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1.
Article in Chinese | WPRIM | ID: wpr-357150

ABSTRACT

<p><b>OBJECTIVE</b>To explore how to improve follow-up rate and follow-up quality in studies related to quality of life.</p><p><b>METHODS</b>A retrospective cross-sectional study was performed in patients with rectal cancer who underwent primary surgery at the Gastrointestinal Surgery Department, The First Affiliated Hospital, Sun Yat-sen University from August 2002 to February 2011 using the European Organization for Research and Treatment of Cancer QLQ-C30 and CR-38 questionnaires. The influence factors of follow-up rate and reasons for missing sex-related items were analyzed.</p><p><b>RESULTS</b>A total of 438 questionnaires were issued. Two hundred and eighty-five responses were received and the follow-up rate was 65.1%. Two hundred and sixty-two patients returned the questionnaires by mail. Responders and non-responders did not differ by sociodemographic and clinical characteristics including sex, age, postoperative time, complication, clinical stage and stoma. Significant differences were found when comparing the missing sex-related items grouped by sex, age, education and working status.</p><p><b>CONCLUSIONS</b>Follow-up mode of mail supplemented by interview is suitable for current reality in China in studies on quality of life. Targeted methods should be adopted when investigating the different patient groups to improve follow-up rate of studies on quality of life and sexual function survey.</p>


Subject(s)
Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Period , Quality of Life , Rectal Neoplasms , Psychology , General Surgery , Retrospective Studies , Surveys and Questionnaires
2.
Chinese Journal of Oncology ; (12): 509-513, 2013.
Article in Chinese | WPRIM | ID: wpr-267510

ABSTRACT

<p><b>OBJECTIVE</b>To explore the impact of clinicopathological features and extent of lymph node dissection on the prognosis in early gastric cancer (EGC) patients.</p><p><b>METHODS</b>A total of 142 EGC cases screened from database of gastric cancer of Sun Yat-sen University, from Aug. 1994 to Jan. 2010, were included in this study. According to the lymph node metastasis status, they were divided into lymph node negative (n = 116) and lymph node positive (n = 26) groups. The clinicopathological features of the two groups and the impact of extent of lymph node dissection on the prognosis were analyzed.</p><p><b>RESULTS</b>There were no significant differences in age, gender, tumor size and location, Borrmann typing, WHO TNM staging, histological typing, and CEA value between the two groups (P > 0.05). The TNM stages in the lymph node positive group were higher than that in the lymph node negative group (P < 0.001). Between the cases who underwent D1 (n = 21) and D2 (n = 121) dissection, there were no significant differences in postoperative hospital days, blood transfusion volume, and operation time (P > 0.05). The median numbers of LN dissected in D1 and D2 cases were 4 (0 to 16) and 20 (12 to 30), with a significant difference (P = 0.000), but the number of positive LN without significant difference (P = 0.502). The postoperative complication rates were 9.5% in the D1 and 3.3% in the D2 dissection groups, without a significant difference (P = 0.128). The median survival time of the lymph node negative and positive groups was 156 vs. 96 months (P = 0.010). In cases who received D2 and D1 lymph node dissection, the median survival time (MST) was 156 vs. 96 months (P = 0.0022). In the lymph node positive group, D2 dissection prolonged survival time significantly than D1 dissection (96 vs. 27months) (P = 0.001). Cox regression analysis showed that the extent of lymph node dissection and LN metastasis were independent prognostic factors for EGC patients.</p><p><b>CONCLUSIONS</b>It is not able to accurately assess the LN metastasis status preoperatively according to the routine clinicopathological features. For the patients with unknown LN metastasis status, D2 dissection should be the first choice. Comparing with D1 dissection, the morbidity of D2 dissection are not increased, but survival time is prolonged.</p>


Subject(s)
Adenocarcinoma , Drug Therapy , Pathology , General Surgery , Adenocarcinoma, Mucinous , Drug Therapy , Pathology , General Surgery , Adult , Aged , Aged, 80 and over , Carcinoma, Signet Ring Cell , Drug Therapy , Pathology , General Surgery , Chemotherapy, Adjuvant , Female , Fluorouracil , Follow-Up Studies , Gastrectomy , Methods , Humans , Leucovorin , Lymph Node Excision , Methods , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Proportional Hazards Models , Retrospective Studies , Stomach Neoplasms , Drug Therapy , Pathology , General Surgery , Survival Rate
3.
Article in Chinese | WPRIM | ID: wpr-314834

