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Downstaging and Tumor Regression in Rectal Cancer Following Neo-Adjuvant Chemoradiotherapy

MDT discussion of comprehensive downstaging treatment for 2 cases of liver cancer

ObjectiveTo explore value of multidisciplinary team (MDT) discussion in comprehensive downstaging treatment of liver cancer.MethodThe clinical data of 2 patients with liver cancer who could not undergo the radical surgery admitted to the Affiliated Hospital of Southwest Medical University were analyzed retrospectively.ResultsCase 1 was diagnosed as the liver cancer with extensive double lung metastasis at admission. The clinical stage was stage Ⅲb; After MDT discussion, the patient was treated with chemotherapy and embolization via hepatic artery and bronchial artery; At the same time, the patient was treated with apatinib; At present, the metastasis of both lungs disappeared completely; The clinical stage was stage ⅡB, and the radical resection was proposed. Case 2 was diagnosed as the right liver cancer at admission. The clinical stage was stage Ⅰ b. The preoperative examination showed that the hepatic reserve function was poor and the patient could not tolerate the half hepatectomy; After MDT discussion, the patient was treated with the combination of chemotherapy and embolization via the hepatic artery and apatinib in the same period; At the same time, the patient was treated with liver protection. The clinical stage was reduced to stage Ⅰ a. The hepatic reserve function improved and the laparoscopic right hemihepatectomy was performed, no recurrence or metastasis was found after 3 months follow-up.ConclusionComprehensive downstaging treatment based on MDT model could bring better clinical outcomes for patients with liver cancer who are unable to undergo one-stage radical surgery.

經皮肝膽管引流/經皮肝泡型棘球蚴穿刺引流聯合阿苯達唑治療晚期中央液化壞死型肝泡型棘球蚴病的降期轉化效果：附5例報道

目的探討經皮肝膽管引流（percutaneous transhepatic biliary drainage，PTCD）和（或）經皮肝泡型棘球蚴穿刺引流（percutaneous transhepatic alveolar echinococcosis drainage，PTCA）聯合阿苯達唑口服治療晚期肝泡型棘球蚴病的轉化治療效果。方法回顧性收集2019年1月至2025年7月期間甘孜藏族自治州人民醫院肝膽一科收治的5例晚期一期不可切除的復雜肝泡型棘球蚴病患者的臨床資料。結果5例患者均來自甘孜藏族自治州。治療前PNM分期顯示：4例為P4N0M0，1例為P3N0M0；所有患者均伴有不同程度黃疸。3例接受PTCD聯合阿苯達唑治療，1例接受PTCA聯合阿苯達唑治療，1例接受PTCD+PTCA聯合阿苯達唑治療。治療后：4例P4N0M0患者降至P2N0M0，1例分期雖未下降（仍為P3N0M0），但其病灶萎縮、肝功能較前好轉。2例患者接受了根治性手術；2例患者具備手術指征但拒絕手術；其余1例患者接受了PTCA聯合阿苯達唑治療，肝功能恢復良好。結論PTCD和（或）PTCA聯合阿苯達唑可在一定程度上改善病灶狀態，為晚期肝泡型棘球蚴病患者提供了根治性手術可能。