ObjectiveTo investigate the impact of primary tumor site on prognosis of colorectal cancer after radical resection in different stages.MethodsFour hundreds and twenty patients with colorectal cancer in our hospital from Jan. 2008 to Dec. 2016 were selected as study subjects, all patients were confirmed by pathology. According to the location of colorectal cancer, the patients were divided into rectum group (n=220), left colon group (n=105) and right colon group (n=95). The difference of clinicopathological features of patients with different group were compared. The risk factors affecting the prognosis of colorectal cancer patients were analyzed by single factor and multi factor unconditional Cox regression analysis, and the survival curve was drawn by Kaplan-Meier method, and the difference test was carried out by log-rank method.ResultsThere were no significant differences between the three groups in age, BMI, smoking history, alcohol history, family history, vascular tumor thrombus, N staging, tumor diameter, nerve invasion and cancer nodule (P>0.05). There were significant differences in sex, pathological type, anterior intestinal obstruction, TNM staging, T staging and M staging (P<0.05). The results of single factor Cox regression analysis showed that sex, pathological type, anterior intestinal obstruction, TNM staging, T staging, M staging, primary tumor site, nerve invasion and cancer nodule were the risk factors for the prognosis of the patients (P<0.05). Multivariate Cox regression analysis showed that TNM staging, location of primary tumor and nerve invasion were risk factors affecting prognosis of patients (P<0.05). The total 5-year survival rate of the rectal group was 80.45% (177/220), the total 5-year survival rate of the left hemicolon group was 67.62% (71/105), and the total 5-year survival rate of the right hemicolon group was 68.42% (65/95). The survival curves of Kaplan-Meier showed that the difference between the three groups was statistically significant (P<0.05).ConclusonsThe 5-year survival rate of patients with rectal cancer is significantly higher than that of patients with left colon cancer and right colon cancer. For patients with different stage of colorectal cancer after radical resection, the prognosis of colorectal cancer can be predicted by the location of primary tumor.
Objective To evaluate the relationship of systemic immune inflammatory index (SII) with the clinical features and prognosis of osteosarcoma patients. Methods The clinical data of patients with osteosarcoma surgically treated in Fuzhou Second Hospital between January 2012 and December 2017 were retrospectively collected. The preoperative SII value was calculated, which was defined as platelet × neutrophil/lymphocyte count. The best critical value of SII was determined by receiver operating characteristic (ROC) curve analysis, and the relationship between SII and clinical features of patients was analyzed by χ2 test. Kaplan-Meier method and Cox proportional hazard model were used to study the effect of SII on overall survival (OS). The nomogram prediction model was established according to the independent risk factors of patients’ prognosis. Results A total of 108 patients with osteosarcoma were included in this study. Preoperative high SII was significantly correlated with tumor diameter, Enneking stage, local recurrence and metastasis (P<0.05). The median follow-up time was 62 months. The 1-, 3-, 5-year survival rates of the low SII group were significantly higher than those of the high SII group (100.0%, 96.4%, 85.1% vs. 95.4%, 73.7%, 30.7%), and the survival of the two groups were statistically different (P<0.05). Univariate Cox regression analyses showed that tumor diameter, Enneking stage, local recurrence, metastasis and SII were associated with OS (P<0.05). Multiple Cox regression analysis showed that Enneking stage (P=0.031), local recurrence (P=0.035) and SII (P=0.001) were independent risk factors of OS. The nomogram constructed according to the independent risk factors screened by the Cox regression model had good discrimination and consistency (C-index=0.774), and the calibration curve showed that the nomogram had a high consistency with the actual results. In addition, the ROC curve indicated that the nomogram had a good prediction efficiency (area under the curve=0.880). Conclusions The preoperative SII level is expected to become an important prognostic parameter for patients with osteosarcoma. The higher the SII level is, the worse the prognosis of patients will be. The nomogram prediction model built on preoperative SII level, Enneking stage and local recurrence has a good prediction efficiency, and can be used to guide the diagnosis and treatment of clinical osteosarcoma.