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the clinicopathological characteristics and analyze the prognostic factors of young patients with gastric cancer.</p><p><b>METHODS</b>A total of 99 patients with the age less than or equal to 40 were admitted in The First Affiliated Hospital of Sun Yat-sen University from August 2001 to December 2009. Their clinicopathological and follow-up data were compared with middle-aged and elderly patients with the age more than 40.</p><p><b>RESULTS</b>There were statistically significant differences in gender, tumor location, Borrmann type, histological type, differentiated histology, depth of invasion, peritoneal metastasis between young patients and elder ones. The 5-year survival rates of young and elder patients were 49.1% and 44.4% respectively, and the difference was not statistically significant (P>0.05). Univariate and multivariate analyses showed that TNM stage (P=0.014) and surgical methods (P=0.012) were independent predictive factors of survival for young patients. For the young patients, the 5-year survival rate was 56.7% after curative resection, 11.1% after palliative resection. Those who underwent palliative surgery or biopsy alone died within 1 year after surgery. The difference between difference surgical procedures in survival were statistically significant (P<0.05).</p><p><b>CONCLUSIONS</b>As compared to elder patients, young patients with gastric cancer have special clinicopathological features. However, no significant difference of survival rate is found between the young and the elder patients. TNM stage and surgical methods are independent prognostic factors of young patients with gastric cancer. Radical resection appears to confer the only chance of prolonged survival.</p>


Subject(s)
Adult , Age Factors , Female , Follow-Up Studies , Gastrectomy , Methods , Humans , Male , Neoplasm Staging , Prognosis , Retrospective Studies , Stomach Neoplasms , Epidemiology , Pathology , General Surgery , Survival Rate
4.
Article in Chinese | WPRIM | ID: wpr-290811

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy and influencing factors of imatinib in patients with advanced gastrointestinal stromal tumor(GIST).</p><p><b>METHODS</b>From April 2004 to January 2010, clinicopathological data of 73 adult patients with advanced GIST treated with imatinib at the First Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The treatment outcomes and associated factors were investigated.</p><p><b>RESULTS</b>Treatment outcomes included complete response in 1(1.4%) patients, partial response in 53(72.6%), stable disease in 14(19.2%), and primary resistant in 5(6.8%). All the patients had routine followed up, the length of which ranged from 12 to 76 (median 32) months. The median progression-free survival was 45.0 months(95% confidence interval, 34.2-55.8). The progression-free survival(PFS) rate was 87.7% in 1 year, 63.6% in 3 year, and 39.6% in 5 years. On multivariate analysis, both mutation status and patient performance were independent factors influencing the efficacy of imatinib treatment(both P<0.01). PFS was significantly better in patients with c-kit exon 11 mutations than those with exon 9 mutations, and better in lower ECOG scales than in higher ones.</p><p><b>CONCLUSION</b>Imatinib is effective in treating patients with advanced GIST, c-kit exon 9 mutations and poor performance status predict an adverse survival benefit of imatinib therapy.</p>


Subject(s)
Adult , Aged , Antineoplastic Agents , Therapeutic Uses , Benzamides , Therapeutic Uses , Exons , Female , Follow-Up Studies , Gastrointestinal Stromal Tumors , Drug Therapy , Genetics , Humans , Imatinib Mesylate , Male , Middle Aged , Mutation , Piperazines , Therapeutic Uses , Proto-Oncogene Proteins c-kit , Genetics , Pyrimidines , Therapeutic Uses , Retrospective Studies , Treatment Outcome , Young Adult
5.
Article in Chinese | WPRIM | ID: wpr-321603

ABSTRACT

<p><b>OBJECTIVE</b>To compare the nutritional status between pancreaticojejunostomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy.</p><p><b>METHODS</b>A retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy. Postoperative early enteral nutrition and parenteral nutrition was performed for all the patients. Nutritional status of two groups was compared in body mass index (BMI), serum nutritional parameters such as albumin, transferrin and prealbumin before surgery and on 1, 3, and 6 months postoperatively.</p><p><b>RESULTS</b>There were no significant differences between PG and PJ groups in operative time, blood loss, pancreatic fistula, perioperative death, or postoperative length of hospital stay. One month after surgery, there were no significant differences in BMI [(17.1±7.0) vs. (19.0±4.8) kg/m(2), P>0.05], albumin [(30.1±0.5) vs. (32.1±1.3) g/L, P>0.05], transferrin [(1.89±0.57) vs. (2.01±0.61) g/L, P>0.05] and prealbumin[(0.18±0.05) vs. (0.18±0.09) g/L, P>0.05]. These parameters were decreased at 1 month after surgery, and gradually recovered to baseline or higher than the preoperative levels at 6 months after surgery. However, the differences were still not statistically significant between two groups.</p><p><b>CONCLUSIONS</b>The influence of PJ and PG on the postoperative nutritional status are comparable.</p>


