Clinical efficiency evaluation and prognostic factors of aspiration guided by neuronavigation to treat pediatric brain abscess / 中华实用儿科临床杂志

Objective:To explore the clinical efficiency evaluation and prognostic factors of aspiration guided by neuronavigation in the treatment of pediatric brain abscess (PBA).Methods:A total of 47 patients with PBA were treated with aspiration guided by neuronavigation between January 2013 and January 2019 at the First Affiliated Hospital of Zhengzhou University.All clinical data were retrospectively analyzed.According to Glasgow Outcome Scale on discharge, all children were divided into 2 groups, namely good prognosis group and poor prognosis group.Prognostic factors were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results:Among the 47 children, 38 children (80.9%) were assigned to the good prognosis group, and 9 children (19.1%) were assigned to the poor prognosis group.Univariate analysis proved that abscess volume>4 cm( χ2=5.650, P=0.017), multiple or multilocular abscess ( χ2=3.258, P=0.027), and abscess located in functional areas ( χ2=6.187, P=0.013) were correlated with poor prognosis.Multivariate analysis revealed that abscess volume>4 cm( OR=5.913, 95% CI: 2.241-25.917, P=0.023) and abscess located in functional areas ( OR=10.519, 95% CI: 3.918-62.513, P<0.001) were independent risk factors for poor prognosis. Conclusion:The treatment of PBA with aspiration guided by neuronavigation is safe, effective and minimal invasive, and the clinical efficiency is satisfactory.Abscess volume>4 cm and abscess located in deepbrain/functional areas are independent risk factors for poor prognosis.

¿Tiene valor pedir más de un perfil inmunohistoquímico en tumores multicéntricos o multifocales de mama? / Has it any value to request more than one immunohistochemical profile in multicentric or multifocal breast tumors?

Introducción La estimación de la prevalencia de tumores mamarios multicéntricos y multifocales es muy variable según los distintos estudios analizados. Esto se debe, en gran parte, a la falta de consistencia al momento de definir ambas formas de presentación. Por este motivo, muchos autores hacen referencia a este tipo de tumor como carcinoma mamario múltiple. El tnm, uicc-ajcc (7ma edición) define a esta forma de presentación como múltiples lesiones de carcinoma mamario presentes en la misma mama de manera sincrónica. Según el Colegio Americano de Patólogos (cap), la caracterización biológica de la lesión de mayor tamaño tumoral es suficiente, salvo que se presenten discordancias entre los tipos histológicos o grados tumorales. A pesar de que la estrategia de evaluar una única lesión en este aspecto tiene claras ventajas en costos y viabilidad, el cáncer de mama es considerado en sí mismo una enfermedad heterogénea, y, al seguir las recomendaciones anteriormente expresadas, se estaría asumiendo que estos tipos de tumores múltiples tienen un comportamiento biológico homogéneo. Por tal motivo, en el presente estudio se analiza el comportamiento biológico (re, rp, her2 y Ki-67) en cada foco tumoral presente, para poder establecer si, al seguir las recomendaciones vigentes actualmente, no estaríamos subtratando a un grupo de nuestras pacientes. Objetivos Evaluar la concordancia en los perfiles inmunohistoquímicos de cada tumor presente de manera sincrónica en la mama. Establecer la asociación entre los tamaños, los tipos histológicos y el grado tumoral. Material y método Se realizó un estudio observacional, retrospectivo en pacientes con diagnóstico y confirmación por estudio histopatológico de pieza quirúrgica de carcinoma mamario multifocal o multicéntrico. De un total de 722 pacientes, se obtuvieron datos de 45 historias clínicas, en un período comprendido, entre marzo de 2015 y septiembre de 2016 (18 meses). Las pacientes analizadas fueron diagnosticadas y tratadas en la Unidad de Mastología de la Clínica Breast y el Hospital Italiano de la Ciudad de La Plata, Buenos Aires, Argentina. Los resultados histopatológicos e Inmunohistoquímicos (ihq) se obtuvieron de los patólogos pertenecientes a nuestro centro mastológico. El perfil ihq se realizó en tejido tumoral obtenido mediante biopsia con aguja gruesa o pieza quirúrgica. Se determinó: Receptores Hormonales para Estrógeno (re) y Progesterona (rp), her2 y Ki-67. Resultados • Se observó una incidencia de 6,23% de tumores multicéntricos, multifocales. • En cuanto al tipo histológico, la correlación entre biopsia con aguja gruesa y análisis de pieza quirúrgica fue del 100% (n:45 pacientes). • Grado histológico tumoral en los distintos focos: 84% (n=38) de concordancia y 16% (n=7) de discordancia. • Variabilidad de subtipos tumorales en cada foco: el 67% (n=30) no presentó discordancias. • Perfil inmunohistoquímico (ihq): el porcentaje de pacientes con concordancia en el perfil inmunohistoquímico y el subtipo tumoral fue superior al grupo de pacientes que presentaron discordancias. En el grupo de pacientes con discordancias, un 20% sobreexpresó el marcador her2. Conclusiones Teniendo en cuenta la heterogeneidad tanto intratumoral como entre los distintos focos que se presenta en estos tumores múltiples, es importante obtener la mayor información posible sobre la morfología y el perfil inmunohistoquímico.

