"Proposed""BS""classification of osteoradionecrosis of the mandible and the corresponding therapeutic strategy" / 中国肿瘤临床

Objective:To introduce a novel clinical classification that can be applied to osteoradionecrosis treatment in an easy and considerably acceptable manner through a retrospective analysis of patients with osteoradionecrosis of the mandible (ORNM). Methods:The clinical data of 99 ORNM patients admitted to shanghai Ninth People's Hospital between 2000 and 2013 were summa-rized. A novel classification was established based on bone necrosis and soft tissue lesions. The new staging system was developed based onBandSclassifications. Corresponding strategies and methods of ORNM treatment at different stages were also proposed. Results:A new staging system with four different stages (i.e., stage 0:8 cases;stageⅠ:14 cases;stageⅡ:65 cases;and stageⅢ:12 cases) was proposed. Conservative treatment was applied to stage 0 patients, whereas sequestrectomy was performed in stageⅠcases. Marginal or segmental resection of the mandible was selected for stageⅡpatients;osteocutaneous flap or just soft tissue flap was also reconstructed. Conclusion:This new classification and staging system is easier to use and more acceptable for clinical evaluation than other systems.

Comparison between the 7th edition of International Union Against Cancer staging system and the Chinese 2008 staging system for nasopharyngeal carcinoma and suggestions for the updating of the staging system / 中华放射肿瘤学杂志

Objective To compare the 7th edition of International Union Against Cancer ( UICC) staging system with the Chinese 2008 staging system for nasopharyngeal carcinoma ( NPC) , and to provide evidence for further updating of the staging system. Methods A retrospective analysis was performed among 767 patients who were pathologically and newly diagnosed with non?metastatic NPC and treated with intensity?modulated radiotherapy from 2006 to 2012. Based on the main prognostic indices, overall survival ( OS) , locoregional failure?free survival( LFFS) local relapse?free survival ( LRFS) , and distant metastasis?free survival ( DMFS) rates, the value of T stage, N stage, and clinical stage in prognostic prediction was compared between the two staging systems. The Kaplan?Meier method was used for calculating survival rates. The log?rank test was used for survival difference analysis. The Cox model was used for multivariate prognostic analysis. Results In terms of T stage, the Chinese 2008 staging system was a significantly better predictor of the OS and LRFS rates than the 7th edition of UICC staging system. In terms of N stage, they were comparable in the prediction of the OS and DMFS rates. In terms of clinical stage, the 7th edition of UICC staging system was a significantly better predictor of the OS rate than the Chinese 2008 staging system. For the new staging system proposed based on the statistical results, the T, N, and clinical staging gave significantly better prognostic prediction. Conclusions The 7th edition of UICC staging system and the Chinese 2008 staging system for NPC have their own advantages in prognostic prediction. The new staging system proposed in this study could contribute to the updating of the current staging system for NPC.

Management of Hepatocellular Carcinoma: Current Status and Future Directions

Hepatocellular carcinoma (HCC) is the second most common cause of cancer death worldwide. This cancer commonly arises against a background of chronic liver disease. As a result, a patient with HCC requires multidisciplinary care. Treatment options vary widely based on tumor burden and metastases. The most widely utilized staging system is the Barcelona Clinic Liver Cancer staging system, which recommends treatments based on tumor size and the underlying liver disease and functional status of the patient. Treatment options range from surgical resection or transplantation to locoregional therapies with modalities such as radiofrequency ablation and transarterial chemoembolization to systemic chemotherapies. Future care involves the development of combination therapies that afford the best tumor response, further clarification of the patients best suited for therapies and the development of new oral chemotherapeutic agents.

Managing Thyroid Microcarcinomas

Papillary thyroid microcarcinomas (PTMCs) are the most common form of classic papillary thyroid carcinoma (PTC). PTMCs are typically discovered by fine-needle-aspiration biopsy (FNAB), usually with sensitive imaging studies, or are found during thyroid surgery in a patient without a previously known history of thyroid carcinoma. However, the definition of PTMC has not always been universally accepted, thus creating controversy concerning the diagnosis and treatment of PTMC. The aim of this review is to summarize the clinical features of PTMC and identify the widely differing opinions concerning the diagnosis and management of these small ubiquitous thyroid tumors.

Revised International Federation of Gynecology and Obstetrics (FIGO) staging systems in gynecologic malignancies / 대한산부인과학회지

The International Federation of Gynecology and Obstetrics (FIGO) has reported annually for the development and changes of gynecologic cancer classification and staging since 1958. FIGO staging systems in gynecologic malignancies has been reflected on prognostic factors in predicting patients' outcomes and organized patients into several groups. The aim of the FIGO staging system is to afford a classification of gynecologic cancer and to share treatment methods with others. The FIGO staging systems have been updated several times every 3 years according to the latest data, which is responsive and adaptive to scientific development including imaging and treatment modalities. In 2008, the FIGO staging system for carcinoma of the cervix, endometrium, vulva, and uterine sarcomas was revised. After applying the revised staging system in clinical setting, it is need to consider and review problems. As a result, we must make up for the weak points in staging systems continuously.

Comparison of four staging systems in predicting outcomes and guiding option of treatment for patients with hepatocellular carcinoma / 中华消化杂志

Objective To compare the Barcelona clinic liver cancer staging classification (BCLC), the Japan integrated staging score (JIS), the cancer of the liver Italian program score (CLIP) and Chinese staging system in terms of their ability to predict outcomes and to guide option of therapy in patients with hepatocellular carcinoma (HCC) in China.Methods Clinical data of 861 HCC patients from Zhongshan Hospital between 2001 and 2002 were retrospectively analyzed. Patients were classified acccording to different staging systems. Survival for patients in different stages and the effects of therapeutic methods on survival time were compared. Results BCLC, JIS and Chinese staging system showed the ability in predicting survival for patients in different staging. CLIP failed to show significant difference in survival rates for each subgroup. There was no significant difference in survival rate between surgery and transarterial chemoembolization (TACE)/transarterial embolization (TAE) for patients classified as BCLC stage C, CLIP scores more than 3 or Chinese stage Ⅲ a.The survival rate, however, was higher in patients received operation than those received TACE/TAE if they were classified as earlier stages. Conclusions The BCLC, JIS and Chinese staging systems show prospective ability for Chinese HCC patients in prediction outcomes, whereas the BCLC and the Chinese staging systems are better at both predicting outcomes and guiding the option of treatment.