ABSTRACT
ABSTRACT Purpose: Salvage robotic-assisted radical prostatectomy (S-RARP) has gained prominence in recent years for treating patients with cancer recurrence following non-surgical treatments of Prostate Cancer. We conducted a systematic literature review to evaluate the role and outcomes of S-RARP over the past decade. Materials and Methods: A systematic review was conducted, encompassing articles published between January 1st, 2013, and June 1st, 2023, on S-RARP outcomes. Articles were screened according to PRISMA guidelines, resulting in 33 selected studies. Data were extracted, including patient demographics, operative times, complications, functional outcomes, and oncological outcomes. Results: Among 1,630 patients from 33 studies, radiotherapy was the most common primary treatment (42%). Operative times ranged from 110 to 303 minutes, with estimated blood loss between 50 to 745 mL. Intraoperative complications occurred in 0 to 9% of cases, while postoperative complications ranged from 0 to 90% (Clavien 1-5). Continence rates varied (from 0 to 100%), and potency rates ranged from 0 to 66.7%. Positive surgical margins were reported up to 65.6%, and biochemical recurrence ranged from 0 to 57%. Conclusion: Salvage robotic-assisted radical prostatectomy in patients with cancer recurrence after previous prostate cancer treatment is safe and feasible. The literature is based on retrospective studies with inherent limitations describing low rates of intraoperative complications and small blood loss. However, potency and continence rates are largely reduced compared to the primary RARP series, despite the type of the primary treatment. Better-designed studies to assess the long-term outcomes and individually specify each primary therapy impact on the salvage treatment are still needed. Future articles should be more specific and provide more details regarding the previous therapies and S-RARP surgical techniques.
ABSTRACT
Abstract Background Fear of cancer recurrence is one of the most distressing psychological consequences in cancer survivors and their informal primary caregivers (IPC). IPC of childhood cancer survivors (CCS) are often their mothers, which could intensify fear of cancer recurrence (FCR) and its impact on both IPC and CCS. However, the phenomenon has not been widely described in this specific population. Objective To summarize and analyze current evidence on the evaluation and management of FCR among IPC of CCS. Method A narrative review of studies included in four databases (PsycInfo, Medline, CINALH, and Web of Science) with no language or year of publication restrictions. Results Measures specifically developed to assess FCR among IPC of CCS comprising an interview and a questionnaire with initial psychometric evaluations and two short, online intervention programs based on cognitive-behavioral-contextual therapy were identified (ENGAGE and CASCAdE). Both have demonstrated acceptability in parents of CCS in high-income countries; preliminary evidence also exists of the effectivity of CASCAdE in reducing FCR. Discussion and conclusion Given the limitations of this area of psychological evaluation, the Fear of Cancer Recurrence Inventory, originally developed for adult cancer survivors, constitutes the most suitable tool for evaluating FCR among IPC of CCS. The CASCAdE program seems a promising intervention for IPC of CSS, although cultural adaptations, evaluations of its acceptability in low- and middle-income countries, and controlled studies in large samples are still required.
Resumen Antecedentes El miedo a la recurrencia del cáncer es una de las consecuencias psicológicas más angustiantes en los supervivientes y sus cuidadores primarios informales (CPI). Los CPI de supervivientes de cáncer infantil (SCI) a menudo son sus madres, lo que podría intensificar el miedo a la recurrencia (MR) y su impacto tanto a los CPI como a los SCI. Sin embargo, el fenómeno no se ha descrito ampliamente en esta población específica. Objetivo Resumir y analizar la evidencia actual sobre la evaluación y manejo del MR entre CPI de SCI. Método Se realizó una revisión narrativa de los estudios incluidos en cuatro bases de datos (PsycInfo, Medline, CINALH y Web of Science) sin restricciones de idioma o año de publicación. Resultados Se identificaron instrumentos desarrollados específicamente para evaluar MR entre CPI de SCI que comprenden una entrevista y un cuestionario, además de dos programas de intervención en línea basados en terapia cognitivo-conductual-contextual (ENAGE y CASCAdE). Ambos demostraron aceptabilidad en los padres de SCI en países de ingresos altos. También existe evidencia preliminar de la efectividad de CASCAdE en la disminución del MR. Discusión y conclusión Dadas las limitaciones de esta área de evaluación psicológica, el Inventario del Miedo a la Recurrencia del Cáncer, desarrollado originalmente para supervivientes adultos, constituye la herramienta más adecuada para evaluar MR en los CPI de SCI. El programa CASCAdE parece una intervención prometedora para CPI de SCI, aunque aún requiere adaptaciones culturales, evaluaciones de aceptabilidad en países de ingresos medio-bajos y estudios controlados con nuestras más grandes.