Estimates of the prevalence of multicentric and multifocal breast tumors is highly variable depending on the different studies analyzed, and this is due largely to the lack of consistency when defining both forms of presentation. For this reason, many authors refer to this type of tumor as multiple breast carcinoma. The tnm (7th edition) defines this presentation as multiple lesions of breast carcinoma present in the same breast synchronously. According to the College of American Pathologists (cap), biological characterization of the lesion of the largest tumor is sufficient, unless discrepancies between the histological tumor types or degrees are presented. Although the strategy of evaluating a single lesion in this regard, has clear advantages in cost and viability, breast cancer is considered itself an heterogeneous disease, and following the recommendations previously expressed, it would be assuming that these type of multiple tumors have a homogeneous biological behavior. Therefore, in this study the biological behavior (er, pr, her2 and Ki-67) is analyzed in each tumor focus, to determine whether to follow the recommendations currently in force, we would not be sub-treatment a group of our patients.

Analysis of clinical features and prognostic factors of desmoplastic small round cell tumor / 上海交通大学学报（医学版）

Objective·To analyze the clinical features and prognostic factors of desmoplastic small round cell tumor (DSRCT). Methods·Clinical datum of 140 patients with DSRCT published from Nov. 2003 to Jul. 2012 were collected and studied retrospectively by searching Medline and Embase databases. The observation indicators were progression-free survival (PFS) or overall survival (OS). Survival rates were calculated using the Kaplan-Meier method and compared between groups using a log-rank test. Multivariate analysis was performed using the Cox model to determine the prognostic factors. Results·Patient median age was (23.2±12.7) years (range 4-74 years, the ratio of male and female was 3.12:1). Frequent symptoms were abdominal pain (35.7%) and evidence of a palpable mass (20.0%). 106 cases tumors were in the abdominal or pelvic cavity, the remaining were extra-abdominal tumors. The frequency of patients receiving conventional chemotherapy, cytoreductive surgery, neoadjuvant chemotherapy, adjuvant chemotherapy or first-line chemotherapy was 76.4%, 52.1%, 17.1%, 47.9% and 38.6%, respectively. Some patients received adjuvant radiotherapy (17.1%), hyperthermic intraperitoneal chemotherapy (4.1%) and bone marrow transplantation (7.3%). By univariate analysis, male gender, absence of metastasis, effective cytoreductive surgery, chemotherapy and multimodal therapy were significant prognostic factors for prolonged OS (all P<0.05). Primary tumor site, extra-abdominal tumors, absence of metastasis and effective cytoreductive surgery were associated with improved PFS (all P<0.05). Cox regression analysis showed effective cytoreductive surgery and chemotherapy were independent prognostic factors. Conclusion·Multimodal therapeutics that clear tumors by surgery, adjuvant therapy are favorable prognostic factors for improved survival level in DSRCT patients.

