Objective:Prostate cancer in elderly patients was formerly treated with androgen deprivation therapy.Since the latter of the 1990s new technologies were introduced into treatments,then strategies have varied.We aimed ...Objective:Prostate cancer in elderly patients was formerly treated with androgen deprivation therapy.Since the latter of the 1990s new technologies were introduced into treatments,then strategies have varied.We aimed to observe the outcomes of elderly patients treated during transition period and compare each stage with others.Methods:During 2008 and 2010,255 patients with prostate cancer older than 75 years were sequentially treated.With exception of patients with bone and/or visceral metastasis,outcomes of 199 patients with localized and locally advanced stages were examined.Complete records were obtained by the end of 2015.Results:In total,122(61%),28(14%),37(19%)and 12(6%)of patients were in stages T1c-T2a,T2b-c,T3 and T4,respectively.Patients generally presented with abnormal screening or lower urinary tract symptom.Seventy-one percent of patients received androgen deprivation therapy as monotherapy and 22% of the radiation-treated patients added androgen deprivation therapy.Patients in stage T1c-T2a and T2b-c showed a favorable prognosis.Some cancer death appeared in patients with T3 and T4 during observation periods.Twenty-seven percent of patients died from prostate cancer-independent complications:pneumonia,heart disease,and brain vascular disease.Tendency is similar to that of Japanese elderly male population.No remarkable side effects from androgen deprivation therapy were noticed.展开更多
Background Glycoprotein non-metastatic melanoma protein B （GPNMB） plays an important role in the pathogenesis of inflammatory and malignant diseases. We investigated the expression of GPNMB in benign and malignant s...Background Glycoprotein non-metastatic melanoma protein B （GPNMB） plays an important role in the pathogenesis of inflammatory and malignant diseases. We investigated the expression of GPNMB in benign and malignant skin diseases. Methods Tissue microarray was performed in the skin tissues of 102 cases including malignant melanoma （MM）, squamous cell carcinoma （SCC）, basal cell carcinoma （BCC）, and benign dermatosis. The expression of GPNMB in the tissues was detected by immunohistochemistry. Twenty cases of normal skin and adjacent neoplastic normal skin tissues were selected as controls. Results GPNMB was positively stained in skin malignancies （38/50, 76%）, which was significantly higher than that in the control and the benign skin tissues （P=0.001 and 〈0.001 respectively）. GPNMB was positively stained in MM （13/15, 87%） and SCC （16/20, 80%） （P 〈0.001）. Significant higher expression of GPNMB was observed in patients aged 〉65 years than those less than 65 years （n=11 and n=9 respectively, P=0.027）. No significant difference of the expression rates was observed between normal control and BCC; however, stronger intensity was detected in the latter. Negative or weak expression was observed in the controls. Conclusion Over-expression of GPNMB correlated strongly and might play an important role in the pathogenesis of MM and SCC.展开更多
Objective:To construct a novel polygenic risk scoring model,in order to predict the benefits of radiosensitivity in patients with non-metastatic breast cancer(NMBC).Methods:A total of 450 NMBC patients from The Cancer...Objective:To construct a novel polygenic risk scoring model,in order to predict the benefits of radiosensitivity in patients with non-metastatic breast cancer(NMBC).Methods:A total of 450 NMBC patients from The Cancer Genome Atlas(TCGA)were enrolled and randomly assigned 6:4(training vs.validation).The empirical Bayes differential analysis was used to perform differential expression analysis,univariate Cox regression and Kaplan-Meier analysis were used to screen for prognosisrelated genes.Finally,LASSO regression and stepwise regression were used to select key prognostic-related genes.We constructed a multivariate Cox proportional risk regression model using key genes.The pRRophetic function was used to predict drug sensitivity of radiosensitivity(RS)and radioresistance(RR)groups for adjuvant therapy.Results:Eight genes(AMH,H2BU1,HOXB13,TMEM132A,TMEM270,ODF3L1,RIIAD1 and RIMBP2)were screened to build a polygenic risk scoring model.The region of characteristic(ROC)curves were drawn based on the 3-,5-and 10-year overall survival(OS),with area under curves(AUCs)of 0.816,0.822 and 0.806,respectively.RS and RR can be effectively distinguished according to the risk score of 2.004.Gene set enrichment analysis(GSEA)showed that necroptosis was significantly enriched in RS,while complement and coagulation cascade,JAK-STAT and PPAR signaling pathways were significantly enriched in RR.Alternatively,for those radioresistant patients,the chemotherapy drugs that might be more helpful are Cisplatin,Docetaxel,Methotrexate and Vinblastine with higher drug sensitivity.Conclusion:The polygenic risk scoring model showed prediction for the benefit of radiotherapy in NMBC patients,which might be used to guide clinical practice.展开更多
