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BACKGROUND: Conversion therapy is a promising option for unresectable locally advanced gastric cancer (GC) patients. This study aimed to investigate the feasibility and efficacy of conversion therapy based on S-1, apatinib combined with transarterial chemotherapy and embolization (TACE). MATERIALS AND METHODS: Twenty eligible unresectable locally advanced GC patients were enrolled in this single-arm, single-center, prospective clinical trial. Apatinib was administered orally at 0.5 g once daily and continuously for 58 d, while S-1 twice daily on d 1-14 was given at a dose calculated according to the body surface area and repeated every 3 wk for three cycles. TACE (oxaliplatin 80 mg/m2 and etoposide 80 mg/m2) was performed on d 1 and was repeated on d 31. RESULTS: Nineteen patients completed conversion therapy and no treatment-related deaths occurred. The objective response rate (ORR) was 94.7% (18/19) and noncurative factors had resolved in 13 patients (68.4%) based on imaging estimation. 18 patients received laparoscopic examination and 12 cases underwent definitive surgery. Based on the intraoperative and postoperative pathological examination, 10 patients received radical resection (R0 + D2/D2+). The patients who underwent the conversion surgery had a superior median overall survival (OS) compared with those who did not (P = 0.010). CONCLUSIONS: S-1 combined with apatinib and TACE regimen is feasible for preoperative treating initial unresectable locally advanced GC patients with high rates of objective response and radical resection which may provide a survival benefit.
Subject(s)
Stomach Neoplasms , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Prospective Studies , Pyridines/therapeutic use , Stomach Neoplasms/pathologyABSTRACT
To evaluate the efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) for unilateral inguinal hernia in children and effect of intraoperative laparoscopic exploration for finding contralateral patent processus vaginalis (CPPV) on prevention of the metachronous contralateral hernia (MCH). We retrospectively analyzed unilateral inguinal hernia ligation in children, which can be diveded into two groups: a total of 252 cases with open surgical ligation from January 2010 to December 2012 (open group), a total of 184 cases underwent laparoscopic percutaneous peritoneal hernia sac high ligation LPEC from January 2013 to March 2015 (LPEC group). Then, we observed postoperative complications, recurrence of hernia, and the postoperative MCH in the two groups and analyzed the influence factors of the MCH. In Open groups and LPEC groups, the complication incidences, respectively, were 4.4 and 1.6 per cent, having statistical difference (P > 0.05), the average postoperative follow-up duration, respectively, were 42 months and 22 months, whereas the overall incidence of MCH, respectively, were 5.2 and 0.5 per cent (P < 0.05). In the first 24 months follow-up time, the overall incidence of MCH, respectively, were 3.6 and 0 per cent. Laparoscopic evaluation was positive for CPPV in 67 cases. We found the prevalence of 56.1 per cent of CPPV in LPEC groups aged 0.6 to 2 years old, finding the incidence gradually decline with the increase of age, until 14.3 per cent to 10 to 12 years old group. Our study shows LPEC has proven efficacy in treatment of unilateral inguinal hernia in children, and routine laparoscopic exploration with this simple maneuver should be actively performed to observe CPPV in all chidren.
Subject(s)
Hernia, Inguinal/surgery , Herniorrhaphy/methods , Laparoscopy/methods , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Peritoneum/surgery , Retrospective Studies , Treatment OutcomeABSTRACT
ObjectiveTo investigate the relationship between gastrc schistosomiasis and gastrc cancer.MethodsThe data of 11 cases of gastrc schistosomiasis were retrospective analyzed.Results 54.5％ (6/11) of gastrc schistosomiasis cases complicated with gastrc cancer,and 83.3％ (5/6) was well-differentiated and moderately differentiated.Seen around the parasite eggs were obvious intestinal metaplasia,glandhyperplasia,abnormalepitheliallesionsandother seriousatypicalhyperplasia.ConclusionsGastric schistosomiasis significantly increases the risk of gastrc cancer.Gnstrc schistosomiasis does not have specific symptoms,and it is clinically sumilar to chronic gastrtis.Therefore,patients with chronic gastrtis-likesymptoms in the schistosomiasis endemic areas should be subjected to an intensive test for gastrc schistosomiasis in the biopsy specimens collected from pyloric antrum and gastric lesser curvature.Patients infected by gastric schistosomiasis are strongly suggested to go regularly for gastric cancer check with gastroscopy.