Analysis of clinical features and prognostic factors of desmoplastic small round cell tumor / 上海交通大学学报（医学版）

Objective: To analyze the clinical features and prognostic factors of desmoplastic small round cell tumor (DSRCT). Methods: Clinical datum of 140 patients with DSRCT published from Nov. 2003 to Jul. 2012 were collected and studied retrospectively by searching Medline and Embase databases. The observation indicators were progression-free survival (PFS) or overall survival (OS). Survival rates were calculated using the Kaplan-Meier method and compared between groups using a log-rank test. Multivariate analysis was performed using the Cox model to determine the prognostic factors. Results: Patient median age was (23.2±12.7) years (range 4-74 years, the ratio of male and female was 3.12: 1). Frequent symptoms were abdominal pain (35.7%) and evidence of a palpable mass (20.0%). 106 cases tumors were in the abdominal or pelvic cavity, the remaining were extra-abdominal tumors. The frequency of patients receiving conventional chemotherapy, cytoreductive surgery, neoadjuvant chemotherapy, adjuvant chemotherapy or first-line chemotherapy was 76.4%, 52.1%, 17.1%, 47.9% and 38.6%, respectively. Some patients received adjuvant radiotherapy (17.1%), hyperthermic intraperitoneal chemotherapy (4.1%) and bone marrow transplantation (7.3%). By univariate analysis, male gender, absence of metastasis, effective cytoreductive surgery, chemotherapy and multimodal therapy were significant prognostic factors for prolonged OS (all P<0.05). Primary tumor site, extraabdominal tumors, absence of metastasis and effective cytoreductive surgery were associated with improved PFS (all P<0.05). Cox regression analysis showed effective cytoreductive surgery and chemotherapy were independent prognostic factors. Conclusion: Multimodal therapeutics that clear tumors by surgery, adjuvant therapy are favorable prognostic factors for improved survival level in DSRCT patients.

Microwave ablation for solitary hepatocellular carcinoma sized less than 5 cm: analysis of prognosis and its influence factors / 介入放射学杂志

Objective To evaluate the curative effect of microwave ablation (MWA) for solitary hepatocellular carcinoma (HCC) sized less than 5 cm,and to discuss the prognosis and its influence factors.Methods The clinical data of 603 HCC patients,who were admitted to authors' hospital during the period from 2011 to 2013 to receive MWA,were retrospectively analyzed.The patients were followed up till March 2016.Results According to the inclusion criteria,a total of 603 patients were enrolled in this study.Complete ablation of HCC lesions was obtained in 5.8％ of patients (35/603).No statistically significant difference in complete ablation rate existed between each other among groups of different tumor diameter (P=0.056).The incidence of severe complications was 1.7％ (10/603).The median survival time was (59.6±1.9)months,while the 1-,2-and 3-year overall survival rates were 94.7％,81.9％ and 71.8％ respectively.In terms of overall survival rate,no statistically significant difference existed between groups of different age as well as between groups of different tumor diameter (P=0.225 and P=0.777 respectively),but statistically significant difference existed between groups of different sex as well as between groups of different recurrence interval (P=0.029 and P＜0.001 respectively).Univariate and multivariate analysis showed that gender,preoperative albumin level and recurrence interval were the factors influencing overall survival rate (P=0.035,P=0.006 and P＜0.001 respectively).Conclusion For the treatment of solitary HCC sized less than 5 cm,MWA has reliable curative effect,it is a safe and minimally-invasive therapy for HCC.The overall survival rate between patients with different age or between patients with different HCC size is not obviously different.The gender,preoperative albumin level and recurrence interval are independent factors that affect the overall survival rate.

Correlation between Mnk2 protein expression and prognosis of patients with esophageal squamous cell carcinoma / 中国病理生理杂志

AIM:To investigate the protein expression of mitogen-activated protein kinase-interacting kinase-2 (Mnk2) and its prognostic effect in the patients with resected esophageal squamous cell carcinoma (ESCC).METHODS:A total of 86 informative patients with surgically resected ESCC and 54 normal esophageal tissues were enrolled .Western blot and immunohistochemistry (IHC) were utilized to assess the protein expression of Mnk 2, and its correlation with prog-nosis was statistically analyzed by the methods of Kaplan-Meier curve and Cox proportional hazard mode .RESULTS:The protein expression of Mnk 2 was elevated in most of tumor tissues compared with the adjacent tissues .Clinicopathologic analysis showed that Mnk2 expression was significantly correlated with the TNM stage (P<0.05).Both disease-free sur-vival ( DFS) and overall survival ( OS) of Mnk2 over-expression patients were shorter than those in Mnk 2 negative expres-sion group.Multivariate analysis confirmed that Mnk2 expression, as an independent and significant factor for both DFS and OS, predicted a poor prognosis of the patients with resected ESCC (P<0.05).CONCLUSION: The expression of Mnk2 was significantly related to the TNM stages , and might be a novel predictor for prognosis in ESCC .