Objective To evaluate the predictive performance of the geometric characteristics, centerline (CL) of pulmonary nodules for prognosis in patients with surgically treatment in the National Lung Screening Trial (NLST). MethodsCT images of 178 patients who underwent surgical treatment and were diagnosed with non-small cell lung cancer (NSCLC) in the low-dose CT (LDCT) cohort from the NLST image database were selected, including 99 males and 79 females, with a median age of 64 (59, 68) years. CT images were processed using commercial software Mimics 21.0 to record the volume, surface area, CL and the area perpendicular to the centerline of pulmonary nodules. Receiver operating characteristic (ROC) curve was used to compare the predictive performance of LD, AD and CL on prognosis. Univariate Cox regression was used to explore the influencing factors for postoperative disease-free survival (DFS) and overall survival (OS), and meaningful independent variables were included in the multivariate Cox regression to construct the prediction model. ResultsThe area under the curve (AUC) of CL for postoperative recurrence and death were 0.650 and 0.719, better than LD (0.596, 0.623) and AD (0.600, 0.631). Multivariate Cox proportional risk regression analysis showed that pulmonary nodule volume (P=0.010), the maximum area perpendicular to the centerline (MApc) (P=0.028) and lymph node metastasis (P<0.001) were independent risk factors for DFS. Meanwhile, age (P=0.010), CL (P=0.043), lymph node metastasis (P<0.001), MApc (P=0.022) and the average area perpendicular to the centerline (AApc) (P=0.016) were independently associated with OS. ConclusionFor the postoperative outcomes of NSCLC patients in the LDCT cohort of the NLST, the CL of the pulmonary nodule prediction performance for prognosis is superior to the LD and AD, CL can effectively predict the risk stratification and prognosis of lung cancer, and spheroid tumors have a better prognosis.
ObjectiveTo analyze the impact of neoadjuvant regimens on prognosis in patients with rectal cancer in the current version of the Database from Colorectal Cancer (DACCA) database. MethodsPatient information was extracted from the updated version of DACCA on November 24, 2022 according to the established screening criteria, and the following items were analyzed: gender, age, body mass index (BMI), marriage, economic conditions, degree of differentiation, neoadjuvant treatment regimen, and pTNM staging. According to the neoadjuvant treatment regimen, the patients were divided into three groups: chemotherapy group, chemotherapy combined radiotherapy group, and chemotherapy combined targeted therapy group, and the overall survival (OS) and disease-specific survival (DSS) of patients in the three groups were analyzed, and the influencing factors of OS and DSS were analyzed by univariate and multivariate Cox proportional hazard regression models. ResultsAccording to the screening criteria, 1 716 valid data were obtained from the DACCA database, of which 954 (55.6%) were in the chemotherapy group, 332 (19.3%) in the chemotherapy combined radiotherapy group, and 430 (25.1%) in the chemotherapy combined targeted therapy group. The differences in the Kaplan-Merier survival curves of patients with different neoadjuvant regimens for OS and DSS in the three groups were statistically significant (χ2=142.142, P＜0.001; χ2=129.528, P＜0.001). There were significant differences in OS rate and DSS rate between the three groups in 3 years and 5 years (P<0.001). Further comparison of different neoadjuvant therapy groups showed that the OS of the chemotherapy combined targeted therapy group was slightly better than that of the chemotherapy group in 3 years, however, OS and DSS in 5 years were slightly worse than those the chemotherapy group, but the difference were not statistically significant (P>0.05). The OS and DSS of the chemotherapy group and the chemotherapy combined targeted therapy group were better than those of the chemotherapy combined radiotherapy group in 3 years and 5 years, and the differences were statistically significant (P<0.01). The results of multivariate analysis showed that patients’ age, economic conditions, degree of tumor differentiation, new auxiliary scheme and pTNM staging were the influencing factors of OS and DSS. ConclusionNeoadjuvant treatment regimen will affect the long-term survival prognosis of rectal cancer patients.
