Therapeutic effect of haploidentical hematopoietic stem cell transplantation for treatment of 59 children with hematological diseases / 中华实用儿科临床杂志

Objective To evaluate the safety and efficacy of haploidentical hematopoietic stem cell transplan-tation(haplo-HSCT)treatment in children with hematological diseases.Methods Fifty-nine cases of less than 14 years old children with hematonosis were analyzed retrospectively,who were enrolled in the Aerospace Central Hospital from July 2012 to June 2016.And the evaluation was carried out by analyzing the success rate of implantation,occu-rrence rate of graft versus host disease(GVHD),infection rate and transplant related mortality(TRM),cumulative re-currence rate,overall survival rate(OS)and disease-free survival rate(DFS).Results In total of 59 cases,the 59 engraftments were successfully transplanted,the median time of leukocyte engraftment was 18(8-23)days,the median time of platelet engraftment was 21(11-68)days,the bone marrow was assessed 28 days after transplanta-tion,which showed that 59 patients achieved complete remission(CR)and DNA test confirmed complete donor chime-rism.With a median of follow-up time of 19(5-56)months,the cumulative recurrence rates ofⅠ,Ⅱgrade andⅢ,Ⅳ grade acute GVHD were(38.3 ± 6.3)%(23 cases)and(16.7 ± 4.8)%(10 cases),respectively,the chronic GVHD cumulative recurrence rate was(65.6 ± 7.5)%(30 cases),the cytomegalovirus(CMV)viremia cumulative recurrence rate was(45.1 ± 6.5)%(27 cases),the Epstein-Barr virus(EBV)viremia cumulative recurrence rate was(10.0 ± 3.9)%(6 cases),the viral cystitis cumulative recurrence rate was(20.0 ± 5.5)%(12 cases),the transplant related mortality was(12.8 ± 6.0)%,the 2-year cumulative recurrence rate of CR group was(8.0 ± 5.4)%,and that of non-remission(NR)group was(64.1 ± 11.9)%.The 2-year OS of CR group was(78.9 ± 7.5)%,the 2-year OS of NR group was(32.5 ± 12.9)%,the 2-year DFS of CR group was(79.5 ± 9.8)%,the 2 years DFS of NR group was(27.4 ± 7.9)%.Conclusions Haplo-HSCT is safe and effective in treating children with hematonosis,and haplo-HSCT has high survival rate and low recurrent,especially when transplantation is per-formed in the remission stage.But the prognosis of haplo-HSCT is poor in the refractory and relapsed patients,and to explore the preventing recurrence measures are very urgent.

Effect of short-term recurrence of early stage colon cancer by laparoscopic colon cancer radical / 中国现代普通外科进展

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.

Outcome of Laparoscopic Liver Resection for Hepatocellular Carcinoma

PURPOSE: Although laparoscopic liver resection has become popular and it has shown good surgical safety and feasibility, the oncologic safety is still not established. Therefore, we analyzed the mid-term survival and disease free survival rates after laparoscopic liver resection for HCC to establish the oncologic safety. METHODS: Between September 2003 and August 2008, 64 patients with hepatocellular carcinoma underwent laparoscopic liver resection. The clinical data of these patients was analyzed by the Kaplan-Meier method. RESULTS: There were 19 major hepatic resections and 45 minor hepatic resections without any mortality. There were 15 complications, including 9 cases of abdominal fluid collection, 3 cases of bile leakage, 2 cases of ascites and 1 case of ileus. The 3 years overall survival and disease free survival rates were 87.8% and 67.3%, respectively. CONCLUSION: We confirmed that laparoscopic liver resection for hepatocellular carcinoma is safe and feasible. The 3 years survival rates and disease free survival rates were as high as those of open resection for hepatocellular carcinoma.

Outcome of Laparoscopic Liver Resection for Hepatocellular Carcinoma

PURPOSE: Although laparoscopic liver resection has become popular and it has shown good surgical safety and feasibility, the oncologic safety is still not established. Therefore, we analyzed the mid-term survival and disease free survival rates after laparoscopic liver resection for HCC to establish the oncologic safety. METHODS: Between September 2003 and August 2008, 64 patients with hepatocellular carcinoma underwent laparoscopic liver resection. The clinical data of these patients was analyzed by the Kaplan-Meier method. RESULTS: There were 19 major hepatic resections and 45 minor hepatic resections without any mortality. There were 15 complications, including 9 cases of abdominal fluid collection, 3 cases of bile leakage, 2 cases of ascites and 1 case of ileus. The 3 years overall survival and disease free survival rates were 87.8% and 67.3%, respectively. CONCLUSION: We confirmed that laparoscopic liver resection for hepatocellular carcinoma is safe and feasible. The 3 years survival rates and disease free survival rates were as high as those of open resection for hepatocellular carcinoma.