Subject(s)
Adult , Aged , Female , Gastrostomy , Humans , Male , Middle Aged , Nutritional Status , Pancreas , General Surgery , Pancreaticoduodenectomy , Pancreaticojejunostomy , Postoperative Period , Retrospective Studies
6.
Article in Chinese | WPRIM | ID: wpr-321560

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the experience and short-term clinical outcomes of hand-assisted laparoscopic surgery (HALS) in sphincter-preserving surgery for low and ultralow rectal cancer.</p><p><b>METHODS</b>Data of 49 patients with rectal cancer who underwent HALS for low or ultralow anterior resection between January 2010 and January 2011 were analyzed retrospectively.</p><p><b>RESULTS</b>The proximal resection margin was (14.3±6.9) cm and the distal margin was(4.3±1.9) cm. The mean operative time was(128.3±70.9) min. On postoperative macroscopic evaluation, the mesorectum was intact in 42 cases, nearly intact in 7 cases. The circumferential resection margin was more than 2 mm in 42 cases, and less than 2 mm in 7 cases. Forty-six patients underwent R0 resection, and 3 cases underwent R1 resection. The median retrieved lymph node (LN) was 16.20±9.23, and the median positive LN was 1.12±2.19. Postoperative pathological examination showed TNM stage was I( in 12 patients, II(A in 18, II(B in 1, III(A in 2, III(B in 8, III(C in 5, IIII( in 3. The median postoperative hospital stay was (6.25±3.87) d. There were no anastomotic leakage, ileus, intra-abdominal or anastomotic bleeding. There were two wound infections.</p><p><b>CONCLUSION</b>Low and ultralow anterior resection for rectal cancer using HALS approach is safe and feasible with favorable short-term outcome.</p>


Subject(s)
Adult , Aged , Aged, 80 and over , Anal Canal , General Surgery , Female , Hand-Assisted Laparoscopy , Methods , Humans , Male , Middle Aged , Rectal Neoplasms , General Surgery , Retrospective Studies , Treatment Outcome
7.
Chinese Journal of Surgery ; (12): 1057-1062, 2012.
Article in Chinese | WPRIM | ID: wpr-247917

ABSTRACT

<p><b>OBJECTIVE</b>The present study aims to investigate health-related quality of life (HRQOL) in disease-free survivors after radical surgery for mid-low rectal cancer.</p><p><b>METHODS</b>A retrospective cross-sectional study was performed in patients with rectal cancer who underwent primary surgery between August 2002 and February 2011 by use of the European Organization for Research and Treatment of Cancer QLQ-C30 and CR-38 questionnaires (n = 330). The impact of clinical characteristics on HRQoL were assessed and compared by univariate and multivariate regression analyses.</p><p><b>RESULTS</b>Two hundred and four effective responses were received. Patients with stoma were more impaired in HRQoL than those without stoma, especially in the field of social psychology, such as emotional function (M(50) = 91.67, U = 2668.5, P = 0.026), social function (M(50) = 83.33, U = 2095.5, P < 0.001), financial difficulties (M(50) = 0, U = 2240.5, P < 0.001) and body image (M(50) = 88.89, U = 2507.0, P = 0.013). Only in the constipation scale (M(50) = 14.29, U = 2376.0, P = 0.001), nonstoma patients had a better score. The analysis in different types of surgical procedure paralleled those of stoma. Patients with complication had a poorer function in some symptom scales such as dyspnoea (M(50) = 0, U = 1505.0, P < 0.001), gastro-intestinal symptom (M(50) = 6.67, U = 1766.0, P = 0.034) and financial difficulties (M(50) = 33.33, U = 1795.5, P = 0.044), and in some functioning scales such as emotional function (M(50) = 83.33, U = 1608.5, P = 0.009), cognitive function (M(50) = 66.67, U = 1612.5, P = 0.010) and body image (M(50) = 66.67, U = 1617.0, P = 0.012). In our study, HRQoL after rectal cancer surgery improved with time. Our multivariate analysis displayed that stoma and postoperative time were the most significant characteristics. Variables associated with worse financial status were less postoperative months, occurrence of complications and presence of stoma.</p><p><b>CONCLUSIONS</b>Different scales of HRQoL in patients of China after curative surgery for mid-low rectal cancer are significantly influenced by different clinical characteristics.</p>


