Objective: To identify clinical and pathologic factors that were associated with the survival of stage IB upper lobe non-small cell lung cancer (NSCLC) patients. Methods: A retrospective study of 147 subjects who had ...Objective: To identify clinical and pathologic factors that were associated with the survival of stage IB upper lobe non-small cell lung cancer (NSCLC) patients. Methods: A retrospective study of 147 subjects who had undergone curative resection for stage IB upper lobe NSCLC was performed. Patients who had received any adjuvant or neo-adjuvant chemotherapy were excluded. Survival function curves were estimated using the Kaplan-Meier procedure. Crude and adjusted hazard ratios (HRs) of potential prognostic factors were estimated using Cox proportional hazards models. Results: Five factors, including age, tumor size, histologic grade of differentiation, number of removed superior mediastinal lymph node stations and presence of visceral pleura invasion, were significantly and independently associated with mortality risk. Adjusted HRs were 2.6 [95% confidence interval (95% CI): 1.1?6.5] and 4.6 (95% CI: 1.9?11) for those aged 58?68 years and those >68 years, respectively, relative to those aged <58 years. HRs for those with poorly and moderately differentiated tumors were 6.4 (95% CI: 2.3?18) and 1.4 (95% CI: 0.7?2.8), respectively. HRs for those with tumor size 3.1?5 cm and >5 cm (vs ?3.0 cm) were 2.3 (95% CI: 1.1?4.9) and 4.3 (95% CI: 1.9?10), respectively. The presence of visceral pleura invasion also increased the risk of mortality (HR=4.0, 95% CI: 1.3?12). Conclusion: Advanced age, larger tumor size, poorly differentiated histology, smaller number of removed superior mediastinal lymph node stations, and presence of visceral pleura invasion were associated with poor survival of surgically treated stage IB upper lobe NSCLC patients.展开更多
This is a report of a nonrandomized comparison of treatment results of 139 patients with stage IB, HA and proximal IIB carcinoma of the uterine cervix treated by radiation alone and 113 treated with a combination of r...This is a report of a nonrandomized comparison of treatment results of 139 patients with stage IB, HA and proximal IIB carcinoma of the uterine cervix treated by radiation alone and 113 treated with a combination of radiation and surgery. The five-year tumor free acturial survival for the patients with stage IB either with irradiation alone (RT) or combined with surgery (RS) was approximately 87%. For stage Ⅱ the tumor free actuarial five-year survival 79% with patients of RS, and 76% with RT. In the 113 patients treated with RS there were 18 (16%). In the 139 patients treated by RT there were 18 (13%) recurrences of pelvic, 4 local recurrences, 11 combined with parametrial, and free parametrial recurrences. There was no significant difference in the survival and recurrence rate of the patients treated with either method. Major complications were comparable in both groups (RT approximately 25% and RS approximately 10%), but 2/3 of those complications recovered without sequelae. The most frequent minor complication in the patients treated with RT was rectosigmoiditis.展开更多
Background This study aimed to investigate whether patients with stage IB NSCLC could benefit from adjuvant chemotherapy.Methods In the years 2010 to 2015,1,829 NSCLC patients with stage IB disease were chosen from th...Background This study aimed to investigate whether patients with stage IB NSCLC could benefit from adjuvant chemotherapy.Methods In the years 2010 to 2015,1,829 NSCLC patients with stage IB disease were chosen from the SEER database.To equalize the baseline characteristics between the surgery plus adjuvant chemotherapy group(intervention)and the surgery alone group(control),propensity score matching(PSM)was used.The log-rank test plotted Kaplan–Meier survival curves to compare the overall survival(OS)and disease-specific survival(DSS).Cox proportional hazard regression was used to perform univariate and multivariate analysis on overall survival.Results One hundred ninety-seven patients in each group with a mean