi-ty chemotherapy results in a high overall response rate, a few advanced gastric patients can achieve a pathologically complete re-sponse. However, no standardized treatment has been achieved. This article introduces five cases of advanced gastric cancer treated with neoadjuvant chemotherapy in the Affiliated Tumor Hospital of Guangxi Medical University. The five cases achieved a pathological complete response. This article also aims to explore the clinicopathological characteristics of these patients, proper cooperative treat-ment practices, and prognostic factors for the benefit of future patients.
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Objective To evaluate the stimulative role of the enhanced recovery program after surgery (ERAS) protocol in patients undergoing radical resection for gastric cancer.Methods A total of 102 consecutive patients undergoing elective gastric resection were included in either the ERAS (n =35,received ERAS perioperative treatment from June 2013 to June 2014) or the control group (n =67,received conventional perioperative treatment from June 2011 to June 2013).Outcomes related to nutrition index,stress index,and recovery index were measured.Results The nutritional index of patients (total lymphocyte count,serum albumin and prealbumin) in the ERAS group was improved on postoperative day (POD) 1 compared with that in the control group [(1.25±0.65) × 109/L vs (1.09±0.71) × 109/L,(36.4±5.2) g/L vs (31.3±4.1) g/L,(0.19±0.08) g/L vs (0.17±0.05) g/L,P ＜ 0.05,respectively].The level of negative nitrogen balance on POD 1 in the ERAS group was slightly lower than that in the control group (P ＞ 0.05),and the level of negative nitrogen balance on POD 7 in the ERAS group was higher than that in the control group (-0.93±2.17 vs -3.87±4.45,P ＜ 0.05).The postoperative cortisol level in the control group was elevated on both POD 1 (P ＜ 0.05) and POD 7 (P ＜ 0.05) compared to the preoperative level [(5.06±1.87) mg/L vs (3.60±1.5) mg/L],(5.15±1.33) mg/L vs (3.60±1.51) mg/L,P ＜ 0.05,respectively].However,the cortisol level was not increased until POD 7 in the ERAS group [(5.08±1.18) mg/L vs (3.20±1.43) mg/L,P ＜ 0.05].The level of IL-6 was elevated in postoperative period compared to preoperative period both in two groups (P ＜ 0.05).And the level of IFN-γin the ERAS group on POD 1 was reduced compared to the preoperative level (P ＜ 0.05).Whether in preoperative or postoperative,the level of IL-1β and TNF-α showed no statistical significance change.In addition,the postoperative recovery conditions (day of oral all-liquid recovery,first day of defecation,hospital stay,maximum pain on visual analogue scale) in the ERAS group were better than those in the control group (P ＜ 0.05).The incidence rates of complications between the two groups were 13.4 ％ (9/67) and 17.1％ (6/35) respectively (P ＞ 0.05).Conclusion ERAS protocol can alleviate surgical stress response and accelerate postoperative recovery without compromising patients' safety.
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Objective To study the applicable value of resection of segment VIII after cryotherapy for hepatocarcinoma. Methods As for 8 patients with hepatocarcinoma in segment VIII, the turnor was dealt with cryotherapy before resected. Results All the tumors were resected smoothly after cryotherapy with less bleeding (mean 430ml), less time (mean 138min) and without severe complications or postoperative death in this series. Conclusions Resection of segment VIII after cryotherapy for hepatocarcinoma is proved safe and feasible, whitch can decrease blood loss, save time, reduce tissue injury, and decrease postoperative recurrence.
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Objective:To determine the therapeutic effects of hepatic radioembolization with phosphorus 32 glass microsphere( 32 P GMS) in the treatment of hepatocellular carcinoma(HCC).Methods:21 cases of HCC had received the hepatic radioembolization by 32 P GMS.Results:The blood flow in the hepatic artery of tumor area reduced remarkably,even nearly disappeared,the size of tumor was smaller after the hepatic artery administration with 32 P GMS.The survival rate of 6,12,and 18 months was 85.7%,61.9%,57.1% respectively.Conclusion:The Intraradioembolization is effective therapy for the advanced HCC.
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Objective To study the applicable value of resection of segment VIII after cryotherapy for hepatocarcinoma. Methods As for 8 patients with hepatocarcinoma in segment VIII, the turnor was dealt with cryotherapy before resected. Results All the tumors were resected smoothly after cryotherapy with less bleeding (mean 430*!ml), less time (mean 138*!min) and without severe complications or postoperative death in this series. Conclusions Resection of segment VIII after cryotherapy for hepatocarcinoma is proved safe and feasible, whitch can decrease blood loss, save time, reduce tissue injury, and decrease postoperative recurrence.
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50% was seen in 7 cases after TACE and PEI(30%),and the 1?3?5 year′s survival rate was 52%?35%? and 9%,respectively.Conclusions Adjuvant chemotherapy was hardly beneficial to the treatment of liver cancer with parasitic blood supply after TACE, while PEI enhanced effect of TACE as a supplementary therapy as judged by long term survival. The change of sIL-2R, AFP level was a sensitive indicator for the outcome of the treatment.