Subject(s)
Adult , Aged , Aged, 80 and over , Body Image , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Postoperative Period , Quality of Life , Rectal Neoplasms , Psychology , General Surgery , Retrospective Studies , Surgical Stomas , Surveys and Questionnaires
8.
Chinese Journal of Surgery ; (12): 870-874, 2012.
Article in Chinese | WPRIM | ID: wpr-245775

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effects of fast track surgery on postoperative insulin sensitivity on the basis of clinical benefits in patients undergoing elective open colorectal resection.</p><p><b>METHODS</b>During May 2008 to December 2008, Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: a fast track group (35 cases) and a conventional care group (35 cases). All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters, stress markers and insulin sensitivity were evaluated in both groups.</p><p><b>RESULTS</b>The 62 patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. The speed of recovery of postoperative insulin sensitivity on 7 days postoperative in the fast-track group (97% ± 9%) was significantly faster than the conventional care group (88.5% ± 9.0%, t = 2.552, P = 0.016). The hospitalization days in the fast-track group was 6 days (M(50)), and it was significantly shorter than the conventional care group ((11.7 ± 3.8) days, Z = 4.360, P = 0.000). The time of recovery of bowel function were faster in the fast-track group (time to pass flatus was 2 days (M(50))) than the conventional care group (4 days, Z = 3.976, P = 0.000). The Infectious complication rate in the fast-track group (2/32) is lower than the other group (8/30, P = 0.040).</p><p><b>CONCLUSION</b>Fast track surgery accelerates recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a lower rate of postoperative infectious complications and a shorter length of postoperative hospital stay.</p>


Subject(s)
Aged , Colorectal Neoplasms , Rehabilitation , General Surgery , Female , Humans , Insulin Resistance , Length of Stay , Male , Middle Aged , Perioperative Care , Methods , Prospective Studies
9.
Chinese Journal of Surgery ; (12): 875-878, 2012.
Article in Chinese | WPRIM | ID: wpr-245774

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the impact of different gastrectomy and reconstruction method on prognosis and quality of life in proximal gastric cancer.</p><p><b>METHODS</b>The 265 cases of proximal gastric cancer received radical resection, according to gastrectomy or reconstruction method, were divided into proximal gastrectomy/gastroesophagostomy group (PG) (n = 63) and total gastrectomy/esophagojejunostomy group (TG) (n = 202). The clinical pathologic features, prognosis, postoperative quality of life in 2 groups were compared.</p><p><b>RESULTS</b>There had no significant differences in age, gender, CEA value between two groups (all P > 0.05). In PG and TG group, tumor size (cm), ratio of organic invasion, lymph nodes metastasis, distal metastasis, TNM IV stage, Borrmann typing, poor or undifferentiated carcinoma was 2.9 ± 1.9 vs. 4.8 ± 2.8, 9.5% vs. 32.2%, 64.7% vs. 70.6%, 0 vs. 8.4%, 6.9% vs. 31.8%, 44.4% vs. 69.2%, 31.7% vs. 53.7%, respectively, all with significant difference (t = -6.260, χ(2) = 29.473, 14.559, 5.665, 32.483, 12.588, 10.954, all P < 0.05). In PG and TG group, the ratio of D3 and D3(+) resection, multi-visceral resection, complications was 0 vs. 13.8%, 9.5% vs. 38.6%, 7.9% vs. 1.5% respectively, showed increasing range of resection and decreasing complications significantly in TG group (all P < 0.05). The median survival time (months) was 62.5 vs. 78.9 in TG and PG group respectively, without significant difference (P > 0.05). In 2 groups, the evaluation index of post-operative quality of life without significant differences (P > 0.05).</p><p><b>CONCLUSIONS</b>For proximal gastric cancer, although the cases received TG with worse clinicopathological features, which prognosis was similar to that received PG. The postoperative quality of life without significant difference between the cases received gastroesophagostomy and esophagojejunostomy.</p>


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Gastrectomy , Methods , Gastroenterostomy , Methods , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Prognosis , Quality of Life , Stomach Neoplasms , Mortality , Pathology , General Surgery
10.
Article in Chinese | WPRIM | ID: wpr-321262