ABSTRACT
It is common that families of cancer patients ask physicians to non-disclose the diagnosis from the patients for purpose of protecting their emotion and quality of life (QOL), but it is conflicted with patients’ increasing demands for right to know in China. Therefore, it is urgent to verify whether non-disclosure (or disclosure) of the diagnosis is more beneficial to patients’ QOL, and provide research evidence for solving the dilemma of non-disclosure or disclosure in medical decision-making. 300 hospitalized patients with early/middle stage liver cancer were recruited, including 162 patients in the disclosure group and 138 patients in the non-disclosure group. The patients’ QOL scale were evaluated at the time of admission, 1 month, 3 months, and 6 months after discharge. The social support scale, trait coping style and trait anxiety/depression scale were assessed at admission. The results showed that 91.30% of the patients in the non-disclosure group knew of the diagnosis of liver cancer by their own way after discharge. The scores of emotional functioning and overall QOL were significantly higher in the disclosure group than those in the non-disclosure group at first month after discharge (P<0.01). At six months after discharge, among the 52 patients with cancer recurrence, the scores of emotional functioning and overall QOL were higher in the disclosure group than those in the non-disclosure group (P<0.05). Additionally, the multivariate analysis showed that, in the presence of age, trait anxiety/depression, social support and other influencing factors, disclosure of diagnosis was positively correlated with the overall QOL at 1 and 6 months after discharge (P<0.05). It indicated that disclosure of cancer diagnosis during hospitalization is more beneficial to improve the QOL of patients with early and middle stage cancer.
ABSTRACT
OBJECTIVES@#Cervical cancer is the most common malignant tumor in the female reproductive system worldwide. The recurrence rate for the treated cervical cancer patients is high, which seriously threatens women's lives and health. At present, the risk prediction study of cervical cancer has not been reported. Based on the influencing factors of cervical cancer recurrence, we aim to establish a risk prediction model of cervical cancer recurrence to provide a scientific basis for the prevention and treatment of cervical cancer recurrence.@*METHODS@#A total of 4 358 cervical cancer patients admitted to the Hunan Cancer Hospital from January 1992 to December 2005 were selected as research subjects, and the recurrence of cervical cancer patients after treatment was followed up. Univariate analysis was used to analyze the possible influencing factors. Variables that were significant in univariate analysis or those that were not significant in univariate analysis but may be considered significant were included in multivariate Cox regression analysis to establish a cervical cancer recurrence risk prediction model. Line graphs was used to show the model and it was evaluated by using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis.@*RESULTS@#Univariate analysis showed that the recurrence rates of cervical cancer patients with different age, age of menarche, parity, miscarriage, clinical stage, and treatment method were significantly different (all P<0.05). Multivariate Cox regression analysis showed that RR=-0.489×(age≥55 years old)+0.481×(age at menarche >15 years old)+0.459×(number of miscarriages≥3)+0.416×(clinical stage II)+0.613×(clinical stage III/IV)+0.366×(the treatment method was surgery + chemotherapy) + 0.015×(the treatment method was chemotherapy alone). The area under the ROC curve (AUC) of the Cox risk prediction model for cervical cancer recurrence constructed was 0.736 (95% CI 0.684 to 0.789), the best prediction threshold was 0.857, the sensitivity was 0.576, and the specificity was 0.810. The accuracy of the Cox risk model constructed by this model was good. From the clinical decision curve, the net benefit value was high and the validity was good.@*CONCLUSIONS@#Patient age, age at menarche, miscarriages, clinical stages, and treatment methods are independent factors affecting cervical cancer recurrence. The Cox proportional hazards prediction model for cervical cancer recurrence constructed in this study can be better used for predicting the risk of cervical cancer recurrence.