follow-up period of 65.4 months were enrolled after PSM.A significant benefit in overall survival([intervention vs.control]HR=0.72;95%CI:0.54 to 0.94;P=0.026)was detected in the intervention group before PSM.And there were significantly improved OS(HR=0.63;95%CI:0.42 to 0.92;P=0.036)and DSS(HR=0.73;95%CI:0.52 to 0.95;P=0.044)for the patients with visceral pleural invasion(VPI)in the intervention group compared with the control group.After PSM,the patients with VPI in the intervention group had better overall survival(HR=0.69;95%CI:0.40 to 0.98;P=0.048)than those in the control group.The Cox proportional hazard regression analysis showed that VPI(HR=1.29;95%CI:1.11 to 1.54;P<0.001)was also an independent prognostic factor.Conclusion Stage IB NSCLC with VPI could benefit from adjuvant chemotherapy after R0 resection.展开更多
AIM:To identify the subset of patients with stage IB gastric cancer with an unfavorable prognosis.METHODS:Overall survival(OS)rates were examined in 103 patients with stage IB(T1N1M0 and T2N0M0)gastric cancer between ...AIM:To identify the subset of patients with stage IB gastric cancer with an unfavorable prognosis.METHODS:Overall survival(OS)rates were examined in 103 patients with stage IB(T1N1M0 and T2N0M0)gastric cancer between January 2000 and December2011.Univariate and multivariate analyses were performed to identify risk factors using a Cox proportional hazards model.RESULTS:The OS rates of patients with T1N1 and T2N0 cancer were 89.2%and 94.1%at 5-years,re-spectively.Both univariate and multivariate analyses demonstrated that tumor location was the only significant prognostic factor.The OS rate was 81.8%at5-years when the tumor was located in the upper third of the stomach and was 95.5%at 5-years when the tumor was located in the middle or lower third of the stomach(P=0.0093).CONCLUSION:These data may suggest that tumor location is associated with survival in patients with stage IB gastric cancer.展开更多
The clinical benefit of neoadjuvant immunochemotherapy in locally advanced cervical cancer(LAcC)remains unclear.This singlearm,phase Ⅱ study(Chinese Clinical Trial Registry,ChiCTR2200065392)aimed to evaluate the effi...The clinical benefit of neoadjuvant immunochemotherapy in locally advanced cervical cancer(LAcC)remains unclear.This singlearm,phase Ⅱ study(Chinese Clinical Trial Registry,ChiCTR2200065392)aimed to evaluate the efficacy and safety of neoadjuvant anti-programmed cell death protein 1(PD-1)antibody tislelizumab in combination with chemotherapy in treatment-naive patients with stage IB3/IIA2 LACC.Enrolled patients received tislelizumab(200 mg,every 3 weeks)plus chemotherapy for 3 cycles before radical surgery.The primary endpoint was the pathological complete response(pCR).Secondary endpoints were objective response rate(ORR)per Response Evaluation Criteria in Solid Tumors version 1.1,disease-free survival,overall survival,and safety.Exploratory endpoints included tissue-based and blood-based biomarkers to identify the biological drivers behind the clinical outcomes.Between November 2022 and March 2024,30 patients were enrolled.All patients completed 3 cycles of neoadjuvant immunochemotherapy and underwent radical surgery.The pCR was observed in 20(66.7%)patients,and 4(13.3%)patients achieved major pathological response(MPR),with an optimal pathological response rate(OPR)of 80.0%.The ORR was 90.0%,with 17(56.7%)complete responses.Survival data were immature at the median follow-up of 14.7 months(data cutoff,December 31,2024).Grade 3 treatment-related adverse events(TRAEs)and immune-related AEs occurred in 26.7%and 3.3%of patients,respectively.No treatment-related death occurred.Patients with pCR had significantly higher expression of PD-L1 CPS at baseline,and a strong relationship with immune-related signature(all p<0.05).Neoadjuvant tislelizumab plus chemotherapy showed promising antitumor efficacy and a well-tolerated safety profle in patients with stage IB3/IIA2 LACC,and might be a potential option in this population.展开更多