ObjectiveTo explore transcatheter arterial chemoembolization (TACE) influences on prognosis of patients with BCLC stage 0–A hepatocellular carcinoma (HCC).MethodsThe clinicopathologic data of BCLC stage 0–A HCC patients underwent the radical resection in the Affiliated Hospital of Southwest Medical University from January 2006 to June 2018 were retrospectively analyzed. These patients were divided into a preoperative TACE treatment group (PTT group, n=365) and a directly surgical resection group (DSR group, n=365). The Kplan-Meier method was used to compare the overall survival (OS) and disease free survival (DFS) between the two groups. The Cox proportional hazard model was used to analyze whether the preoperative TACE was an independent factor affecting the prognosis of patient with BCLC stage 0–A HCC.ResultsA total of 465 patients with BCLC stage 0–A HCC were enrolled, including 365 patients in the DSR group and 100 patients in the PTT group. The baseline data of the two groups were similar（P>0.050）. In the cohort, the 1-, 3-, 5-, 10-year OS rates and DFS rates were 95.3%, 83.5%, 74.3%, 56.8% and 88.0%, 63.8%, 51.1%, 36.4%, respectively in the DSR group, which were 92.7%, 72.9%, 52.3%, 35.3% and 78.1%, 54.2%, 40.4%, 31.2%, respectively in the PTT group. The Kplan-Meier survival analysis showed that the OS and DFS in the DSR group were significantly better than those in the PTT group (P=0.009, P=0.033). The multivariate Cox proportional hazard model analysis showed that the preoperative TACE was the independent risk factor for the poor prognosis in the patients with BCLC stage 0–A HCC [ HR=1.389, 95% CI (1.158, 2.199), P=0.021].ConclusionsFor patients with BCLC stage 0–A HCC, preoperative TACE doesn’t improve patient’s prognosis and might reduce survival rate. If there is no special reason, direct surgery should be performed.
Objection To analyze the relationship between blood type and prognosis of colorectal cancer patients in the Database from Colorectal Cancer (DACCA). Methods The DACCA version selected for this data analysis was updated on January 5, 2022. The data items analysis included age, gender, blood type, tumor location, tumor pathological nature, pathological TNM (pTNM) stage, survival status and survival time. According to the ABO blood type classification, it was divided into four blood type groups: A blood type group, B blood type group, AB blood type group, and O blood type group. The overall survival (OS) and disease specific survival (DSS) were analyzed in four blood type groups, and the OS and DSS of each blood type group were analyzed in pTNM stage stratification. Results A total of3 486 rows of data were obtained from the DACCA database according to the screening conditions. There was no significantdifference in OS and DSS among blood typy A, B, AB and O group (P>0.05); At specific time points, the 1-year OS of the blood type A group was worse than that of blood type B (95.8% vs. 99.6%), the 1-year OS of the blood type B group was better than that of blood type O group (99.6% vs. 96.9%), and the differences were statistically significant (P<0.008 7), but the differences between OS and DSS in the remaining 1, 3, 5 and 10 years of patients with different blood type groups were not statistically significant (P>0.008 7). In each pTNM staging subgroup, the differences between 1, 3, 5 and 10-year OS and DSS were not statistically significant among different blood type groups (P>0.008 7). Conclusions Overall, there was no significant difference in prognosis among the blood type A, B, AB, and O groups. Comparing specific blood types and follow-up time, patients with blood type B have slightly better 1-year OS than patients with blood type A or blood type O. Comparisons between other ABO blood groups and between ABO blood groups classified by the pTNM staging subgroup did not show a difference.
ObjectiveTo compare the the effectiveness of robot-assisted thoracic surgery (RATS) with video-assisted thoracic surgery (VATS), in stageⅠ lung adenocarcinoma.MethodsFrom January 2012 to December 2018, 291 patients were included. The patients were allocated into two groups including a RATS group with 125 patients and a VATS group with 166 patients. Two cohorts (RATS, VATS ) of clinical stageⅠ lung adenocarcinoma patients were matched by propensity score. Then there were 114 patients in each group (228 patients in total). There were 45 males and 69 females at age of 62±9 years in the RATS group; 44 males, 70 females at age of 62±8 years in the VATS group. Overall survival (OS) and disease-free survival (DFS) were assessed. Univariate and multivariate analyses were performed to identify factors associated with the outcomes.Results Compared with the VATS group, the RATS group got less blood loss (P<0.05) and postoperative drainage (P<0.05) with a statistical difference. There was no statistical difference in drainage time (P>0.05) or postoperative hospital stay (P>0.05) between the two groups. The RATS group harvested more stations and number of the lymph nodes with a statistical difference (P<0.05). There was no statistical difference in 1-year, 3-year and 5-year OS and mean survival time (P>0.05). While there was a statistical difference in DFS between the two groups (1-year DFS: 94.1% vs. 95.6%; 3-year DFS: 92.6% vs. 75.2%; 5-year DFS: 92.6% vs. 68.4%, P<0.05; mean DFS time: 78 months vs. 63 months, P<0.05) between the two groups. The univariate analysis found that the number of the lymph nodes dissection was the prognostic factor for OS, and tumor diameter, surgical approach, stations and number of the lymph nodes dissection were the prognostic factors for DFS. However, multivariate analysis found that there was no independent risk factor for OS, but the tumor diameter and surgical approach were independently associated with DFS.ConclusionThere is no statistical difference in OS between the two groups, but the RATS group gets better DFS.