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the molecular mechanism involved in the downregulation of vascular endothelial growth factor(VEGF) expression through the suppression of signal transducer and activator of transcription 3(Stat3) by(-)-Epigallocatechin-3-gallate (EGCG).</p><p><b>METHODS</b>After human gastric cancer cells (AGS) were treated with IL-6 (50 μg/L) and EGCG(0, 5, 10, 25 or 50 μmol/L), the expression levels of VEGF, total Stat3(tStat3), and activated Stat3(pStat3) in tumor cells were examined by Western blotting. The influence of the inhibitor of Stat3 pathway on the IL-6-induced VEGF expression was investigated. VEGF protein level in tumor cell culture medium was determined by ELISA and VEGF mRNA expression in tumor cells by RT-PCR. Tumor cell nuclear extract was prepared and nuclear expression of pStat3 was detected. Stat3-DNA binding activity was examined with chromatin immunoprecipitation (ChIP) assay.</p><p><b>RESULTS</b>IL-6 significantly increased VEGF expression in AGS gastric cancer cells. Compared with the group without IL-6, the expression and secretion of VEGF protein, and mRNA expression increased by 2.4 fold,2.8 fold, and 3.1 fold(all P<0.01), respectively. EGCG treatment markedly reduced VEGF protein, release and mRNA expression in a dose-dependent manner. When compared with the control group induced by IL-6, EGCG and AG490(a Stat3 pathway inhibitor) significantly inhibited VEGF expression induced by IL-6 (P<0.01). EGCG dose-dependently inhibited pStat3 induced by IL-6(P<0.05), but not tStat3 (P>0.05). Stat3 nuclear translocation and Stat3-DNA binding activity in AGS cells or that induced by IL-6 were directly inhibited by EGCG(P<0.05).</p><p><b>CONCLUSION</b>EGCG reduces expression of VEGF in gastric cancer cells through the inhibition of Stat3 activity.</p>


Subject(s)
Catechin , Pharmacology , Humans , Interleukin-6 , Metabolism , RNA, Messenger , Genetics , STAT3 Transcription Factor , Metabolism , Signal Transduction , Stomach Neoplasms , Metabolism , Pathology , Tumor Cells, Cultured , Vascular Endothelial Growth Factor A , Metabolism
11.
Article in Chinese | WPRIM | ID: wpr-321204

ABSTRACT

<p><b>OBJECTIVE</b>To explore whether neutrophil-lymphocyte ratio (NLR) is an effective prognostic marker in gastric cancer.</p><p><b>METHODS</b>Clinical data of 775 patients with gastric cancer in the First Affiliated Hospital of Sun Yat-sen University from 1994 to 2006 were analyzed retrospectively. According to preoperative NLR, the patients were divided into the low NLR group (NLR≤3.79, n=652) and the high NLR group (NLR>3.79, n=123). The 5-year survival rates of two groups of different TNM stage, different surgical intervention were separately analyzed.</p><p><b>RESULTS</b>The 5-year survival rates in the low NLR group and high NLR group were 44.0% and 12.2% respectively (P<0.01). In different TNM stages: stage I (97.8% vs 33.3%), stage II (55.4% vs 32.0%), stage IIIA (30.2% vs 11.1%), stage IIIB (15.5% vs 8.3%), stage IV (10.7% vs 2.1%), and in different surgical intervention: D1 curative gastrectomy (93.3% 33.3%), D2 group (51.3% vs 20.4%), D3 group (42.4% vs 10.5%), D4 group (14.3% vs 2.0%), and in palliative operation group (8.3% vs 2.2%). There were significant differences of 5-year survival rate in TNM staging and surgical procedures between the high and low NLR groups (all P<0.05).</p><p><b>CONCLUSION</b>Preoperative NLR may be a prognostic marker in patients with gastric cancer.</p>


Subject(s)
Aged , Gastrectomy , Humans , Lymphocytes , Neoplasm Staging , Neutrophils , Prognosis , Retrospective Studies , Stomach Neoplasms , Diagnosis , Survival Rate
12.
Chinese Medical Journal ; (24): 2799-2800, 2011.
Article in English | WPRIM | ID: wpr-292799

ABSTRACT

Splenic cysts are unusual in daily surgical practice and less than 1000 cases have been reported. Primary, true or epithelial splenic cysts, are even rarer. Usually, most of the cysts are asymptomatic until of significant size, at which time they are then detected incidentally on ultrasonography or CT scan. We report a case of a 25-year-old woman with giant epithelial splenic cyst with about 3000 ml of clear-yellow fluid was collected from the cyst. The splenectomy specimen measured 205 mm × 192 mm × 137 mm and weighed 4000 g.


