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【Objective】 To establish and verify a nomogram model of overall survival (OS) of prostate cancer patients based on the SEER data. 【Methods】 A total of 12 642 patients diagnosed with prostate cancer during 2010 and 2015 were extracted from the SEER database. Patients were randomly divided into the model group (n=8 850) and validation group (n=3 792). The independent risk factors for OS were analyzed with univariate Cox proportional risk regression, lasso regression and multivariate Cox proportional risk regression. A nomogram was constructed to predict the 1-year, 3-year and 5-year OS. The prediction potential of the model was evaluated with the consistency index (C-index), calibration curve and receiver operating characteristic (ROC) curve. 【Results】 Multivariate Cox regression analysis showed that age, T stage, N stage, M stage, bone metastasis, liver metastasis and regional lymphadenectomy were independent risk factors for OS (P<0.05). The seven factors were used to construct an OS nomogram model. The C-index of the modeling set was 0.750, and the area under the ROC curve (AUC) at 1, 3 and 5 years were 0.77, 0.77 and 0.76, respectively;the C-index of the validation set was 0.765, and the AUC at 1, 3 and 5 years were 0.83, 0.79 and 0.76, respectively. The calibration curves of the modelling set and validation set showed a good agreement with the actual survival prediction rate. Risk stratification of patients based on the nomogram model showed that the OS of patients in the high-risk group was significantly lower than that in the low-risk group (P<0.001). 【Conclusion】 The nomogram can be used to predict the prognosis of prostate cancer patients, and is important for individualized treatment plans.
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Objective:To compare the complications between breast-conserving surgery with free dermal fat graft (FDFG) and traditional breast-conserving surgery (TBCS) in breast cancer patients, and to analyze the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.Methods:The clinical data of 120 breast cancer patients who underwent breast-conserving surgery with FDFG (FDFG group, 50 cases) or TBCS (TBCS group, 70 cases) in Liuzhou People's Hospital from June 2015 to September 2020 were retrospectively analyzed. The incidence of overall complications and various complications between the two groups were compared, the influencing factors of complications in the FDFG group were analyzed, and the cosmetic outcome was evaluated.Results:There was no significant difference between the two groups in age, lymph node status, clinical TNM stage, etc (all P > 0.05). In the FDFG group, the proportions of patients with the longest tumor diameter > 3 cm and tumor in upper inner quadrant were significantly higher than those in the TBCS group [52.0% (26/50) vs. 27.1% (19/70), χ2 = 7.69, P = 0.006; 38.0% (19/50) vs. 15.7% (11/70), χ2 = 7.73, P = 0.005]. The operation time, intraoperative blood loss, postoperative hospital stay and weight of resected tissues in the FDFG group were higher than those in the TBCS group [(251±69) min vs. (213±41) min, (107±29) ml vs. (68±26) ml, (8.8±2.5) d vs. (6.1±1.6) d, (81±26) g vs. (56±20) g], and the differences were statistically significant ( t values were 10.14, 30.58, 22.20, and 14.54, respectively, all P < 0.001). There were no significant differences in the incidence of overall complications, bleeding, infection, or poor wound healing between the two groups (all P > 0.05). The incidence rate fat liquefaction in the FDFG group was higher than that in the TBCS group [14.0% (7/50) vs. 1.4% (1/70), χ2 = 5.53, P = 0.019]. Multivariate logistic regression analysis showed that the weight of FDFG ( OR = 14.056, 95.0% CI 1.764-111.985, P = 0.013) and the thickness of FDFG ( OR = 19.599, 95.0% CI 1.743-220.345, P = 0.016) were independent influencing factors for the incidence of complications in the FDFG group. The percentage of 'excellent' or 'good' cosmetic outcome in the FDFG group was 90% (45/50). Conclusions:Breast-conserving surgery with FDFG can extend the resected area for tumor without increasing the incidence of overall complications and could provide patients a superior cosmetic outcome, but the incidence of fat liquefaction is higher than that of TBCS. The weight and thickness of FDFG are the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.
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Objective:To compare toally endoscopic thyroidectomy(TET) with open thyroidectomy(OT) in the treatment of differentiated thyroid cancer.Methods:Data of 190 patients at Liuzhou People's Hospital from Jul 2017 to Dec 2019 were analyzed. Patients were divided into endoscopic surgery group ( n=95) and open surgery group ( n=95). Results:The operation time and the hospital stay in endoscopic group were longer than that in open surgery group[(153±25) min vs. (116±17) min, (5.56±1.08) d vs.(5.08±1.04) d, t=11.827，3.083， both P<0.05)]. There was no significant difference in intraoperative blood loss [(33±14) ml vs. (37±16) ml, t=-1.851 P>0.05], recurrent laryngeal nerve paralysis, hypoparathyroidism and wound complications (4% vs. 9%, 9% vs. 15%,1% vs. 3%, all P>0.05). There was no significant difference in the number of central lymph node dissection between the two groups (6.12±3.54 vs. 6.35±4.75, t=-0.404, P<0.05). The length of scar in endoscopic group was shorter [(3.03±0.27) cm vs. (6.47±0.53) cm, t=-56.138, P<0.05), and the postoperative cosmetic score evaluated by the patients was higher (8.76±0.75 vs. 7.39±0.76, P<0.05), than those in open group. There were no tumor recurrence nor metastasis in neither group by short term follow-up. Conclusions:TET is similar to OT on clinical curative effectiveness for differentiated thyroid carcinoma while carries a better cosmetic result .
