Analysis of the efficacy of postoperative radiotherapy in gallbladder cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To summarize the experiences in gallbladder cancer treatment, evaluate the efficacy of postoperative radiotherapy, and investigate the method of improving the survival of gallbladder cancer patients.</p><p><b>METHODS</b>One hundred and twenty-seven gallbladder cancer patients, treated in our center by radical resection (84 cases) and combined with postoperative radiotherapy (43 cases), between June 2003 to December 2009 were included in this study. Their clinical data and follow-up results were retrospectively analyzed. According to AJCC staging criteria, the survival time and 1-, 3- and 5-year survival rates of the surgery group and the postoperative radiotherapy group at the different pathological stages and resection margin status were compared.</p><p><b>RESULTS</b>The median survival time of postoperative radiotherapy patients in stage III was 16.9 months, and the 1-year, 3-year, and 5-year survival rates were 55.7%, 23.5% and 18.2%, respectively, significantly higher than that of the simple operation group ( median survival time 14.3 months, and 1-year, 3-year, 5-year survival rates 42.7%, 22.6% and 16.7%, respectively) (P<0.05). The median survival time of postoperative radiotherapy patients in stage IV, the median survival time was 9.7 months in the postoperative radiotherapy group and 6.3 months in the simple surgery group, and the 1-year survival rates were 14.2% and 9.8%, the 3-year survival rates were 7.2% and 3.9%, the 5-year survival rates were 7.2% and 1.9%, respectively, all showing a statistically significant difference (P<0.05). Among the stage III and IVpatients, all the 1-, 3- and 5-year survival rates of the postoperative radiotherapy group were higher than that of the simple R0 and R1 surgical resection group (all P<0.05), but with a non-significant difference between the stageIandIIpatients (P>0.05). The main side effects in postoperative radiotherapy patients including nausea, vomiting and abdominal pain, all were successfully alleviated by symptomatic and supportive therapy, and the radiotherapy was successfully completed.</p><p><b>CONCLUSIONS</b>With regard to the gallbladder cancer patients in stage III and IV, the survival rate can be obviously increased by postoperative radiotherapy. However, for patients in stageIand II, whether postoperative radiotherapy significantly improves the survival or not, needs to be further validated in larger scale studies.</p>

Role of radical resection in patients with gallbladder carcinoma and jaundice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gallbladder carcinoma (GBC) is a commonly-seen malignancy of the biliary tract characterized by difficult early diagnosis, rapid growth, early metastasis, and poor prognosis. Nearly half of GBC patients also have jaundice, which is a mark of the advanced stage of GBC. The role of radical resection in patients of gallbladder carcinoma with jaundice is still a matter of uncertainty, which we attempted to clarify in this study.</p><p><b>METHODS</b>Totally, 251 GBC patients who received treatment at the Eastern Hepatobiliary Surgery Hospital (EHBH) from December 2002 to January 2010 were recruited into this study. We divided them into group A (jaundice group, n=117) and group B (non-jaundice group, n=134). Clinical records and follow-up data were collected and retrospectively analyzed in both groups.</p><p><b>RESULTS</b>Compared with group A, patients in group B had a longer median survival time ((6.0±0.5) months vs. (15.0±2.6) months, P<0.01). Even in patients with stage III or stage IV GBC, the median survival time in patients without jaundice (n=111), was still longer than that in patients with jaundice (n=116) (P<0.01). The radical resection rate was lower in group A patients than in group B patients with stage III or stage IV GBC; 31.9% vs. 63.1%. However, the median survival time of patients undergoing radical resection did not show a statistical difference between jaundice patients and non-jaundice patients; (12.0±4.3) months vs. (18.0±3.0) months (P>0.05).</p><p><b>CONCLUSIONS</b>GBC with jaundice usually implies advanced stage disease and a poor prognosis for the patients. However, our findings indicate that as long as the patient's condition allows, radical resection is still feasible for GBC patients with jaundice, and may achieve a prognosis close to those GBC patients without jaundice.</p>

Surgical treatment of obstructive jaundice induced by biliary invasion in patients with gallbladder cancer: An analysis of outcome in 48 cases / 第二军医大学学报

Objective: To analyze the outcomes of surgical treatment of obstructive jaundice induced by biliary invasion in patients with gallbladder carcinoma. Methods: We retrospectively analyzed the clinical data of 48 patients with gallbladder cancer and biliary invasion-induced obstructive jaundice, who were treated in our hospital during January 2004 to December 2008. Results: Thirty-six patients who received surgical treatment had a median survival time of (17.39±3.98) months, and 12 patients received non-surgical treatment had a median survival time (3.75±0.51) months, with significant difference found between the two groups (P<0.01). Fifteen patients underwent radical resection, 7 underwent R1 resection, and 14 underwent R2 resection, with their median survival time being (30.93±7.42) months, (13.57±6.70) months, and (5.00±0.67) months, respectively; there were significant difference between the three groups (P<0.01). Conclusion: The prognosis of gallbladder cancer with obstructive jaundice is poor; surgical treatment can partly improve the prognosis of patients with obstructive jaundice-induced by gallbladder invasion. Radical curative resection, sometime with cholecystectomy, partial hepatectomy, or bile duct resection, should be performed for these patients.

CT perfusion study of acute local cerebral infarction in rhesus monkeys / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the value of CT perfusion in early diagnosis and management of superacute local cerebral infarction in rhesus monkeys.</p><p><b>METHOD</b>Acute local cerebral infarction was induced in the rhesus monkeys during digital subtraction angiography (DSA) by introduction of pale thrombus prepared from autologous blood into the M1 branch of the middle cerebral artery (MCA). Plain CT scan and CT perfusion scanning were performed at different time points before and after DSA operation, and the results were analyzed in conjunction with the pathologic changes.</p><p><b>RESULTS</b>Ischemic lesions were displayed on CT perfusion images, which showed local hypoperfusion, reduced cerebral blood flow and volume, and mean transit time delay in the compromised area. Local hypointense infarct area was identified in plain CT scan 24 h after the DSA operation, and the results were in good agreement with pathological examination during autopsy.</p><p><b>CONCLUSION</b>CT perfusion imaging of the brain can accurately capture the cerebral perfusion deficits in acute ischemic stroke before morphologic changes take place, and therefore provides good means for thrombolytic treatment evaluation of stroke.</p>