Objective:This study aimed to evaluate the prognostic value of the pretreatment systemic immune-inflammation index(SII)in non-metastatic nasopharyngeal carcinoma(NPC).Methods:We retrospectively analyzed the data of 83...Objective:This study aimed to evaluate the prognostic value of the pretreatment systemic immune-inflammation index(SII)in non-metastatic nasopharyngeal carcinoma(NPC).Methods:We retrospectively analyzed the data of 839 patients with non-metastatic NPC recruited from two independent institutions.The training-set cohort and the external validation-set cohort was comprised of 459 and 380 patients from each institution,respectively.The optimal cut-offvalue of SII was determined,and a prognostic risk stratification model was developed based on the training cohort and further assessed in the validation cohort.The propensity score matching(PSM)method was applied to minimize the confounding effects of unbalanced covariables.Results:The optimal cut-offvalue of the SII in the training cohort was 686,which was confirmed using the vali-dation cohort.Multivariate analysis showed that both before and after PSM,SII values>686 were independently associated with worse progression-free survival(PFS)ratio in both cohorts(before PSM,P=0.008 and P=0.008;after PSM,P=0.008 and P=0.007,respectively).Based on the analysis of independent prognostic factors of SII and N stage,we developed a categorical risk stratification model,which achieved significant discrimination among risk indexes associated with PFS and distant metastasis-free survival(DMFS)in the training cohort.There was no significant difference in PFS between RT alone and combined therapies within the low-and intermediate-risk groups(5-year PFS,77.5%vs.75.3%,P=0.275).Patients in the high-risk group who received concurrent chemoradiotherapy experienced superior PFS compared with those who received other therapies(5-year PFS,64.9%vs.40.3%,P=0.003).Conclusion:Pretreatment SII predicts PFS of patients with non-metastatic NPC.Prognostic risk stratification incorporating SII is instructive for selecting individualized treatment.展开更多
BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have diff...BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different conclusions.AIM To explore the medium-term effect of postoperative HRQoL in such patients.METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups.HRQoL was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(SF-36)Health Survey questionnaire,emphasizing eight specific items.RESULTS This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical procedures.More episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR group.The results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo postoperatively.Only the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 mo.CONCLUSION Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo postoperatively.Patients should undergo LR if there is no contraindication.展开更多
BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and society.The role of combination therapy includi...BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and society.The role of combination therapy including surgery,radiotherapy,and chemotherapy in non-metastatic EOPC is not well-defined.AIM To investigate the treatment patterns and survival outcomes in patients with non-metastatic EOPC.METHODS A total of 277 patients with non-metastatic EOPC who were treated at our institution between 2017 and 2021 were investigated retrospectively.Overall survival(OS),disease-free survival,and progression-free survival were estimated using the Kaplan-Meier method.Univariate and multivariate analyses with the Cox proportional hazards model were used to identify prognostic factors.RESULTS With a median follow-up time of 34.6 months,the 1-year,2-year,and 3-year OS rates for the entire cohort were 84.3%,51.5%,and 27.6%,respectively.The median OS of patients with localized disease who received surgery alone and adjuvant therapy(AT)were 21.2 months and 28.8 months,respectively(P=0.007).The median OS of patients with locally advanced disease who received radiotherapy-based combination therapy(RCT),surgery after neoadjuvant therapy(NAT),and chemotherapy were 28.5 months,25.6 months,and 14.0 months,respectively(P=0.002).The median OS after regional recurrence were 16.0 months,13.4 months,and 8.9 months in the RCT,chemotherapy,and supportive therapy groups,respectively(P=0.035).Multivariate analysis demonstrated that carbohydrate antigen 19-9 level,pathological grade,T-stage,N-stage,and resection were independent prognostic factors for non-metastatic EOPC.CONCLUSION AT improves postoperative survival in localized patients.Surgery after NAT and RCT are the preferred therapeutic options for patients with locally advanced EOPC.展开更多