Subject(s)
Adult , Cysts , Diagnosis , Diagnostic Imaging , General Surgery , Female , Humans , Splenectomy , Splenic Diseases , Diagnosis , Diagnostic Imaging , General Surgery , Ultrasonography
13.
Chinese Medical Journal ; (24): 1217-1220, 2011.
Article in English | WPRIM | ID: wpr-239863

ABSTRACT

<p><b>BACKGROUND</b>Distal pancreatectomy traditionally included splenectomy; the spleen, however, is an important organ in the immunologic defense of the host and is worthy of preservation. The aim of this research was to study the feasibility, safety and clinical effects of spleen and splenic vessel-preserving distal pancreatectomy.</p><p><b>METHODS</b>A retrospective review was performed for 26 patients undergoing distal pancreatectomy for benign or low grade malignant disease with splenectomy (n = 13) or splenic preservation (n = 13) at the First Hospital of Sun Yat-sen University and Guangdong General Hospital in Southern China from May 2002 to April 2009.</p><p><b>RESULTS</b>All 26 pancreatectomies with splenectomy or splenic preservation were performed successfully. There was no statistically significant difference between two groups in mean operative time ((172 ± 47) minutes vs. (157 ± 52) minutes, P > 0.05), intraoperative estimated blood loss ((183 ± 68) ml vs. (160 ± 51) ml, P > 0.05), incidence of noninfectious and infection complication and mean length of postoperative hospital stay ((10.1 ± 2.2) days vs. (12.1 ± 4.6) days, P > 0.05). The platelet counts examined one week after operation were significantly higher in the distal pancreatectomy with splenectomy group than the other group ((37.3 ± 12.8) × 10(9)/L vs. (54.7 ± 13.2) × 10(9)/L, P < 0.05).</p><p><b>CONCLUSIONS</b>Spleen-preserving distal pancreatectomy appears to be a feasible and safe procedure. In selected cases of benign or low-grade malignant disease, spleen-preserving distal pancreatectomy is recommended.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Pancreatectomy , Methods , Mortality , Perioperative Period , Retrospective Studies , Spleen
14.
Chinese Medical Journal ; (24): 3084-3088, 2010.
Article in English | WPRIM | ID: wpr-285726

ABSTRACT

<p><b>BACKGROUND</b>Diabetes mellitus plays an important role in cancer prevalence and outcomes. The aim of this study was to evaluate the influence of DM on stages and outcomes among patients with colorectal cancer.</p><p><b>METHODS</b>The study enrolled 945 patients who were diagnosed as having colorectal carcinoma from August 1994 to December 2002. In the cohort, 26 patients were diagnosed as having DM. With a median follow-up of 45.8 months, differences in overall survival and disease-free survival between the diabetes and non-diabetes groups were analyzed.</p><p><b>RESULTS</b>Kaplan and Meier analysis showed that there were no significant differences between the two groups in overall survival rates at 3 years or 5 years. At 5 years, patients with DM, compared with patients without diabetes, experienced a significantly lower disease-free survival rate (34.2% diabetics vs. 55.1% non-diabetics; P = 0.025).</p><p><b>CONCLUSIONS</b>DM was associated with an increased risk of recurrence in patients with colorectal cancer.</p>


Subject(s)
Adult , Aged , Colorectal Neoplasms , Mortality , Diabetes Mellitus, Type 2 , Mortality , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged
15.
Article in Chinese | WPRIM | ID: wpr-266320

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical effect of surgery following systemic targeted therapy of tyrosine kinase inhibitors (TKIs) in patients with metastatic gastrointestinal stromal tumors (GIST).</p><p><b>METHODS</b>From June 2007 to December 2009, data of 15 consecutive patients with metastatic GIST treated with imatinib/sunitinib followed by surgery were retrospectively analyzed.</p><p><b>RESULTS</b>Disease responses to TKI treatment was categorized into controlled disease (including partial response and stable disease) (6, 40.0%), limited progression (4, 26.7%), and generalized progression (5, 33.3%), respectively. Surgeries were performed after mean 12 months following TKI therapies. Gross complete resection or optimal debulking with minimal residual disease were managed to performed in 8/10 patients with disease controlled and limited progression, while optimal debulking only achieved in 2/5 patients with generalized progression. Surgical morbidity was 20.0% (3/15). After operation, patients with disease controlled and limited progression had a median progression-free survival of 25.0 months and 2-year overall survival rate of 100%. In contrast, for patients with generalized progression, the median progression- free survival was 3 months (P<0.01), and median overall survival 10.5 months.</p><p><b>CONCLUSIONS</b>Patients with metastatic GIST who have controlled disease or limited progression to TKI therapy can benefit from surgical resection. Surgery should be selective in patients with generalized progression since surgery hardly improves survival in these patients.</p>


