Efficacy and Safety of Anlotinib for Patients with Advanced NSCLC Who Progressed After Standard Regimens and the Preliminary Analysis of an Efficacy Predictor.

BACKGROUND: The aim of this study was to investigate the efficacy and safety of anlotinib for patients with advanced non-small cell lung cancer (NSCLC) who progressed after standard regimens in real world situations and the preliminary analysis of an efficacy predictor. METHODS: A total of 118 patients with advanced NSCLC who progressed after standard regimens were included in this retrospective study. Efficacy was evaluated and toxicity profile was recorded. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier survival curve and multivariate analysis was adjusted using Cox regression analysis. RESULTS: All of the 118 patients with NSCLC were available for evaluation of efficacy. Complete response (CR, 0 case), partial response (PR, 10 cases), stable disease (SD, 79 cases) and progressive disease (PD, 29 cases) were evaluated according to RECIST version 1.1. In consequence, objective response rate (ORR) was 8.47% and disease control rate (DCR) was 75.42%. The median PFS of the 118 patients with NSCLC was 4.3 months and the median OS was 10.3 months. The results of Cox regression analysis suggested that ECOG score was an independent factor for PFS. The toxicity profile indicated that hypertension and hand-foot syndrome were the most common adverse reactions. Additionally, the preliminary analysis of an efficacy predictor suggested that the PFS of patients with hypertension was superior to those without hypertension. CONCLUSION: Anlotinib is effective and safe for patients with advanced NSCLC who progressed after standard regimens in real world situations. Hypertension may be a biomarker for efficacy prediction.

[Study on thoracoabdominal incision for thoracic esophageal carcinoma by rotation position].

OBJECTIVE: To explore the clinical feasibility of thoracoabdominal incision for thoracic esophageal carcinoma by rotation position. METHODS: From January 2004 to December 2007, 126 patients with thoracic esophageal carcinoma performed operation by rotation position. There were 75 males and 51 females aged 46 to 78 years. Tumor was located mid-esophagus in 74 patients, whereas sub-esophagus was present in 52 patients. All patients underwent esophagectomy by rotation position (thoracoabdominal incision). Thoracic and abdominal cavity were exposed well. RESULTS: All operations were completed successful. Anastomotic stoma was located right thorax. The mean number of tow-field lymph node dissection was 25.6. There was no mortality. Postoperative complication include pulmonary complication, incision infection, recurrent laryngeal nerve damage, arrhythmia. The operation time was significantly shortened by rotation position. The number of lymph node dissection was significantly increased. CONCLUSION: The results of this study demonstrated that thoracoabdominal incision for thoracic esophageal carcinoma by rotation position exposes the operation fields clearly and make radical lymphadenectomy thoroughly. Disease-free survival is significantly improved.

Management of primary small cell carcinoma of the esophagus.

BACKGROUND: Primary small cell carcinoma of the esophagus is rare. Although surgery is successful in eradicating local tumor, the five-year survival rate of patients with primary small cell carcinoma of the esophagus after resection is lower than that of patients with primary squamous cell carcinoma of the esophagus. The purpose of this study was to analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma of the esophagus. METHODS: A total of 73 patients with primary small cell carcinoma of the esophagus who had been treated by surgery from 1984 to 2003 were analyzed retrospectively. RESULTS: In this series, the overall resection rate was 94.5% (69/73), the radical resection rate 89.0% (65/73) and the operative mortality 1.4% (1/73). The 1-, 3- and 5-year survival rates of patients were 50.7%, 13.7% and 8.2%, respectively. CONCLUSIONS: Primary small cell carcinoma of the esophagus is rare with a poor prognosis. Surgical resection is the leading method for patients with stage I or II primary small cell carcinoma of the esophagus. Postoperative chemotherapy is beneficial to these patients. The patients of stage III or IV should be given chemotherapy and radiation therapy.

[Expression of ezrin and CD44-v6 in human esophageal squamous cell carcinoma and its clinical significance].

OBJECTIVE: To evaluate the expression of ezrin and CD44-v6 in esophageal squamous cell carcinoma, and to evaluate its relationship with lymph node metastasis (LNM) and histological grading. METHODS: The expression of ezrin and CD44-v6 in 71 patients with esophageal squamous cell carcinoma was studied using immunohistochemical (SP) method. The correlation of their expression with relevant clinical data was statistically analyzed. RESULTS: In normal esophageal squamous epithelia, the expression of ezrin was found in 33 cases among 71 cases and the expression of CD44-v6 in 18 cases among 71 cases. In esophageal squamous cell carcinoma, the expression of ezrin was found in 64 cases among 71 cases and CD44-v6 in 58 cases among 71 cases. The expression of ezrin was closely related to LNM. The positive rate of ezrin expression in LNM cases was significantly higher than that in cases without LNM. The expression of CD44-v6 had a close relation to tumor differentiation and LNM. The positive rate of CD44-v6 expression in LNM cases was significantly higher than that in patients without LNM. The expression of ezrin in CD44-v6 positive cases was significantly higher than that of CD44-v6 negative cases. The LNM rate was 60.0% in 48 patients with positive expression of both ezrin and CD44-v6, while none of lymph node metastasis was found in the 6 patients with both negative. CONCLUSION: The test of CD44-v6 and ezrin expression may have significant prognostic value for assessing the degree of malignancy and potential LNM probability of ESCC. Ezrin may become a new target in evaluation of tumor prognosis.

[Surgical treatment of primary small-cell esophageal carcinoma].

OBJECTIVE: To explore the surgical treatment of primary small-cell esophageal carcinoma (PSEC). METHODS: We retrospectively analyzed the clinical data of 73 patients with PSEC who received surgical treatment in our hospital from 1984 to 2003. RESULTS: The overall resection rate was 94.5%. The complete resection rate was 89.0% and operation mortality was 1.4%. The 1-year, 3-year, and 5-year survival were 50.7%, 13.7%, and 8.2%, respectively. CONCLUSIONS: PSEC is a rare malignant tumor with poor prognosis. Surgical resection is the main method for patients in stage I or II, and postoperative chemotherapy seems to be helpful. Patients in stage Ill or IV should be managed with chemotherapy and radiotherapy.