Clinical analysis of 19 cases of adult primary mediastinal liposarcoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the pathoclinical features of adult primary mediastinal liposarcoma and their correlation with the prognosis.</p><p><b>METHODS</b>The clinical data of 19 patients with adult primary mediastinal liposarcoma who were treated in our hospital between 1970 and 2011 were retrospectively analyzed. Eighteen patients underwent open thoracic tumor excisions for at least one time, and the remaining one patient only received biopsy surgery. Histopathological results after surgery revealed that 6 well-differentiated type tumors, 6 myxoid type tumors, 3 pleomorphic type tumors, 2 mixed type tumors, and 2 un-classified tumors.</p><p><b>RESULTS</b>Among 6 patients with well-differentiated type tumors, 1 died after having been survived for 10 years; 5 were still alive, with a mean duration of 126.2 months,the 5-year survival rate was 100%. Among 6 patients with myxoid type tumors, 5 patients had follow-up data, with a mean survival of 26.2 months. Among 3 patients with pleomorphic type tumors, only one patient had follow-up data: the patient finally died, with a survival of 34 months. Of 2 patients with mixed type tumors, only one patient had follow-up data: the patient survived 8 months and died. Of 2 patients with un-classified type tumors, one had follow-up data: the patient lived for 24 months and died.</p><p><b>CONCLUSIONS</b>Mediastinal liposarcoma is a rare disease. Surgery is the primary therapeutic modality. Different pathological subtypes have different epidemiological features, biological behaviors, and malignant potentials. Pathological subtype is an important prognosis factor. Patients with well-differentiated tumors have much better prognosis than those with other subtypes.</p>

The risk factors and treatment of bronchopleural fistula after pneumonectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the risk factors which influencing the development of bronchopleural fistula (BPF) in pulmonary resections for lung cancer. To clarify the preventive techniques and treatment strategies of BPF.</p><p><b>METHODS</b>Review the clinical data of 32 patients of postpneumonectomy BPF from 965 patients accepted pneumonectomy for lung cancer from May 1987 to May 2007. Univariate and multivariate analyses were performed by the logistic regression procedure to identify the significant risk factors for BPF in 965 pulmonary resections for lung cancer.</p><p><b>RESULTS</b>The prevalence of BPF was 3.3% (32/965). BPF occurred in the right main bronchial stump in 28 patients, left main bronchial stump in 4 patients. The significant risk factors for BPF formation were right pneumonectomy, preoperative irradiation, prolonged mechanical ventilation, bronchial stump more than 2 cm and hypoalbuminemia. Multivariate analysis identified right pneumonectomy, preoperative radiotherapy and hypoalbuminemia as the risk factors of BPF. Successful closure of BPF was achieved in 13 patients (40.6%). The fistula was successfully closed in 5 of 6 patients who had received biologic glues applied bronchoscopically with a fistula less than 3 mm. Pedicled omentum was successfully used for the treatment in 5 of 6 patients with a fistula more than 3 mm.</p><p><b>CONCLUSIONS</b>Right pneumonectomy, high-dose preoperative radiation therapy and hypoalbuminemia are risk factors for postpneumonectomy BPF. Biologic glues can be applied bronchoscopically to achieve endobronchial closure of the fistula less than 3 mm. Omentoplasty is useful for the fistula more than 3 mm.</p>

Phase II study of paclitaxel and cisplatin for advanced squamous-cell carcinoma of esophagus / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Paclitaxel was used in a phase II trial in combination with cisplatin for esophageal cancer. The anti-tumor response, toxicity and survival of the treated patients were evaluated.</p><p><b>METHODS</b>Thirty patients with advanced, unresectable, or complicated with metastasis were allotted, twenty-seven patients had no prior chemotherapy while 3 patients had received adjuvant chemotherapy. Patients were given paclitaxel 175 mg/m(2) by 3-hour infusion on D1, and cisplatin 40 mg/m(2) daily on D2 and D3. Granulocyte colony-stimulating factor (G-CSF) was not routinely administered unless the patient had neutropenia. Treatment was recycled every 21 days.</p><p><b>RESULTS</b>Thirty patients (male/female, 28/2; median age 58) completed a median of 3 cycles and 27 patients were evaluable for response. Major objective responses were observed in 16 patients (59.3%; 95% confidence interval, 38.9% to 75.5%), including 5 complete responses (18.5%) and 11 partial responses (40.7%). The median time to tumor progression was 5.0 months (range, 1 to 23 months). The median actuarial survival was 9.7 months (range, 1 to 23 months). Twenty-eight patients were assessable for toxicity. The most common nonhematologic toxicity was alopecia. Grade 3 to 4 neutropenia was observed in 17.9% of the patients. Toxicity was manageable with dose attenuation and G-CSF support.</p><p><b>CONCLUSION</b>The combination of paclitaxel and cisplatin can be considered as a main regimen in the treatment of advanced esophageal cancer.</p>