Background:Transarterial chemoembolization(TACE)based neoadjuvant therapy was proven effective in hepatocellular carcinoma(HCC).Recently,tyrosine kinase inhibitors(TKIs)and immune checkpoint inhibitors(ICIs)also showe...Background:Transarterial chemoembolization(TACE)based neoadjuvant therapy was proven effective in hepatocellular carcinoma(HCC).Recently,tyrosine kinase inhibitors(TKIs)and immune checkpoint inhibitors(ICIs)also showed promise in HCC treatment.However,the prognostic benefits associated with these treatments remain uncertain.This study aimed to explore the relationship between pathologic response and prognostic features in HCC patients who received neoadjuvant therapy.Methods:HCC patients who received TACE either with or without TKIs/ICIs as neoadjuvant therapy before liver resection were retrospectively collected from the First Affiliated Hospital,Zhejiang University School of Medicine in China.Pathologic response was determined by calculating the proportion of non-viable area within the tumor.Major pathologic response(MPR)was defined as the presence of non-viable tumor cells reaching a minimum of 90%.Complete pathologic response(CPR)was characterized by the absence of viable cells observed in the tumor.Results:A total of 481 patients meeting the inclusion criteria were enrolled,with 76 patients(15.8%)achieving CPR and 179(37.2%)reaching MPR.The median recurrence-free survival(m RFS)in the CPR+MPR group was significantly higher than the non-MPR group(31.3 vs.25.1 months).The difference in 3-year overall survival(OS)rate was not significant.Multivariate Cox regression analysis identified failure to achieve MPR(hazard ratio=1.548,95%confidence interval:1.122–2.134;P=0.008),HBs Ag positivity(HR=1.818,95%CI:1.062–3.115,P=0.030),multiple lesions(HR=2.278,95%CI:1.621–3.195,P<0.001),and baseline tumor size>5 cm(HR=1.712,95%CI:1.031–2.849,P=0.038)were independent risk factors for RFS.Subgroup analysis showed that 67 of 93(72.0%)patients who received the combination of TACE,TKIs,and ICIs achieved MPR+CPR.Conclusions:In individuals who received TACE-based neoadjuvant therapy for HCC,failure to achieve MPR emerges as an independent risk factor for RFS.Notably,the combination of TACE,TKIs,and ICIs demonstrated the highest rate of MPR.展开更多
Hepatocellular carcinoma(HCC)is a major health problem worldwide with high incidence and mortality rate[1,2].Proper treatments for HCC mainly include surgical resection,transcatheter arterial chemoembolization(TACE),r...Hepatocellular carcinoma(HCC)is a major health problem worldwide with high incidence and mortality rate[1,2].Proper treatments for HCC mainly include surgical resection,transcatheter arterial chemoembolization(TACE),radiofrequency ablation(RFA),and liver transplantation.However,many patients who are diagnosed with advanced HCC are not eligible for surgery,even the TACE and RFA does not necessarily have a good therapeutic effect.Until now,sorafenib is currently the first-line antitumor drug for the treatment of patients with advanced HCC.展开更多
Pancreatic acinar cell carcinoma(PACC)is a rare malignant tumor of pancreatic epithelial cells,which produces pancreatic exocrine enzymes.PACC originates from acinar cells and terminal branches of the pancreatic ducts...Pancreatic acinar cell carcinoma(PACC)is a rare malignant tumor of pancreatic epithelial cells,which produces pancreatic exocrine enzymes.PACC originates from acinar cells and terminal branches of the pancreatic ducts in the exocrine tissue of the pancreas.PACC accounts for 1%−2%of pancreatic exocrine tumors[1].Herein,we present an elderly woman with PACC who recovered after effective laparoscopic surgery.The tumor was located on the left side of the abdomen;imaging suggested that it was a gastrointestinal stromal tumor of the gastric wall origin,infiltrating the tail of the pancreas and omentum,while postoperative pathology suggested PACC.展开更多
To the Editor:Choledochocele,also known as type III choledochal cysts in the classification by Todani et al.[1],is a congenital abnormality of the biliary system.It is characterized by a cystic dilation of intramural ...To the Editor:Choledochocele,also known as type III choledochal cysts in the classification by Todani et al.[1],is a congenital abnormality of the biliary system.It is characterized by a cystic dilation of intramural segment of the distal common bile duct(CBD)protruding into the descending duodenum.Choledochocele makes up about 0.5%−4%of choledochal cysts[1,2].Compared with other subtypes,the incidence of choledochocele is extremely low and it frequently presents in adults at a relatively older age,with an average age of 51 years[3].The diagnosis and treatment are challenging.Here,we present a case of a young female patient with this rare disease entity,who recovered after effective endoscopic retrograde cholangiopancreatography(ERCP)management.展开更多