Correlation between Mnk2 protein expression and prognosis of patients with esophageal squamous cell carcinoma / 中国病理生理杂志

AIM:To investigate the protein expression of mitogen-activated protein kinase-interacting kinase-2 (Mnk2) and its prognostic effect in the patients with resected esophageal squamous cell carcinoma (ESCC).METHODS:A total of 86 informative patients with surgically resected ESCC and 54 normal esophageal tissues were enrolled .Western blot and immunohistochemistry (IHC) were utilized to assess the protein expression of Mnk 2, and its correlation with prog-nosis was statistically analyzed by the methods of Kaplan-Meier curve and Cox proportional hazard mode .RESULTS:The protein expression of Mnk 2 was elevated in most of tumor tissues compared with the adjacent tissues .Clinicopathologic analysis showed that Mnk2 expression was significantly correlated with the TNM stage (P<0.05).Both disease-free sur-vival ( DFS) and overall survival ( OS) of Mnk2 over-expression patients were shorter than those in Mnk 2 negative expres-sion group.Multivariate analysis confirmed that Mnk2 expression, as an independent and significant factor for both DFS and OS, predicted a poor prognosis of the patients with resected ESCC (P<0.05).CONCLUSION: The expression of Mnk2 was significantly related to the TNM stages , and might be a novel predictor for prognosis in ESCC .

Complicaciones intrahospitalarias del infarto del miocardio con elevación del segmento ST / In-hospital complications of ST-segment elevation myocardial infarction

Introducción: el infarto con elevación del segmento ST es uno de los diagnósticos más frecuentes de los ingresos en unidades de cuidados intensivos en cualquier institución de salud cubana. Objetivo: analizar los principales factores de riesgo relacionados con el infarto agudo del miocardio y sus complicaciones intrahospitalarias, así como los predictores de estas complicaciones. Métodos: estudio descriptivo, longitudinal y prospectivo desde 2013 hasta 2016 que incluyó a 272 pacientes consecutivos que ingresaron en la Unidad de Cuidados Coronarios Intensivos del Hospital Militar Central Dr. Carlos J. Finlay con el diagnóstico de infarto agudo de miocardio con elevación del segmento ST. Resultados: La edad media fue de 63,4 ± 11,7 años, predominó el sexo masculino (61,8 por ciento). Los principales factores de riesgo: hipertensión arterial y tabaquismo (66,5 por ciento en ambos casos). Del total de pacientes, 109 sufrieron complicaciones intrahospitalarias, la angina postinfarto fue la más frecuente (34,9 por ciento). El shock cardiogénico y las complicaciones mecánicas se asociaron significativamente con la mortalidad intrahospitalaria (p = 0,007 y p < 0,001, respectivamente). La edad ≥ 60 años, la clase funcional Killip-Kimball ≥ II y la no realización de intervención coronaria percutánea constituyeron factores pronósticos de eventos adversos durante el ingreso. Conclusiones: las complicaciones intrahospitalarias del infarto agudo de miocardio con elevación del segmento ST no son frecuentes. Existen factores pronóstico de complicaciones como la edad avanzada, clase funcional Killip-Kimball ≥ II y la no realización del intervención coronaria percutánea(AU)

Introduction: ST-segment elevation acute myocardial infarction is one of the most frequent diagnoses of admission in intensive care units at any health institution in our country. Objective: Analyze the principal risk factors related with the acute myocardial infarction and its complications in the admission, as well as these complications predictors. Method: A descriptive, prospective study was conducted in 272 consecutive patients who were admitted in Coronary Intensive Care Unit of Dr. Carlos J. Finlay Central Military Hospital. ST-segment elevation myocardial infarction was their diagnosis. They period studied was from September 2013 to August 2016. Results: The patients` median age was 63.4 ± 11.7 years, and 168 (61.8 percent were male. The main risk factors were hypertension and smoking (66.5 percent in both cases). One hundred nine (109) patients suffered complications in hospital; the post-infarct angina was the most frequent (34.9 percent). The association among cardiogenic shock and mechanical complications with mortality was significant (p< 0.007 and p< 0.001, respectively). Independent associations were found between age ? 60 years, the Killip-Kimball functional classification ? II, non-performing percutaneous coronary intervention were prognostic factors for adverse events during admission. Conclusions: The complications of ST-segment elevation myocardial infarction during hospital admittance are not frequent. There are prognosis factors of complications like advanced age, functional Killip-Kimball classification ? II and non-performing percutaneous coronary intervention(AU)