Subject(s)
Pregnancy , Humans , Female , Middle Aged , Adolescent , Prognosis , Uterine Cervical Neoplasms/epidemiology , Abortion, Spontaneous , Neoplasm Recurrence, Local/pathology , Proportional Hazards Models , Risk Factors , Retrospective StudiesABSTRACT
Objective:To analyze the significance of empowerment intervention for main caregivers of stomach neoplasm patients undergoing chemotherapy on fear of cancer recurrence, psychological capital.Methods:Using convenient sampling method, the 90 patients with stomach neoplasm treated with chemotherapy from January to December 2021 were randomly divided into control group (45 cases) and observation group (45 cases), and one main caregiver was selected for each patient.The control group was given the routine nursing scheme of stomach neoplasm patients undergoing chemotherapy, and the observation group was given the intervention mode of empowering the main caregivers on the basis of the routine nursing scheme of stomach neoplasm chemotherapy. The fear of cancer recurrence, psychological capital and quality of life of the two groups before intervention and after three chemotherapy cycles were statistically compared by using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Positive Psychological Capital Questionnaire (PPQ) and Functional Assessment of Cancer Thearpy-General model(FACT-G).Results:Finally 44 cases in the observation group and 43 cases in the control group were included. The total scores of FCR, PPQ and FACT-G in the observation group were (39.7 ± 3.2), (112.8 ± 16.9), (84.2 ± 9.1) points before intervention respectively, and(31.1 ± 2.5), (134.7 ± 15.6), (94.1 ± 9.6) points after intervention respectively.The differences were statistically significant( t=20.02, 8.94, 7.02, all P<0.05). The total score of FCR in the observation group was significantly lower than that in the control group after intervention, which were (31.1 ± 2.5) points and (37.7 ± 2.8) points respectively, the difference was statistically significant ( t=11.60, P<0.05). The total score of PPQ in the observation group was (134.7 ± 15.6) points after intervention, which was significantly higher than that in the control group (114.8 ± 15.8) points after intervention, the difference was statistically significant ( t=5.91, P<0.05). The total FACT-G score of the observation group was (94.1 ± 9.6) points, which was higher than that of the control group (86.5 ± 9.0) points, the difference was statistically significant ( t=3.81, P<0.05). Conclusions:The implementation of empowerment intervention for main caregivers of stomach neoplasm patients undergoing chemotherapy can reduce the fear of cancer recurrence, improve psychological capital, and improve the quality of life.
ABSTRACT
INTRODUCTION@#Fear of cancer recurrence (FCR) among cancer survivors is a persistent and distressing psychosocial concern that affects recovery and quality of life. The prevalence of FCR in Singapore is unknown. This cross-sectional study was designed to examine FCR and identify factors associated with FCR in mixed-cancer survivors locally.@*METHODS@#Cancer survivors in remission (n = 404) were assessed for: FCR using the Fear of Cancer Recurrence Inventory (FCRI); emotional distress using the Hospital Anxiety and Depression Scale; and quality of life using the World Health Organization Quality of Life-BREF. Clinical and severe/pathological FCR was determined based on the severity scale of FCRI, known as FCRI-Short Form. Multivariate logistic regression was performed to examine factors associated with FCR.@*RESULTS@#The mean score on the FCRI was 59.5 ± 30.4. 43.6% of cancer survivors had clinical FCR and 32.1% had severe/pathological FCR. Younger age (odds ratio [OR] 0.952, 95% confidence interval [CI] 0.911-0.995, p < 0.05), higher educational status (OR 2.55, 95% CI 1.15-5.65, p < 0.05) and higher levels of emotional distress (OR 1.17, 95% CI 1.10-1.24, p < 0.001) were significantly associated with severe/pathological levels of FCR.@*CONCLUSION@#The present study is the first to determine levels of FCR among cancer survivors in Singapore. While the total FCR scores were similar to those of international studies, severe/pathological levels of FCR were found to be four times higher. These findings highlight a problem that is not widely recognised or acknowledged, but which deserves greater attention.
