AIM To provide evidence regarding the postoperative treatment of patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer, for which guidelines have not been established. METHODS Patients who had undergone curative resect...AIM To provide evidence regarding the postoperative treatment of patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer, for which guidelines have not been established. METHODS Patients who had undergone curative resection between 1996 and 2014 with a pathological stage of T4 b N1-3 M0/Tx N3 b M0 for gastric cancer were retrospectively analyzed; staging was based on the 7 th edition of the American Joint Committee on Cancer staging system. The clinicopathological characteristics, administration of adjuvant chemotherapy, and patterns of recurrence were studied. Univariate and multivariate analyses of prognostic factors were conducted. The chemotherapeutic agents mainly included fluorouropyrimidine, platinum and taxanes, used as monotherapy, doublet, or triplet regimens. Patterns of first recurrence were categorized as locoregional recurrence, peritoneal dissemination, or distant metastasis.RESULTS The 5-year overall survival(OS) of the whole group(n = 176) was 16.8%, and the median OS was 25.7 mo(95%CI: 20.9-30.5). Lymphovascular invasion and a node positive rate(NPR) ≥ 0.8 were associated with a poor prognosis(P = 0.01 and P = 0.048, respectively). One hundred forty-seven(83.5%) of the 176 patients eventually experienced recurrence; the most common pattern of the first recurrence was distant metastasis. The prognosis was best for patients with locoregional recurrence and worst for those with peritoneal dissemination. Twelve(6.8%) of the 176 patients did not receive adjuvant chemotherapy, while 164(93.2%) patients received adjuvant chemotherapy. Combined chemotherapy, including doublet and triplet regimens, was associated with a better prognosis than monotherapy, with no significant difference in 5-year OS(17.5% vs 0%, P = 0.613). The triplet regimen showed no significant survival benefit compared with the doublet regimen for 5-year OS(18.5% vs 17.4%, P = 0.661). Thirty-nine(22.1%) patients received adjuvant chemotherapy for longer than six months; the median OS in patients who received adjuvant chemotherapy for longer than six months was 40.2 mo(95%CI: 30.6-48.2), significantly longer than the 21.6 mo(95%CI: 19.1-24.0) in patients who received adjuvant chemotherapy for less than six months(P = 0.001).CONCLUSION Patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer showed a poor prognosis and a high risk of distant metastasis. Adjuvant chemotherapy for longer than six months improved outcomes for them.展开更多
The present study investigated the adaptability and growth of a fast-growing clone (BN1) of N. cadamba planted as short-rotation plantation species in the south subtropical region of China, using 17 sampled sites repr...The present study investigated the adaptability and growth of a fast-growing clone (BN1) of N. cadamba planted as short-rotation plantation species in the south subtropical region of China, using 17 sampled sites representing different environments, planting models and ages, and local weather station temperature records. BN1’s growth characteristics were further compared with the most productive eucalypts planted nearby. The survival of BN1 seedlings raised and transplanted with tissue-culture micro-cuttings was >94.0% in the 1st year, and the percentage of the effective trees with diameter at breast height ( Dbh ) ≥ 8 cm was >71.0% over 30-month old. Most of the sampled sites and trees were susceptible to low-temperature or frost injury in the 1st winter, with average damage index ( Id ) ranging from 0.1 to 2.6. Some sites/trees were infected by caterpillar or borer pests, but the damage was neglectable. The injured trees quickly sprouted out leading shoots and recovered their growing vigor from low temperature or insect damage. Temperature factors were closely related to Id (P °C) with risk of significant frost damage on BN1 trees;one site (No. 9) was not suitable with frequent and heavy cold damage ( Id =2.6 ). BN1 grew extremely fast, with average diameter at breast height ( Dbh ) ranging from 14.5 - 20.3 cm and average tree height ( Ht ) from 12.3 - 16.0 m at 54-month old, and Dbh from 17.8 - 22.7 cm and from 14.4 - 15.9 m at 66-month old, over different sites/soils and planting models. Peak for both Dbh and Ht appeared in the 2nd year, but after 6-year old for average individual tree volume ( Vt ). BN1 was faster in Dbh at most sites but slower in Ht at all sites than eucalypts compared. Some sampled sites of BN1 performed similarly as or obviously better than most productive eucalypts in stock volume (Vs). With properly planting density, tending and rotation, BN1 could be expected to outperform fast-growing eucalypts in terms of Dbh , Vt and Vs, and to produce all diameter grades of timbers if the rotation age is extended beyond 8 to 9 years. Discussion was also given to potential silvicultural models, risks and limitations of planting BN1 and other superior N. cadamba varieties.展开更多
