ABSTRACT
BACKGROUND: In Japan, the current standard waist circumference cutoff value for persons with multiple cardiovascular risk factors remains controversial. In this study we aimed to analyze the health-check examination data from a large Japanese population and propose a revised waist circumference cutoff value. METHODS: Subjects of this study were 12,725 adults who underwent a health-check by thorough medical examination between April 2006 and March 2007. Medical examinations included measurement of waist circumference, fasting blood triglycerides, HDL cholesterol, glucose concentrations, blood pressure and collection of demographic characteristics. Receiver operating characteristic (ROC) curve analysis was utilized to find appropriate waist circumference cutoff values in relation to multiple cardiovascular risk factors with two or more of the following: dyslipidemia (hypertriglyceridemia or low HDL cholesterol), hypertension, and hyperglycemia defined by the Japanese criteria of metabolic syndrome. RESULTS: The average age of the subjects was 50.7 years (standard deviation [SD]: 8.8) for men and 49.7 years (SD: 8.6) for women. ROC curve analysis showed maximum sensitivity plus specificity at a waist circumference of 87 cm in men (0.66 and 0.62, respectively) and 83 cm in women (0.73 and 0.70). When analyzed by ten-year age groups, the ROC curves for younger age groups were shifted up and to the left compared to older age groups, but associations between cutoff values and age were not clear. CONCLUSION: In Japan, the appropriate cutoff value of waist circumference for persons with multiple cardiovascular risk factors is 87 cm for men and 83 cm for women.
Subject(s)
Anthropometry , Body Mass Index , Cardiovascular Diseases/epidemiology , Health Status , Obesity/classification , Waist-Hip Ratio , Adult , Aged , Aged, 80 and over , Cardiovascular Diseases/physiopathology , Cross-Sectional Studies , Female , Humans , Japan/epidemiology , Lipids/blood , Male , Metabolic Syndrome/epidemiology , Metabolic Syndrome/physiopathology , Middle Aged , Obesity/complications , Obesity/epidemiology , ROC Curve , Reference Values , Risk FactorsABSTRACT
BACKGROUND: Neoadjuvant chemotherapy (NAC) has recently received increasing attention in an attempt to increase the rate of complete tumor resections, reduce systemic metastases, and prolong survival in patients with advanced gastric cancer.METHODS: Since 1993, 21 patients with unresectable or non-curative resectable gastric cancer received NAC, consisting of 5-fluorouracil, leucovorin, and cisplatin (FLP) with at least two cycles before surgery.RESULTS: All except 2 patients underwent surgical treatment, and resection was performed in 18 (85.7%). There were no deaths and no major morbidity following operation. There was no complete response (CR), but 12 patients (57.1%) had a partial response (PR), the response rate was 47.6% for the primary region, 64.7% for abdominal para-aortic (No.16) lymph node metastasis, 40.0% for liver metastasis, and 11.1% for peritoneal dissemination. One-year survival of the 21 patients was 40.5%, and median survival time (MST) was 322 days. MST in the responders was 571 days, and that in non-responders was 199 days ( P < 0.01). MST was 835 days in patients who underwent curative resection and 310 days in those who underwent non-curative surgery ( P < 0.01). There was no grade 4 toxicity, but grade 3 leukopenia occurred in 4 patients (19.0%), grade 3 anemia occurred in 3 patients (14.3%), and grade 3 stomatitis in 2 patients (9.5%). There were no serious renal disorders and no treatment-related death.CONCLUSIONS: The combination of FLP for NAC was feasible and useful for tumor reduction, especially for No.16 lymph node metastasis. There was a survival benefit in patients whose tumor had PR or who had had curative resection. We should confirm the effect and survival benefit of FLP for NAC by a prospectively randomized clinical controlled study.
ABSTRACT
The recent literatures has few reports of the state of the art and latest results in the treatment of gastric cancer, although such information is necessary for conducting new clinical trials and for obtaining informed consent from patients. In the panel discussions at the 71st Gastric Cancer Congress of Japan (held in Tokyo, June 1999), 18 representative institutions and hospitals in Japan reported their latest results for the surgical treatment of gastric cancer, indicating the state of the art in the treatment of gastric cancer. Here we report a summary of these sessions.
