ABSTRACT
To validate the efficiency of pathologic grading system in pathologic stage IA lung adenocarcinoma (LUAD), and explore whether integrating preoperative radiological features would enhance the performance of recurrence discrimination. We retrospectively collected 510 patients with resected stage IA LUAD between January 2012 and December 2019 from Guangdong Provincial People's Hospital (GDPH). Pathologic grade classification of each case was based on the International Association for the Study of Lung Cancer (IASLC) pathologic staging system. Kaplan-Meier curves was used to assess the power of recurrence stratification. Concordance index (C-Index) and receiver operating characteristic curves (ROC) were used for evaluating the clinical utility of different grading systems for recurrence discrimination. Patients of lower IASLC grade showed improved recurrence-free survival (RFS) (P < 0.0001) where numerically difference was found between grade II and grade III (P = 0.119). By integrating the IASLC grading system and radiological feature, we found the RFS rate decreased as the novel radiopathological (RP) grading system increased (P < 0.0001). The difference of RFS curves between any 2 groups as per the RP grading system was statisticallysignificant (RP grade I vs RP grade II, p = 0.007; RP grade I vs RP grade III, P < 0.0001; RP grade II vs RP grade III, P = 0.0003). Compared with the IASLC grading system, the RP grading system remarkably improved recurrence survival discrimination (C-index: 0.822; area under the curve, 0.845). Integrating imaging features into pathologic grading system enhanced the efficiency of recurrence discrimination for resected stage IA LUAD and might help conduct subsequent management.
ABSTRACT
OBJECTIVE: Chronic post surgical pain (CPSP) occurres frequently (from 10% to 50%) and has serious effects on the mood and activities of patients. This study was designed to evaluate the relationship between acute post surgical pain and chronic post surgical pain. METHODS: Electronic search databases included PubMed, EMBASE, Cochrane database and web of science. 9-stars Newcastle-Ottawa Scale was used to evaluate the quality of included studies. The odds ratio was used as a summary statistic index. Heterogeneity was assessed with I (2). RESULTS: We collected data from 4 case-control studies with or without chronic post surgical pain and compared those with patients who had acute post surgical pain or not. The age, sex was controlled as confounding factors. We collected 765 patients with chronic post surgical pain, of which 38.82% used to have acute post surgical pain. The risk ratio of patients with acute post surgical pain, as compared with no acute post surgical pain, was 3.10 for chronic post surgical pain (95% CI: 2.44, 3.96). CONCLUSION: Acute post surgical pain is a rick factor for chronic post surgical pain. We need to pay much attention to this phenomenon. However, more studies with high quality were still needed to confirm these findings.