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Breast conserving surgery has become one of the standard procedures for breast cancer and its oncological safety and cosmetic outcome have been confirmed by a large number of clinical studies. But there are still some patients who are not suitable for breast conserving surgery, they have to undergo total mastectomy or breast reconstruction with more damage. Free dermal fat graft (FDFG) can better solve the problems in breast conserving surgery, especially for cases with large breast tissue defect after lesion excision and upper inner quadrant lesion which makes local plastic surgery difficult. This article reviews the application of FDFG in breast conserving surgery.
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Objective To explore the ultrasonographic and CT imaging features of predominantly cystic thyroid carcinoma (PCTC).Methods The retrospective analysis was performed on 30 cases of thyroid carcinoma with predominantly cystic composition confirmed by pathololy in the General Surgery Department of the First Affiliated Hospital of China Medical University from Jan.2011 to Dec.2016.The distribution of their solid portion's ultrasound characters including the eccentric configuration,irregular margin and increased vascularity were observed in all PCTCs.The CT images of 9 cases were analyzed,and the distribution of their solid portion's CT characters including irregular margin,uneven enhancement and papillary structure were observed in 9 PCTCs.Results In the ultrasound images of 30 PCTCs' whole shapes,26 cases (86.7％) showed oval and 24 cases (80.0％) showed smooth margin.26 cases (86.7％) showed eccentric configuration,20 cases (66.7％) showed rich blood flow and 19 cases (63.3％) showed irregular margin in the solid portion's ultrasound image.Only 7 cases(23.3％) showed microcalcification.Every ultrasound image of 30 PCTCs showed at least one or more of the three ultrasound characters,including eccentric configuration,irregular margin and increased vascularity.In the solid portion of 9 PCTCs,7 cases (77.8％) showed irregular margin,6 cases (66.7％) showed uneven enhancement and 6 cases(66.7％) showed papillary structure in the CT image,and every one of them showed at least one or more of the above 3 CT characters.Conclusion When the solid portion of predominantly cystic thyroid nodule appears to have some suspicious malignant characters in the image of ultrasound or CT,we should be vigilant that the nodule may be malignant.
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Objective:To compare the therapeutic effects between immediate breast reconstruction (IBR) after skin-sparing mastecto-my and modified radical mastectomy (MRM) in young breast cancer patients (≤35 years), as well as to analyze the prognostic factors of IBR in these patients. Methods:The clinicopathological data of young breast cancer patients who had undergone IBR after skin-spar-ing mastectomy (60 cases) and MRM (68 cases) in Liuzhou People's Hospital from July 2008 to June 2014 were retrospectively ana-lyzed. Local recurrence, disease-free survival, and overall survival of the patients between the two groups were compared. The influ-encing factors for survival of the IBR group patients, such as age, tumor size, and nipple-areolar complex preservation, were analyzed. Results:All patients were followed-up for a period ranging from 15 to 88 months with a median of 51. In the IBR group, local recur-rence, distant metastasis, and death occurred in 3, 8, and 5 cases, respectively. The 3-and 5-year disease-free survival rates (DFSR) were 91.7%and 81.7%, respectively, whereas the overall survival rate (OSR) was 91.7%. In the MRM group, local recurrence, distant metastasis, and death occurred in 2, 9, and 5 cases, respectively. The 3-and 5-year DFSRs were 94.1%and 83.8%, respectively, where-as the OSR was 92.6%. No statistical difference was noted between the two groups (P>0.05). The analysis of prognostic correlation fac-tors in the IBR group patients shows that lymph node metastasis and estrogen and progesterone receptor-negative correlated with the tumor-free survival and overall survival rates (P<0.05). Conclusion:No apparent statistical difference in the comparison of the local re-currence and long-term survival rate was observed between the two groups' young breast cancer patients who underwent IBR after skin-sparing mastectomy and MRM. IBR after skin-sparing mastectomy is safe for young breast cancer patients with early-stage, and nipple-areolar complex preservation does not increase the risk of recurrence in the IBR group patients. Lymph node metastasis and es-trogen and progesterone receptor-negative are the major prognostic factors of IBR after skin-sparing mastectomy in young breast can-cer patients.
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Pancreatic carcinoma is currently one of the most intractable malignant tumors of the digestive tract. Studies have found that the occurrence, progression and metastasis of pancreatic carcinoma are closely associated with the tumor's glycolytic pathway, most pancreatic carcinomas show the elevated glycolytic phenotype. To some extent, affecting the glycolytic pathway can influence the energy metabolism of the tumor without affecting the normal cells theoretically. Therefore, glycolytic pathway may become a new target for the treatment of pancreatic carcinoma.
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Humans , Energy Metabolism , Glycolysis , Pancreatic Neoplasms , MetabolismABSTRACT
Objective To investigate the surgical method and therapeutic effects of immediate breast reconstruction with extended latissimus dorsi myocutaneous flap after nipple-sparing mastectomy.Methods From January 2008 to July 2014,61 patients with breast cancer were given immediate breast reconstruction with extended latissimus dorsi myocutaneous flap after nipple-sparing mastectomy.Results All of the 61 patients obtained successful breast reconstruction without flap necrosis and serious complications.Followed-up from 12 to 78 months,all patients were no local recurrence,but distant metastasis was occurred in 4 cases and death in 1 case.The morphology of reconstructed breast was excellent in 93.4 ％ (57/61) cases.Conclusion Immediate breast reconstruction with extended latissimus dorsi myocutaneous flap after nipplesparing mastectomy is safe,easy to master and has few serious complications.The reconstructed breast has a natural and beautiful appearance and improves the quality of life.It does not affect postoperative adjuvant therapy.Most Chinese patients can obtain breast reconstruction without implant.This method is worth to spread.