ABSTRACT
Objective To compare postoperative adjuvant chemoradiotherapy with adjuvant chemotherapy in patients with gastric cancer by a meta-analysis.Methods PubMed,EMbase,Cochrane Library,Wanfang,CNKI,VIP,and CBM databases were searched to identify the controlled clinical trials of postoperative adjuvant chemoradiotherapy versus adjuvant chemotherapy for gastric cancer.The obtained data were analyzed using RevMan 5.2.5 and Stata 12.0.The difference between two groups was estimated by calculating the odds ratio (OR) with 95％ confidence interval (CI).Results A total of 12 controlled clinical trials involving 1674 gastric cancer patients,which were selected according to inclusion and exclusion criteria,were included in this meta-analysis.The meta-analysis showed that the 3-and 5-year survival rates were significantly higher in the adjuvant chemoradiotherapy group than in the adjuvant chemotherapy group (OR=2.96,95％ CI=1.75-5.03,P=0.000; OR=1.45,95％ CI=1.06-1.99,P =0.020);the local recurrence rate was significantly lower in the adjuvant chemoradiotherapy group than in the adjuvant chemotherapy group (OR =0.50,95％ CI =0.34-0.72,P =0.000) ; there was no significant difference in distant metastasis rate between the two groups (OR =0.79,95％ CI =0.58 -1.07,P =0.130).Conclusions The meta-analysis of existing study results shows that compared with adjuvant chemotherapy alone,adjuvant chemoradiotherapy is a relatively safe and effective postoperative treatment for gastric cancer.
ABSTRACT
To explore the clinical application and value of small incisions in the treatment of benign thyroid diseases with endoscopic assistance.A total of 57 cases with thyroid nodules were operated under the assistance of ultrasonic scalpel and endoscope with the lifting-up of special instrument and small neck incisions.However one malignant case was converted iuto open surgery according to frozen sections.The other 56 cases were successfully operated.The mean operative duration was 42 min and postoperative stay 2 -3 days.All incisions achieved primary healing and the length range was 1.5 - 3.5 cm.Except for transient hoarseness in 1 case,there was no such complications as choking,lip paralysis or hemorrhage,etc.All were discharged uneventfully.This surgical approach shall be recommended for its merits of miniinvasiveness,less hemorrhage,fewer complications and wider applications.