Survival analysis of patients with spontaneous rupture of hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the prognostic factors influencing overall survival (OS) in patients with spontaneous rupture of hepatocellular carcinoma (HCC-SR).</p><p><b>METHODS</b>The medical records of 44 patients with HCC-SR treated in our department from January 1, 2005 to April 1 2011 were retrospectively reviewed. The clinical and prognostic data of 19 HCC-SR patients who received curative hepatectomy were compared with data of 137 HCC patients with no SR who were managed by curative hepatectomy during the same period. Type of HCC-SR was defined according to previously established criteria. The clinicopathological data were evaluated for possible associations with OS of HCC-SR by univariate analysis with the Kaplan-Meier method followed by multivariate analysis with the Cox proportional hazard model.</p><p><b>RESULTS</b>While some clinical features differed between the HCC-SR patients and non-HCC-SR patients, the postoperative prognosis was comparable between the two groups: (1) The 1-, 2-, 3- and 5-year postoperative cumulative recurrence rates were 78.9% (15/19), 89.5% (17/19), 94.7% (18/19) and 94.7% (18/19) in the HCC-SR group but 43.1% (59/137), 54.0% (74/137), 59.1% (81/137) and 66.4% (91/137) in the non-HCC-SR group respectively, and the differences reached statistical significance (P = 0.006, 0.003, 0.002, and 0.014); (2) The 1-, 2-, 3- and 5-year postoperative disease-free survival rates were 10.5% (2/19), 5.3% (1/19), 5.3% (1/19) and 5.3% (1/19) in the HCC-SR group but 40.1% (55/137), 21.2% (29/137), 12.4% (17/137) and 4.4% (6/137) in the non-HCC-SR group respectively, and only the 1-year disease-free survival rate was significantly different (P = 0.032); (3) The 1-, 2-, 3- and 5-year postoperative OS rates were 42.1% (8/19), 10.5% (2/19), 5.3% (1/19) and 5.3% (1/19) in the HCC-SR group but 59.1% (81/137), 32.8% (45/137), 19.0% (26/137) and 6.6% (9/137) in the non-HCC-SR group, and none of the differences reached statistical significance (P = 1.972, 0.061, 0.200, 1.000). Multivariate analysis identified that severity of concomitant liver cirrhosis, levels of alpha fetoprotein (AFP), choice of treatment modality, and type of HCC-SR acted as factors influencing OS.</p><p><b>CONCLUSIONS</b>Patients with HCC-SR receiving curative hepatectomy have higher postoperative recurrence rates than their non-HCC-SR counterparts, but the two groups have similar postoperative OS rates. OS is influenced by severity of concomitant liver cirrhosis, level of AFP, choice of treatment modality, and type of HCC-SR.</p>

Prognosis in patients with small hepatocellular carcinoma: a meta-analysis.

BACKGROUND/AIMS: To evaluate the impact of anatomic and non-anatomic liver resection on prognosis of patients with small hepatocellular carcinoma (HCC) using a meta-analysis. METHODOLOGY: Literature on anatomic versus non-anatomic liver resection for the treatment of small HCC published in public was retrieved. RESULTS: Four non-randomized controlled trials studies were included in this analysis. These studies included a total of 776 patients: 484 treated with anatomic liver resection and 282 treated with non-anatomic resection. No significant differences were found concerning the 1, 3 and 5-year disease-free survival rate between the two groups. There was no significant difference between the two groups when comparing the 1, 3 and 5-year overall survival rate. We use the sensitivity analysis which found anatomic resection could extend the 3-year disease-free survival rate when compared with non-anatomic resection (odds ratio (OR)=0.72, 95% confidence interval (CI): 0.52-0.99, p=0.04). CONCLUSIONS: Anatomic liver resection can extend the 3-year disease-free survival rate of patients with small hepatocellular carcinoma. Further randomized controlled trials are needed to define the exact value of anatomic resection and non-anatomic resection for small HCC.

Radiation-induced G2 phase arrest may contribute to the radioresistance of breast cancer stem cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate radiation-induced cell cycle changes of human breast cancer stem cells enriched by suspension culture.</p><p><b>METHODS</b>The tumorigenicity of human breast cancer stem cell line MCF-7 cultured in serum-free media was confirmed in NOD/SCID mice, and the radiosensitivity of the cells was tested by clone formation assay following radiation exposure. Flow cytometry was performed to evaluate radiation-induced cell cycle changes, and the protein expression of pCDC25C (ser216) was measured by Western blotting.</p><p><b>RESULTS</b>After the exposure to 2 Gy radiation, the survived fraction of the cells in suspension culture and those in adherent culture was 0.856 ∓ 0.061 and 0.783 ∓ 0.097, respectively, and the cells in suspension culture showed an obviously greater capacity of tumorigenicity in NOD/SCID mice. The radiation exposure resulted in an obvious increase in the proportion of G2 phase cells from (22.03 ∓ 2.12)% to (45.83 ∓ 2.25)% and significantly increased the expression of pCDC25C (ser216).</p><p><b>CONCLUSION</b>Radiation- induced G2 phase arrest may contribute to the resistance of the breast cancer stem cells to radiotherapy.</p>