ABSTRACT
INTRODUCTION@#Children with solid organ tumours often present for curative surgery. Even with the best surgical technique, micrometastases can occur. Preclinical studies support the postulation that neuraxial anaesthesia maintains the body's immune and inflammatory milieu against metastasis. However, human retrospective adult studies showed varying results, and no study has been done in children. We aimed to find out if intraoperative epidural, perioperative opioid and volatile dose are associated with relapse-free survival (RFS) in children with solid organ tumours.@*METHODS@#This is a retrospective cohort study of 126 children from a tertiary paediatric unit who were diagnosed with solid organ tumours (neuroblastoma, hepatoblastoma or sarcoma) over a 16-year period. RFS, stratified by tumour subtypes, was estimated using the Kaplan-Meier method. Adjusted hazard ratios (aHRs) were obtained from multivariable Cox regression models after taking potential covariates into account.@*RESULTS@#Of 126 children with solid organ tumours (51.6% neuroblastoma, 34.9% sarcoma and 13.5% hepatoblastoma), 53.2% received combined general anaesthesia (GA)/epidural. A total of 21 (31.3%) and 20 (33.9%) patients relapsed during the study period in the combined GA/epidural group and the GA alone group, respectively. Patients with sarcoma receiving combined GA/epidural had a clinically meaningful lower risk of relapse compared to patients receiving GA alone (aHR 0.51, 95% confidence interval 0.14-1.79), although this was not statistically significant.@*CONCLUSION@#Our study demonstrated some clinically meaningful associations, especially in paediatric sarcoma patients. Overall, however, there was no statistically significant association between epidural use and an improved RFS.
ABSTRACT
Objective:To investigate the predictive effect of perioperative depression and anxiety symptoms in breast cancer patients on the fear of cancer recurrence.Methods:A total of 194 patients with breast cancer during perioperative period from May 2019 to May 2020 in Qilu Hospital of Shandong University were selected. The depression, anxiety and fear of cancer recurrence were investigated by the general information questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9) and the Fear of Progression Questionnaire-Short Form (FOR-Q-SF) at admission and two weeks after surgery, respectively.Results:Perioperative depression and anxiety symptoms of breast cancer patients were significant predictors of fear of cancer recurrence ( B value was 2.325, OR value was 10.22, P<0.05; B value was 2.570, OR value was 13.07, P<0.05), and patients with depression and anxiety symptoms after surgery were at higher risk of fear of cancer recurrence ( OR values were 7.653-25.403, P<0.01). Conclusions:For breast cancer patients with negative emotions and fear of disease progression, it is necessary to help them improve their psychological coping ability, encouraging patients to actively cooperate with follow-up treatment, improving the prognosis, and improving their overall quality of life.
ABSTRACT
Introduction: Surgery is the treatment of choice in locoregional thyroid neoplasia recurrence. The intense tissue healing process observed after surgery changes the neck anatomy, makes reoperation difficult, and interferes with surgical success. The use of the Radioguided Occult Lesion Localization (ROLL) technique has become a viable option to localize thyroid tumors. Objective: To analyze the use of the ROLL technique for the treatment of thyroid cancer recurrence with respect to its clinical, surgical and anatomopathological aspects. Methods: A descriptive cross-sectional study that analyzed 56 medical records and anatomopathological examinations of patients of both sexes who had thyroid neoplasms, underwent previous surgeries on this topography, and were submitted to the ROLL technique for recurrence removal from March 2011 to March 2019. Results: Most patients were women aged 46.05 years, on average. Papillary thyroid neoplasm was the most prevalent histological finding. In 100% of the cases, application of the ROLL technique identified and removed the lesions marked with suspicion for malignancy. Conclusion: Radioguided surgery has proved to be a very effective and safe tool to assist with lesion localization for the treatment of thyroid cancer recurrence. This technique has brought no additional side effects to patients, required minimal radiation and made surgery less invasive, reducing postoperative complication rates.