Clinical features and prognostic factors of small cell lung cancer: A retrospective study in 148 patients / 华中科技大学学报（医学）（英德文版）

To better understand the outcomes of small cell lung cancer (SCLC), we examined the clinical features and prognostic factors of SCLC in this study. A total of 148 patients who were diagnosed as having SCLC between January 2009 and December 2013 in Cancer Center of Union Hospital, Wuhan, China, were enrolled and their clinical features and prognostic factors were retrospectively analyzed. Log-rank test and Cox regression model were employed for analysis of prognostic factors. The 1- and 2-year overall survival (OS) rates were 59.7% and 25.7%, respectively, for limited disease (LD) patients whose median survival time (MST) was 16 months. The 1- and 2-year OS rates were 29.5% and 5.3%, respectively, for extensive disease (ED) patients whose MST was 10 months. The univariate analysis and multivariate analysis revealed that age, tumor stage, serum CEA and Ki-67 antigen were significantly correlated to the outcomes of SCLC, and they were significant prognostic factors for SCLC.

Factores pronósticos en la neumonía asociada a la ventilación mecánica / Prognosis factors in the pneumonia associated with the mechanical ventilation

Se llevó a cabo una investigación analítica de casos y controles, de 172 pacientes expuestos a ventilación mecánica, atendidos en la Unidad de Cuidados Intensivos del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde mayo del 2013 hasta igual periodo del 2014, con vistas a identificar los factores pronósticos que inciden en la aparición de la neumonía asociada a la ventilación mecánica. El grupo de estudio estuvo conformado por 72 afectados, y el control por 100. Entre los factores que mostraron importancia pronóstica significativa figuraron: tiempo de intubación superior a 7 días, sedación, reintubación y administración previa de antibióticos.

An analytic investigation of cases and controls, of 172 patients exposed to mechanical ventilation, assisted in the Intensive Care Unit from "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba was carried out from May, 2013 to the same period of 2014, with the objective of identifying the prognosis factors influencing on the emergence of pneumonia associated with the mechanical ventilation. The study group was formed by 72 affected, and the control group by 100. Among the factors showing significant importance for prognosis there were: intubation time longer than 7 days, sedation, reintubation and previous administration of antibiotics.

Factores de pronóstico relacionados con la mortalidad por neumonía asociada a ventilación mecánica / Prognosis factors related to mortality due to pneumonia associated to mechanical ventilation

Se realizó un estudio observacional, analítico y retrospectivo de 45 pacientes con neumonía asociada a ventilación mecánica, atendidos en la Unidad de Cuidados Intensivos del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde mayo de 2011 hasta igual mes de 2012, con vistas a identificar los factores de pronóstico relacionados con la mortalidad por esa causa. No hubo asociación estadística entre el número de muertes por neumonía y la presencia de sedación, reintubaciones, intubación de emergencia, así como enfermedad de base; sin embargo, existió un incremento de esta variable en los afectados con neumonías de curso tardío, edad avanzada, protección gástrica, administración previa de antimicrobianos, antibioticoterapia empírica inadecuada, enfermedades asociadas y en los que habían permanecido en estado de coma. Se demostró que la duración prolongada de la ventilación mecánica y la elevada estadía también influyeron en los fallecimientos

An observational, analytic and retrospective study of 45 patients with pneumonia associated with mechanical ventilation, assisted in the Intensive Care Unit of Saturnino Lora Torres Provincial Teaching Clinical Surgical Hospital in Santiago de Cuba was carried out from May, 2011 to the same month of 2012, with the aim of identifying the prognosis factors related to mortality due to that cause. There was no statistical association between the number of deaths as a result of pneumonia and the sedation, reintubations, emergency intubations, as well as with the initial disease; however, an increment of this variable existed in the affected patients with long lasting pneumonias, advanced age, gastric protection, previous administration of antimicrobians, inadequate empiric antibiotic therapy, associated diseases and in those who remained in coma. It was demonstrated that the lasting duration of mechanical ventilation and the prolonged stay also influenced in the deaths

Prognostic and survival analysis of primary liver cancer after hepatectomy / 肿瘤研究与临床

