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1.
Dig Liver Dis ; 51(10): 1430-1437, 2019 10.
Article in English | MEDLINE | ID: mdl-31054962

ABSTRACT

BACKGROUND AND AIMS: The liver function reserve in Child-Pugh (C-P) grade A hepatocellular carcinoma (HCC) patients varies widely, and the value of platelet-albumin-bilirubin (PALBI) grade in predicting posthepatectomy liver failure (PHLF) grade B/C and overall survival (OS) remains unknown. METHODS: From Dec 2004 to Dec 2013, 2038 C-P grade A HCC patients after resection were enrolled. Univariate and multivariate analyses were performed to clarify the risk factors for PHLF grade B/C and OS. RESULTS: The PALBI grade had higher area under the curve values than albumin-bilirubin (ALBI) and C-P grade in predicting PHLF grade B/C (0.693, 0.683, 0.529 in the entire cohort; 0.677, 0.646, 0.516 in patients who underwent major resection). PALBI grade differentiated C-P grade A patients into three groups with distinct prognoses (P < 0.001), whereas ALBI grade differentiated C-P grade A patients into two groups (P < 0.001). Furthermore, PALBI grade identified three groups with clearly different prognoses in ALBI grade 1 patients (P = 0.032). Multivariate analyses showed that PALBI grade was one of the independent and significant prognostic factors of PHLF grade B/C and OS. CONCLUSIONS: PALBI grade offers a simple, objective and discriminatory method for risk stratification of PHLF grade B/C and OS in C-P grade A HCC patients following resection.


Subject(s)
Bilirubin , Blood Platelets , Carcinoma, Hepatocellular/physiopathology , Liver Failure/etiology , Liver Neoplasms/physiopathology , Serum Albumin , Adolescent , Adult , Aged , Biomarkers , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/surgery , China/epidemiology , Female , Hepatectomy , Humans , Liver Failure/mortality , Liver Neoplasms/mortality , Liver Neoplasms/surgery , Male , Middle Aged , Multivariate Analysis , Prognosis , ROC Curve , Retrospective Studies , Risk Assessment , Severity of Illness Index , Survival Analysis , Young Adult
2.
Chinese Medical Journal ; (24): 1158-1162, 2012.
Article in English | WPRIM (Western Pacific) | ID: wpr-269283

ABSTRACT

<p><b>BACKGROUND</b>In both the seventh edition of the International Union Against Cancer (UICC) staging system for gastric cancer and the 14th edition of the Japanese Gastric Cancer Association (JGCA) system, T(4a) is defined as "Tumor perforates serosa (visceral peritoneum) without invasion of adjacent structures." The aim of this study was to investigate the differences in prognosis between patients with serosa-penetrating and serosa-invading T(4a)N(0)M(0) gastric carcinomas.</p><p><b>METHODS</b>Data were collected from 221 patients with T(4a)N(0)M(0) gastric carcinoma who underwent D2 resection at our cancer center between January 1990 and December 2008. The cohort included 42 patients with serosa-penetrating tumors and 179 patients with serosa-invading tumors. The average follow-up time was 85.5 months. Spearman's rank correlation, Kaplan-Meier plots, and Cox proportional hazards regression models were used to analyze the data.</p><p><b>RESULTS</b>The 5-year survival rate of patients with serosa-penetrating and serosa-invading gastric cancers were 31% and 62% respectively (P < 0.05). The relapse rates after D2 radical surgery were 16.2% in patients with serosa-invading gastric cancer versus 59.5% in those with serosa-penetrating tumors (P < 0.05). Peritoneal dissemination and distant organ/lymph node metastatic rates were 76.0% and 24.0% respectively in patients with penetrating tumors, versus 44.8% and 55.2% respectively in patients with invading tumors (P < 0.05). Multivariate analysis showed that penetration of the serosa was an independent prognostic indicator of overall survival.</p><p><b>CONCLUSIONS</b>Our findings provide a basis for the concept that serosa-penetrating T(4a)N(0)M(0) gastric carcinoma represents a more aggressive cancer than serosa-invading T(4a)N(0)M(0) gastric carcinoma. Serosa penetration is an independent factor for poor prognosis of patients with gastric carcinoma.</p>


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Gastrectomy , Neoplasm Invasiveness , Neoplasm Staging , Peritoneum , Pathology , Prognosis , Proportional Hazards Models , Stomach Neoplasms , Mortality , Pathology , General Surgery , Survival Rate
3.
Chinese Journal of Cancer ; (12): 19-28, 2012.
Article in English | WPRIM (Western Pacific) | ID: wpr-294441

ABSTRACT

Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with high local invasiveness. To date, there is no consensus on the imaging characteristics of NACC. To address this, we retrospectively reviewed 10 cases of NACC and summarized the magnetic resonance imaging (MRI) features. MR images of 10 patients with histologically validated NACC were reviewed by two experienced radiologists. The location, shape, margin, signal intensity, lesion texture, contrast enhancement patterns, local invasion, and cervical lymphadenopathy of all tumors were evaluated. Clinical and pathologic records were also reviewed. No patients were positive for antibodies against Epstein-Barr virus (EBV). The imaging patterns of primary tumors were classified into two types as determined by location, shape, and margin. Of all patients, 7 had tumors with a type 1 imaging pattern and 3 had tumors with a type 2 imaging pattern. The 4 tubular NACCs were all homogeneous tumors, whereas 3 (60%) of 5 cribriform NACCs and the sole solid NACC were heterogeneous tumors with separations or central necrosis on MR images. Five patients had perineural infiltration and intracranial involvement, and only 2 had cervical lymphadenopathy. Based on these results, we conclude that NACC is a local, aggressive neoplasm that is often negative for EBV infection and associated with a low incidence of cervical lymphadenopathy. Furthermore, MRI features of NACC vary in locations and histological subtypes.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Adenoid Cystic , Diagnosis , Pathology , General Surgery , Lymphatic Metastasis , Magnetic Resonance Imaging , Methods , Nasopharyngeal Neoplasms , Diagnosis , Pathology , General Surgery , Neoplasm Invasiveness , Neoplasm Staging , Retrospective Studies
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