基金supported by grants from the National Natural Science Foundation of China(82270682)the Natural Science Foundation of Zhejiang Province(LQ21H030007 and LQ20H30006)。
文摘Background:Transarterial chemoembolization(TACE)based neoadjuvant therapy was proven effective in hepatocellular carcinoma(HCC).Recently,tyrosine kinase inhibitors(TKIs)and immune checkpoint inhibitors(ICIs)also showed promise in HCC treatment.However,the prognostic benefits associated with these treatments remain uncertain.This study aimed to explore the relationship between pathologic response and prognostic features in HCC patients who received neoadjuvant therapy.Methods:HCC patients who received TACE either with or without TKIs/ICIs as neoadjuvant therapy before liver resection were retrospectively collected from the First Affiliated Hospital,Zhejiang University School of Medicine in China.Pathologic response was determined by calculating the proportion of non-viable area within the tumor.Major pathologic response(MPR)was defined as the presence of non-viable tumor cells reaching a minimum of 90%.Complete pathologic response(CPR)was characterized by the absence of viable cells observed in the tumor.Results:A total of 481 patients meeting the inclusion criteria were enrolled,with 76 patients(15.8%)achieving CPR and 179(37.2%)reaching MPR.The median recurrence-free survival(m RFS)in the CPR+MPR group was significantly higher than the non-MPR group(31.3 vs.25.1 months).The difference in 3-year overall survival(OS)rate was not significant.Multivariate Cox regression analysis identified failure to achieve MPR(hazard ratio=1.548,95%confidence interval:1.122–2.134;P=0.008),HBs Ag positivity(HR=1.818,95%CI:1.062–3.115,P=0.030),multiple lesions(HR=2.278,95%CI:1.621–3.195,P<0.001),and baseline tumor size>5 cm(HR=1.712,95%CI:1.031–2.849,P=0.038)were independent risk factors for RFS.Subgroup analysis showed that 67 of 93(72.0%)patients who received the combination of TACE,TKIs,and ICIs achieved MPR+CPR.Conclusions:In individuals who received TACE-based neoadjuvant therapy for HCC,failure to achieve MPR emerges as an independent risk factor for RFS.Notably,the combination of TACE,TKIs,and ICIs demonstrated the highest rate of MPR.
基金supported by grants from the National Natural Science Foundation of China(81874228)Science and Tech-nology Department of Zhejiang Province(2015C03034)。
文摘Hepatocellular carcinoma(HCC)is a major health problem worldwide with high incidence and mortality rate[1,2].Proper treatments for HCC mainly include surgical resection,transcatheter arterial chemoembolization(TACE),radiofrequency ablation(RFA),and liver transplantation.However,many patients who are diagnosed with advanced HCC are not eligible for surgery,even the TACE and RFA does not necessarily have a good therapeutic effect.Until now,sorafenib is currently the first-line antitumor drug for the treatment of patients with advanced HCC.
文摘Pancreatic acinar cell carcinoma(PACC)is a rare malignant tumor of pancreatic epithelial cells,which produces pancreatic exocrine enzymes.PACC originates from acinar cells and terminal branches of the pancreatic ducts in the exocrine tissue of the pancreas.PACC accounts for 1%−2%of pancreatic exocrine tumors[1].Herein,we present an elderly woman with PACC who recovered after effective laparoscopic surgery.The tumor was located on the left side of the abdomen;imaging suggested that it was a gastrointestinal stromal tumor of the gastric wall origin,infiltrating the tail of the pancreas and omentum,while postoperative pathology suggested PACC.
基金the Natural Science Foundation of Zhejiang Province(LQ21H160025).
文摘To the Editor:Choledochocele,also known as type III choledochal cysts in the classification by Todani et al.[1],is a congenital abnormality of the biliary system.It is characterized by a cystic dilation of intramural segment of the distal common bile duct(CBD)protruding into the descending duodenum.Choledochocele makes up about 0.5%−4%of choledochal cysts[1,2].Compared with other subtypes,the incidence of choledochocele is extremely low and it frequently presents in adults at a relatively older age,with an average age of 51 years[3].The diagnosis and treatment are challenging.Here,we present a case of a young female patient with this rare disease entity,who recovered after effective endoscopic retrograde cholangiopancreatography(ERCP)management.
