Objective： This retrospective study was conducted to investigate the impact of more extended mediastinal lymphadenectomy on the outcome of lung cancer patients treated with R0 resection. Methods： During the investig...Objective： This retrospective study was conducted to investigate the impact of more extended mediastinal lymphadenectomy on the outcome of lung cancer patients treated with R0 resection. Methods： During the investigation period, 325 lung cancer cases were enlisted and 278 cases entered the analysis. The patients were divided into Control group （n=116） and Research group （n=162） according to the different extents of mediastinal lymph node clearance at different time periods. Three major parameters were retrospectively assessed to compare the quality of surgical care： extent of lymph node clearance, resection volume, and postoperative recovery process and common complications. Comparison of the outcome between two groups was carried out. Results： Research group showed a significant quality improvement of lymphadenectomy, such as more mediastinal node stations investigated （more than 3 N2 stations investigated： Research group, 90.7% vs. Control group, 55.2%; P=0.001） and more nodes collection （total nodes 26.1±10.0 vs. 19.1±8.3, P=0.000; N2 nodes 15.5±7.2 vs. 9.8±5.6, P=0.000）. However, overall survival （OS） and disease-free survival （DFS） were not significantly different either between two groups （5-year OS： Control group, 56.4±4.6% vs. Research group, 62.6±4.3%; P=0.271） or between subgroups from stage I to IIIa. TNM stage and histology were significant factors associated with OS and DFS in multivariate analysis; extent of mediastinal lymphadenectomy was not associated with OS or DFS. Conclusions： More radical mediastinal lymphadenectomy may not lead to an improved oncological outcome for lung cancer treated with R0 resection.展开更多
Objective:This is a prospective,single-arm,phase Ib study to evaluate the safety and efficacy of camrelizumab combined with chemotherapy and apatinib as neoadjuvant therapy for locally advanced thoracic esophageal squ...Objective:This is a prospective,single-arm,phase Ib study to evaluate the safety and efficacy of camrelizumab combined with chemotherapy and apatinib as neoadjuvant therapy for locally advanced thoracic esophageal squamous cell carcinoma(ESCC).Methods:The regimen encompassed 2-4 cycles of neoadjuvant camrelizumab,nab-paclitaxel,nedaplatin,and apatinib to treatment-naive patients with resectable locally advanced ESCC.The treatment was repeated every 14 days.Initially,six patients were planned to receive two cycles of neoadjuvant therapy as safety assessment,and then 24 patients received four cycles of neoadjuvant therapy,followed by esophagectomy after 4-8 weeks.The primary endpoint was safety.The key secondary endpoints were pathologic complete response(pCR)and major pathologic response(MPR).Results:This study enrolled 30 patients,among whom,five patients received two cycles of neoadjuvant therapy,and one patient missed the second cycle of therapy due to grade 3 elevated alanine transaminase(ALT)level.The remaining 24 patients received four planned cycles of neoadjuvant therapy.Eleven patients(36.7%)devel-oped grade 3 neoadjuvant treatment-related adverse events(TRAEs).No patient developed grade 4 or 5 TRAEs.Neutropenia(23.3%)was the most common grade 3 TRAE.Twenty-nine patients underwent esophagectomy af-ter neoadjuvant therapy.Among them,15 patients(51.7%)achieved MPR,including seven patients with pCR(24.1%).Radiographic analyses established a significant correlation between maximal standardized uptake value(SUV max)reduction and pathologic regression(P=0.00095).Conclusions:Neoadjuvant camrelizumab combined with chemotherapy plus apatinib demonstrated a manageable safety profile for patients with locally advanced ESCC,and an encouraging efficacy was observed in most of the treated patients.A decrease in SUV max of the primary tumor may be a predictor of pathologic response to neoadjuvant camrelizumab combined with chemotherapy plus apatinib in ESCC.展开更多
Objective:This study conducted inverse probability of treatment weighting(IPTW)survival analysis to examine survival in pancreatic adenocarcinoma patients.Methods:In this population-based study,data from the Surveilla...Objective:This study conducted inverse probability of treatment weighting(IPTW)survival analysis to examine survival in pancreatic adenocarcinoma patients.Methods:In this population-based study,data from the Surveillance,Epidemiology,and End Results program of the United States were analyzed to identify patients diagnosed with adenocarcinoma of the pancreas 2004 to 2014.Differences in survival rates were examined among patients who underwent pancreatectomy alone,radiotherapy alone,and those who had pancreatectomy plus adjuvant radiotherapy.Kaplan-Meier estimates and Cox proportional hazards models with the IPTW were performed to determine the effect of different treatments on overall and cancer-specific survival.This study was approved by the Ethics Review Board of Weifang Medical University.Results:A total of 8191 patients were included,with 3409 taking pancreatectomy only,2865 taking radiotherapy only,and 1917 taking pancreatectomy plus adjuvant radiotherapy.Patients who received surgery plus adjuvant radiotherapy had statistically a higher survival rate than those who received the other 2 treatments.Survival analysis with the IPTW for the 3 different groups showed that the difference in median overall survival time among these patient groups was significant.Conclusion:Using IPTW survival analysis,the present study shows that surgery with adjuvant radiotherapy is significantly associated with improved overall and cancer-specific survival among patients with pancreatic adenocarcinoma.展开更多
基金supported partially by the Strategic Priority Research Program of the Chinese Academy of Sciences (XDA06020101)the National Natural Science Foundation (No. 81350028)+1 种基金the National High Technology Research and Development Program of China (863 Program, No. 2012AA02A502)the Beijing Municipal Science & Technology Commission (No. Z111107067311018)
文摘Objective： This retrospective study was conducted to investigate the impact of more extended mediastinal lymphadenectomy on the outcome of lung cancer patients treated with R0 resection. Methods： During the investigation period, 325 lung cancer cases were enlisted and 278 cases entered the analysis. The patients were divided into Control group （n=116） and Research group （n=162） according to the different extents of mediastinal lymph node clearance at different time periods. Three major parameters were retrospectively assessed to compare the quality of surgical care： extent of lymph node clearance, resection volume, and postoperative recovery process and common complications. Comparison of the outcome between two groups was carried out. Results： Research group showed a significant quality improvement of lymphadenectomy, such as more mediastinal node stations investigated （more than 3 N2 stations investigated： Research group, 90.7% vs. Control group, 55.2%; P=0.001） and more nodes collection （total nodes 26.1±10.0 vs. 19.1±8.3, P=0.000; N2 nodes 15.5±7.2 vs. 9.8±5.6, P=0.000）. However, overall survival （OS） and disease-free survival （DFS） were not significantly different either between two groups （5-year OS： Control group, 56.4±4.6% vs. Research group, 62.6±4.3%; P=0.271） or between subgroups from stage I to IIIa. TNM stage and histology were significant factors associated with OS and DFS in multivariate analysis; extent of mediastinal lymphadenectomy was not associated with OS or DFS. Conclusions： More radical mediastinal lymphadenectomy may not lead to an improved oncological outcome for lung cancer treated with R0 resection.