Subject(s)
Adult , Aged , Benzamides , Disease-Free Survival , Female , Gastrointestinal Stromal Tumors , Pathology , Therapeutics , Humans , Imatinib Mesylate , Indoles , Therapeutic Uses , Intraoperative Period , Male , Middle Aged , Piperazines , Therapeutic Uses , Protein Kinase Inhibitors , Therapeutic Uses , Pyrimidines , Therapeutic Uses , Pyrroles , Therapeutic Uses , Retrospective Studies , Survival Rate , Treatment Outcome
16.
Article in Chinese | WPRIM | ID: wpr-266291

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the effect of different ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery on 5-year overall survival rate and operative mortality.</p><p><b>METHODS</b>The results of several literatures from different countries on high or low ligation of the inferior mesenteric artery and prognosis were analyzed using meta-analysis.</p><p><b>RESULTS</b>Seven studies were included. The 5-year overall survival rate was compared between low and high ligation. The odd ratio (OR) for 5-year survival was 0.87 (95% CI=0.76-0.98, P=0.02), and the OR for perioperative mortality was 1.28 (95% CI=0.94-1.75, P=0.19).</p><p><b>CONCLUSIONS</b>High ligation of the inferior mesenteric artery may improve 5-year overall survival rate. Perioperative mortality may not be influenced by the level of ligation.</p>


Subject(s)
Humans , Mesenteric Artery, Inferior , General Surgery , Prognosis , Rectal Neoplasms , Diagnosis , General Surgery , Sigmoid Neoplasms , Diagnosis , General Surgery
17.
Article in Chinese | WPRIM | ID: wpr-237192

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics between mucinous gastric cancer (MGC) and poorly differentiated gastric cancer(PDGC) and factors associated with prognosis.</p><p><b>METHODS</b>Medical records of 1016 consecutive patients with gastric cancer were retrospectively reviewed. Sixty-eight patients with MGC and 508 with PDGC were identified. Clinicopathologic characteristics and overall survival data were analyzed.</p><p><b>RESULTS</b>As compared to PDGC patients, patients with MGC were significantly older [(59.2±11.9) years vs. (54.1±13.2) years], had significantly more distant metastasis(36.8% vs. 23.8%), more peritoneal seeding(29.4% vs. 16.9%), and less radical resection(60.3% vs. 76.6%). There were no significant differences in 5-year survival rate between MGC and PDGC patients(29.4% vs. 35.5%). However, for tumors in the middle third of the stomach, the survival rate of MGC patients was lower than that of PDGC. Using a Cox proportional hazard ratio model, lymph node involvement and radical resection were independent prognostic factors for survival of MGC patients, while tumor invasion, lymph node involvement, and radical resection were associated with survival in patients with PDGC.</p><p><b>CONCLUSION</b>Although MGC and PDGC differ in age, frequencies of peritoneal seeding, distant metastasis, and rate of radical resection, overall survival is comparable.</p>


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Stomach Neoplasms , Classification , Pathology
18.
Chinese Journal of Surgery ; (12): 673-676, 2009.
Article in Chinese | WPRIM | ID: wpr-280604

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate and compare the results of vagina vasorum lymph node dissection (VLND) and non-vagina vasorum lymph node dissection (NVLND) in patients with gastric cancer after radical operation.</p><p><b>METHODS</b>A total of 759 cases of evaluable patients with gastric cancer, operated from June 1994 to April 2005, were retrospectively analyzed. Of which, 627 cases underwent radical gastrectomy: 215 patients received VLND and 412 cases received NVLND. The operation time, intraoperative blood loss, operative complications and survival rate were recorded and compared between the two groups.</p><p><b>RESULTS</b>The 5- and 10-year overall accumulative survival rates of VLND group and NVLND group were 55.4% and 51.2%, 39.1%and 36.8%, respectively (all P < 0.05). No significant differences in intraoperative blood transfusion (loss), operation time, operative complication rate was found between the two groups. The 5- and 10-year accumulative survival in patients with a tumor of phase N0-N2, T2-T4, Ib-IV in VLND groups were all significant higher than those in NVLND group.</p><p><b>CONCLUSIONS</b>VLND is a safe technique in advanced gastric cancer, it dose not prolong operation time or increase operative complications but improves survival.</p>


