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Objective To compare curative effect between lenvatinib combined with locoregional therapy and locoregional therapy on PD-L1-positive hepatocellular carcinoma patients with type Ⅰ-Ⅲ portal vein tumor thrombus according to Cheng's classification. Methods The patients in lenvatinib combined with locoregional therapy group received orally-administered lenvatinib at a dose of 12 mg qd for patients≥60 kg or 8 mg qd for patients < 60 kg. The locoregional therapy group only received locoregional therapy. We retrospectively analyzed the clinical data and prognosis of two groups. Results The CR+PR were 78.1% and 53.6% in the combination group and locoregional therapy group, respectively (P < 0.05). The response rate, disease control rate and overall survival of the combination group were higher than those in the locoregional therapy group (P < 0.05). Conclusion The curative effect and overall survival of lenvatinib combined with locoregional therapy is better than locoregional therapy on PD-L1-positive hepatocellular carcinoma patients with type Ⅰ-Ⅲ portal vein tumor thrombus according to Cheng's classification.
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Objective: To evaluate the prognostic impact of tumor deposits on the overall survival (OS) of gastric cancer (GC) patients. Methods: Between January 2007 and December 2012, 312 GC patients undergoing curative resection in The First Affiliated Hospital of Hainan Medical University were enrolled. Patients were categorized into two groups based on the tumor deposit status of postopera-tive pathology: positive group, presence of tumor deposits and negative group, absence of tumor deposits. The correlations of tumor deposit status with clinicopathological and potential prognostic factors were analyzed. Results: Eighty-four (26.9%) patients had tumor deposits. There were significant differences in Borrmann type, tumor size, depth of invasion, N stage, tumor-node-metastasis (TNM) stage, and lymphovascular invasion between the two groups on univariate analysis. Multivariate analysis revealed that Borrmann type, N stage, and lymphovascular invasion were independently associated with the presence of tumor deposits. In univariate survival analy-sis, age, tumor location, Borrmann type, tumor size, TNM stage, type of gastrectomy, lymphovascular invasion, and presence of tumor deposits were found to be significant prognostic factors. GC patients with tumor deposits had a significantly lower 5-year OS rate than those without tumor deposits (5-year OS: 34.5% vs . 67.5% , P<0.001). Multivariate analysis revealed that age, Borrmann type III/IV, TNM stage, lymphovascular invasion, and presence of tumor deposits were independent prognostic factors for this cohort. Further stratified analysis demonstrated that the significant prognostic differences between the two groups were only observed in patients with stage N0-3a disease. There were no significant differences in survival between patients with and without tumor deposits at the N3b stage. The prognosis of GC patients with tumor deposits was independently correlated with N stage, lymphovascular invasion, and postoperative chemotherapy. Conclusions: The presence of tumor deposits was an independent prognostic factor in GC patients and can be used as a prognostic indicator for GC patients with stage N0-3a disease. GC patients with tumor deposits should receive postop-erative chemotherapy regardless of TNM stage.
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Objective To study the clinical application of intercalated combination of osimertinib and docetaxel in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. Methods T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the sou-thern Hainan Province treated at the Third People's Hospital of Hainan Province from January 2018 to October 2018 were enrolled,and they were divided into intercalated combination of osimertinib and docetaxel group (n = 32)and osimertinib group (n = 28)according to the treatment. The patients in intercalated combination of osimertinib and docetaxel group received oral osimertinib (80 mg,qd),and received docetaxel (75 mg/ m2 , repeated in three-week intervals)when taking to tumor progression,and oral osimertinib treatment (80 mg, qd)was maintained until tumor partial response or stable disease after chemotherapy. The patients in osimer-tinib group received oral osimertinib (80 mg,qd). The patients in both groups received zoledronic acid. The response rate,disease control rate,overall survival (OS)and the incidence of adverse reactions of both groups were contrastively analyzed. Results The response rate of intercalated combination of osimertinib and doceta-xel group (62. 5％,20 / 32)was higher than that of osimertinib group (35. 7％,10 / 28),and disease control rate (93. 8％,30 / 32)was also higher than that of osimertinib group (67. 9％,19 / 28),with statistically sig-nificant differences (χ2 = 4. 286,P = 0. 038;χ2 = 6. 687,P = 0. 010). The median OS of intercalated combi-nation of osimertinib and docetaxel group was 10. 0 months,which was longer than that of osimertinib group (9. 0 months),with statistically significant difference (χ2 = 5. 917,P = 0. 015). Moreover,the adverse reac-tions in both groups were all grade Ⅰ or Ⅱ,which could be relieved or improved through symptomatic treat-ment. Conclusion Intercalated treatment of osimertinib with docetaxel is safe and effective in T790M muta-tion-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. It can prolong the survival time of patients.
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Objective To evaluate the effect of different skin flap management methods on post operative (subcutaneous) fluid collection and skin flap necrosis after modified radical mastectomy for breast cancer. (Methods) A retrospectively analysis of clinical data of 119 cases of breast cancer operated by modified (radical) mastectomy in our hospital in recent four years. Statistically analyse the relationship between 4 different skin flap management methods to postoperative subcutaneous fluid collection and skin flap necrosis. Results 43 out of 119 cases developed postoperative subcutaneous fluid collection and/or skin flap necrosis. There were 13 cases with complication of subcutaneous fluid collection, 3 cases with skin flap necrosis among 79 (cases) treated by transverse incision;20cases with complication of subcutaneous fluid collection, and 7 cases of skin flap necrosis among 40 cases treated by longitudinal incision; 23cases with complication of subcutaneous fluid collection, and 8 cases of skin flap necrosis among 60 cases treated by "skin flap management type one"; 23cases with complication of subcutaneous fluid collection, and 2 cases of skin flap necrosis among 59 cases treated by "skin flap management type two". Conclusions A transverse incision after subcutaneous (injection) of 1∶400 adrenaline saline solution, plus the use of scalpel dissection and the technique of skin flap fixation by the "rivet" method can effectively decrease postoperative development of subcutaneous fluid (collection) and necrosis of incisional skin margins.