ABSTRACT
Abstract Background: The current evidence suggests that oncological surgery, which is a therapy used in the treatment of solid tumors, increases the risk of metastasis. In this regard, a wide range of tumor cells express Voltage-Gated Sodium Channels (VGSC), whose biological roles are not related to the generation of action potentials. In epithelial tumor cells, VGSC are part of cellular structures named invadopodia, involved in cell proliferation, migration, and metastasis. Recent studies showed that lidocaine could decrease cancer recurrence through its direct effects on tumor cells and immunomodulatory properties on the stress response. Objective: The aim of this narrative review is to highlight the role of VGSC in tumor cells, and to describe the potential antiproliferative effect of lidocaine during the pathogenesis of metastasis. Contents: A critical review of literature from April 2017 to April 2019 was performed. Articles found on PubMed (2000-2019) were considered. A free text and MeSH-lidocaine; voltage-gated sodium channels; tumor cells; invadopodia; surgical stress; cell proliferation; metastasis; cancer recurrence - for articles in English, Spanish and Portuguese language - was used. A total of 62 were selected. Conclusion: In animal studies, lidocaine acts by blocking VGSC and other receptors, decreasing migration, invasion, and metastasis. These studies need to be replicated in humans in the context of oncological surgery.
Resumo Justificativa: As evidências atuais sugerem que a cirurgia oncológica, usada no tratamento de tumores sólidos, aumenta o risco de metástase. Nesse sentido, uma ampla gama de células tumorais expressa Canais de Sódio Dependentes de Voltagem (CSDV), cujos papéis biológicos não estão relacionados à produção de potencial de ação. Nas células epiteliais tumorais, o CSDV é parte integrante de estruturas celulares denominadas invadópodes, que participam da proliferação, migração e metástase celular. Estudos recentes mostraram que a lidocaína pode diminuir a recorrência do câncer através de efeitos diretos nas células tumorais e de propriedades imunomoduladoras na resposta ao estresse. Objetivo: O objetivo desta revisão narrativa é analisar o papel do CSDV nas células tumorais e descrever o possível efeito antiproliferativo da lidocaína na patogênese das metástases. Conteúdo: Foi realizada uma revisão crítica da literatura de Abril de 2017 a Abril de 2019. Os artigos encontrados no PubMed (2000 − 2019) foram analisados. Pesquisamos textos de linguagem livre e descritores MeSH-lidocaína; canais de sódio dependentes de voltagem; células tumorais; invadópodes; estresse cirúrgico; proliferação celular; metástase; recorrência do câncer − em artigos publicados em inglês, espanhol e português. Foram selecionadas 62 publicações. Conclusão: Em estudos empregando animais, a lidocaína atua bloqueando o CSDV e outros receptores, diminuindo a migração, invasão e metástase. Esses estudos precisam ser replicados em humanos submetidos a cirurgia oncológica.
Subject(s)
Humans , Animals , Voltage-Gated Sodium Channels/drug effects , Lidocaine/pharmacology , Neoplasms/surgery , Cell Movement/drug effects , Cell Proliferation/drug effects , Voltage-Gated Sodium Channels/metabolism , Voltage-Gated Sodium Channel Blockers/pharmacology , Neoplasm Metastasis/prevention & control , Neoplasms/pathologyABSTRACT
The status of fear of recurrence and its psychosocial interventions among cancer survivors, including incidence of fear of cancer recurrence in various cancer populations, common measurement tools, influencing factors and its psychosocial interventions. It aims to improve medical staff's attention to the mental state of cancer survivors, provides a theoretical basis for the subsequent research.
ABSTRACT
Objective@#To investigate the effect of resilience on fear of cancer recurrence in breast cancer patients and to find the specific role of perceived social support between them.@*Methods@#From April 2018 to January 2019, we invited 456 breast cancer patients hospitalized in the Department of Breast surgery in Qilu Hospital of Shandong University in Jinan to participate in the study and to finish a questionnaire survey which including the general information questionnaire, Chinese version of the Fear of Progression Questionnaire-Short Form, The Connor-Davidson Resilience Scale and Perceived Social Support Scale.@*Results@#The average score of fear of cancer recurrence in breast cancer patients was (41.5±7.7), and 85.99% (313/364) of the patients′ score was clinically significant (total score ≥ 34). Resilience could negatively predict the fear of cancer recurrence (β=-0.240 P < 0.01). Perceived social support is the moderation between resilience and fear of cancer recurrence (β=-0.179, P<0.01).@*Conclusions@#The level of resilience could affect the level of fear of cancer recurrence in breast cancer patients, and the increase in the level of perceived social support could enhance the effect of resilience on the fear of cancer recurrence, thus further reducing the level of patient′s fear of recurrence.