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Gastrectomy , Humans , Lymph Node Excision , Methods , Lymphatic Metastasis , Male , Middle Aged , Retrospective Studies , Stomach Neoplasms , Pathology , General Surgery , Survival Analysis , Treatment Outcome , Young Adult
19.
Chinese Journal of Surgery ; (12): 1204-1208, 2009.
Article in Chinese | WPRIM | ID: wpr-280593

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the protein expression, methylation promoter, somatic and germ-line mutations of E-cadherin gene (CDH1) in hereditary gastric cancer in China and to investigate its possible roles.</p><p><b>METHODS</b>Eight probands diagnosed with ICG-HGC criterion were enrolled in our database from June 1994 to October 2007. Tumor tissues were detected for CDH1 expression by using immunohistochemistry (IHC) methods. CDH1 DNA sequencing was performed for all its 16 exons both in tumor and normal tissues of the same patients to detect somatic and germ-line mutations. Methylation promoter study was performed by using specific primers and polymerase chain reaction (PCR) methods.</p><p><b>RESULTS</b>IHC analysis confirmed that the CDH1 expression was negative in 7 probands and downregulated in the other on proband. Six mutations in five probands were found with DNA sequencing: two silent mutations and four missense mutations. All six mutations were absent in normal tissues, thereby excluded its presence in germ-line cells. Both DNA missense mutations and gene silencing through promoter methylation was found in 4 probands. Two probands has only promoter methylation and one proband had only silent mutation. No DNA missense mutations or promoter methylation was found in one proband.</p><p><b>CONCLUSIONS</b>CDH1 gene germ-line mutations are relatively rare in hereditary gastric cancer in China, and whereas CDH1 somatic mutations and promoter methylation synergistically induce CDH1 downregulation in these patients.</p>


Subject(s)
Cadherins , Genetics , DNA Methylation , DNA Mutational Analysis , Germ-Line Mutation , Humans , Promoter Regions, Genetic , Genetics , Stomach Neoplasms , Genetics
20.
Chinese Journal of Oncology ; (12): 371-374, 2009.
Article in Chinese | WPRIM | ID: wpr-293111

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the value of EUS and PET-CT in combination with spiral CT in preoperative assessment of gastric cancer invasion to the pancreas.</p><p><b>METHODS</b>Sixty advanced gastric cancer patients with suspected pancreatic invasion detected by spiral CT were selected in this study. All the 60 cases were then examined by EUS and 14 of them by PET-CT. The results were compared and evaluated with the findings during surgical operation and pathological results.</p><p><b>RESULTS</b>The rate of correct preoperative diagnosis of pancreatic invasion by spiral CT in advanced gastric cancer patients was 63.3%, with an overdiagnosis rate of 36.7%. The diagnostic accuracy was increased to 87.8% and overdiagnosis reduced to 7.3%, when combined with EUS. There was a significant difference in diagnostic accuracy between spiral CT alone and spiral CT combined with EUS (P<0.01), but no significant difference between spiral CT alone and spiral CT combined with PET-CT (P>0.05). Spiral CT-EUS was more valuable in assessment of tumor location and invasion than PET-CT (P<0.01).</p><p><b>CONCLUSION</b>The accuracy of spiral CT alone in the preoperative assessment of advanced gastric cancer with invasion to the pancreas is not high enough yet at present. Spiral CT combined with EUS can provide more accurate information on the tumor location, invasion site and extent of gastric cancer invasion to the pancreas, and reduce the overstaging rate caused by spiral CT alone. However, spiral CT combined with PET-CT does not show such improvement significantly.</p>


Subject(s)
Adenocarcinoma , Diagnosis , Pathology , Adenocarcinoma, Mucinous , Diagnosis , Pathology , Aged , Carcinoma, Signet Ring Cell , Diagnosis , Pathology , Endosonography , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Pancreas , Pathology , Positron-Emission Tomography , Preoperative Period , Prospective Studies , Stomach Neoplasms , Diagnosis , Pathology , Tomography, Spiral Computed
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