Objective To explore the factors related to the prognosis and survival duration of primary liver cancer patients after hepatectomy.Methods The data of primary liver cancer patientswho were treated by surgical resection were analyzed retrospectively.Kaplain-Meier method was used to evaluate survival rates.Log-rank test and Cox regression analysis were used to screen out related clinical phathology factors.Results The median survival time was eighteen months.Univarivate analysis showed that liver function Child-Pugh classification,cirrhosis,tumor size,HBV infection,AFP,portal vein tumor thrombus significantly correlated with survival rates (P ＜ 0.05).Multivariate analysis showed that liver function Child-Pugh classification,tumor size,AFP and portal vein tumor thrombus were the independent prognostic factors of primary liver cancer (P ＜ 0.05).Conclusion Many factors are related to the prognosis of primary liver cancer after operation.Liver function Child-Pugh classification,tumor size,AFP and portal vein tumor thrombus affect prognostic independently.

A Short-Term Analysis of Parameters Affecting the Outcome of Sacral Neuromodulation

PURPOSE: Sacral neuromodulation has become an effective option for controlling intractable symptoms of overactive bladder: urgency and urge incontinence. However, it has its limitations in that an intermittent pulse generator (IPG) is insertable only in patients with symptom improvement of at least 50%. In this study, we aimed to investigate the parameters that predict surgical outcomes. MATERIALS AND METHODS: Data from 31 candidates for sacral neuromodulation were retrospectively analyzed. Twenty patients out of 31 candidates had satisfactory symptom improvement after tinned lead test implantation, which resulted in IPG implantation. Data and neural stimulation parameters were compared and analyzed between successful IPG implants (group 1) and test failures (group 2). RESULTS: The percentage of female patients was higher in the IPG implant group (group 1: 95%, group 2: 64%). There was a significant difference in symptom duration, between the two groups (group 1: 40.5 months, group 2: 91 months). There was a significant difference in the number of episodes of urgency between the two groups (group 1: 6.83/day, group 2: 9.66/day, p=0.012), and severity of urgency showed significant difference between two groups (group 1

Clinical Significance of MUC2 and MUC5AC Expression in Gastric Adenocarcinomas

PURPOSE: We examined the clinical significance of MUC2 and MUC5AC gene expression in gastric adeno-carcinoma tissues. METHODS: Two hundred specimens were obtained from gastric carcinoma patients who underwent gastric cancer operations at Samsung Medical Center between January 2001 and January 2005. MUC2 and MUC5AC expression were examined immunohistochemically, and correlated with clinicopathologic features and prognostic significance. RESULTS: MUC2 expression was positive in 88 tissues (44.0%) and MUC5AC expression was positive in 125 tissues (62.5%). MUC2 expression was associated with cancer advancement, lymph node metastasis, T classification, distant metastasis, and endolymphatic invasion. Loss of MUC5AC expression was significantly related to cancer advancement, lymph node metastasis, advanced T stage, and distant metastasis. MUC2 expression was usually negative in early gastric cancer (78%), but usually positive in advanced gastric cancer (66%). MUC5AC was usually positive in early gastric cancer (74%). The prognosis of the MUC2(-) group was significantly better than the MUC2(+) group (P<0.001). There was no relationship with MUC5AC expression and survival. Multivariate analysis showed that T classification, lymph node metastasis, distant metastasis, endolymphatic invasion, and MUC2 expression were independent prognostic factors, but MUC5AC expression was not. CONCLUSION: MUC2 and MUC5AC expression correlated with several clinicopathologic parameters (cancer advancement, lymph node metastasis, advanced T classification, distant metastasis). MUC2 expression was a significant independent prognostic factor and positive MUC2 expression suggested poor prognosis. MUC2 expression may have prognostic significance in gastric adeno-carcinomas.