ABSTRACT
The status of fear of recurrence and its psychosocial interventions among cancer survivors, including incidence of fear of cancer recurrence in various cancer populations, common measurement tools, influencing factors and its psychosocial interventions. It aims to improve medical staff's attention to the mental state of cancer survivors, provides a theoretical basis for the subsequent research.
ABSTRACT
Objective To investigate the effect of resilience on fear of cancer recurrence in breast cancer patients and to find the specific role of perceived social support between them. Methods From April 2018 to January 2019, we invited 456 breast cancer patients hospitalized in the Department of Breast surgery in Qilu Hospital of Shandong University in Jinan to participate in the study and to finish a questionnaire survey which including the general information questionnaire, Chinese version of the Fear of Progression Questionnaire-Short Form, The Connor-Davidson Resilience Scale and Perceived Social Support Scale. Results The average score of fear of cancer recurrence in breast cancer patients was (41.5 ± 7.7), and 85.99%(313/364)of the patients′ score was clinically significant (total score ≥ 34). Resilience could negatively predict the fear of cancer recurrence (β=-0.240 P<0.01). Perceived social support is the moderation between resilience and fear of cancer recurrence (β =-0.179, P＜0.01). Conclusions The level of resilience could affect the level of fear of cancer recurrence in breast cancer patients, and the increase in the level of perceived social support could enhance the effect of resilience on the fear of cancer recurrence, thus further reducing the level of patient′s fear of recurrence.
ABSTRACT
Objective This paper reviews the research context of the fear of cancer recurrence abroad, and presents the research hotspots and frontiers in this field, which will further provide references for the research of the fear of cancer recurrence in China. Methods Web of Science database was retrieved,the time of papers published, the number of publications and periodicals were analyzed.The Map drawing was accomplished with the help of Histcite software. Results Total 5322 effective literatures were investigated,most of the papers are published by the United States, Butow P was the high yield authors. and the core journal is "PSYCHO-ONCOLOGY". High frequency key words mainly concentrated on cancer, breast cancer, prostate cancer, quality of life, prognosis, chemotherapy (symptom distress and management). Conclusion In the aspect of fear of cancer recurrence, Europe and America are in a leading position, compared with the international level,there is still a gap in the field of FCR in China , the depth and breadth of research needs to be extended further, We should keep path with the international FCR research hotspot, to broaden our research scope and improve the quality of related research.
ABSTRACT
Objective To investigate the application of superficial brachytherapy in the treatment of the upper arm skin invasion of breast cancer. Methods This study was conducted on a female patient with ipsilateral chest wall, axillary, and clavicle recurrence, and circumferential skin and subcutaneous soft tissue invasion in the ipsilateral upper arm after modified radical mastectomy for breast cancer. The upper arm lesions were treated with 192Ir high-dose-rate superficial brachytherapy at a dose of 50 Gy in 25 fractions. Dosimetric parameters were compared between superficial brachytherapy and electron irradiation plan. Treatment outcomes and adverse reactions were observed during and after treatment. Results The heterogeneity index(HI)for target volume was 1.62 and 1.94 in superficial brachytherapy and electron irradiation plan, respectively. The D90,D100, and V150%for clinical target volume were higher in superficial brachytherapy than in electron irradiation plan(205 vs. 189 cGy;163 vs. 110 cGy;6.3% vs. 3.23%). The D0.1,D1, and D2for the humerus were also higher in superficial brachytherapy than in electron irradiation plan(155 vs. 80 cGy;147 vs. 55 cGy;145 vs. 36 cGy)and much lower than the bone tolerance dose in both treatments. The lesions partially subsided after superficial brachytherapy. The main adverse reaction was grade 2 radiation dermatitis. Conclusions Compared with electron irradiation plan, superficial brachytherapy is a simple and effective approach for irradiation of shallow target volume with a large curvature, such as circumferential upper arm skin invasion of breast cancer. Superficial brachytherapy achieves satisfactory homogeneity and dose distribution.
