Long-term outcome and analysis of prognostic factors in 114 cases of postoperative stage III gastric cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the results of long-term follow up of patients with postoperative stage III gastric cancer and the prognostic factors.</p><p><b>METHODS</b>We retrospectively analyzed the clinicopathological data of 114 patients with stage III gastric cancer treated in our hospital from April 1998 to January 2006. Kaplan-Meier univariate analysis and Cox regression analysis were performed to evaluate the candidate prognostic factors, such as gender, age, pathological stage, histological differentiation, lymphovascular tumor thrombus, tumor residual and postoperative chemotherapy.</p><p><b>RESULTS</b>In the 114 cases, the 5-year overall survival rate was 28.6% and 10-year survival rate was 22.6%. The 5-year survival rates of stage IIIA, IIIB and IIIC patients were 38.3%, 33.8% and 19.5%, respectively, and 10-year survival rates were 33.5%, 29.6% and 11.1%, respectively. Univariate analysis showed that pathological stage, tumor residual and postoperative chemotherapy were significantly correlated with prognosis (P < 0.05). Multivariate analysis showed that pathological stage, tumor residual and postoperative chemotherapy were independent prognostic factors of stage III gastric cancer patients (P < 0.05 for all).</p><p><b>CONCLUSIONS</b>The long-term survival of stage III gastric cancer patients remains poor. Pathological stage, tumor residual and postoperative chemotherapy are the most significant factors influencing prognosis of stage III gastric cancer after radical resection. Postoperative chemotherapy can improve their survival.</p>

A clinical study on multi-disciplinary team and surgery for resectable colorectal cancer with liver metastases / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the survival outcomes of the surgery for colorectal cancer with liver metastases (CRCLM), and study the mode of multi-disciplinary team (MDT) for CRCLM.</p><p><b>METHODS</b>The retrospective analysis was conducted for 38 patients with CRCLM received MDT management and surgical treatment from January 2009 to August 2011. The peri-operative and survival outcomes of MDT and surgery were evaluated.</p><p><b>RESULTS</b>All the cases met the present criteria of resetability for CRCLM, but only 4 cases (10.5%) met the previous one. Coloproctectomy and hepatectomy were performed in all cases, with 39 colorectal neoplasms and 155 liver lesions removed. One case died of postoperative septic shock. Colorectal and hepatic specific complications were absent in the others patients except one case of biliary leak which was treated with conservative management. Neoadjuvant chemotherapy was arranged in 13 cases. Adjuvant chemotherapy was administered for every patient. After a mean follow-up of (22 ± 10) months according to the finding time of liver metastases, recurrence and metastases were observed in 16 cases and 6 cases died of late-stage cachexia. The 1-, 2- and 3-overall survival rate were 94.4%, 85.3% and 75.8% respectively, and the 1-, 2- and 3-disease-free survival rate were 70.1%, 54.2% and 54.2% respectively.</p><p><b>CONCLUSIONS</b>MDT mode for resectable CRCLM is recommendable. Surgical resection of CRCLM is feasible and safe, which seems to achieve favourable short-middle oncologic outcomes. And long-term survival is expected.</p>

Observation and clinical significance of adjuvant chemotherapy-induced amenorrhea in premenopausal breast cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>A retrospective analysis of 160 pre-menopausal breast cancer patients was carried out to elucidate the the menstrual outcome in those cases who had undergone adjuvant chemotherapy after surgery, and evaluate the relationship between chemotherapy-induced amenorrhea (CIA) and recurrence of the disease.</p><p><b>METHODS</b>160 pre-menopausal breast cancer patients were collected, 62/159 (39.0%) of them were node positive, 91/158 (57.6%) were ER positive, and 95/155 (61.3%) were PR positive. 111 cases had infiltrative ductal carcinoma, 26 cases had infiltrative lobular carcinoma, and 22 cases with others. In 152 cases data were collected by face-to-face interview and 8 cases by phone conversation. Types and cycles of chemotherapy regimen as well as menstrual abnormalities were recorded before, during, and after chemotherapy completion. Follow up duration was 12-72 months after chemotherapy completion for all patients.</p><p><b>RESULTS</b>107 (66.9%) developed CIA, 24 cases returned to normal menses (22.4%), 83 cases continued CIA during more than 12-month follow up (77.6%). The rate of CIA increased with age (P < 0.01). During the follow up, disease free survival (DFS) rate was 85.9% in CIA group and 79.2% in non-CIA group, with no statistically significant difference. But in hormonal receptor positive patients, DFS was 80.0% in non-CIA and 90.1% in CIA, respectively (P = 0.04), showing a significant difference. Because of the small number of died cases, no analysis of the overall outcome was carried out.</p><p><b>CONCLUSION</b>Adjuvant chemotherapy causes ovarian function suppression, and may further leading to amenorrhoea. Women who experienced amenorrhoea after chemotherapy had a significantly better disease-free survival (DFS) rate showed by univariate analysis than women who continued normal menstruation. Chemotherapy is insufficient therapy for very young patients who are in high risk with hormone responsive disease, particularly when chemotherapy fails to induce amenorrhea. Further research is needed to evaluate interventional chemotherapy to improve the quality of life in women with early stage breast cancer who experienced ovarian toxicity. The post-chemotherapy menstruation status is a clinically valuable, objective and salient marker for sufficient endocrine effect of chemotherapy in ER/PR-positive premenopausal patients.</p>

Adjuvant chemotherapy after orthotopic liver transplantation for advanced hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the feasibility, reliability and therapeutic effectiveness of adjuvant chemotherapy for advanced hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>The clinical data of adjuvant chemotherapy after OLT in 10 advanced HCC patients were studied retrospectively. FAP chemotherapy regimen was adopted calcium folinate (CF) 200 mg/m(2) and 5-Fluorouracil 500 mg/m(2) iv on D1 to D5, and doxorubicin 40 mg/m(2), cisplatin 30 mg/m(2) iv on D1, with 28 days as a cycle. The opportune time of chemotherapy, chemotherapy regimen, synergistic action between cytotoxic agent and immunosuppressive agent on liver and kidney and side-effects were preliminarily evaluated.</p><p><b>RESULTS</b>7/10 patients are surviving, with the longest survival of 32 months, and the shortest 9 months. Three patients died after operation, two at 13 months, one at 20 months after OLT, all died of metastasis. The incidence of one year survival was 9/9. During the period of chemotherapy, the side-effects of adjuvant chemotherapy were moderate.</p><p><b>CONCLUSION</b>Chemotherapy which is able to prolong the life-span of patients with advanced HCC after orthotopic liver transplantation is feasible and effective, the side-effects were mild. The choice of opportune time of chemotherapy might influence the outcome.</p>