Prognostic Factors in Transitional Cell Carcinoma of the Renal Pelvis: Multivariate Analysis / 대한비뇨기과학회지

Purpose: This study was designed to assess the prognostic factors in patients with transitional cell carcinoma of the renal pelvis (renal pelvis tumor) using multivariate analysis. MATERIALS AND METHODS: Fifty six patients (43 males and 13 females), who were treated surgically for a renal pelvis tumor, were enrolled in this study. The traditional prognostic factors including age, sex, initial symptoms and duration, urine cytology, excretory urographic findings, location, method of surgical treatment, tumor stage, grade, size of tumor, and multiplicity were analyzed with respect to the disease recurrence and survival rate using an univariate log-rank test, Kaplan-Meier's survival curve and a multivariate Cox regression analysis model. RESULTS: The mean age of the patients was 58.9 years and the mean duration of follow up was 50.5 months. Recurrences occurred in 26 patients, and 9 patients died from cancer. On univariate analysis, the initial tumor stage (p=0.013) and tumor grade (p=0.023) are prognostic factors for the recurrence of a renal pelvis tumor, and the initial tumor stage (p<0.001), tumor grade (p=0.001), tumor size (p=0.013), multiplicity (p=0.034), and tumor recurrence (p=0.012) are prognostic factors for the tumor specific survival rate. However, on multivariate analysis, the initial tumor stage is a prognostic factor for tumor recurrence and survival. The interval between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate without statistical significance (p=0.067) CONCLUSIONS: The primary tumor stage is the only independent prognostic factor of both the disease recurrence and disease specific survival rate on multivariate analysis. The duration between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate. Further studies are necessary to clarify this result.

Primary Non-Hodgkin's Gastric Lymphoma

PURPOSE: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. MATENRIALS AND METHODS: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. RESULTS: The lower one-third of the stomach was the most frequent site (42%), and the most frequent chief complaint was epigastric pain (54%). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases (82%), a carcinoma in 15 cases (13%), an ulcer in 4 cases (4%), and a gastrointestinal stromal tumor in 1 case (1%). The stage distributions by Musshoff's criteria were 71 cases (54%) of stage IE, 36 cases (27%) of stage II1E, 8 cases (6%) of stage II2E, 2 cases (2%) of stage IIIE, and 15 cases (11%) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases (23%) of low grade, 96 cases (73%) of intermediate grade, and 5 cases (4%) of high grade. Chemotherapy-related complications occurred in 25 cases (22%) while operation-related complications occurred in 6 cases (5%). Seventeen patients (13%) only underwent surgery, 19 (14%) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients (73%) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was 85% in stage I or II and 47% in stage III or IV (P=0.0000). CONCLUSION: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.

Rate of Mortality with Hip Fracture and its Prognostic Factors in an elderly Japanese population

The purpose of this study was to clarify the survival rates and prognostic factors in elderly Japanese patients with hip fractures. This study investigated the outcome of 256 patients aged 60 years and older with surgically treated hip fractures. Information including age, gender, duration of hospitalization, place of residence before fracture and at discharge, and level of mobility before fracture and at discharge was obtained from patient records. The survival of the patients after discharge was determined by mail surveys supplemented with telephone inquiries.The observed survival rates were significantly lower than the expected survival rates (p<0.001, by Mantel Haenszel test). The short-term mortality rates were 6% for six months and 12.7% for one year, which were lower than previously reported rates in Western countries. Significantly higher hazard ratios (HR) for mortality adjusted for age and gender were observed in patients who had lived in places other than their own home before fracture (HR=2.67(1.63-4.3)), were discharged to places other than their own home (Nursing home HR=2.25 (1.24-4.1) or to a non-orthopedic unit (HR=5.95 (3.12-11.34)), those requiring full-time assistance for mobility at discharge (HR=5.71 (3.59-9.01)), and those who had stayed in a hospital for fewer than 40 days (HR=2.20 (1.38-3.51)). After adjusting for the effects of all the potential prognostic factors, discharge to places other than their own home and the lowest level of mobility at discharge remained significant factors causing adverse effects on survival.Therefore, to improve the prognosis, patients should be allowed to recover to a level at which they can ambulate with some assistance, enabling them return to their own homes.

Prognostic factors in 83 patients with cervical carcinoma treated with high-dose-rate brachytherapy and external radiotherapy / 中国癌症杂志