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ObjectiveTo investigate the postoperative risk factors for gastrointestinal stromal tumors.MethodsFrom December 2005 to December 2010,sixty-one gastrointestinal stromal tumors patients of People' s Hospital of Tongling city gastrointestinal surgery department were analyzed retrospectively.Using the logistic regression model to calculate the postoperative recurrence risk factors. Results Sixty-one patients underwent operation,including gastrectomy (40 cases ),partial intestina parva resection (7 cases),partial colon resection ( 3 cases ),Dixon' s operation ( 2 cases ) and tumorectomy ( 9 cases ).Fifteen patients were given postoperative imatinib Mesylate Capsules (Glivec) treatment.Fifty-seven patients were followed-up more than 1 year and 7 cases were found palindromia ( 12％ ).Logistic model shows that the malignant degree of gastrointestinal stromal tumors is the only risk factor of postoperative palindromia.ConclusionsMalignant degree of gastrointestinal stromal tumors is the main risk factor for postoperative palindromia.Imatinib mesylate capsules treatment may be beneficial to the greater stage patients.
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Objective To explore the effect of lymph node metastases in gastric cancer on vagniae vasorum of gastric vessels,in order to provide evidence for the surgical treatment of gastric cancer.Methods The study included 90 specimens of left and right gastric arteries from 47 patients who underwent radical gastrectomy for carcinoma from January 2004 to 2006.All specimens were dealt with frozen section method,then they were stained with HE and immunohistochemical method respectively.Results Metastatic cancer cells were not found inside vagina vasorum in stage Ⅰ specimens.Cytokeratiu positive of tumor cens in or on vagina vasorum was showed on 25 slices from 10 tumors.Among them,2 slices from 1 tumor belonged to stage Ⅱ.8 slices from 3 tumors belonged to stage Ⅲ and 15 slices from 6 tumors belonged to stage Ⅳ.There was significant differences among cytokeratin positive rate in different stages of gastric cancer(P＜0.01).Conclusion Vaginae vasorum dissection is recommended when clearing lymph node around arteries in radical gastrectomy for carcinomas in stage Ⅱ above.
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Objective To examine the expression of p16 protein in malignant tumor of bile duct and itsrelationship with tumor behavior. Methods pl6 protein was studied by immunohistochemical method.Results The positive expression rate of MTS,/p16 in malignant tumor was lower than that in benign ones,and had close correlationship with the invasiveness and lymph nodes metastasis (P0.01 ). Conclusion The investigation of MTS1/p16 is of .great importance in evaluating the invasiveness of tumor, meta-potential of lymph node and clinicalprognosis.
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Objectives:In order to study the immune function after postoperative parenteral nutrition enriched with arginine in patients with gastrointestinal carcinoma. Methods:Forty patients who underwent radical operation of gastrointestinal carcinoma were randomly divided into experimental group( n= 20),in which patients received TPN enriched with arginine,and control group (TPN, n =20).At day 1 before operation,day 1 and day 8 after operation,IgG,IgA,IgM,T cell subgroups.NK cell activity and IL 2 were dectected. Results:The immune function of patients with gastrointestinal carcinoma was depressed at different levels.At day 1 after operation,IgG,IgM,IgA,CD4 +,CD4 +/CD8 +,Nk cell activity and IL 2 decreased more significantly than those before operation.The immunefunction recovered rapidly and exceeded the level before preoperation in experimental group.The difference was significant( P