Graves' Disease Presenting Concurrently with Thyroid Cancer

PURPOSE: Graves' disease presenting concurrently with thyroid cancer is a rare condition. The clinical behaviors and the extent of surgery in this condition is still controversial. This study examined the prognostic factors influencing the long-term outcomes as well as the appropriate treatment modalities in patients with Graves' disease presenting concurrently with thyroid cancer. METHODS: Forty nine patients who underwent surgery for thyroid cancer with Graves' disease were enrolled in this study. The outcomes of various types of surgical treatments as well as the factors associated with the long-term outcome were retrospectively analyzed. RESULTS: There were 42 women and 7 men with a median age 39 years (15~70 years). The surgical procedures included a bilateral subtotal thyroidectomy (n=17), a bilateral total thyroidectomy (n=16), and a total and contralateral subtotal thyroidectomy (n=16). The mean follow-up period was 83 months (4~218 months) after surgery. Disease-free survival at 5 and 10 years were 97.6% and 88.9%, respectively. Univariate log-rank survival analyses revealed that the age at diagnosis, the size of the thyroid cancer, capsular invasion, multiplicity, lymph node involvement, and clinical cancer to be poor prognostic factors. However, the extent of the surgical treatment was not significant for survival. CONCLUSION: The prognosis is expected to be poor when thyroid cancer presenting concurrently with Graves' disease is clinically apparent or has invaded the thyroid capsule. Patients with Graves' disease should be screened with ultrasonography to detect thyroid cancer. A total thyroidectomy or completion total thyroidectomy is not necessary in patients who do not have any of the poor prognostic factors, such as incidentally detected microcarcinoma postoperatively.

Multivariate analysis of prognostic factors after radical resection for hepatocellular carcinoma / 中华肝胆外科杂志

Objective To determine the prognostic factors after radical resection (RR) for hepatocellular carcinoma (HCC).Methods Altogether 144 patients who had undergone RR for HCC from 1988 through 1995 were included for a univariate and a Cox multivariate analysis.Nineteen factors contributing to overall survival rate (SR) and disease-free SR were analysed.Results The 5-year SR and disease-free SR (N=144) were 47.3% and 23.9%,separately.Multivariate analysis revealed that classification of RR was the signficant factor to overall SR,and presence of vessel invasion was the signficant factor to disease-free SR.The 5-year SR and disease-free SR in the patholngically RR and clinically RR groups were 60.2%,29.0% and 14.0%,0%,respectively.The 5-year disease-free SR in the group without (or with) vessel invasion was 27.8% (or 0%).Conclusions The classification of RR is the determinative prngnostie factor.Pathologically RR is the first option for patients with in- dications.It is essential to improve adjuvant therapy to decrease postoperative recurrence and metastasis rates.

Prognostic Factors For Survival in Patients with Lymph Node Metastasis Identified at the Time of Surgery for Cervical Carcinoma / 대한산부인과학회잡지

The presence of metastatic lymph nodes in cervical carcinoma is one of the most important prognostic factors to survival. In general, the characteristics of metastatic lymph nodes such as number, site, and bilaterality etc. can modify the survival of patients with lymph node metastasis. This nonrandomized retrospective study was performed to identify prognostic factors for survival in patients with FIGO stage IA2, I B and IIA, IIB carcinoma of the cervix with nodal metastases. From January 1, 1993, to December 31, 1995, 86 patients with FIGO stage I A, I B and IIA, IIB carcinoma of the cervix were found to have nodal metastasis at the time of radical hysterectomy and pelvic lymphadenectomy at the Department of Obstetrics and Gynecology, Korea Cancer Center Hospital. The prognostic significance of number of metastatic lymph nodes, site(s) of lymph node metastases, cervical lesion size, age, FIGO stage have been evaluated. In this study, the 3-year disease free survival rate (DFSR) and clinical characteristics were compared with the prognostic factors. Univariate analysis revealed significant that number of metastatic lymph nodes (p=0.0008) and tumor size (p=0.0490) were significant prognostic factor, but there were no significant differences in 3-year DFSR according to age (p=0.1257), FIGO stage (0.4687), site(s) of lymph node metastases (p=0.5552). However, by multivariate analysis only number of metastatic lymph nodes (p=0.0248) was noted to be a significant prognostic factor determining survival of the patient. A risk of recurrence increased continuously in accordance with increased of the number of metastatic lymph nodes. In particular the 3-year DFSR fell markedly from 85.3% in patient with less than four metastatic lymph node to 25.9% in those with five or more metastatic lymph node (p=0.0008). These results demonstrated that the number of metastatic lymph nodes was the most important and independent prognostic factor in patients with cervical cancer showing lymph node metastasis.