ObjectiveTo understand the relation between the occupation and long-term prognosis of the patients with colorectal cancer (CRC) based on the Database from Colorectal Cancer (DACCA). MethodsThe selected updated DACCA database as of June 29, 2022 was used for this study. The included patients were assigned into intellectual occupations group (intellectual group) and manual occupations group (manual group) referring to relevant regulatory documents in China. The survival status of the intellectual group and the manual group was compared, and then were stratified by pTNM stage. ResultsA total of 1 974 patients were included from the DACCA database according to the selection criteria, 349 of whom in the intellectual group and 1 625 of whom in the manual group. The intellectual group had higher 5-year cumulative overall survival rate (92.1% vs. 84.5%, P<0.001) and disease-specific survival rate (92.1% vs. 85.8%, P=0.002), as well as higher 10-year cumulative overall survival rate (72.4% vs. 55.2%, P<0.001) and disease-specific survival rate (75.4% vs. 59.1%, P<0.001) compared to the manual group. The stratified analysis by pTNM stage found that, for the patients with pTNM Ⅲ stage, the 5- and 10-year cumulative overall survival rates of the intellectual group were higher than those of the manual group (94.0% vs. 82.3%, P<0.001; 67.1% vs. 43.7%, P=0.014), simultaneous the 5- and 10-year cumulative disease-specific survival rates were the same as the overall survival rate (94.0% vs. 83.5%, P=0.001; 69.5% vs. 47.9%, P=0.026). Furthermore for the the patients with pTNM Ⅱ stage , it was found that the the 10-year cumulative disease-specific survival rate of the intellectual group was higher than that of the manual group (93.5% vs. 78.7%, P=0.009).ConclusionsFrom the analysis results of this study, occupation might be related to long-term prognosis in CRC cancer patients. A general trend is that the long-term prognosis of patients with intellectual occupations might be better than that of patients with manual occupations, and this difference might be relatively marked in the patients with pTNM Ⅱ and Ⅲ stages, but it needs to be autious and objective.
At present, breast cancer is most common malignant tumor among female population. The treatment of breast cancer comprises surgery, radiotherapy, neoadjuvant and adjuvant therapy, with surgical as the main treatment approach. Common surgical methods for breast cancer include breast conservation surgery (BCS) and mastectomy. This article reviews the recent researches about the survival of breast cancer patients receiving BCS, the quality of life for patients receiving BCS, the survival of young and elderly patients receiving BCS, BCS after neoadjuvant chemotherapy, BCS for patients with breast cancer susceptibility gene mutation, and BCS for patients with ipsilateral breast tumor recurrence, so as to provide reference for the follow-up work of medical staff.
Objective To systematically evaluate the efficacy and safety of single and bilateral lung transplantation in the treatment of end-stage chronic obstructive pulmonary disease (COPD). Methods Chinese and English databases were searched by computer, including PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang database, VIP database and CBM. Case-control studies on single lung transplantation or bilateral lung transplantation for COPD were collected from the inception to July 31, 2022. We evaluated the quality of the literature via Newcastle-Ottawa Scale (NOS). All results were analyzed using Review Manager V5.3 and STATA 17.0. Results A total of 8 studies were included covering 14076 patients, including 8326 patients in the single lung transplantation group and 5750 patients in the bilateral lung transplantation group. NOS scores were≥6 points. The results of meta-analysis showed that there was no statistical difference in the postoperative 1-year survival between the two groups (P=0.070). The 2-year survival rate (P=0.002), 3-year survival rate (P<0.001), 5-year survival rate (P<0.001), overall survival rate (P＜0.001), postoperative forced expiratory volume in one second/predicted value (P<0.001), postoperative forced vital capacity (P<0.001), and postoperative 6-minute walking distance (P=0.002) were lower or shorter than those in the bilateral lung transplantation group, the postoperative intubation time (P=0.030) was longer than that in the bilateral lung transplantation group. Bilateral lung transplantation group showed better surgical results. There was no statistical difference in the mortality, obliterative bronchiolitis, length of hospitalization, primary graft dysfunction, or postoperative adverse events (P>0.05). Conclusion Bilateral lung transplantation is associated with better long-term survival and postoperative lung function compared with single lung transplantation. In-hospital mortality and postoperative complications are similar between them.