基金supported by the Na-tional Key R&D Program of China(2018YFC0910600)National Science&Technology Fundamental Resources Investigation Program of China(2019FY101101)+1 种基金the Non-profit Central Research Institute Fund of Chi-nese Academy of Medical Sciences(2019PT320022)the Beijing Xisike Clinical Oncology Research Foundation(Y-Young2021-0145).
文摘Objective:This is a prospective,single-arm,phase Ib study to evaluate the safety and efficacy of camrelizumab combined with chemotherapy and apatinib as neoadjuvant therapy for locally advanced thoracic esophageal squamous cell carcinoma(ESCC).Methods:The regimen encompassed 2-4 cycles of neoadjuvant camrelizumab,nab-paclitaxel,nedaplatin,and apatinib to treatment-naive patients with resectable locally advanced ESCC.The treatment was repeated every 14 days.Initially,six patients were planned to receive two cycles of neoadjuvant therapy as safety assessment,and then 24 patients received four cycles of neoadjuvant therapy,followed by esophagectomy after 4-8 weeks.The primary endpoint was safety.The key secondary endpoints were pathologic complete response(pCR)and major pathologic response(MPR).Results:This study enrolled 30 patients,among whom,five patients received two cycles of neoadjuvant therapy,and one patient missed the second cycle of therapy due to grade 3 elevated alanine transaminase(ALT)level.The remaining 24 patients received four planned cycles of neoadjuvant therapy.Eleven patients(36.7%)devel-oped grade 3 neoadjuvant treatment-related adverse events(TRAEs).No patient developed grade 4 or 5 TRAEs.Neutropenia(23.3%)was the most common grade 3 TRAE.Twenty-nine patients underwent esophagectomy af-ter neoadjuvant therapy.Among them,15 patients(51.7%)achieved MPR,including seven patients with pCR(24.1%).Radiographic analyses established a significant correlation between maximal standardized uptake value(SUV max)reduction and pathologic regression(P=0.00095).Conclusions:Neoadjuvant camrelizumab combined with chemotherapy plus apatinib demonstrated a manageable safety profile for patients with locally advanced ESCC,and an encouraging efficacy was observed in most of the treated patients.A decrease in SUV max of the primary tumor may be a predictor of pathologic response to neoadjuvant camrelizumab combined with chemotherapy plus apatinib in ESCC.
基金partially supported by the National Natural Science Foundation of China(No.81872719)the National Bureau of Statistics Foundation Project(No.2018LY79)+6 种基金the Natural Science Foundation of Shandong Province(No.2019MH034)the Poverty Alleviation Fund project of Weifang Medical University(No.FP1801001)partially supported by the National Natural Science Foundation of China(No.81803337)the Shandong Provincial Youth Innovation Team Development Plan of Colleges and Universities(No.2019-6-156,Lu-Jiao)the Shandong Provincial Government Fund for Overseas Study(No.27,2019,Lu-Jiao)the Shandong Science and Technology Development Plan Project(No.2015 WS0067)the Weifang Medical University Doctoral Foundation Project(No.2017BSQD51).
文摘Objective:This study conducted inverse probability of treatment weighting(IPTW)survival analysis to examine survival in pancreatic adenocarcinoma patients.Methods:In this population-based study,data from the Surveillance,Epidemiology,and End Results program of the United States were analyzed to identify patients diagnosed with adenocarcinoma of the pancreas 2004 to 2014.Differences in survival rates were examined among patients who underwent pancreatectomy alone,radiotherapy alone,and those who had pancreatectomy plus adjuvant radiotherapy.Kaplan-Meier estimates and Cox proportional hazards models with the IPTW were performed to determine the effect of different treatments on overall and cancer-specific survival.This study was approved by the Ethics Review Board of Weifang Medical University.Results:A total of 8191 patients were included,with 3409 taking pancreatectomy only,2865 taking radiotherapy only,and 1917 taking pancreatectomy plus adjuvant radiotherapy.Patients who received surgery plus adjuvant radiotherapy had statistically a higher survival rate than those who received the other 2 treatments.Survival analysis with the IPTW for the 3 different groups showed that the difference in median overall survival time among these patient groups was significant.Conclusion:Using IPTW survival analysis,the present study shows that surgery with adjuvant radiotherapy is significantly associated with improved overall and cancer-specific survival among patients with pancreatic adenocarcinoma.