There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diab...There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.展开更多
文摘Objective:Prostate cancer in elderly patients was formerly treated with androgen deprivation therapy.Since the latter of the 1990s new technologies were introduced into treatments,then strategies have varied.We aimed to observe the outcomes of elderly patients treated during transition period and compare each stage with others.Methods:During 2008 and 2010,255 patients with prostate cancer older than 75 years were sequentially treated.With exception of patients with bone and/or visceral metastasis,outcomes of 199 patients with localized and locally advanced stages were examined.Complete records were obtained by the end of 2015.Results:In total,122(61%),28(14%),37(19%)and 12(6%)of patients were in stages T1c-T2a,T2b-c,T3 and T4,respectively.Patients generally presented with abnormal screening or lower urinary tract symptom.Seventy-one percent of patients received androgen deprivation therapy as monotherapy and 22% of the radiation-treated patients added androgen deprivation therapy.Patients in stage T1c-T2a and T2b-c showed a favorable prognosis.Some cancer death appeared in patients with T3 and T4 during observation periods.Twenty-seven percent of patients died from prostate cancer-independent complications:pneumonia,heart disease,and brain vascular disease.Tendency is similar to that of Japanese elderly male population.No remarkable side effects from androgen deprivation therapy were noticed.
文摘Background Glycoprotein non-metastatic melanoma protein B （GPNMB） plays an important role in the pathogenesis of inflammatory and malignant diseases. We investigated the expression of GPNMB in benign and malignant skin diseases. Methods Tissue microarray was performed in the skin tissues of 102 cases including malignant melanoma （MM）, squamous cell carcinoma （SCC）, basal cell carcinoma （BCC）, and benign dermatosis. The expression of GPNMB in the tissues was detected by immunohistochemistry. Twenty cases of normal skin and adjacent neoplastic normal skin tissues were selected as controls. Results GPNMB was positively stained in skin malignancies （38/50, 76%）, which was significantly higher than that in the control and the benign skin tissues （P=0.001 and 〈0.001 respectively）. GPNMB was positively stained in MM （13/15, 87%） and SCC （16/20, 80%） （P 〈0.001）. Significant higher expression of GPNMB was observed in patients aged 〉65 years than those less than 65 years （n=11 and n=9 respectively, P=0.027）. No significant difference of the expression rates was observed between normal control and BCC; however, stronger intensity was detected in the latter. Negative or weak expression was observed in the controls. Conclusion Over-expression of GPNMB correlated strongly and might play an important role in the pathogenesis of MM and SCC.
基金This study was supported by National Natural Science Foundation of China(81773363,81872558 and 81972969)Key R&D Project of the Department of Science and Technology of Zhejiang Province(2020C03028)+1 种基金Key Project Jointly Built by the Ministry of Zhejiang Health Commission(2021438235)Major Project of Wenzhou Bureau of Science and Technology(2020ZY0011),China.
文摘Objective:To construct a novel polygenic risk scoring model,in order to predict the benefits of radiosensitivity in patients with non-metastatic breast cancer(NMBC).Methods:A total of 450 NMBC patients from The Cancer Genome Atlas(TCGA)were enrolled and randomly assigned 6:4(training vs.validation).The empirical Bayes differential analysis was used to perform differential expression analysis,univariate Cox regression and Kaplan-Meier analysis were used to screen for prognosisrelated genes.Finally,LASSO regression and stepwise regression were used to select key prognostic-related genes.We constructed a multivariate Cox proportional risk regression model using key genes.The pRRophetic function was used to predict drug sensitivity of radiosensitivity(RS)and radioresistance(RR)groups for adjuvant therapy.Results:Eight genes(AMH,H2BU1,HOXB13,TMEM132A,TMEM270,ODF3L1,RIIAD1 and RIMBP2)were screened to build a polygenic risk scoring model.The region of characteristic(ROC)curves were drawn based on the 3-,5-and 10-year overall survival(OS),with area under curves(AUCs)of 0.816,0.822 and 0.806,respectively.RS and RR can be effectively distinguished according to the risk score of 2.004.Gene set enrichment analysis(GSEA)showed that necroptosis was significantly enriched in RS,while complement and coagulation cascade,JAK-STAT and PPAR signaling pathways were significantly enriched in RR.Alternatively,for those radioresistant patients,the chemotherapy drugs that might be more helpful are Cisplatin,Docetaxel,Methotrexate and Vinblastine with higher drug sensitivity.Conclusion:The polygenic risk scoring model showed prediction for the benefit of radiotherapy in NMBC patients,which might be used to guide clinical practice.