ABSTRACT
Objective To study the influence of capecitabine or S-1 combined with oxaliplatin on the quality of life and serum tumor marker in gastric cancer patients with postoperative recurrence and metastasis.Methods One hundred and six cases of postoperative recurrence and metastasis treated by gastric cancer radical operation in our hospital from January 2013 to December 2015were selected and divided into the control group and observation group according to the random number table method,53 cases in each group.The control group was given S-1 combined with oxaliplatin treatment,while the experimental group was given capeeitabine combined with oxaliplatin treatment.The clinical efficacy,quality of life,serum related tumor markers and adverse reactions were compared between the two groups.Results The effective rate was 64.15％ in the control group and 69.81％ in the observation group,the difference was not statistically significant (P＜0.05).The improvement rate of the quality of life in the control group was 73.58％,the stability rate was 18.87％ and decline rate was 26.42％,the total improvement rate was 73.58％,which in the observation group were 49.06 ％,20.75 ％,30.19 ％ and 69.81 ％ respectively,the differences were not statistically significant (P＞0.05).After treatment,the levels of CA50,CA125,CA199 and CEA in the two groups were significantly decreased compared with before treatment (P＜0.05),but the serum related tumor markers had no statistically significant difference between the two groups (P＞0.05).The common adverse reactions in the two groups included hemoglobin decrease,white blood cell decline,thrombocytopenia,nausea and vomiting,the two groups could be tolerated,the difference was not statistically significant (P＞0.05).Conclusion Capecitabine or S-1 combined with oxaliplatin has the same curative effect in treating postoperative recurrence and metastasis after gastric cancer operation,the improvement of quality of life and serum related tumor indicators is similar,and the adverse reactions could be tolerated.
ABSTRACT
Objective To study the influence of capecitabine or S-1 combined with oxaliplatin on the quality of life and serum tumor marker in gastric cancer patients with postoperative recurrence and metastasis.Methods One hundred and six cases of postoperative recurrence and metastasis treated by gastric cancer radical operation in our hospital from January 2013 to December 2015were selected and divided into the control group and observation group according to the random number table method,53 cases in each group.The control group was given S-1 combined with oxaliplatin treatment,while the experimental group was given capeeitabine combined with oxaliplatin treatment.The clinical efficacy,quality of life,serum related tumor markers and adverse reactions were compared between the two groups.Results The effective rate was 64.15％ in the control group and 69.81％ in the observation group,the difference was not statistically significant (P＜0.05).The improvement rate of the quality of life in the control group was 73.58％,the stability rate was 18.87％ and decline rate was 26.42％,the total improvement rate was 73.58％,which in the observation group were 49.06 ％,20.75 ％,30.19 ％ and 69.81 ％ respectively,the differences were not statistically significant (P＞0.05).After treatment,the levels of CA50,CA125,CA199 and CEA in the two groups were significantly decreased compared with before treatment (P＜0.05),but the serum related tumor markers had no statistically significant difference between the two groups (P＞0.05).The common adverse reactions in the two groups included hemoglobin decrease,white blood cell decline,thrombocytopenia,nausea and vomiting,the two groups could be tolerated,the difference was not statistically significant (P＞0.05).Conclusion Capecitabine or S-1 combined with oxaliplatin has the same curative effect in treating postoperative recurrence and metastasis after gastric cancer operation,the improvement of quality of life and serum related tumor indicators is similar,and the adverse reactions could be tolerated.
