RESUMO
OBJECTIVE: The aim of this retrospective study was to evaluate the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with surgery in the treatment of hepatocellular carcinoma. METHODS: We retrospective included 89 cases of primary hepatocellular carcinoma in the Department of General Surgery of Fuzhou Infection Hospital from January 2012 to December 2014. For the included 89 subjects, 38 cases received surgery (control group) and other 51 patients received operation followed by postoperative TACE (experiment group). 3 months after the operation, the objective response rate (ORR) and disease control rate (DCR) were compared between the two group. Moreover, the Kaplan–Meier survival curve was used to evaluate the long‑term survival of the two groups. RESULTS: Three months after the operation, the objective response was evaluated for the two groups. The ORR and DCR were 55%, 74% for the control group and 78%, 92% for the experiment group with significant difference between the two groups (P < 0.05); the median survival time was 13. 10 months with 1‑ and 2‑year survival rate of 50% and 21% in the control group; the median survival time was 16.40 months with 1‑ and 2‑year survival rate of 63% and 39% in the experiment group. The hazard ratio was 1.66 with it 95% confidence of 1.05–2.83, which indicated that the patients in the experiment group have less risk of death in the period of follow‑up (P < 0.05). CONCLUSION: Postoperation TACE treatment modality was superior to surgery alone for the treatment of hepatocellular carcinoma.
RESUMO
Erdheim-Chester disease (ECD) is a rare systemic non-Langerhans histiocytosis that affects multiple organ systems. It occurs more often in adults, and paediatric ECD is extremely rare. The diagnosis of ECD can be established based on clinical presentations and imaging but the final diagnosis should be based on biopsy. Treatment of ECD has involved the use of corticosteroids, radiotherapy, chemotherapy, surgery and haematopoietic stem cell transplantation, yet the efficacy of these treatments is difficult to determine. At present, it is thought that the treatment of interferon-α (IFN-α) is safe and effective for ECD. Herein, we report on an 11-year old girl who was admitted to hospital because of systemic bone pain and limping, and the final diagnosis of ECD was based on evidence provided by her clinical presentation, imaging and biopsy of a lesion of the right ilium. The patient was treated with subcutaneous IFN-α at a dosage of 3 Χ 10(6) units three times weekly for 19 months. We thought that the treatment of IFN-α was safe and effective for the girl's clinical manifestations, and IFN-α might be a valuable first-line therapy for paediatric ECD.
La enfermedad Erdheim-Chester (ECD) es una enfermedad sistémica rara caracterizada por histocitosis de células no Langerhans, que afecta múltiples sistemas orgánicos. Se presenta más a menudo en adultos, siendo su ocurrencia pediátrica sumamente rara. El diagnóstico de ECD puede establecerse a partir de sus manifestaciones clínicas e imagen médica, pero su diagnóstico final debe basarse en la biopsia. El tratamiento de ECD incluye el uso de corticosteroides, radioterapia, quimioterapia, cirugía y trasplante de células madre hematopoyéticas. Sin embargo, es difícil determinar la eficacia de estos tratamientos. En la actualidad, se piensa que el tratamiento con interferon-α (IFN-α), es seguro y eficaz para ECD. Aquí reportamos el caso de una niña de 11 años, que fue ingresada al hospital debido a dolores óseos sistémicos y cojera. El diagnóstico final de ECD se basó en evidencias proporcionadas por sus manifestaciones clínicas, el uso de la imagen médica, y la biopsia de una lesión del ilion derecho.