目的系统性回顾文献以探讨术后辅助化疗在完全切除的IB期非小细胞肺癌中的作用。方法本研究针对术后辅助化疗对完全切除的IB期非小细胞肺癌的影响,检索了Pubmed,Embase,Cochrane Library和Web of Science等数据库,收集符合纳入标准的随...目的系统性回顾文献以探讨术后辅助化疗在完全切除的IB期非小细胞肺癌中的作用。方法本研究针对术后辅助化疗对完全切除的IB期非小细胞肺癌的影响,检索了Pubmed,Embase,Cochrane Library和Web of Science等数据库,收集符合纳入标准的随机对照试验。数据通过RevMan 5.3软件进行分析。结果本研究共纳入6项研究,包括1 286例患者。两组患者5年总生存率相似,但差异无统计学意义(HR:0.83,95%CI:0.66~1.04,P=0.11)。但亚组分析表明,对于肿瘤直径≥4 cm的患者5年总生存率有统计学意义(HR:0.51,95%CI:0.26~0.99,P=0.05)。辅助化疗组5年无病生存率明显高于单纯手术组(HR:0.58,95%CI:0.35~0.94,P=0.03)。结论术后辅助化疗不会增加IB期非小细胞肺癌患者的5年总生存率。但是,术后辅助化疗可能会增加肿瘤直径≥4cm的患者的5年总生存率和5年无病生存率。展开更多
Clinical Question How to choose the drugs of adjuvant therapy for nonsmall-cell lung cancer(NSCLC)patients harboring driver gene mutation?Recommendations Recommendation 1:We suggest osimertinib(80 mg)adjuvant therapy ...Clinical Question How to choose the drugs of adjuvant therapy for nonsmall-cell lung cancer(NSCLC)patients harboring driver gene mutation?Recommendations Recommendation 1:We suggest osimertinib(80 mg)adjuvant therapy in stage Ib–IIIa EGFR-positive(Ex19del or L858R)NSCLC patients after surgery.According to the results of the ADAURA study,the benefit of osimertinib administration increases with advancing tumor stage.(Strong recommendation,high certainty of evidence)展开更多
文摘Objective: To identify clinical and pathologic factors that were associated with the survival of stage IB upper lobe non-small cell lung cancer (NSCLC) patients. Methods: A retrospective study of 147 subjects who had undergone curative resection for stage IB upper lobe NSCLC was performed. Patients who had received any adjuvant or neo-adjuvant chemotherapy were excluded. Survival function curves were estimated using the Kaplan-Meier procedure. Crude and adjusted hazard ratios (HRs) of potential prognostic factors were estimated using Cox proportional hazards models. Results: Five factors, including age, tumor size, histologic grade of differentiation, number of removed superior mediastinal lymph node stations and presence of visceral pleura invasion, were significantly and independently associated with mortality risk. Adjusted HRs were 2.6 [95% confidence interval (95% CI): 1.1?6.5] and 4.6 (95% CI: 1.9?11) for those aged 58?68 years and those >68 years, respectively, relative to those aged <58 years. HRs for those with poorly and moderately differentiated tumors were 6.4 (95% CI: 2.3?18) and 1.4 (95% CI: 0.7?2.8), respectively. HRs for those with tumor size 3.1?5 cm and >5 cm (vs ?3.0 cm) were 2.3 (95% CI: 1.1?4.9) and 4.3 (95% CI: 1.9?10), respectively. The presence of visceral pleura invasion also increased the risk of mortality (HR=4.0, 95% CI: 1.3?12). Conclusion: Advanced age, larger tumor size, poorly differentiated histology, smaller number of removed superior mediastinal lymph node stations, and presence of visceral pleura invasion were associated with poor survival of surgically treated stage IB upper lobe NSCLC patients.
文摘This is a report of a nonrandomized comparison of treatment results of 139 patients with stage IB, HA and proximal IIB carcinoma of the uterine cervix treated by radiation alone and 113 treated with a combination of radiation and surgery. The five-year tumor free acturial survival for the patients with stage IB either with irradiation alone (RT) or combined with surgery (RS) was approximately 87%. For stage Ⅱ the tumor free actuarial five-year survival 79% with patients of RS, and 76% with RT. In the 113 patients treated with RS there were 18 (16%). In the 139 patients treated by RT there were 18 (13%) recurrences of pelvic, 4 local recurrences, 11 combined with parametrial, and free parametrial recurrences. There was no significant difference in the survival and recurrence rate of the patients treated with either method. Major complications were comparable in both groups (RT approximately 25% and RS approximately 10%), but 2/3 of those complications recovered without sequelae. The most frequent minor complication in the patients treated with RT was rectosigmoiditis.
基金supported by the National Postdoctoral Innovation Talents Support Program of China(No.BX20230083)National Natural Science Foundation of China(No.82303564)Youth Foundation of Zhongshan Hospital,Fudan University(No.2022–020).