ABSTRACT
Objective:Comparing the influence of colon cancer recurrence of laparoscopic and open operation to evaluate the safety and validity of operation.Methods:The cohort study includes 62 cases of laparoscopic and 83 cases of open colon cancer radical surgery from January 2010 to October 2012.The research aimed at comparing the effects of laparoscopic and open surgery for colon cancer recurrence by analyzing postoperative follow-up ending and GCC-mRNA & CEA.Results:There have no obvious differences in age,sex,BMI,tumor size,stage,grade,pathological types and resection range between laparoscopy and open group(P＞0.05).Postoperative 3-years recurrence of two groups have no difference (P＞0.05),but 1-year recurrence rate of laparoscopic was obviously lower than open operation (3.2％ vs 14.5％,P＜0.05).There have no obvious differences of postoperative overall survival rate and mortality(P＞0.05),but 1-year disease-free survival rate of laparoscopic group was obviously higher than laparotomy group (93.5％ vs 81.3％,P＜0.05).The postoperative GCC-mRNA and CEA positive rate of laparoscopic was significantly lower than laparotomy group.Univariable and Multivariable analysis reveals that laparoscopic colorectal cancer radical can obviously reduce the cancer recurrence within 1 year (P＜0.05).Addition,stage,aspirin and other amino acid drugs are independent risk factors of postoperative recurrence (P＜0.05).Conclusion:Laparoscopic colon cancer radical surgery is a safe and effective operation and can reduce short-term recurrence of colorectal cancer compared to open surgery.
ABSTRACT
El tratamiento quirúrgico del cáncer de mama ha evolucionado, desde cirugías radicales que incluían la pared torácica hasta cirugías conservadoras de resección tumoral con margen oncológico seguro complementadas con radioterapia; estas se consideran alternativa a la cirugía radical. La supervivencia es similar en ambos procedimientos. Metodología: Estudio de cohorte retrospectivo que evaluó las características demográficas, patológicas y desenlaces clínicos, como recaída y mortalidad, en mujeres con cáncer invasivo, sometidas a cirugía conservadora entre 1998 y 2007 en el INC. Resultados: Se incluyeron 358 pacientes con edad promedio de 53 años y estados tumorales tempranos en su mayoría. Con mediana de seguimiento de cuatro anos se presentaron 40 recaídas entre locales, regionales y sistémicas con una tasa de recaída de 2,6 recaídas por 100 pacientes/año. Se presentó un mayor porcentaje de recaídas en estado clínico avanzado (p=0,022), tamaño tumoral mayor de 2 centímetros (p=0,02) y a mayor número de ganglios comprometidos en el vaciamiento axilar (p=0,004). La tasa de mortalidad fue 1,2 muertes por 100 pacientes/año. Los márgenes positivos se relacionaron con estado clínico avanzado (p=0,010) y las pacientes con márgenes positivos que recibieron manejo no quirúrgico presentaron un porcentaje mayor de recaída, comparado con las llevadas a cirugía (p=0,023). Esta diferencia se conservó al comparar manejo quirúrgico con no quirúrgico en márgenes positivos invasivos (p=0,037). Conclusiones: El estado clínico avanzado, se relacionó con márgenes positivos y recaída tumoral. El compromiso ganglionar axilar y el manejo no quirúrgico de los márgenes positivos determinaron un mayor porcentaje de recaída.
Surgical treatment for breast cancer has improved from radical surgery involving the chest wall, to conservative tumor resection surgery with oncologically safe margins. This latter, when supplemented with radiotherapy, is considered an alternative to radical surgery with similar survival for both procedures. Methodology: Retrospective observational study was performed to assess the clinical response in women older than 18 years with invasive cancer undergoing conservative surgery between 1998 and 2007. Results: A total 358 patients, with the majority in early tumor states were included for final revision. The mean age was 53 years. During a four year follow-up there were 40 local, regional and systemic relapses, with a progression rate of 2.6 relapses per 100 patients / year. There was a higher percentage of recurrence in advanced clinical status (P=.022), tumor size greater than 2 cm (P=.02), and greater number of lymph node involvement in the axillary clearance. Mortality rate was 1.2 deaths per 100 patients / year. Positive margins were associated with advanced clinical status (P=.010), and patients who received non-surgical management had a higher relapse rate compared with patients who had surgery (P=.023). This difference was maintained when comparing surgery with non-surgical management in invasive positive margins (P=.037). Conclusions: Advanced clinical stage was associated with positive margins and tumor relapse. Axillary lymph node involvement, and non-surgical management of surgical margins, resulted in a higher percentage of recurrence.