Purpose:To investigate the related factors affecting the prognosis of patients with cervical carcinoma treated with radiotherapy. To analyze the relationship between the survival rate and some factors such as the tumor size,treatment days and local control.Methods:From April 1993 to April 2001,83 cervical carcinoma patients with stage Ⅰ,Ⅱ,Ⅲ were treated with cobalt teletherapy and 192 Ir high-dose-rate brachytherapy as primary treatment. The method of external irradiation: first deliver DT25-26Gy/13 fraction,then increase the dose to DT48-50Gy with middle lead block in the field. The internal radiation method: the dose ir A point is DT 35 Gy/7 fraction. Kaplan- Meier method was used to calculate the survival rate and Log-rank test for the difference significance.Results:①local control: the 1-,2-,3-,5-year survival rates in complete response and partial response patients and progressive patients were respectively 95.87%,77.12%,73.09% 73.09%and 34.29%,0%,0%,0%,there is significant difference between them . ②treatment days :the 1-,2-,3-,5-year survival rates in the patients with treatment days exceeding 56 days and not exceeding 56 days were respectively 93.88%,82.86% 80.19%,80.19% and 78.95%,30.55%,22.91%,22.91%,there is significant difference between them . ③the maximum tumor diameter : the 1-,2-,3-,5- year survival rates in patients with the maximum tumor diameter exceeding 4 centimeters and not exceeding 4 centimeters were respectively 95.12%,82.86%,79.67%,79.67% and 81.93%,58.20%,53.35%,53.35%,there is significant difference between them.Conclusions:①The patients with local residual tumor and bigger tumor volume had relatively poorer prognosis;②The treatment days should be shortened to 8 weeks if possible;③ The comprehensive treatment and shortened treatment days may improve the therapeutic effect for the patients with tumor size ≥4cm,local residual and progressive tumor.

Comparison of Clinical and Pathological Findings in Unifocal and Multifocal Prostate Cancer / 대한비뇨기과학회지

PURPOSE: Multifocal prostate cancer has been reported in 50%?85% of all carcinoma cases, but clinical and prognostic significance of this finding is unclear. Patients who underwent radical perineal prostatectomy for localized prostate cancer were retrospectively analysed. The clinical and pathological findings and prognostic significance of prostate cancer focality were assessed. MATERIALS AND METHODS: Between 1995 and 1998, 28 consecutive radical prostatectomy specimens were reviewed by slicing the specimens into 4mm sections. Preoperative screening parameters, clinical stage and pathological findings including the gleason score, extracapsular extension(ECE), positive surgical margin, vascular invasion, lymph-node invasion, DNA ploidy and p53 etc. were evaluated to assess the prognostic significance of multifocal prostate cancer. RESULTS: Fifty percent(14/28) of patients had multifocal prostate cancer. There were no statistical differences in the comparison of age, PSA, PSAD, gleason score in needle biopsy, number of needle biopsy with carcinoma between the multifocal and unifocal prostate cancer groups. The preoperative parameters were not able to predict uni- or multifocality. Of the patients with positive surgical margin, 14.3% had unifocal and 42.9% multifocal cancers(p>0.05). Lymph node invasions were detectable in 14.3% of multifocal cases and 0% in unifocal cases(p>0.05). However the postoperative pathologic findings were not significantly different in both groups(p>0.05). CONCLUSIONS: Although the result of our study was different from the previous reports, based on these findings, it is apparent that a long term follow-up of the patients outcome will be necessary to fully assess the prognostic ability of the cancer focality in men undergoing radical prostatectomy for treatment of prostate adenocarcinoma.

Eevaluation of p53 proteinas overexpression an independent prognostic factor in esophageal squamous cell carcinoma / 中华消化杂志

Mutation and overexpression of the tumor suppressor gene product, p53, is believed to play an important role in the development of human malignant tumors. Many studies shows that overxpression of the mutant p53 gene product is common in human malignant tumours including esophageal cancer. However, the prognostic significance of overexpression of p53 gene is not well defined. In this study, we have investigated the overexpression of p53 gene product in 174 esophageal squamous cell carcinoma collected from Sichuan Cancer Hospital, Chengdu, China. 48.9% of these esophageal squamous cell carcinomas were positive for p53 staining. Correlations of overexpression of p53 with clinicopathological features including histological type and grade, clinical staging, age and sex was analyzed in all specimens. The prognostic significance of p53 stained esophageal squamous cell carcinoma was analyzed in 111 of these patients follow-up for five-year. Significant statistical correlations were observed between p53 positive and poor prognosis analyzed by Cox proportional hazard regression analysis, (F=0.04). No statistically significant differences were observed between p53 overexpression and the clinicopathological factors including age, sex, differentiation and clinical staging of the cancer, but patients with Vositioly expressed p53 has a poorer prognosis than those with negative expression. The present study indicate that overexpression of p53 may be a useful independent prognostic factor in esophageal squamous cell carcinoma at its early stage.