文摘Background This study aimed to investigate whether patients with stage IB NSCLC could benefit from adjuvant chemotherapy.Methods In the years 2010 to 2015,1,829 NSCLC patients with stage IB disease were chosen from the SEER database.To equalize the baseline characteristics between the surgery plus adjuvant chemotherapy group(intervention)and the surgery alone group(control),propensity score matching(PSM)was used.The log-rank test plotted Kaplan–Meier survival curves to compare the overall survival(OS)and disease-specific survival(DSS).Cox proportional hazard regression was used to perform univariate and multivariate analysis on overall survival.Results One hundred ninety-seven patients in each group with a mean follow-up period of 65.4 months were enrolled after PSM.A significant benefit in overall survival([intervention vs.control]HR=0.72;95%CI:0.54 to 0.94;P=0.026)was detected in the intervention group before PSM.And there were significantly improved OS(HR=0.63;95%CI:0.42 to 0.92;P=0.036)and DSS(HR=0.73;95%CI:0.52 to 0.95;P=0.044)for the patients with visceral pleural invasion(VPI)in the intervention group compared with the control group.After PSM,the patients with VPI in the intervention group had better overall survival(HR=0.69;95%CI:0.40 to 0.98;P=0.048)than those in the control group.The Cox proportional hazard regression analysis showed that VPI(HR=1.29;95%CI:1.11 to 1.54;P<0.001)was also an independent prognostic factor.Conclusion Stage IB NSCLC with VPI could benefit from adjuvant chemotherapy after R0 resection.
基金Supported by Non-Governmental Organizations Kanagawa Standard Anti-cancer Therapy Support System
文摘AIM:To identify the subset of patients with stage IB gastric cancer with an unfavorable prognosis.METHODS:Overall survival(OS)rates were examined in 103 patients with stage IB(T1N1M0 and T2N0M0)gastric cancer between January 2000 and December2011.Univariate and multivariate analyses were performed to identify risk factors using a Cox proportional hazards model.RESULTS:The OS rates of patients with T1N1 and T2N0 cancer were 89.2%and 94.1%at 5-years,re-spectively.Both univariate and multivariate analyses demonstrated that tumor location was the only significant prognostic factor.The OS rate was 81.8%at5-years when the tumor was located in the upper third of the stomach and was 95.5%at 5-years when the tumor was located in the middle or lower third of the stomach(P=0.0093).CONCLUSION:These data may suggest that tumor location is associated with survival in patients with stage IB gastric cancer.
基金supported by the 358 program Clinical Trial Fund of Tianjin Cancer Hospital(Grant No.TZ3582023-010)the National Natural Science Foundation of China(Grant No.82202863)。
文摘The clinical benefit of neoadjuvant immunochemotherapy in locally advanced cervical cancer(LAcC)remains unclear.This singlearm,phase Ⅱ study(Chinese Clinical Trial Registry,ChiCTR2200065392)aimed to evaluate the efficacy and safety of neoadjuvant anti-programmed cell death protein 1(PD-1)antibody tislelizumab in combination with chemotherapy in treatment-naive patients with stage IB3/IIA2 LACC.Enrolled patients received tislelizumab(200 mg,every 3 weeks)plus chemotherapy for 3 cycles before radical surgery.The primary endpoint was the pathological complete response(pCR).Secondary endpoints were objective response rate(ORR)per Response Evaluation Criteria in Solid Tumors version 1.1,disease-free survival,overall survival,and safety.Exploratory endpoints included tissue-based and blood-based biomarkers to identify the biological drivers behind the clinical outcomes.Between November 2022 and March 2024,30 patients were enrolled.All patients completed 3 cycles of neoadjuvant immunochemotherapy and underwent radical surgery.The pCR was observed in 20(66.7%)patients,and 4(13.3%)patients achieved major pathological response(MPR),with an optimal pathological response rate(OPR)of 80.0%.The ORR was 90.0%,with 17(56.7%)complete responses.Survival data were immature at the median follow-up of 14.7 months(data cutoff,December 31,2024).Grade 3 treatment-related adverse events(TRAEs)and immune-related AEs occurred in 26.7%and 3.3%of patients,respectively.No treatment-related death occurred.Patients with pCR had significantly higher expression of PD-L1 CPS at baseline,and a strong relationship with immune-related signature(all p<0.05).Neoadjuvant tislelizumab plus chemotherapy showed promising antitumor efficacy and a well-tolerated safety profle in patients with stage IB3/IIA2 LACC,and might be a potential option in this population.
文摘Clinical Question How to choose the drugs of adjuvant therapy for nonsmall-cell lung cancer(NSCLC)patients harboring driver gene mutation?Recommendations Recommendation 1:We suggest osimertinib(80 mg)adjuvant therapy in stage Ib–IIIa EGFR-positive(Ex19del or L858R)NSCLC patients after surgery.According to the results of the ADAURA study,the benefit of osimertinib administration increases with advancing tumor stage.(Strong recommendation,high certainty of evidence)