文摘Objective:This study aimed to evaluate the prognostic value of the pretreatment systemic immune-inflammation index(SII)in non-metastatic nasopharyngeal carcinoma(NPC).Methods:We retrospectively analyzed the data of 839 patients with non-metastatic NPC recruited from two independent institutions.The training-set cohort and the external validation-set cohort was comprised of 459 and 380 patients from each institution,respectively.The optimal cut-offvalue of SII was determined,and a prognostic risk stratification model was developed based on the training cohort and further assessed in the validation cohort.The propensity score matching(PSM)method was applied to minimize the confounding effects of unbalanced covariables.Results:The optimal cut-offvalue of the SII in the training cohort was 686,which was confirmed using the vali-dation cohort.Multivariate analysis showed that both before and after PSM,SII values>686 were independently associated with worse progression-free survival(PFS)ratio in both cohorts(before PSM,P=0.008 and P=0.008;after PSM,P=0.008 and P=0.007,respectively).Based on the analysis of independent prognostic factors of SII and N stage,we developed a categorical risk stratification model,which achieved significant discrimination among risk indexes associated with PFS and distant metastasis-free survival(DMFS)in the training cohort.There was no significant difference in PFS between RT alone and combined therapies within the low-and intermediate-risk groups(5-year PFS,77.5%vs.75.3%,P=0.275).Patients in the high-risk group who received concurrent chemoradiotherapy experienced superior PFS compared with those who received other therapies(5-year PFS,64.9%vs.40.3%,P=0.003).Conclusion:Pretreatment SII predicts PFS of patients with non-metastatic NPC.Prognostic risk stratification incorporating SII is instructive for selecting individualized treatment.
基金Supported by The Research Foundation of E-Da Cancer Hospital and E-Da Hospital,Kaohsiung,Taiwan,No.EDCHI111002 and NCKUEDA11110.
文摘BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different conclusions.AIM To explore the medium-term effect of postoperative HRQoL in such patients.METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups.HRQoL was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(SF-36)Health Survey questionnaire,emphasizing eight specific items.RESULTS This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical procedures.More episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR group.The results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo postoperatively.Only the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 mo.CONCLUSION Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo postoperatively.Patients should undergo LR if there is no contraindication.
文摘BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and society.The role of combination therapy including surgery,radiotherapy,and chemotherapy in non-metastatic EOPC is not well-defined.AIM To investigate the treatment patterns and survival outcomes in patients with non-metastatic EOPC.METHODS A total of 277 patients with non-metastatic EOPC who were treated at our institution between 2017 and 2021 were investigated retrospectively.Overall survival(OS),disease-free survival,and progression-free survival were estimated using the Kaplan-Meier method.Univariate and multivariate analyses with the Cox proportional hazards model were used to identify prognostic factors.RESULTS With a median follow-up time of 34.6 months,the 1-year,2-year,and 3-year OS rates for the entire cohort were 84.3%,51.5%,and 27.6%,respectively.The median OS of patients with localized disease who received surgery alone and adjuvant therapy(AT)were 21.2 months and 28.8 months,respectively(P=0.007).The median OS of patients with locally advanced disease who received radiotherapy-based combination therapy(RCT),surgery after neoadjuvant therapy(NAT),and chemotherapy were 28.5 months,25.6 months,and 14.0 months,respectively(P=0.002).The median OS after regional recurrence were 16.0 months,13.4 months,and 8.9 months in the RCT,chemotherapy,and supportive therapy groups,respectively(P=0.035).Multivariate analysis demonstrated that carbohydrate antigen 19-9 level,pathological grade,T-stage,N-stage,and resection were independent prognostic factors for non-metastatic EOPC.CONCLUSION AT improves postoperative survival in localized patients.Surgery after NAT and RCT are the preferred therapeutic options for patients with locally advanced EOPC.
基金supported by the MST of Taiwan under Grant No.101-2221-E-008-125-MY3
文摘There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.