文摘AIM To provide evidence regarding the postoperative treatment of patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer, for which guidelines have not been established. METHODS Patients who had undergone curative resection between 1996 and 2014 with a pathological stage of T4 b N1-3 M0/Tx N3 b M0 for gastric cancer were retrospectively analyzed; staging was based on the 7 th edition of the American Joint Committee on Cancer staging system. The clinicopathological characteristics, administration of adjuvant chemotherapy, and patterns of recurrence were studied. Univariate and multivariate analyses of prognostic factors were conducted. The chemotherapeutic agents mainly included fluorouropyrimidine, platinum and taxanes, used as monotherapy, doublet, or triplet regimens. Patterns of first recurrence were categorized as locoregional recurrence, peritoneal dissemination, or distant metastasis.RESULTS The 5-year overall survival(OS) of the whole group(n = 176) was 16.8%, and the median OS was 25.7 mo(95%CI: 20.9-30.5). Lymphovascular invasion and a node positive rate(NPR) ≥ 0.8 were associated with a poor prognosis(P = 0.01 and P = 0.048, respectively). One hundred forty-seven(83.5%) of the 176 patients eventually experienced recurrence; the most common pattern of the first recurrence was distant metastasis. The prognosis was best for patients with locoregional recurrence and worst for those with peritoneal dissemination. Twelve(6.8%) of the 176 patients did not receive adjuvant chemotherapy, while 164(93.2%) patients received adjuvant chemotherapy. Combined chemotherapy, including doublet and triplet regimens, was associated with a better prognosis than monotherapy, with no significant difference in 5-year OS(17.5% vs 0%, P = 0.613). The triplet regimen showed no significant survival benefit compared with the doublet regimen for 5-year OS(18.5% vs 17.4%, P = 0.661). Thirty-nine(22.1%) patients received adjuvant chemotherapy for longer than six months; the median OS in patients who received adjuvant chemotherapy for longer than six months was 40.2 mo(95%CI: 30.6-48.2), significantly longer than the 21.6 mo(95%CI: 19.1-24.0) in patients who received adjuvant chemotherapy for less than six months(P = 0.001).CONCLUSION Patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer showed a poor prognosis and a high risk of distant metastasis. Adjuvant chemotherapy for longer than six months improved outcomes for them.
文摘The present study investigated the adaptability and growth of a fast-growing clone (BN1) of N. cadamba planted as short-rotation plantation species in the south subtropical region of China, using 17 sampled sites representing different environments, planting models and ages, and local weather station temperature records. BN1’s growth characteristics were further compared with the most productive eucalypts planted nearby. The survival of BN1 seedlings raised and transplanted with tissue-culture micro-cuttings was >94.0% in the 1st year, and the percentage of the effective trees with diameter at breast height ( Dbh ) ≥ 8 cm was >71.0% over 30-month old. Most of the sampled sites and trees were susceptible to low-temperature or frost injury in the 1st winter, with average damage index ( Id ) ranging from 0.1 to 2.6. Some sites/trees were infected by caterpillar or borer pests, but the damage was neglectable. The injured trees quickly sprouted out leading shoots and recovered their growing vigor from low temperature or insect damage. Temperature factors were closely related to Id (P °C) with risk of significant frost damage on BN1 trees;one site (No. 9) was not suitable with frequent and heavy cold damage ( Id =2.6 ). BN1 grew extremely fast, with average diameter at breast height ( Dbh ) ranging from 14.5 - 20.3 cm and average tree height ( Ht ) from 12.3 - 16.0 m at 54-month old, and Dbh from 17.8 - 22.7 cm and from 14.4 - 15.9 m at 66-month old, over different sites/soils and planting models. Peak for both Dbh and Ht appeared in the 2nd year, but after 6-year old for average individual tree volume ( Vt ). BN1 was faster in Dbh at most sites but slower in Ht at all sites than eucalypts compared. Some sampled sites of BN1 performed similarly as or obviously better than most productive eucalypts in stock volume (Vs). With properly planting density, tending and rotation, BN1 could be expected to outperform fast-growing eucalypts in terms of Dbh , Vt and Vs, and to produce all diameter grades of timbers if the rotation age is extended beyond 8 to 9 years. Discussion was also given to potential silvicultural models, risks and limitations of planting BN1 and other superior N. cadamba varieties.
