Current status and future perspectives on the methods of prognosis evaluation for intrahepatic cholangiocarcinoma / 中华外科杂志

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary malignant tumor in the liver after hepatocellular carcinoma. Its incidence and mortality rates have increased worldwide in recent years. Surgical resection is the best treatment modality for ICC;however,the overall prognosis remains poor. Accurate evaluation of post operative prognosis allows personalized treatment and improved long-term outcomes of ICC. The American Joint Commission on Cancer TNM staging manual is the basis for the standardized diagnosis and treatment of ICC;however,the contents of stage T and stage N need to be improved. The nomogram model or scoring system established in the analysis of commonly used clinicopathological parameters can provide individualized prognostic evaluation and improve prediction accuracy;however,more studies are needed to validate the results before clinical use. Meanwhile,imaging features exhibit great potential to establish the post operative prognosis evaluation system for ICC. Molecular-based classification provides an accurate guarantee for prognostic assessment as well as selection of populations that are sensitive to targeted therapy or immunotherapy. Therefore,the establishment of a prognosis evaluation system,based on clinical and pathological characteristics and centered on the combination of multidisciplinary and multi-omics,will be conducive to improving the long-term outcomes of ICC after surgical resection in the context of big medical data.

Selective neck dissection in the management of tongue squamous cell carcinoma with clinically negative nodes / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To compare the effectiveness of selective neck dissection (SND) with radical or modified radical neck dissection (RND) for the management of tongue squamous cell carcinoma with clinically negative nodes (cN0).</p><p><b>METHODS</b>There were 33 patients who were treated with SND (including 14 supraomohyoid neck dissection and 19 level I -IV neck dissection ) between January 1998 and December 2002. According to T classifications, treatment modality and pathological status of lymph node (pN), the control group of 33 patients were randomly selected from the cN0 tongue squamous cell carcinoma patients who were treated with RND between January of 1980 and December of 1997. Kaplan-Meier was used to calculate the rate of regional recurrence and 5-year survival rate.</p><p><b>RESULTS</b>The neck recurrent for RND population was 9.1% (3 patients), which was not statistically different from the neck recurrent in the SND population 12.1% (4 patients). Also, the 5-year survival rates were no statistic difference between SND and RND groups (82.9%, 28 patients vs 78.8%, 26 patients). The rate of recurrent outside the dissection area for level I -IV neck dissection population was 0, which was statistically different from the rate of recurrent outside the dissection area in the supraomohyoid neck dissection population (14.3%, 2 patients).</p><p><b>CONCLUSIONS</b>Comparing to the radical or modified neck dissection, the SND offered the same oncologic compromise for patients with cN0 tongue squamous cell carcinoma. I -IV neck dissection was recommended.</p>