Treatment and prognosis of 108 patients with high-risk gastrointestinal stromal tumor / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the treatment methods and prognostic factors of high-risk gastrointestinal stromal tumor (GIST).</p><p><b>METHODS</b>Clinicopathological date and follow-up data of 108 patients with high-risk GIST from January 2002 to February 2016 treated at our department were retrospectively reviewed. The patients were divided into two groups according to whether they received adjuvant therapy after surgery. A group of patients received imatinib adjuvant therapy(adjuvant therapy group, 69 cases). Another group of patients were not treated with imatinib until they were found to have disease progression(follow-up observation group, 39 cases). The survival rate and recurrence rate were compared between two groups, and the risk factors of prognosis were analyzed by Cox regression model.</p><p><b>RESULTS</b>All the cases were followed up with a median time of 48 months(1 to 161 months). Recurrence and / or metastasis occurred in 57(52.8%) patients during follow-up. The postoperative recurrence and / or metastasis rate was 34.8%(24/69) and 84.6%(33/39) respectively in the adjuvant therapy group and the follow-up observation group, the difference was statistically significant(P=0.000). Twenty-eight(25.9%) patients died. The 1-, 3-, 5-, 10-year survival rates of the 108 patients undergoing follow-up were estimated to be 99.8%, 87.7%, 76.0% and 42.7% respectively. The 5-year survival rates were 79.3% and 72.3% in the adjuvant therapy group and the follow-up observation group, the difference was not statistically significant (P=0.648). Univariate analysis showed that mitotic count, radical degree and tumor rupture were predictive factors of survival after resection of primary high-risk GIST (all P<0.05). Multivariate analysis using Cox regression model revealed that the mitotic count (P=0.013, RR=2.400, 95%CI:1.206 to 4.779) and radical degree(P=0.003, RR=3.968, 95%CI:1.609 to 9.784) were independent prognostic factors.</p><p><b>CONCLUSION</b>Comprehensive treatment of radical surgery combined with targeted therapy and close followed up can lead to better long-term survival of high-risk patients with GIST.</p>

Effect of nutritional status on postoperative outcomes for patients with gastric cancer / 中国肿瘤临床

Objective:To evaluate the effect of nutritional status on postoperative outcomes for patients with gastric cancer. Methods:Data of 353 gastric cancer patients at Xinjiang Medical University Affiliated Tumor Hospital between January 2013 and October 2014 were collected prospectively. Preoperative nutritional status was evaluated using Nutrition Risk Screening 2002 (NRS 2002). Postoperative complication rates were compared among different preoperative nutritional status. Results:On the basis of NRS 2002, the morbidities of patients with and without malnutrition risk were 47.0%(77/164) and 31.2%(59/189), respectively (P=0.002). Among the patients with an NRS score of at least 3, the complication rate was significantly lower in the group with preoperative nutrition than in the group of patients without preoperative nutrition support (P=0.013). NRS 2002 was a significant predictor of postoperative complications (P=0.039, OR=1.634, 95%CI:1.025-2.606) on the basis of multivariable logistic regression analysis. Conclusion:As a nutritional evaluation tool, NRS 2002 may predict postoperative complications for gastric cancer patients.

Efficacy and perioperative effect of docetaxel plus oxaliplatin and S-1 in treating advanced gastric cancer / 中国肿瘤临床

Objective: This study investigates the effect of docetaxel + oxaliplatin + S-1 (DOS program) in treating advanced gastric cancer and surgical safety assessment. Methods: Fifty patients with advanced gastric cancer admitted to the Department of Gastrointestinal Surgery, The Affiliated Tumor Hospital of Xinjiang Medical University between January 2011 and May 2012 were enrolled in this study. These patients were randomized into the observation arm (n=25) and the control group (n=25). The observer group was administered three cycles of chemotherapy using a DOS program before surgical treatment, whereas the control group underwent surgery. Results: Compared with the control group, the clinical response rate (64.0%), D2 lymph node dissection rate (88.0% vs. 64.0%), and R0 resection rate (92.0%vs. 68.0%) in the observation group were significantly higher (P0.05). The patients exhibited good tolerance to chemotherapy, with bone marrow suppression and gastrointestinal reactions as the main adverse effects. Conclusion:The DOS program is a highly efficient, advanced gastric cancer neoadjuvant chemotherapy. The program can improve patient survival and has good patient tolerance and compliance, good peri-operative safety, high R0 resection rate, and low postoperative lymph node metastasis rate.